scholarly journals The laparoscopic repair of inguinal hernia in female children in the republic of North Macedonia

2021 ◽  
pp. 27-27
Author(s):  
Toni Risteski
Keyword(s):  
Inguinal Hernia ◽  
Average Length ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Prospective Clinical Study ◽  
Normal Position ◽  
Left Groin ◽  
Minimal Invasiveness ◽  
Female Children ◽  
The Right

Introduction/Objective. Laparoscopic inguinal hernia repair in children is a minimally invasive method, and with its safety, feasibility and excellent cosmesis is an acceptable alternative in comparison with open repair. Methods. This is a prospective clinical study, with national data of 49 female children aged 1-14, treated via laparoscopic approach. Operative time, time to verticalization (normal position in bed, standing/walking), hospital stay, nausea, pain and cosmetic effects (size and visibility of mark), were elaborated. Results. The results revealed that 5 (10.2%) children had a family history of inguinal hernia. A total of 29 (59.2%) children had hernia located on the right side, 19 (38.8%) on the left side and 1 (2%) on both sides. The average diametar of the inguinal opening was 3 ? 2.17 cm. Sixteen children (32.7%) had presence of hidden hernia. The average operation time of the unilateral intervention was 29.5 ? 6.8 min, and for bilateral hernias it was 43.6 ? 7.2 minutes. The average length of hospitalization was 14.1 ? 3.1 hours, and the time needed for a full return to a normal position in bed was 2.6 ? 0.6 hours. The average length of scar in the right, as well as in left groin region was 2.2 ? 0.4 mm. A total of 46 (93.9%) parents/guardians were satisfied by the aesthetic look, while 3 (6.1%) had no particular opinion regarding this question. Conclusion. The introduction of laparoscopic surgery in the treatment of inguinal hernia is a promising method, which plays an important role as an alternative surgical technique because of the minimal invasiveness of the technique and improved recovery of the children.

scholarly journals Laparoscopic treatment of inguinal hernia in female children – national experience

2021 ◽  
Vol 20 (1) ◽  
pp. 20-26
Author(s):  
Toni Risteski
Keyword(s):  
Inguinal Hernia ◽  
Open Repair ◽  
Average Length ◽  
Prospective Clinical Study ◽  
Indirect Inguinal Hernia ◽  
Group 4 ◽  
Repair Materials ◽  
Female Children ◽  
The Mean

Background. Although, laparoscopic inguinal hernia repair in children is gaining ground as a safe, feasible, and popular method, still many pediatric surgeons continue to debate its safety, efficacy, and cosmesis in comparison with conventional open repair. Materials and methods. This was a prospective clinical study, that elaborated 98 female children aged 1–14 with clinically diagnosed indirect inguinal hernia. Equal proportions of 49 children were treated via laparoscopic (PIRS) either conventional open repair (OR). Outpatient clinic follow up was performed regardless of the type of the intervention, on the 7th day and 6 weeks after discharge. Results. The mean age of children in PIRS vs. OR group was 5.3±2.7 vs. 5.9±3.3 years. There was no significant differences between the groups related to age (p = 0.4221), weight (p = 0.5482), family history (p = 0.5377), and residency rural/urban (p = 0.3161). The average length of unilateral vs. bilateral PIRS repair (29.5±6.8 vs. 43.6±7.2 min) was significantly shorter than OR (44±4.2 vs. 97±8.1 min) for consequently p = 0.0023 vs. p = 0.00001. The post-operative hospitalization after PIRS repair was 14.1±3.1 hours and was significantly shorter compared to OR – 44±4.2 hours (p = 0.00001). In OR group, 4 (8.2%) children had postoperative nausea compared to none in PIRS group. Significantly bigger cosmetic satisfaction was found in PIRS compared to OM group (p = 0.0001). Conclusion. With due respect to OR as a gold standard, the proven advantages of PIRS are motivation for further improvement of this technique for the purpose of treatment of inguinal hernia of female children.

scholarly journals Liver Surgery for Hepatocellular Carcinoma: Laparoscopic versus Open Approach

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
C. G. Ker ◽  
J. S. Chen ◽  
K. K. Kuo ◽  
S. C. Chuang ◽  
S. J. Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Average Length ◽  
Survival Rates ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Open Approach ◽  
Full Diet ◽  
Or Groups ◽  
Significant Difference

In this study, we try to compare the benefit of laparoscopic versus open operative procedures.Patients and Methods. One hundred and sixteen patients underwent laparoscopic liver resection (LR) and another 208 patients went for open liver resection (OR) for hepatocellular carcinoma (HCC). Patients' selection for open or laparoscopic approach was not randomized.Results. The CLIP score for LR and OR was 0.59 ± 0.75 and 0.86 ± 1.04, respectively, (). The operation time was 156.3 ± 308.2 and 190.9 ± 79.2 min for LR and OR groups, respectively. The necessity for blood transfusion was found in 8 patients (6.9%) and 106 patients (50.9%) for LR and OR groups. Patients resumed full diet on the 2nd and 3rd postoperative day, and the average length of hospital stay was 6 days and 12 days for LR and OR groups. The complication rate and mortality rate were 0% and 6.0%, 2.9% and 30.2% for LR and OR groups, respectively. The 1-yr, 3-yr, and 5-yr survival rate was 87.0%, 70.4%, 62.2% and 83.2%, 76.0%, 71.8% for LR and OR group, respectively, of non-significant difference. From these results, HCC patients accepted laparoscopic or open approach were of no significant differences between their survival rates.

scholarly journals The role of laparoscopic approach in bilaterality assessment in patients with unilateral inguinal hernia

2017 ◽  
Vol 4 (6) ◽  
pp. 2047
Author(s):  
Ahmed M. S. M. Marzouk ◽  
Haitham S. E. Omar ◽  
Heba O. E. Ali
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Unilateral Inguinal Hernia ◽  
Frequent Finding ◽  
Ultrasound Assessment ◽  
Group 3 ◽  
The Right ◽  
Unilateral Group

Background: Patients presented with unilateral inguinal hernia are at risk for the possibility of contra-lateral occult hernias; small early-developed hernias may be difficult to be elicited by clinical, imaging assessment and during open repair. This study to evaluate laparoscopic identification of contra-lateral occult hernia with regard to the pre-operative clinical and imaging study.Methods: Retrospective analysis of patients presented in the period of March to December 2015 with unilateral inguinal hernia for which medical and ultrasound imaging assessment were done. Laparoscopic trans abdominal pre-peritoneal (TAPP) approach was done with intraoperative evaluation of the presence of contra-lateral occult hernias.Results: During the study period (27) patients (25 Males and 2 females) presented with unilateral inguinal hernia were clinically evaluated, 18 (66.6%) patients had right sided hernia, 9 (33.33%) had left sided, In all the studied patients routine ultrasound assessment was done and no documented cases of presence of contra-lateral hernia, Intraoperative abdominal exploration successfully Identifies bilateral inguinal hernias in 7 cases (25.9%) with mean age (44.14 years, SD 10.99) compared to (34.97 years, SD 10.51) in the Unilateral group, 3 cases on the left side (16.6% of total right side patients) and 4 cases on the right side (44.4% of total left side patients). operative time for unilateral repair was (Mean 85.8 minutes, SD 18.8), and for discovered bilateral cases (Mean 145.9 minutes, SD 46.8).Conclusions: The presence of occult inguinal hernia is a frequent finding specially in older age group of patients, also in our study we found the percentage of occult hernias are more in patients presented with left side disease. Laparoscopic (TAPP) approach is a useful tool for assessment of the presence of such hernias, and gives the privilege of simultaneous repair in same operation with the advantage of avoiding the patient’s later surgery together with the laparoscopic surgery benefits of less pain, rapid recovery and shorter hospital stay.

scholarly journals A 9-year experience study of single-port micro-laparoscopic repair of pediatric inguinal hernia using a simple needle

Hernia ◽  
2019 ◽  
Vol 24 (3) ◽  
pp. 639-644
Author(s):  
R. Chen ◽  
S. Tang ◽  
Q. Lu ◽  
X. Zhang ◽  
W. Zhang ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Single Port ◽  
Average Length ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Invasive Procedure ◽  
High Ligation ◽  
Laparoscopic Technique ◽  
Inguinal Hernias ◽  
Laparoscopic Techniques

Abstract Purpose As laparoscopic techniques and equipments improve, laparoscopic inguinal hernia repair has been gaining popularity. The objective of the study was to summarize 9 years of experience using a single-port micro-laparoscopic approach to repair pediatric inguinal hernias with a simple hernia needle. Methods 1880 children with inguinal hernias were enrolled using micro-laparoscopic surgery between June 2009 and 2018. All patients underwent high ligation surgery using a single-port micro-laparoscopic technique. The clinical data were retrospectively analyzed. Results All micro-laparoscopic surgeries were successfully performed in the 1880 patients, who ranged in age from 2 months to 14 years (3.66 ± 2.96 years) including 1622 males and 258 females. Among them, 1299 cases were unilateral hernias and 581 cases were bilateral hernias. The average operating time was 12.5 ± 3.5 min for a unilateral hernia and 20.5 ± 4.5 min for bilateral hernias. All patients were discharged 1–2 days after surgery, and the average length of their hospital stay was 2–4 days. Complications of knot reaction and pneumoscrotum occurred in 5 cases (0.27%) and 54 cases (2.87%), respectively, but these cases were properly managed, with no major impact on the operational outcomes. All patients were followed up for 3–65 months; there were 13 recurrent cases (0.69%). Conclusions Single-port micro-laparoscopic herniorrhaphy in children using a simple hernia needle is a reliable and minimally invasive procedure.

The most recent recommendations for the surgical treatment of inguinal hernia

2019 ◽  
Vol 98 (7) ◽  
pp. 268-272
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Hernia Sac ◽  
Minimal Invasiveness

Introduction: The publication of new guidelines in recent years shows that surgical treatment of inguinal hernia remains topical. The main goal is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain. The main purpose of this article is to summarize the latest recommendations in surgical treatment of the groin hernias, especially in the case of strangulation. Methods: The authors made literature review of all the guidelines published by the hernia societies, including related articles, in the last ten years. Results: The use of the EHS classification system is suggested. In elective operations, mesh repair is recommended. The Lichtenstein technique is the standard in open inguinal hernia repair. Transabdominal preperitoneal and totally extraperitoneal approach have comparable outcomes. Their clear advantages include minimal invasiveness. Mesh repair is recommended also in the case of strangulation, but only in clean and clean-contaminated operations. A laparoscopic approach should be considered as well. Inter alia, it allows an assessment of bowel viability during the whole procedure. The need of bowel resection is hence lower compared to open surgery. If it is not possible to use the mesh, the Shouldice method is regarded as the best non-mesh repair technique. If there is concern about bowel viability, visualization, either by formal laparoscopy, hernia sac laparoscopy or laparotomy, is recommended. Hernioscopy is a simple and safe procedure that uses the hernia sac for insertion of a port following insufflation and diagnostic examination. It requires less advanced laparoscopic skills than does emergency laparoscopic hernia repair. It can be performed even by surgeons who lack sufficient experience with laparoscopy. Conclusion: In elective procedures, the mesh repair is recommended. It is recommended also in the case of strangulation, but not in a contaminated- dirty surgical field. If there is concern about bowel viability, visualization, either by formal laparoscopy, hernia sac laparoscopy or laparotomy, is needed.

scholarly journals Long-term results of laparoscopic TAPP treatment of inguinal hernia with artificial mesh in Viet Duc University Hospital

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Mạnh Toàn Đỗ
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complication ◽  
Intraoperative Complications ◽  
Fluid Collection ◽  
Operation Time ◽  
University Hospital ◽  
Long Term Results ◽  
Laparoscopic Operation ◽  
The Right

Tóm tắt Đặt vấn đề: Thoát vị bẹn điều trị bằng phẫu thuật. Phẫu thuật nội soi đã được sử dụng rộng rãi, có nhiều ưu điểm như sau mổ người bệnh (NB) ít đau, sớm trở lại các hoạt động thường ngày, ít các tai biến – biến chứng và tỷ lệ tái phát thấp. Phương pháp nghiên cứu: Đánh giá kết quả điều trị thoát vị bẹn bằng phẫu thuật nội soi đặt lưới nhân tạo trước phúc mạc đường qua ổ bụng (TAPP). Đối tượng và phương pháp nghiên cứu: Nghiên cứu tiến cứu, mô tả không đối chứng 72 người bệnh thoát vị bẹn được phẫu thuật nội soi tại Bệnh viện Hữu nghị Việt Đức từ 10/2015 đến tháng 07/2017. Kết quả: 72 người bệnh (100% nam giới), tuổi trung bình 49,8. Chỉ số ASA I (41,7%), ASA II (51,4%); ASA III (6,9%). Thoát vị bẹn phải (44,5%), trái (45,8%) và hai bên (9,7%). Thoát vị bẹn trực tiếp (37,9%), gián tiếp (58,3%) và hỗn hợp (3,8%). Theo phân loại của Nyhus: loại 2 (18,9%); loại 3 (74,7%) và loại 4 (6,4%). Thời gian phẫu thuật là 117,1 phút. Tai biến trong mổ (2,8%) gồm: tổn thương bó mạch thượng vị dưới (1,4%) và rách bàng quang (1,4%). Biến chứng sớm (9,7%) gồm: nhiễm trùng vết mổ (1,4%); tràn khí dưới da bụng (1,4%); tụ dịch và máu vùng bẹn (6,9%). Không có người bệnh cần chuyển phương pháp mổ. Không có tử vong trong và sau mổ. Thời gian nằm viện trung bình 5,1 ngày. Kết quả lâu dài (18,1%) gồm: đau và tê vùng bẹn (13,9%); đau thừng tinh – tinh hoàn (1,4%); giảm ham muốn tình dục (2,8%). Tái phát 02 người bệnh (2,8%). Xếp loại: tỷ lệ tốt (79,1%); khá (15,3%); trung bình (2,8%); kém (2,8%). Kết luận: Phẫu thuật TAPP điều trị thoát vị bẹn ở người lớn là phương pháp an toàn, hiệu quả và tính khả thi cao. Abstract Introduction: Surgery is the prior treatment of inguinal hernia. Laparoscopic operation has been increasingly used to treat the disease in surgical units because of its effective ness and low rate of postoperative complication. This research targeted to access long term results of laparoscopic TAPP with artificial mesh in inguinal hernia cases. Material and Methods: This was a prospective descriptive study involving 72 patients who underwent laparoscopic TAPP to treat inguinal hernia in Viet Duc Hospital from 10/2015 to 07/2017. Results: 72 patients, who were all male, were at the average age of 49.8. Their ASA scores were I, II and III in 41.7%, 51.4% and 6.9% respectively. 45.8% patients had left inguinal hernia, 44.5 % patients had disease on the right and 9.7% of them were with bilateral inguinal hernia. Direct hernia was seen in 37.9% cases, indirect hernia was 58.3% and the last 3.8% patients suffered from combined hernia. The disease was graded with Nyhus classification: grade II – 18.9%; grade III – 74.7%; grade IV – 6.4%. The mean operation time was 117.1 minutes. Intraoperative complications occured in 2.8% cases, which were inferior epigastric artery (1.4 %) and bladder (1.4%) injuries . Short term postoperative complication (9.7%) included mainly fluid collection at the groin. There was no operative conversion and no perioperative fatality. 18.1 % patients complained about mild pins and needles in their groin (13.9%), painful spermatic cord (1.4%) hyposexuality (2.8%). Postoperative hospital stay averaged 5.1. With the recurrent rate of 2.8 %, long term postoperative results which were classified as very good in 79.1%; good in 15.3%; medium in 2.8% and bad in 2.8% cases. Conclusion: laparoscopic TAPP treatment of inguinal hernia with artificial mesh was an efficient, safe and highly feasible method Keyword: Laparoscopic transabdominal preperitoneal (TAPP) approach.

scholarly journals The meaning of laparoscopic procedure against inguinal hernia

2020 ◽  
Author(s):  
Hideaki Sato ◽  
Jyoji Yoshizawa ◽  
Akihide Sugiyama ◽  
Tomokazu Nakagami ◽  
Yu Watarai
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Approach ◽  
Oral Intake ◽  
Operation Time ◽  
Surgical Time ◽  
Processus Vaginalis ◽  
Patent Processus Vaginalis ◽  
Postoperative Symptoms ◽  
Contralateral Patent Processus Vaginalis ◽  
Contralateral Hernia

Abstract Background Laparoscopic approach, especially laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia (IH) is widely spread but few studies have compared its invasiveness with that of conventional approach (POTTS). This study compared the role and invasiveness of LPEC with POTTS at our institute. Material and methods The records of 940 IH patients from 2014 to 2019 were analyzed on the basis of age, sex, method of surgery, pre- and post-operative diagnosis, postoperative symptoms, and complications. Results The POTTS group comprised 393 males, of which 44 were diagnosed with contralateral hernia (7.1%). In the LPEC group, 158 males had an average age of 3.88 years. The contralateral patent processus vaginalis (CPPV) was identified in 148 patients during operation. POTTS operation time for patients aged < 1 year was 42.7 minutes, vs 33.4 minutes for LPEC. The two groups experienced comparable paces of fever and first oral intake time; however, pain and recurrence rate were greater in the LPEC group. Conclusion LPEC can be performed to avoid contralateral recurrences; surgical time is reduced for patients aged < 1 year. However, the reduced invasiveness of LPEC compared to that of POTTS did not minimize postoperative symptoms or complications.

scholarly journals Incarcerated sigmoid large-cell neuroendocrine carcinoma in an inguinal hernia

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Martino Gerosa ◽  
Niccolò Incarbone ◽  
Emanuele Di Fratta ◽  
Giulio Maria Mari ◽  
Angelo Guttadauro ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Histopathological Examination ◽  
Laparoscopic Approach ◽  
Large Cell ◽  
Surgical Trauma ◽  
Incarcerated Hernia ◽  
Left Groin ◽  
First Case ◽  
Direct Hernia

Abstract Large-cell neuroendocrine carcinomas (NECs) of the colon are extremely rare aggressive tumors. A 79-year-old man presented at our hospital for muco-hematic diarrhea, weight loss and incarcerated hernia in his left groin. Colonoscopy revealed sigmoid stenosis. Computed tomography confirmed an incarcerated hernia containing sigmoid mass and massive abdominal adenopathy. In absence of colonic obstruction, the patient underwent elective palliative sigmoid resection and colostomy by laparoscopic approach, and direct hernia repair through inguinal access. Histopathological examination revealed a large cells sigmoid NEC. We report the first case of large-cell neuroendocrine colon cancer incarcerated in an inguinal hernia. Due to the advanced stage, we have performed a palliative laparoscopic resection in order to reduce surgical trauma, confirm pre-operative results and minimize post-operative complications, and direct hernia repair through inguinal access.

scholarly journals TAPP technique for congenital inguinal hernia

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Dan Dumitrescu ◽  
Costel Savlovschi ◽  
Victor Dumitrescu
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Surgical Intervention ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Surgical Team ◽  
Hernia Surgery ◽  
New Era ◽  
Recommended Treatment ◽  
The Right

Laparoscopic hernia repair has opened a new era in hernia surgery shifting paradigms from anterior to posterior approaches. This has exposed surgeons to new anatomical perspective, tehnical challenges and clinical implication. We present the case of a 53-year-old patient admitted to surgery in outpatient conditions with the diagnosis of bulky inguinal-scrotum hernia. Transabdominal pre-peritoneal (TAPP) repair was our option to solve the inguinal parietal defect. Intraoperatively, in the peritoneal cavity, lateral to the epigastric vessels, the parietal flaccid defect was revealed, communicating with the right scrotum cavity, with clear evidence of testicle, suggestive of external congenital oblique hernia. Peritoneal sectioning and take-off, with Cooper's, spermatic vessels and the relevant channel, were the precursors of the dissection and 360-degree take-off of the herniated sac, with the support of the herniated suture ligament, followed by in-line, and the abandonment of the distal, open, unbounded end. The application of the 3D-MAX mesh, fixed with Capsure at the Cooper ligament, preperitoneal drainage and closure of the resorbable thread peritoneum were the endpoints of surgical intervention. The postoperative progression was favorable with discharge on the 2nd postoperative day. Control at 30 days postoperatively did not identify possible complications, it presented without painful accusations, without suggestive elements for hydrocele and without signs of relapse. The laparoscopic approach, even in the case of bulky parietal defects, remains a recommended treatment option with the best results, but largely depending on the surgical team experience.

Laparoscopic Approach to Adrenalectomy: Review of Perioperative Outcomes in a Single Center

2011 ◽  
Vol 77 (5) ◽  
pp. 592-596 ◽  
Author(s):  
Phuong H. Nguyen ◽  
Jennifer E. Keller ◽  
Yuri W. Novitsky ◽  
B. Todd Heniford ◽  
Kent W. Kercher
Keyword(s):  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Average Length ◽  
Perioperative Complications ◽  
Laparoscopic Approach ◽  
Perioperative Outcomes ◽  
Estimated Blood Loss ◽  
American Society ◽  
The Right ◽  
American Society Of Anesthesiologists

Laparoscopic expertise increases the volume of adrenalectomies at referral centers. We report our 10-year experience with laparoscopic adrenalectomy. All laparoscopic adrenalectomies at a single institution were prospectively recorded in a surgical outcomes database. Patient demographics, operative/perioperative outcomes, and adrenal pathology were reviewed retrospectively. From March 1999 through July 2009, 154 laparoscopic adrenalectomies were performed in 150 patients. Average patient age was 49.9 years (range 15-82); mean body mass index was 31.1 kg/m2 (range 17-56). Pathologic diagnoses included hyperaldosteronism (n = 69), nonfunctional adenoma (n = 28), pheochromocytoma (n = 23), hypercortisolism (n = 14), malignancy (primary n = 3, metastasis n = 9), and cyst (n = 4). Seventy-three per cent (n = 110) occurred on the left, 23 per cent (n = 35) on the right, 2.6 per cent (n = 4) bilateral, and 0.6 per cent (n = 1) as extra-adrenal. The average tumor measured 3.6 cm (range 0.4-12). The average operative time was 156 minutes (range 62-409), the mean estimated blood loss was 60 mL (range 10–100), and mean American Society of Anesthesiologists score was 2.6 (range 1-4). Three operations (0.2%) were converted to open. Three patients (0.2%) experienced perioperative complications (respiratory failure, urinary tract infection, line sepsis, and readmission within 30 days). The average length of stay was 3.4 days (range 1–14) and mean follow-up was 96.9 days (5-2567). No wound-related complications or deaths occurred. Pathologic diagnosis was not associated with a particular side or development of a complication ( P > 0.5). Patients with pheochromocytomas had the longest operative times, highest estimated blood loss, and highest American Society of Anesthesiologists scores (218.2 minutes, 128 mL, 3.0; P < 0.004). Laparoscopic adrenalectomy is safe and effective. Removal of pheochromocytomas is more challenging and may be more appropriate for referral to a specialized center for optimal outcomes.

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