scholarly journals Mesh repair versus mayo repair for paraumbilical hernia: a comparative study

2018 ◽  
Vol 5 (3) ◽  
pp. 1052
Author(s):  
Shashidhara Naik C. ◽  
Seshagiri Rao K. ◽  
Abhinava D. M. ◽  
Mallikarjuna N. Manangi ◽  
Santhosh C. S. ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Mesh Repair ◽  
Linea Alba ◽  
Paraumbilical Hernia ◽  
Medical College ◽  
Pediatric Age Group ◽  
Complex Process ◽  
Operative Outcome ◽  
Prosthetic Mesh Repair

Background: Para umbilical hernia is a multifactorial and complex process they are most commonly found along the midline linea Alba. This study aims to assess the efficacy of mesh repair in comparison to Mayo Repair and to analyze the morbidity associated with the management.Methods: The study was conducted in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College & Research Institute, with clinical features suggestive of Paraumbilical Hernia (Minimum 30 cases each) from October 2010 to September 2012. Pediatric age group and those patients requiring emergency surgery have been excluded. 30 patients underwent Mayo’s repair and 30 patients underwent Mesh repair. Follow up period ranged from 2 months to 24 months.Results: paraumbilical hernia was found more commonly between 4rd and 6th decade of life with female: male 2.3:1. Most common presenting symptom was swelling with cough impulse (36.5%) and reducibility present. Commonest predisposing factors were multiparty and obesity. Percentage of early postoperative complications in Mayo’s repair was 13.6% and in Mesh repairs 6.6%. No statistical difference was noted. Percentage of recurrence following Mayo’s repair was 10% and following mesh repair was 0%. Postoperative complications like seroma, infections were similar in both procedures (Mayo’s repair and Mesh repair).Conclusions: Prosthetic mesh repair is a technique with good post-operative outcome, low recurrent rate and excellent patient satisfaction. It could become the gold standard in adult umbilical and paraumbilical hernia repair, in the future.

scholarly journals P139 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL REPAIR FOR SMALL AND MEDIUM PRIMARY UMBILICAL AND MIDLINE HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Kryspin Mitura
Keyword(s):  
Mesh Repair ◽  
Laparoscopic Approach ◽  
Mesh Size ◽  
Complication Rates ◽  
Linea Alba ◽  
Hernia Defect ◽  
Transabdominal Preperitoneal ◽  
Open Mesh Repair ◽  
Onlay Mesh

Abstract Aim Complications of open mesh repair for primary umbilical and midline hernias (PUMH) may lead to significant re-admissions and follow-up costs. Although laparoscopic intraperitoneal onlay mesh repair reduces infection rates, especially in overweight patients, it’s controversial in these hernias, mainly due to potential adhesions’ formation. Laparoscopic transabdominal preperitoneal technique (lap-TAPP) may address these issues, as it combines advantages of both open and laparoscopic approaches. The aim of this study is to present the initial results of lap-TAPP for PUMH in regard to its feasibility and complication rates. Material and Methods We evaluated 25 consecutive cases of lap-TAPP repair for PUMH. Patients’s characteristics, intraoperative findings, and postoperative complications after 30-days follow-up were analyzed. Results 21 male and 4 female patients were included in analysis (mean BMI 29.8 kg/m2). Surgery time was 82 minutes (55-120). We found 20 umbilical and 11 epigastric linea alba hernias. Mesh size was 144cm2 (120-225); mean hernia defect width was 25mm (10-40). In 9 patients (36%) the peritoneal rents were created which were easily closed with sutures. All patients were discharged on 1 POD with no complications. After 30-days we found no recurrences or bulging, no pain complaints. We found one subcutaneous small hematoma with no need for intervention. Conclusions Laparoscopic TAPP for small and medium PUMH is a safe and feasible technique with low complication rate. However, this method is technically demanding and time consuming while performed with laparoscopic approach as it requires precise and subtle plane dissection, and non-ergonomic closure hernia defect.

Is Onlay Polypropylene Mesh Repair an Available Option for Incisional Hernia Repair? A Retrospective Cohort Study

2019 ◽  
Vol 85 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Oscar Cano-Valderrama ◽  
JosÉ L. Porrero ◽  
Esther Quirós ◽  
Oscar Bonachia ◽  
MarÍA J. Castillo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Onlay Mesh

Lately, incisional hernia repair (IHR) with onlay polypropylene mesh has been replaced by other surgical procedures. The aim of this study was to compare the complication and recurrence rate after onlay mesh repair and other surgical procedures for IHR. A retrospective cohort study of patients who underwent IHR in a single center was conducted. The data were obtained from electronic medical records. Patients who had been lost during follow-up were contacted for a visit in the clinic. Univariate and multivariate analysis was performed with Stata 13.0 to analyze the factors associated with postoperative complications and hernia recurrence. Between June 2004 and December 2015, 1078 patients underwent IHR in a single center. Onlay mesh repair was performed in 125 patients (11.6%). Other surgical procedures included Rives procedure (29.3%), sublay mesh repair (38.6%), intrabdominal mesh repair (17.1%), and primary closure (3.4%). After a mean follow-up of 2.8 years, 73 (7%) patients developed a recurrence. A higher percentage of complications were seen after onlay mesh repair than after other surgical procedures (22.4% vs 13.1%, P = 0.005). Nevertheless, recurrence was less frequent after onlay mesh repair (4.2% vs 7.1%, P = 0.241). Logistic regression discarded an association between onlay mesh repair and hernia recurrence or postoperative complications. Incisional hernia repair with onlay polypropylene mesh repair was not associated with a higher incidence of postoperative complications or recurrence rate. So, this procedure should not be discarded in selected patients presenting with incisional hernia.

scholarly journals Repair of incisional hernias - Experience with a combined fascial and prosthetic mesh repair

2012 ◽  
Vol 1 (2) ◽  
pp. 6-9
Author(s):  
SM Amjad Hossain ◽  
Khairun Nahar
Keyword(s):  
Hospital Stay ◽  
Mesh Repair ◽  
Rectus Sheath ◽  
Early Mobilization ◽  
Prosthetic Mesh ◽  
Biliary Surgery ◽  
Total Period ◽  
Incisional Hernias ◽  
Prosthetic Mesh Repair

Repairs of incisional (ventral) hernia is one of the commonly performed operation in Bangladesh. This is a prospective study conducted in Shaheed Suhrawardy Hospital, Dhaka and a private Hospital (BDM Hospital) at Dhaka city from June 2001 to 31st May 2004 with a total period of 3 years and with total patients 43. Incisional hernias develop in upto 11% of surgical abdominal wounds with a possible recurrence, following repairs of 44%. There are several methods of repair of incisional hernias, including laparoscopic method of repair which is gaining popularity day by day. But we describe our experience with a combined fascial and prosthetic mesh repair. Of total 43 patients treated, 27 were female & 16 were male. The original operation was gynaecological in 27, bowel related surgery in 15 cases & biliary surgery in 4 patients. The incisions were midline in 31 patients, transverse in 10 patients and paramedian in 2 patients. The hernias were considered subjectively to be large in 21, medium in 16 and small in 6 patients. A parameter was compiled for each patient, noting intraoperative and post postoperative complications , post operative hospital stay and analgesic requirements. Post operative complications included seroma formation in 6 patients. One patient developed wound infection and require removal of the mesh 10 Control infection. Post operative hospital stay ranged from 2 to 17 days. Of total 43 patients 36 were available for follow- up. Seven drops from follow up. Follow up was from 6 months to 36 months. One (2.5%) of these patients complained of persistent lump and one reported persistent pain. Hernia recurrence in one patient (2.5%) , 35 was found to have no recurrence. We advocate these technique because it is applicable to all hernias,most of the mesh is behind the rectus sheath and has two points of fixation, it is relatively pain free allowing early mobilization has a less complication rate and low recurrence rate.DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12158 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.6-9

321 The Darn Technique for Small (< 2 Cm Diameter) Midline Hernias

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Pawlak ◽  
M Newman ◽  
A. De Beaux ◽  
B Tulloh
Keyword(s):  
Local Anaesthesia ◽  
Mesh Repair ◽  
Abdominal Wall Defect ◽  
Long Term Results ◽  
Suture Repair ◽  
Recurrence Rates ◽  
Record System ◽  
Linea Alba ◽  
Medical Record System

Abstract Aim Primary midline hernias arising in the linea alba are common. While mesh repair has been shown to reduce recurrence rates even in small hernias, many surgeons still use a suture repair for defects of less than 2 cm. The recent European and Americas Hernia Societies Guidelines recommended suture repair only for hernias &lt;1 cm. A darn is a tension-free repair where, in effect, a “mesh” is hand-woven across the defect in situ. Method Eligible patients undergoing this repair between 1 January 2008 and 31 December 2017 were identified from a prospective computer-based medical record system and their case notes reviewed. Inclusion criteria were adult patients with a primary midline abdominal wall defect smaller than 2 cm at the widest point measured intra-operatively. Follow up was by telephone. Those who reported possible recurrence or other symptoms in the region of their repair were reviewed in person. Results 47 suture-darn repairs were undertaken. Fifteen operations (32%) were performed under local anaesthesia. Forty-one patients were followed up with a mean of 80 ± 35 and median of 87 months after surgery. Six patients (13%) were lost to follow-up. Recurrence was found in two cases (5%) and one patient has since been diagnosed with a new epigastric hernia some 5 cm cranial to the previous repair. Conclusions The darn repair for small primary midline hernias is quick and inexpensive with promising long-term results. It can be performed under local anaesthesia. It can serve as an alternative to mesh repair for defects less than 2 cm in maximum dimension.

scholarly journals EARLY POSTOPERATIVE COMPLICATIONS OF MESH REPAIR OF INGUINAL HERNIA BY LICHTENSTEIN TENSION-FREE REPAIR

1969 ◽  
Vol 4 (1) ◽  
pp. 413-420
Author(s):  
BAKHT SARWAR ◽  
MOHAMMAD AMIN
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Wound Infection ◽  
Urinary Retention ◽  
Mesh Repair ◽  
Tension Free ◽  
Early Postoperative Complications ◽  
Primary Inguinal Hernia ◽  
Scrotal Swelling

BACKGROUND: To find out the early postoperative complications of mesh repair of inguinal herniaby Lichtenstein tension free repair.METHODOLOGY: This descriptive study was done in Surgical Unit of District HeadquartersHospital, Timergara, Dir Lower, for 1 year, from 01-01-2013 to 31-12-2013. A total of 100 cases ofinguinal hernia, male, age 20 years and above, all inguinal hernias (direct and indirect) and recurrenthernias were included in the study in which mesh repair was performed. Females and complicatedhernias (strangulated/obstructed) cases were excluded from the study. Included cases were followed upin the ward and at 2 weeks and 1st month postoperatively for any complications.RESULTS: Majority 23% cases were in the age range of 51-60 years. The right sided hernia found in62% cases, in 55% cases indirect inguinal hernia and in majority 97% cases primary inguinal hernia wasrecorded. Postoperatively at 2 weeks follow up wound hematoma was found in 10% cases, seroma in09%, wound infection in 02%, pain in 12%, urinary retention in 06%, and scrotal swelling in 04% cases.Postoperatively at 1st month follow up wound hematoma was found in 06% cases, seroma in 04%,wound infection in 01%, pain in 07%, urinary retention in 03%, and scrotal swelling in 01% cases.CONCLUSIONS: In majority of cases right sided, indirect, primary inguinal hernia has been recorded.Older age males and patients with poor and unhygienic conditions were more affected with this disease.KEY WORDS: Inguinal hernia-primary; recurrent, mesh hemioplasty, postoperative pain, woundinfection, hematoma, seroma.

INTRAOPERATIVE MITOMYCIN C AND 5 FLUOROURACILAPPLICATION DURING PRIMARY TRABECULECTOMY : A COMPARATIVE STUDY

2021 ◽  
pp. 15-17
Author(s):  
Gopal Prasad Singh ◽  
Urvashi Singh ◽  
Alka Jha
Keyword(s):  
Postoperative Complications ◽  
Mitomycin C ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
The Other ◽  
Average Period ◽  
Medical College ◽  
Primary Glaucoma

Aim: To compare the outcome variables of these 2 commonly used anti-metabolites 5-Fluorouracil and Mitomycin-C in trabeculectomy surgeries in primary glaucoma. Material & methods: The present study was conducted on 50 eyes of 39 patients of primary glaucoma who underwent trabeculectomy over a period from January 2019 to August 2020 at Darbhanga Medical College & Hospital, Laheriasarai, Darbhanga.The patients were randomly categorized into 2 groups of 25 each. One group received 5-Fluorouracil in the dose of 50 mg/ml for duration of 4 to 5 minutes intraoperatively. The other group received intraoperative Mitomycin-C in the dose of 0.4 mg/ml applied over duration of 2 to 3 minutes. Result:Maximum complications were seen during early postoperative period in which maximum number were seen with POAG (9 cases) followed by PACG (5 cases). Late postoperative complications were seen in POAG and PACG (2 in each). Conclusion:Long-term complications may only become apparent many years later. Since our study had average period follow up of about 42 weeks, we are not able to comment on the long-term complications following the use of these drugs. In this study both 5-Fluorouracil and Mitomycin-C were found to be equally safe.

scholarly journals Clinical assessment and follow up of post-operative outcomes in endonasal dacryocystorhinostomy: our experience

2018 ◽  
Vol 4 (5) ◽  
pp. 1225
Author(s):  
Mayur H. Ingale ◽  
Vinod V. Shinde ◽  
Ashutosh S. Kumar ◽  
Harsh R. Singh
Keyword(s):  
Postoperative Complications ◽  
Invasive Procedure ◽  
Nasolacrimal Duct ◽  
Female Dominance ◽  
Age Group ◽  
Medical College ◽  
Operative Outcomes ◽  
Endoscopic Dcr ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Endonasal dacryocystorhinostomy (DCR) was the gold standard for the treatment of nasolacrimal duct obstruction. The objective of the study was to assess the postoperative outcomes of endoscopic DCR.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital Pimpri, Pune from July 2011 to September 2013. A total of 50 patients with complaints of continuous lacrimation were included in the study. All the patients underwent endoscopic DCR and they were observed for postoperative complications and outcome.  </p><p class="abstract"><strong>Results:</strong> Most of the patients were in 31-40 years age group with the mean age of 33.18 years. Female dominance was observed in the study (M:F- 1:4). Postoperative complications such as epistaxis were observed in 2 cases (4.0%), nasal synechiae in 3 cases (6.0%) and postoperative crusting in 15 cases (30.0%). In 45 (90%) patients the outcome was successful at the end of 6 months and in case of 5 (10.0%) patients it was unsuccessful.</p><p class="abstract"><strong>Conclusions:</strong> The findings of the study concluded that<strong> </strong>endoscopic DCR was a simple, safe and invasive procedure as it has direct approach to the sac, produces excellent results without any external scar.</p>

Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

2020 ◽  
Vol 20 (2) ◽  
pp. 61-64
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
Rifat Zaman ◽  
Md Amanur Rasul ◽  
Akm Shahadat Hossain ◽  
Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Low Dose ◽  
Ureteropelvic Junction Obstruction ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
College Hospital ◽  
Medical College ◽  
Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

Lichtenstein Versus Desarda’s Technique of Hernia Repair

2020 ◽  
Vol 22 (2) ◽  
pp. 99-103
Author(s):  
Md Fardhus ◽  
AMSM Sharfuzzaman ◽  
Md Nayeem Dewan ◽  
Md Abul Hossain ◽  
Ahmed Sami Al Hasan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Operative Time ◽  
Seroma Formation ◽  
Age Group ◽  
Serous Fluid ◽  
Medical College ◽  
Randomized Control ◽  
And Gender

Aim: To compare Desarda’s versus Lichtenstein’s mesh repair in patients with unilateral, primary, reducible inguinal hernia in terms of mean operative time and seroma formation Methods: This randomized control trial conducted at Department of Surgery, Patuakhali Medical College & Hospital, Patuakhali. Eighty patients with unilateral, primary, reducible inguinal hernia were randomly distributed into two groups to undergo hernia repair i.e. Lichtenstein (L) and Desarda’s (D). Outcome was measured in terms of mean operative time and seroma formation. Seroma formation was defined as presence of enclosed cavity containing serous fluid determined by ultrasonography at 30th post-operative day. Results: Thirty three patients (41.25%) were above 50 years of age, whereas remaining 47 patients (58.75%) were below 50 years of age. Five patients (6.25%) were female and 75 patients(93.75%) were male. Seroma formation was 5% in Desarda’s group while 7.5% in Lichtenstein group (P> 0.05). Similarly difference in mean operative time was statistically non-significant. Seroma formation was common in older age group. There was no effect of smoking, obesity, operative time and gender on seroma formation. Conclusion: It is concluded that there is no difference in frequency of seroma formation and mean operative time in Desarda’s or Lichtenstein’s technique of hernia repair. Journal of Surgical Sciences (2018) Vol. 22 (2) : 99-103

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