scholarly journals Beyond Belsey: complex laparoscopic hiatus and diaphragmatic hernia repair

2019 ◽  
Vol 101 (3) ◽  
pp. 162-167 ◽  
Author(s):  
D Zanotti ◽  
C Fiorani ◽  
A Botha
Keyword(s):  
Diaphragmatic Hernia ◽  
Hiatus Hernia ◽  
Intraoperative Complications ◽  
Gastric Volvulus ◽  
Laparoscopic Approach ◽  
Acute Presentation ◽  
Different Types ◽  
The Right ◽  
Diaphragmatic Hernia Repair

Background Diaphragmatic and hiatus hernias can cause mild chronic symptoms or have an acute presentation with gastric volvulus and obstruction. Elective or emergency surgery is indicated in symptomatic patients and nowadays is generally performed laparoscopically. Methods We report four different types of hernias: a giant hiatus hernia following a gastric pull-up for recurrent congenital diaphragmatic hernia; a Bochdalek hernia in a pregnant young woman; concomitant hiatus and Morgagni hernias; and a giant hiatus hernia occupying the right chest. All were approached laparoscopically, either electively or as an emergency. Results Surgery led to a resolution of symptoms in all the cases. We had no any intraoperative complications. Two patients developed minor postoperative complications (chest infection). No recurrences were found during a mean follow-up of 18 months. Conclusions Transabdominal laparoscopic approach is a safe and feasible approach to all cases of symptomatic hiatus and diaphragmatic hernia.

Diaphragmatic hernia repair using a rectus abdominis muscle pedicle flap in three dogs

2013 ◽  
Vol 26 (02) ◽  
pp. 135-139 ◽  
Author(s):  
P. Chantawong ◽  
K. Komin ◽  
W. Banlunara ◽  
M. Kalpravidh
Keyword(s):  
Diaphragmatic Hernia ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Wound Edge ◽  
Pedicle Flap ◽  
Fluoroscopic Examination ◽  
Paradoxical Motion ◽  
Radial Tear ◽  
Diaphragmatic Hernia Repair

SummaryObjective: To report the clinical use of a pedicle flap from the rectus abdominis muscle to repair extensive diaphragmatic tears in dogs with diaphragmatic hernia.Materials and methods: Three dogs with a combination of radial and circumferential diaphragmatic tears were studied. The circumferential tear was repaired by suturing the wound edge with the edge at the abdominal wall. A pedicle flap of the rectus abdominis muscle was used for repairing the radial tear. The dogs were examined radiographically for lung and diaphragm appearance and evidence of reherniation at 10 days, and at one, two, and four months after surgery, and fluoroscopically for paradoxical motion of the diaphragm at one and four months.Results: The rectus abdominis muscle pedicle flap was successfully used in all three dogs. The animals recovered uneventfully without evidence of reherniation during the four follow-up months. Fluoroscopic examination revealed no paradoxical motion of the diaphragm.Clinical significance: A rectus abdominis muscle pedicle flap can be used for repairing large diaphragmatic defects in dogs.

scholarly journals FIXING JEJUNAL MANEUVER TO PREVENT PETERSEN HERNIA IN GASTRIC BYPASS

2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 69-72 ◽  
Author(s):  
Abdon José MURAD-JUNIOR ◽  
Christian Lamar SCHEIBE ◽  
Giuliano Peixoto CAMPELO ◽  
Roclides Castro de LIMA ◽  
Lucianne Maria Moraes Rêgo Pereira MURAD ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Internal Hernia ◽  
Intraoperative Complications ◽  
Transverse Mesocolon ◽  
Internal Hernias ◽  
Hernia Formation ◽  
Elective Laparoscopic Cholecystectomy ◽  
The Right ◽  
Interesting Alternative

Background : Among Roux-en-Y gastric bypass complications is the occurrence of intestinal obstruction by the appearance of internal hernias, which may occur in Petersen space or the opening in mesenteric enteroenteroanastomosis. Aim : To evaluate the efficiency and safety in performing a fixing jejunal maneuver in the transverse mesocolon to prevent internal hernia formation in Petersen space. Method : Two surgical points between the jejunum and the transverse mesocolon, being 5 cm and 10 cm from duodenojejunal angle are made. In all patients was left Petersen space open and closing the opening of the mesenteric enteroenteroanastomosis. Results : Among 52 operated patients, 35 were women (67.3%). The age ranged 18-63 years, mean 39.2 years. BMI ranged from 35 to 56 kg/m2 (mean 40.5 kg/m2). Mean follow-up was 15.1 months (12-18 months). The operative time ranged from 68-138 min. There were no intraoperative complications, and there were no major postoperative complications and no reoperations. The hospital stay ranged from 2-3 days. During the follow-up, no one patient developed suspect clinical presentation of internal hernia. Follow-up in nine patients (17.3%) showed asymptomatic cholelithiasis and underwent elective laparoscopic cholecystectomy. During these procedures were verified the Petersen space and jejunal fixation. In all nine, there was no herniation of the jejunum to the right side in Petersen space. Conclusion : The fixation of the first part of the jejunum to left side of the transverse mesocolon is safe and effective to prevent internal Petersen hernia in RYGB postoperatively in the short and medium term. It may be interesting alternative to closing the Petersen space.

scholarly journals Laparoscopic Repair of Congenital Diaphragmatic Hernia in Adults

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sanjay Kumar Saroj ◽  
Satendra Kumar ◽  
Yusuf Afaque ◽  
Abhishek Kumar Bhartia ◽  
Vishnu Kumar Bhartia
Keyword(s):  
Surgical Treatment ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Laparoscopic Repair ◽  
Harmonic Scalpel ◽  
Postoperative Recovery ◽  
Early Recovery ◽  
Asymptomatic Patients ◽  
The Right

Background, Aims, and Objectives. Congenital diaphragmatic hernia typically presents in childhood but in adults is extremely rare entity. Surgery is indicated for symptomatic and asymptomatic patients who are fit for surgery. It can be done by laparotomy, thoracotomy, thoracoscopy, or laparoscopy. With the advent of minimal access techniques, the open surgical repair for this hernia has decreased and results are comparable with early recovery and less hospital stay. The aim of this study is to establish that laparoscopic repair of congenital diaphragmatic hernia is a safe and effective modality of surgical treatment.Materials and Methods.A retrospective study of laparoscopic diaphragmatic hernia repair done during May 2011 to Oct 2014. Totaln=13(M/F: 11/2) cases of confirmed diaphragmatic hernia on CT scan, 4 cases Bochdalek hernia (BH), 8 cases of left eventration of the diaphragm (ED), and one case of right-sided eventration of the diaphragm (ED) were included in the study. Largest defect found on the left side was 15 × 6 cm and on the right side it was 15 × 8 cm. Stomach, small intestine, transverse colon, and omentum were contents in the hernial sac. The contents were reduced with harmonic scalpel and thin sacs were usually excised. The eventration was plicated and hernial orifices were repaired with interrupted horizontal mattress sutures buttressed by Teflon pieces. A composite mesh was fixed with nonabsorbable tackers. All patients had good postoperative recovery and went home early with normal follow-up and were followed up for 2 years.Conclusion.The laparoscopic repair is a safe and effective modality of surgical treatment for congenital diaphragmatic hernia in experienced hands.

scholarly journals Modified everting sutures combined with reattachment to the inferior tarsal plate for involutional lower eyelid entropion: A new technique

2020 ◽  
Vol 47 (4) ◽  
pp. 347-353
Author(s):  
Emine Malkoc Sen ◽  
Kubra Ozdemir Yalcinsoy
Keyword(s):  
Recurrence Rate ◽  
Intraoperative Complications ◽  
Case Series ◽  
Lower Eyelid ◽  
New Technique ◽  
Before And After ◽  
A New Technique ◽  
The Right ◽  
Horizontal Eyelid Laxity

Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity.Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate.Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring.Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.

scholarly journals Treatment of Chronic Traumatic Diaphragmatic Hernia Based on Laparoscopic Repair: Experiences From 23 Cases

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiaonan Liu ◽  
Li Luan ◽  
Guangyong Zhang ◽  
Bo Li
Keyword(s):  
Diaphragmatic Hernia ◽  
Laparoscopic Repair ◽  
Operation Time ◽  
Patient Characteristics ◽  
Fast Recovery ◽  
Intraoperative Bleeding ◽  
Traumatic Diaphragmatic Hernia ◽  
Blood Loss Volume ◽  
Diaphragmatic Hernia Repair

Background: We aimed to investigate the safety and effectiveness of laparoscopic repair for treating chronic traumatic diaphragmatic hernia (CTDH).Methods: In this retrospective analysis, we included 23 cases with CTDH underwent laparoscopy in our hospital between June 2015 and October 2019 was performed. The patient characteristics were recorded. We compared the diameter of hernia ring, surgery duration, intraoperative bleeding volume, means of repairing, as well as the follow-up data.Results: All the patients underwent laparoscopic diaphragmatic hernia repair, without conversion to laparotomy or thoracotomy. The operation time ranged from 60 min to 200 min (mean, 108.04 ± 42.93 min). The blood loss volume ranged from 10 to 300 ml (mean volume, 63.48 ± 71.69 ml). The postoperative hospital stayed ranged from 5 to 15 days (mean, 6.22 ± 2.11 days). The patients were followed up for 1–50 months (mean, 17.5 ± 10.90 months). No recurrence of diaphragmatic hernia was found.Conclusions: Laparoscopic repair of CTDH is featured by fast recovery, high security, and effectiveness. Reducing the hernia contents and close of the hernia ring are crucial for the surgery that is performed based on the size and location of the diaphragmatic hernia.

scholarly journals Treatment for right-sided intrathoracic kidney with congenital diaphragmatic hernia by combined thoracoscopic and laparoscopic approach: a case report and literature review

2021 ◽  
Author(s):  
Mingming Yu ◽  
Fang Chen ◽  
Sisi Wei ◽  
Hua Xie
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Laparoscopic Approach ◽  
Postoperative Recovery ◽  
Normal Function ◽  
Hernia Sac ◽  
Surgical Methods ◽  
Long Term Follow Up ◽  
Intrathoracic Kidney ◽  
The Right

Abstract BackgroundIntrathoracic kidney (ITK) associated with congenital diaphragmatic hernia (CDH) is rare congenital anomaly and usually requires surgery. The surgical methods and approaches are diverse.Case presentationWe reported a case of a 5-year-old boy who was diagnosed as right-sided ITK with CDH. Surgical treatment was performed by combined thoracoscopic and laparoscopic approach. Anatomical reposition of the right kidney and nephropexy were carried out under laparoscopy, and repair of the hernia was performed under thoracoscopy. The postoperative recovery was uneventful and long-term follow-up demonstrated normal function and development of the kidney.ConclusionCombined thoracoscopic and laparoscopic approach is minimally invasive and effective for treatment of ITK associated with CDH. It provides better visualization of the diaphragmatic foramen and the hernia sac, and can achieve anatomical reposition and fixation of the ectopic kidney.

scholarly journals Prevention of vault prolapse in cases of procedentia using combined vaginal and laparoscopic approach for vault suspension: Agrawal’s technique

2020 ◽  
Vol 10 (1) ◽  
pp. 296
Author(s):  
Priti Agrawal ◽  
Rishi Agrawal ◽  
Jyotirmay Chandrakar
Keyword(s):  
Intraoperative Complications ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Complication Rates ◽  
Vault Prolapse ◽  
Duration Of Surgery ◽  
Vault Suspension ◽  
Average Operating ◽  
Average Operating Time

Background: The objective of the current study was to assess the need of vault suspension after completion of hysterectomy in all cases of procedentia to prevent vault prolapse and to reduce the operating time for sacrocolpopexy using combined vaginal and laparoscopic approach by two surgeons.Methods: A total of 25 women undergoing surgery for procedentia were included. After completion of hysterectomy the need for vault suspension was assessed intraoperatively. In all cases polypropelene mesh was fixed vaginally to the uterosacral and cardinal ligaments. Vaginal vault was closed vaginally. Laparoscopic surgeon did laparoscopic sacrocolpopexy (LSC). Intraoperative and post-operative complications were then evaluated.Results: Our average operating time was 35 minutes for vaginal hysterectomy and 15 minutes for LSC. The shorter duration of surgery was because mesh was fixed vaginally and trackers were used to fix the mesh to sacral promontory. Intraoperative complications like bladder, ureteric, bowel injuries and hemorrhage were nil in our series. Postoperative stay in hospital was uneventful and all cases were discharged on second postoperative day. Conversion rate to laparotomy was nil. All cases have completed follow up for 5 years with 100% subjective and objective improvement.Conclusions: Restoration of vagina to its normal anatomic position remains the most important fact to prevent vault prolapse. Our technique is very easy, less time taking with negligible complication rates.

378 REDO LAPAROSCOPIC FUNDOPLICATON IN A PATIENT WITH WRAP MIGRATION FOLLOWING TWICE FAILED NISSEN FUNDOPLICATION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Rajinder Parshad ◽  
Eshan Verma ◽  
Ankur Goyal
Keyword(s):  
Laparoscopic Fundoplication ◽  
Pleural Cavity ◽  
Nissen Fundoplication ◽  
Laparoscopic Approach ◽  
Laparoscopic Toupet Fundoplication ◽  
Redo Fundoplication ◽  
Complex Procedure ◽  
The Right ◽  
Work Up

Abstract   Re-operation for wrap failure is a complex procedure required in 3–6% of patients. This video demonstrates a successful laparoscopic redo fundoplication in a patient who had previously undergone laparoscopic Nissen's fundoplication twice for GERD in another institution, first for GERD in 2014 and then for recurrence of reflux. Patient presented to us with dysphagia and regurgitation. The work-up revealed wrap migration into the right pleural cavity. A successful redo laparoscopic Toupet fundoplication was performed. Methods The video describes the procedure of laparoscopic re do fundoplication. Results Patient is doing well at a follow up of 16 months. Conclusion Re-do laparoscopic fundoplication can be successfully accomplished through laparoscopic approach. Video https://drive.google.com/file/d/1Perelnr0fwGIk1kiAexYvXnJY01cO98C/view?usp=sharing.

Ex-vivo renal surgery and auto-transplantation for benign and malignant renal pathologies: our early evolving experience of three cases

2017 ◽  
Vol 11 (1) ◽  
pp. 27-32
Author(s):  
Muhammad Z Aslam ◽  
Tim Brown ◽  
Ali A Thwaini
Keyword(s):  
Partial Nephrectomy ◽  
Ex Vivo ◽  
Intraoperative Complications ◽  
Disease Recurrence ◽  
Laparoscopic Nephrectomy ◽  
Renal Surgery ◽  
Renal Functions ◽  
Doppler Signals ◽  
The Right

Objectives: We describe our experience of ex-vivo renal surgery and autotransplantation for complex renal pathologies. These cases were carried out in the urology and transplant departments between July 2015 and January 2016. Materials and methods: Case 1 was a 63-year-old man presenting with spontaneous bleed from a renal mass in a solitary functional right kidney. Case 2 was a 50-year-old man with bilateral renal tumours involving renal veins. Case 3 was a 50-year-old man with two previous failed right-sided pyeloplasties. Results: No intraoperative complications were encountered. Case 1 underwent laparoscopic nephrectomy, ex-vivo partial nephrectomy followed by autotransplantation. There was no disease recurrence after 6 months’ follow-up, with stable renal functions. Case 2 had bilateral open radical nephrectomies performed. On the right autotransplantation was performed after ex-vivo partial nephrectomy. On the left, a further procedure was abandoned after radical nephrectomy due to extensive disease involvement. Postoperatively, the patient became anuric with poor Doppler signals. Exploration suggested complete renal vein obstruction with infarction of the autotransplanted right kidney requiring nephrectomy. Disease recurrence at the native renal bed was found at 6 months’ follow-up. Case 3 had laparoscopic nephrectomy, ex-vivo pyeloplasty and autotransplantation was performed. At 12 months’ follow-up, the patient was asymptomatic with stable renal functions. Conclusions: Ex-vivo renal surgery is a viable option for complex renal conditions. However, appropriate patient selection is essential to achieve good outcomes.

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