scholarly journals Lessons Learned from the Student’s Surgery Academic League: Is It Worth It?

2020 ◽  
Vol 44 (1) ◽  
Author(s):  
Luiz Eduardo Correia Miranda ◽  
Ana Clara Galindo Miranda ◽  
Diego Laurentino de Lima ◽  
Ana Karla Alves Arraes
Keyword(s):  
Inguinal Hernia ◽  
Medical Students ◽  
General Surgery ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Lessons Learned ◽  
University Hospital ◽  
Undergraduate Medical Students ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

Abstract: Introduction: One of the great challenges of a medical school curriculum is to offer training in basic surgical techniques, which allows graduates to develop competences to take care of simple cases presented in the primary care level of SUS. In order to approach the problem of the technical-surgical qualification of medical students and taking advantage of the interest raised by students’ leagues, a surgical care project directed at patients with inguinal hernia was proposed and carried out, based on the students’ academic leagues. The aim of this study is to disclose and discuss the results and the academic experience learned from a students’ league in surgical learning. Methods: This report encompasses the three-year experience of an academic league aiming to approach the problem of the technical-surgical qualification of medical students and which takes advantage of the academic leagues among undergraduate medical students. The participants comprised one general surgery professor, one anesthesiologist, and undergraduate medical students interested in the surgical clinic, from the School of Medicine, University of Pernambuco, Recife (PE), Brazil. Results: Twenty-four students were included. Ninety-six patients were submitted to surgery. Two seminars with nine lectures and one workshop on surgical skills were held. One paper entitled “League of Inguinal Hernia Surgery” was presented. We did not observe hernia recurrences; the surgical complications were minimum and small in number. The students showed fast development of surgical, interpersonal, and communication skills. However, this education model included a small number of students and offered heavy competition to the general surgery residents in their first year at the University Hospital. Conclusion: The academic league in surgery allows a rich pedagogical experience, offering the opportunity for human and technical qualification. However, the proposed model has limitations. In our opinion, it does not represent a solution for the flaws and omissions observed in the school’s curricular grid.

scholarly journals P004 TREATMENT OF RECURRENT INGUINAL HERNIA AFTER TRANSINGUINAL PREPERITONEAL (TIPP) SURGERY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Lysanne van Silfhout ◽  
Ludo van Hout ◽  
Myrthe Jolles ◽  
Hilco P. Theeuwes ◽  
Willem J.V. Bökkerink ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Outcomes ◽  
Medical Records ◽  
Surgical Techniques ◽  
Recurrent Inguinal Hernia ◽  
Hernia Surgery ◽  
Exclusion Criteria ◽  
Inguinal Hernia Surgery ◽  
Mean Time

Abstract Aim To report feasibility and surgical outcomes of recurrent inguinal hernia repair after TransInguinal PrePeritoneal (TIPP) repair. Material and Methods Patients who underwent recurrent IHR after TIPP between January 2013 and January 2015 in a single hernia-dedicated teaching hospital were included. Exclusion criteria were femoral hernia, incarcerated hernia and reasons for unreliable follow-up. Electronic medical records were assessed retrospectively to register surgical outcomes and complications. Results Thirty-three patients underwent surgical repair of recurrent inguinal hernia after TIPP. Twenty patients were treated with a “re-TIPP when possible” strategy; resulting in 13 successful re-tipps and 7 conversions to Lichtenstein repair. Eleven patients underwent primarily a Lichtenstein’s repair, the remaining two patients underwent recurrent IHR using other techniques (transrectus sheath Pre-Peritoneal and transabdominal preperitoneal repair). Mean time of surgery was 44.7 minutes (standard deviation 16.7). There was one patient (3.0%) with a re-recurrent inguinal hernia during follow-up. Other minor complications included urinary tract infection. There were no significant differences in post-operative results between the different surgical techniques used for recurrent IHR. Conclusions These results indicate that after TIPP it is feasible and safe to perform re-surgery for recurrence with an anterior approach again. For these recurrences, a Lichtenstein can be performed, or a ‘re-TIPP if possible’ strategy can be applied by experienced TIPP surgeons. Whether a re-TIPP has the same advantages over Lichtenstein as is for primary inguinal hernia surgery, needs to be evaluated in a prospective manner.

Lower Incidence of Postoperative Pain after Open Inguinal Hernia Surgery with the Usage of Synthetic Glue-Coated Mesh (Adhesix®)

2018 ◽  
Vol 84 (12) ◽  
pp. 1932-1937
Author(s):  
Anna-Maria ThÖLix ◽  
Jyrki Kössi ◽  
Veikko Remes ◽  
Tom Scheinin ◽  
Jukka Harju
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Demographic Data ◽  
Mesh Fixation ◽  
University Hospital ◽  
Chronic Groin Pain ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Anchoring System

Chronic groin pain after inguinal hernia mesh repair is a common problem. Mesh fixation without sutures has been suggested to have several advantages over the traditional suture fixation. The aim of this study was to compare two self-adhering meshes, the glued Adhesix® (AH) and the gripping Parietene ProGrip® (PP), and evaluate their impact on postoperative chronic pain and overall recovery. Two consultant surgeons performed altogether 393 open inguinal hernia operations at the Helsinki University Hospital during 2014 to 2015. The two groups, AH (n = 169) and PP (n = 224) were similar and comparable in terms of demographic data. The data were collected and analyzed from the patients’ medical records in the hospital's register. The patients were followed up for a period of 19 months (5-31 months). The number of patient contacts due to postoperative pain was significantly less common in the AH group than in the PP group, 4/169 (2.4%) versus 19/224 (8.5%) patients, respectively ( P = 0.011). The duration of pain was under three months for most patients, only two patients in the PP group had pain for over one year. The pain was treated most patients with anti-inflammatory painkillers, whereas injections of a local anesthetic and corticosteroid, and chronic pain medication was needed in some cases. It seems that the use of glue-coated mesh (Adhesix®) was associated with less postoperative visits due to pain compared with the self-fixating mesh with absorbable anchoring system (ProGrip®). Further studies with long-term follow-up are needed to confirm these results.

Laparoscopic inguinal hernia repair in children via PIRS (percutaneous internal ring suturing)

2020 ◽  
Vol 99 (6) ◽  
pp. 277-281
Keyword(s):  
Inguinal Hernia ◽  
Pediatric Surgery ◽  
Inguinal Canal ◽  
Operating Time ◽  
Initial Study ◽  
University Hospital ◽  
Internal Ring ◽  
Hernia Surgery ◽  
Safe Alternative ◽  
Inguinal Hernia Surgery

Introduction: The miniinvasive approach is a trend in pediatric surgery nowadays. The new surgical technique called percutaneous internal ring suturing (PIRS) is a promising method bringing all the benefits of miniinvasive surgery. Methods: Prospective study of patients operated on using the PIRS technique from 01 January 2018 to 01 January 2020 at the Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University, University Hospital Motol. Results: 73 patients (25 boys and 48 girls) were operated on using PIRS. The median age was 68 months. 90 % of operations were performed by the same team of surgeons. During the procedure there were found 53 right-sided and 38 left-sided inguinal hernias. In 18 cases the hernia was bilateral, but only in 13 cases was this diagnosis made before the operation. A non-absorbable stitch was used in 57 cases to close the internal ring of the inguinal canal, and a non-absorbable monofilament in 16. The median operating time was 34 minutes. There were 3 recurrences (3.3 %) in our study. Conclusion: In our initial study, the PIRS technique proved to be a safe alternative method to the open inguinal hernia surgery. This method provides the benefit of allowing to revise the contralateral inguinal canal as a prevention of a metachronous inguinal hernia. The cosmetic results were excellent.

scholarly journals Inguinodynia: review of predisposing factors and management

2020 ◽  
Vol 47 ◽  
Author(s):  
CIRÊNIO DE ALMEIDA BARBOSA ◽  
DEBORAH CAMPOS OLIVEIRA ◽  
NATHÁLIA MOURA DE-MELO-DELGADO ◽  
JÚLIA GALLO DE-ALVARENGA MAFRA ◽  
RONALD SOARES DOS SANTOS ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Technique ◽  
Surgical Procedures ◽  
Lower Incidence ◽  
Surgical Techniques ◽  
Hernia Surgery ◽  
Intrinsic Factors ◽  
Inguinal Hernia Surgery ◽  
Surgical Recovery ◽  
The Common

ABSTRACT Herniorrhaphy is one of the most common surgical procedures, with an estimated 20 million operations performed annually worldwide. One of the common complications associated with this procedure is inguinodynia, defined as pain beyond three months after inguinal hernia surgery. In this review, we have addressed the main aspects of this complication with current articles, published in the last five years. Inguinodynia has a multifactorial nature and studies have shown that its development is related to the surgical technique and intrinsic factors of the patient that imply greater predisposition to this phenomenon. In this regard, it has been discussed which surgical techniques imply a lower incidence of this complication. Many studies have focused on understanding intrinsic features of each patient, both in physical and cognitive aspects, and how the approach of these factors can favor a better post-surgical recovery. The treatment of this condition is still challenging, and there are no established universal guidelines. We believe that due to its multifactorial nature, the treatment is hampered due to the individuality inguinodynia presentations.

scholarly journals P116 “KIGNSNORTH MODIFIED SCORE” FOR OPEN INGUINAL HERNIA REPAIR COMPLICATIONS PREDICTION. POINTHER STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Alejandro Bravo-Salva ◽  
Alba Gonzalez-Martin ◽  
Margarita Salva-Puigserver ◽  
Clara Tellez-Marques ◽  
Joan Sancho-Insenser ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Inguinal Hernia Repair ◽  
Groin Hernia ◽  
University Hospital ◽  
Wound Complications ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

Abstract Aim Aim of our study is to analysis of postoperative outcomes (30 days) after elective unilateral open anterior inguinal hernia repair and prove correlation to modified Kingsnorth (MK) score classification system. Material and Methods Prospective registered (NTC 04806828) study of all consecutive unilateral open anterior groin hernia repair performed at a University Hospital General Surgery Department from January 2019 to December 2020. Data was stored at National Spanish Groin Hernia Registry (EVEREG). All patients were preoperatively classified using MK score. Statistical analysis of postoperative complications and their relation to preoperative modified Kingsnorth scale was performed. Results 403 patients were included. 61% were performed as ambulatory surgery. 15.7% had more than 5-8 MK punctuation. A total of 62 patients had postoperative complications, 81% of all complications were classified as Clavien I. Higher Surgery duration was directly related to higher MK (Pearson's correlation 0.291; P < 0.0001score.) Statistically significant relationship with the presence of higher rate of complications were a KN score of 5-8 (OR 2.7; 95% CI 1.07-4.82; P = 0.03) whereas performance of surgery by an abdominal wall surgery specialist had less complications (OR 0.28; 95% CI 0.08-0.92; P = 0.03) Conclusions MK classification predicts surgical wound complications on patients who undergo a primary unilateral inguinal hernia surgery. A KN score of 5-8 had a higher probability of wound complications. When surgery was performed by a specialist in abdominal wall surgery, less postoperative complications were observed.

New Four-fold Technique to Spread the Self-Gripping Mesh in Open Inguinal Hernia Surgery

2021 ◽  
Author(s):  
Arun Kumar Gupta ◽  
Aman Raj ◽  
Devadatta Poddar ◽  
Lalit Kumar Bansal ◽  
Peeyush Kumar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
The Self ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

scholarly journals Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

2021 ◽  
pp. 30-35
Author(s):  
V.V. Skyba ◽  
◽  
A.V. Ivanko ◽  
N.V. Voytyuk ◽  
V.V. Lysytsia ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Open Access ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Lower Percentage ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

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