scholarly journals A comparison of Lichtenstein repair versus posterior wall repair plus mesh repair for direct inguinal hernias

2017 ◽  
Vol 5 (1) ◽  
pp. 228 ◽  
Author(s):  
Anubhav Goel ◽  
Ankur Bansal ◽  
Dipt Kumar ◽  
Abhishek Pathak
Keyword(s):  
Mesh Repair ◽  
Posterior Wall ◽  
Lichtenstein Repair ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernias ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Better Than

Background: Lichtenstein’s tension free mesh repair is the most commonly performed in open inguinal hernias. The present study was done by comparing Lichtenstein Repair (LR) v/s posterior wall repair (PR)+ Lichtenstein repair (LR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate.Methods: This study was conducted in SNMC Agra where patients of unilateral male direct inguinal hernia were included. A total of 60 patients were taken and divided into two groups (A and B) randomly of 30 each. In group A patients were operated by LR and in group B patients were operated by PR+LR and followed up for a period of six months. The outcomes of the both techniques were compared.Results: Mean age was 48.3 years in group A and 49.5 in group B. The mean duration of surgery for group A is around 29.34 min and group B is 46.28 min which was significant. The pain was not statistically significant in both groups on day 1 and 3. There was 1 (3.3%) recurrence in group A and no recurrence in group B. Post-operative complications were similar in both groups.Conclusions: LR+PR were comparatively better than only LR in all direct inguinal hernias because of low recurrence rate (0%).

A COMPARATIVE STUDY BETWEEN ONLAY AND RETRORECTUS MESH REPAIR IN THE TREATMENT OF INCISIONAL HERNIAS

2021 ◽  
pp. 65-69
Author(s):  
S. Yashwanth ◽  
S. Dayakar
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hospital Stay ◽  
Wound Infection ◽  
Mesh Repair ◽  
Duration Of Surgery ◽  
Group A ◽  
Onlay Mesh ◽  
The Mean ◽  
Group B

INTRODUCTION: Over the years, surgeons tried the placement of mesh at different locations like On-lay, Under-lay, Sub-lay and pre-peritoneal, retroperitoneal intraperitoneal, Inter-muscular, etc. with each procedure having its advantages and disadvantages. Commonly Onlay and sub lay mesh repairs are done. Though the literature says, sub lay procedures have fewer complications and a high success rate. However, in a few studies, the ideal position for mesh repair appears to be retro muscular, where the force of abdominal pressure holds the mesh against deep surfaces of muscles. In this study, a comparison of both Onlay and retro rectus procedures with regards to the duration of surgery, postoperative complications like seroma, wound infection, wound dehiscence, and also the period of postoperative stay in the hospital. The aim of the study is To compare 'Onlay' versus 'retro rectus' mesh repair in inuencing the outcome in incisional hernia with regards to Duration of surgery, Postoperative complications like seroma formation, wound infection, Postoperative stay, Recurrences. PATIENTS AND METHODOLOGY: Type of Study: A Prospective comparative study Study Setting: Department of general surgery, Narayana Medical College & Hospital, Nellore.Study Period: November 2018 to September 2020 Study Sample: 50 cases, divided into two groups by random allocation technique. Groups A and B with 25 patients in each group. RESULTS: The mean age of cases in Group A is 40.48 years. The mean age of patients in Group B is 44.08 years. Youngest was 31 years and 36 years in group A and group B, respectively, and the eldest was 51 years and 53 years in group A and group B, respectively. In Group A, 11 were male, and 14 were female, and in Group B, 11 were male, and 14 were female. The male to female ratio in the study was 1:1.27. The mean Operative Time in Group A was 1.93 Hrs, and that in Group B was 2.98Hrs. Nine patients (36%) in group A and one patient (4%) in group B had seroma formation. Eight patients (32%) in group A and one patient (4%) in group B had a wound infection. The mean Hospital Stay in Group A was 5.44 Days, and Group B was 4.88 days. No short-term recurrences were noted in either of the two groups when followed for six months. CONCLUSION : Retrorectus mesh repair is an excellent alternative to Onlay mesh repair that may apply to incisional hernia. The mesh-related overall complication rate like seroma wound infections and hospital stay is less than Onlay mesh repair.

The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

2021 ◽  
Vol 15 (10) ◽  
pp. 2712-2714
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Asif ◽  
Imran Yousaf ◽  
Muhammad Faheem Anwer ◽  
Muhammad Waseem Anwar
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Recovery Time ◽  
Mesh Repair ◽  
Operative Procedure ◽  
Total Extraperitoneal ◽  
Outcome Comparison ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

scholarly journals Comparison of prophylactic versus regular use of antibiotics in elective major obstetrical and gynecological surgeries

2019 ◽  
Vol 8 (2) ◽  
pp. 580
Author(s):  
Ramya Sreevarshni Shunmugha Sundharam ◽  
Hiremath P. B. ◽  
Sankareswari R.
Keyword(s):  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Mean Value ◽  
Controlled Study ◽  
Therapeutic Drug ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Thus, this study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries.Methods: This randomized controlled study was conducted in a tertiary care teaching hospital during the study period of June 2017 to April 2018 with 140 cases. Group A received a single dose of Injection Ceftriaxone 1g. Group B, received Injection Ceftriaxone 1 gm and Injection Metronidazole 500 mg for five days. The data was entered in excel sheet and analyzed using SPSS (Version 16).Results: The mean age group in Group A and Group B was found to be 34.24±10.5 and 35.97±11.89, respectively. There was no statistical significance between group A and B for incidence of infection in the post-operative period and duration of hospital stay. The mean value in group A for duration of surgery was found to be 67.5±13.5 and in group B mean value was 72.1±14.9. (p value <0.05).Conclusions: This study demonstrated that administration of prophylactic antibiotic rather than conventional antibiotic at caesarean and gynecological surgeries are not associated with significant difference in post-operative morbidities.

scholarly journals MESH VERSUS SIMPLE ANATOMICAL REPAIR OF EPIGASTRIC AND PARAUMBILICAL HERNIAS

1969 ◽  
Vol 6 (1) ◽  
pp. 708-713
Author(s):  
AJMAL KHAN ◽  
AMIULLAH ◽  
MANZOOR ALI ◽  
SAIFUREHMAN ◽  
ANWAR SYED
Keyword(s):  
Hospital Stay ◽  
Mesh Repair ◽  
Umbilical Hernia ◽  
Rectus Sheath ◽  
Epigastric Hernia ◽  
Large Size ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Simple Repair

BACKGROUND: The standard method of repair of Para-umbilical hernia (PUH) and Epigastric herniais by the Mayo technique, using a double-breasted flap of the rectus sheath. The result of this techniquein the hands of others is highly variable. The present study describes and evaluates the comparison of aProlene mesh versus simple anatomical repair of (PUH) and Epigastric hernias. The use of a Prolenemesh in hernia repair is not a new concept with previous investigators yielding consistently excellentresults in the repair of Para-umbilical and Epigastric Hernias.OBJECTIVE: To compare the outcomes of the two modalities of surgical procedures (mesh versussimple anatomical repair) in terms of post-operative complications, hospital stay and rate of recurrencein two groups of Para-umbilical and epigastric hernia patients.MATERIAL AND METHODS: This comparative prospective study was conducted in the Departmentof Surgery Saidu group of teaching Hospital Saidu Sharif Swat KPK. One Hundred and Thirty twoconsecutive patients having large size, Para umbilical and epigastric hernia were included for the study,from Feb 2010 to Feb 2014 in two groups, 72 (group A) for mesh repair and 60 (group B) for simpleanatomical repair. All patients of these type hernias were admitted throughout patient department(OPD). Less than 4cm size hernia, Pregnant ladies, patients having strangulated hernia presented asemergency and patient unfit for general anesthesia were excluded from study.RESULTS: Majority of patients 63% belong to age of 35 to 60 years and 87 % were females. Supraumbilical swelling was the commonest presentation 80%.Cough impulse and reducibility was positive in90% of cases (some Epigastric hernias were irreducible). Contents of sac were omentum in 74% to 83%and small intestine 17% to 26%. Operative time was longer in group A (mesh repair) ranged from 60 to90 minutes while that was 50 to 70 minutes in group B (simple anatomical repair). Post-operativeevaluation took place after 2weeks then, 1, 2, 3months then 6monthly for 30 months (average 18months). The number of complications requiring treatment was the primary aim. There were threerecurrences observed in group A (4.16%) but six cases of group B (10%) presented with recurrence inwhich simple anatomical repaired was performed. The mean hospital stay for group A was 3.7 days andfor group B, 4.6 days.CONCLUSION: Mesh repair compare to simple anatomical repair, is with less hospital stay and lessrecurrence for Para umbilical and epigastric hernia having a defect of more than4 cm in leneaAlba.KEYWORDS: Para-umbilical hernia, simple repair, meshplasty, complications, recuurence.

scholarly journals A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

2019 ◽  
Vol 6 (4) ◽  
pp. 1264
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Preetham Anguraj ◽  
Jeyakumar Sundaraj ◽  
Manimaran Pethuraj
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Controlled Study ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Ventral Hernias

Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.

scholarly journals Role of bicipital tenotomy in adhesive capsulitis

2020 ◽  
Author(s):  
Mohamed Aly
Keyword(s):  
Frozen Shoulder ◽  
Capsular Release ◽  
Biceps Tenotomy ◽  
Arthroscopic Capsular Release ◽  
Group A ◽  
The Mean ◽  
Long Head ◽  
Group B ◽  
Better Than

Purpose: To compare the results of arthroscopic capsular release of frozen shoulder with the tenotomy of the long head of biceps tendon versus capsular release without long head of biceps tenotomy. Methods: This is a prospective study that will include forty patients with resistant frozen shoulder presenting to El- Hadra University Hospital, Alexandria, Egypt. Arthroscopic release will be performed on twenty patients with biceps tenotomy (group A), while the other twenty patients will undergo arthroscopic release without biceps tenotomy (group B). Patients were evaluated preoperatively, at 2 week and 6 weeks postoperatively as regard Constant and Murley score. Results: In group (A), at the end of the follow up period, the mean score was (84.55 ± 19.32) ranging from 68.0 – 164.0 according to the Constant and Murly shoulder score. (table 5) . In group (B), at the end of the follow up period, the mean score was (79.55 ± 6.85) ranging from 68.0 – 94.0 according to the Constant and Murly shoulder score. . The difference between the means of postoperative total score in both groups was statistically insignificant (p = 0.718). Conclusion: Arthroscopic capsular release is an effective and safe method for treatment of refractory cases of frozen shoulder in which other treatment methods failed. Arthroscopic capsular release, achieves dramatic pain and motion improvement immediately postoperative, allowing very early postoperative rehabilitation. Circumferential capsular release is mandatory to achieve considerable range of shoulder motion in all directions. There are no significant differences between arthroscopic capsular release with biceps tenotomy and without biceps tenotomy regarding to final Constant and Murley score. Internal rotation is the slowest and most difficult motion to recover while gains in forward elevation are achieved the fastest.The improvement in range of external rotation is better than the improvement in the internal rotation. Diabetes mellitus is a bad prognostic risk factor, and the improvement in the range of motion in non-diabetic patients is better than the improvement in diabetic

Tension-Free Mesh Repair for Incarcerated Groin Hernia: A Comparative Study

2020 ◽  
pp. 155335062090139
Author(s):  
Fuqiang Chen ◽  
Min Liu ◽  
Cuihong Jin ◽  
Fan Wang ◽  
Yingmo Shen ◽  
...  
Keyword(s):  
Mesh Repair ◽  
Groin Hernia ◽  
Biological Mesh ◽  
Suture Repair ◽  
Lichtenstein Repair ◽  
Tension Free ◽  
Group A ◽  
Group B ◽  
Incarcerated Groin Hernia

Background. Management of emergent groin hernias remains challenging, due to limited consensus in surgical approach and repair options (eg, mesh vs nonmesh, biological mesh, and polypropylene [PP] mesh). Methods. A 5-year retrospective study was conducted on 118 patients who received emergency incarcerated groin hernia repair in Beijing Chaoyang Hospital. The incidence of surgical site infection (SSI), preoperative mortality, sepsis, and ileus was noted. In the follow-up, postoperative foreign body sensation, chronic pain, seroma/hematoma, and recurrence were recorded. The outcomes of different surgical procedures (with mesh/without mesh, biological mesh/PP mesh, transabdominal preperitoneal (TAPP)/Lichtenstein repair) were compared and analyzed. Results. Out of the 118 patients, 14 cases received suture repair (as group A); 104 cases had TAPP repair (n = 44) or Lichtenstein repair (n = 60) with meshes, including 23 cases of biological mesh (as group B); and 81 cases had repair with PP mesh (group C). There were no significant differences between the 3 groups regarding SSI, mortality, sepsis, and ileus. After 20.5 months of follow-up (range from 6 to 65 months), 21.4% of group A developed recurrence, a rate significantly higher than that of group B (4.3%) and group C (0). The incidence of seroma/hematoma in group B was higher than that in group A (7.1%) and group C (7.4%). The results between TAPP group and Lichtenstein group were comparable. Conclusion. Tension-free mesh repair in the treatment of emergency incarcerated groin hernia is safe and effective, which can reduce hernia recurrence without increasing infection risk. The results of biological mesh and PP mesh were comparable.

scholarly journals Modified Hasson technique versus Veress technique: a comparative study

2019 ◽  
Vol 6 (9) ◽  
pp. 3246
Author(s):  
Robinson George ◽  
Mebin Mathew ◽  
Veerabhadra Radhakrishna ◽  
Ashna Rahman ◽  
Aswini Thenamangalath
Keyword(s):  
Port Site ◽  
Port Placement ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B ◽  
Needle Entry ◽  
Better Than

Background: There are two techniques of port placement for laparoscopy, Veress and Hasson. Both have their own advantages of disadvantages. Plenty of new modifications of these techniques have been tried to reduce the risks. We modified Hasson’s technique and evaluated whether the technique is better than the standard Veress technique.Methods: A retrospective analysis was carried out in the Department of General Surgery, Al Azhar Medical College Hospital, India from January 2013 to December 2018.Results: There were 156 patients in group A who underwent laparoscopy by Modified Hasson technique. The Veress technique was used in 149 patients who belonged to group B. There was no difference between the two groups in terms of age and indications for the surgery. The entry time (the time to place the first port) for group A was significantly lesser than that of group B (2.08±0.65 min vs. 4.59±0.53 min; p=0.000). There were a total of two complications in group A which was significantly lesser than that of group B (14; p=0.002). There was no significant difference between the two groups in terms of extraperitoneal port placement, intraperitoneal injury, failure to enter the abdomen, port site seroma, port site infection, port site hematoma, and mortality. But, port site hematoma was significantly lesser in group A compared to group B (0 vs. 5; p=0.027).Conclusions: Modified Hasson’s entry was found to be much better than Veress needle entry due to its simplicity for beginners in laparoscopy, lesser time of achieving pneumoperitoneum and lesser duration of surgery in our study.

scholarly journals A study on the effect of topical lidocaine gel versus drops on surgeon’s comfort during manual small incision cataract surgery

2018 ◽  
Vol 7 (8) ◽  
pp. 1485
Author(s):  
Prakash Krishnan ◽  
Sancy Mary Sam ◽  
Sanitha Kuriachan ◽  
Nirmala Sethuraman
Keyword(s):  
P Value ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Prospective Comparison ◽  
Topical Lidocaine ◽  
Duration Of Surgery ◽  
Lidocaine Gel ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Cataract is a frequent surgical procedure performed worldwide. The study compared lidocaine 4% drops with 2% gel on surgeon’s comfort, need for supplemental anaesthesia and duration of surgery in patients who underwent manual small incision cataract surgery.Methods: This was a Prospective, Comparison study conducted at a Single centre by multiple surgeons. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were surgeon’s comfort, need for supplemental anesthesia and duration of surgery.Results: The mean duration of surgery for gel was 20±8 minutes as compared to 29±6 minutes with drops (p*- value<0.001). 26 (87%) patients in gel did not require any supplemental anesthesia as compared to 3 (10%) patients in drops. Peribulbar supplementation was required for 20 (67%) patients in drops as compared to 1 (3%) patient in gel (p*- value<0.001). 26 (87%) patients in gel were operated comfortably by the surgeon as compared to 2 (6%) patients in drops. Mild to Moderate discomfort was experienced by the surgeon in operating 27 (90%) patients in drops as compared to 3(10%) patients in gel (p*- value<0.001).Conclusions: The surgeons were more comfortable using gel with least requirement of supplemental anaesthesia and faster completion compared to drops.

scholarly journals Drotaverine hydrochloride versus valethamate bromide for cervical dilatation in labour: a comparative study

2020 ◽  
Vol 9 (5) ◽  
pp. 1986
Author(s):  
Deepshikha . ◽  
Monica Soni ◽  
Deepak Gupta ◽  
Santosh Godara
Keyword(s):  
Active Phase ◽  
Cervical Dilatation ◽  
Obstetrics And Gynecology ◽  
Medical College ◽  
Group A ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Better Than

Background: Labor is the most perilous journey a woman has to undertake. Painless and short labor is desired by every woman and is a constant aim for obstetrician. Objective of this study was to compare the efficacy of drotaverine hydrochloride with valethamate bromide for cervical dilatation in labor in primigravida.Methods: The present study was conducted in the department of obstetrics and gynecology, S. P. Medical College and Associated Group of Hospitals, Bikaner, Rajasthan from 1st August 2018 to 31st July 2019 over a period of 1 year. Total of 300 patients were included in the study with 150 patients in each of the two groups. In this study the effects of Drotaverine hydrochloride (Group A) and Valethamate bromide (Group B) on cervical dilatation were compared.Results: In our study, the mean drug delivery interval was 101.58±78.06 mins in Group A and 134.24±94.12 mins in Group B. The mean number of doses of drug required was 1.27±0.55 in Group A and 4.17±1.62 in Group B.  The difference was statistically highly significant (p <0.001).Conclusions: Drotaverine hydrochloride is found to be better than valethamate bromide in shortening the duration of active phase of labor in primigravidae. Drotaverine was found to be a better drug, hence, can be used to reduce the agony of the laboring woman without any significant side effects on the mother or the fetus.

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