scholarly journals The Lichtenstein Plug Technique.the Safe Repair

2019 ◽  
Vol 2 (2) ◽  
pp. 01-03
Author(s):  
Pedro Rodríguez
Keyword(s):  
Femoral Hernia ◽  
Elective Surgery ◽  
Work Group ◽  
Early Recovery ◽  
Surgical Time ◽  
Average Hospital ◽  
Basic Work ◽  
Operative Complications ◽  
The Mean ◽  
The Right

Summary Various techniques have been developed for the repair of femoral hernia. The technique with the Lichtenstein Plug since 1989 has allowed to obtain a lower rate of complications and recurrences, as well as an early recovery of the patients usual activities. Its application, widely spread in elective surgery, can also be performed in emergency surgery. The aim of this work is to review the experience of our basic group of work in the surgical treatment of Femoral hernia using this technique. Methods A retrospective descriptive observational study was conducted In our basic work group from the surgery service of the General Teaching Hospital “Enrique Cabrera” between 2009 and 2018, to which this surgical technique was applied. We study the anatomical variants of hernias as well as post-operative complications and clinical evolution. Results The mean age of the patients was 58.7 years (19-92 years), being the female with the highest incidence 78%, as well as, the most frequent location the right, 67.5%. The prosthesis used in the hernioplasty was that of polypropylene. Local anesthesia was applied to 29 patients (63%) of them. The average surgical time was25 minutes, (15-65 minutes). Ambulation was early and the average hospital stay was lessthan 24 hours, in most patients. Only one infectionof the wound and one hernia recurrence in one patient was confirmed. Conclusion Therefore, we believe that the Lichtenstein Plug technique should be considered among the techniques of choice in the treatment of femoral hernia

scholarly journals The Lichtenstein Plug Technique. The safe repair

2019 ◽  
Keyword(s):  
Femoral Hernia ◽  
Elective Surgery ◽  
Work Group ◽  
Average Hospital Stay ◽  
Early Recovery ◽  
Surgical Time ◽  
Average Hospital ◽  
Basic Work ◽  
Operative Complications ◽  
The Mean

Summary: Various techniques have been developed for the repair of femoral hernia. The technique with the Lichtenstein Plug since 1989 has allowed to obtain a lower rate of complications and recurrences, as well as an early recovery of the patients usual activities. Its application, widely spread in elective surgery, can also be performed in emergency surgery. The aim of this work is to review the experience of our basic group of work in the surgical treatment of Femoral hernia using this technique. Métodos: A retrospectiva descriptiva observacional sud das conducta in our basic work group from the surgery servicie of the General Tracking Hospital “Enrique Cabrera” veteen 2009 and 2018, to chicha this surgical technique das ampliad. De sud the anatómica variantes of hernias as well as post-operative complications and clínical evolución. Resultas: The mean age of the patients has 58.7 yesar (19-92 yesar), Begin the fémale with the Hughes incidente 78%, as well as, the most of frecuente locación the light, 67.5%. The próstesis usted in the hernioplasty was that of polypropylene. Local anesthesia was applied to 29 patients (63%) of them. The average surgical time was 25 minutes, (15-65 minutes). Ambulation was early and the average hospital stay was lessthan 24 hours, in most patients. Only one infection of the wound and one hernia recurrence in one patient was confirmed. Conclusion: Therefore, we believe that the Lichtenstein Plug technique should be considered among the techniques of choice in the treatment of femoral hernia

scholarly journals This is the easy repair of Femoral Hernia

2021 ◽  
Vol 2 (3) ◽  
pp. 01-04
Author(s):  
Pedro Rolando López Rodríguez ◽  
Jorge Satorre Rocha ◽  
Olga León González ◽  
Luis Marrero Quiala ◽  
Eduardo Garcia Castillo ◽  
...  
Keyword(s):  
Femoral Hernia ◽  
Work Group ◽  
Hernia Recurrence ◽  
Average Hospital Stay ◽  
Surgical Time ◽  
Average Hospital ◽  
Basic Work ◽  
Operative Complications ◽  
The Mean ◽  
The Right

Introduction: Various techniques have been developed for the repair of femoral hernia. The technique with the Lichtenstein Plug since 1989 has allowed to obtain a lower rate of complications and recurrences. AIM: The aim of this work is to review the experience of our basic group of work in the surgical treatment of femoral hernia using this technique. Methods: A retrospective descriptive observational study was conducted in our basic work group from the surgery service of the General Teaching Hospital “Enrique Cabrera” between 2009 and 2020, to which this surgical technique was applied (Plug Lichtenstein). We study the anatomical variants of hernias as well as post-operative complications and clinical evolution. Results: The mean age of the patients was 58.7 years (19-92 years), being the female with the highest incidence 81,7%, as well as, the most frequent location the right, 64.7%. The prosthesis used in the hernioplasty was that of polypropylene. Local anesthesia was applied to 48 patients (67,6%) of them. The average surgical time was25 minutes, (15-65 minutes). Ambulation was early and the average hospital stay was lessthan 24 hours, in most patients. Only one infectionof the wound and one hernia recurrence in one patient was confirmed. Conclusion: Therefore, we believe that the Lichtenstein Plug technique should be considered among the techniques of choice in the treatment of femoral hernia

scholarly journals Operating Rooms efficiency: leveraging data to improve management of elective surgery

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Quercioli ◽  
G A Carta ◽  
G Cevenini ◽  
G Messina ◽  
N Nante ◽  
...  
Keyword(s):  
Historical Data ◽  
Elective Surgery ◽  
District General Hospital ◽  
Operating Rooms ◽  
Accurate Estimation ◽  
Surgical Time ◽  
Accurate Analysis ◽  
Management Efficiency ◽  
Scheduling Model ◽  
The Mean

Abstract Background Careful scheduling of elective surgery Operating Rooms (ORs) is crucial for their efficient use, to avoid low/over utilization and staff overtime. Accurate estimation of procedures duration is essential to improve ORs scheduling. Therefore analysis of historical data about surgical times is fundamental to ORs management. We analyzed the effect, in a real setting, of an ORs scheduling model based on estimated optimum surgical time in improving ORs efficiency and decreasing the risk of overtime. Methods We studied all the 2014-2019 elective surgery sessions (3,758 sessions, 12,449 interventions) of a district general hospital in Siena's Province, Italy. The hospital had3 ORs open 5 days/week 08:00-14:00. Surgery specialties were general surgery, orthopedics, gynecology and urology. Based on a pilot study conducted in 2016, which estimated a 5 times greater risk of having an OR overtime for sessions with a surgical time (incision-suture)>200 minutes, from 2017 all the ORs were scheduled using a maximum surgical time of 200 minutes calculated summing the mean surgical times for intervention and surgeon (obtained from 2014-2016 data). We carried out multivariate logistic regression to calculate the probability of ORs overtime (of 15 and 30 minutes) for the periods 2014-2016 and 2017-2019adjusting for raw ORs utilization. Results The 2017-2019 risk of an OR overtime of 15 minutes decreased by 25% compared to the 2014-2016 period (OR = 0.75, 95%CI=0.618-0.902, p = 0.003); the risk of a OR overtime of 30 minutes decreased by 33% (OR = 0.67, 95%CI= 0.543-0.831, p < 0.001). Mean raw OR utilization increase from 62% to 66% (p < 0.001). Mean number of interventions per surgery sessions increased from 3.1 to 3.5 (p < 0.001). Conclusions This study has shown that an analysis of historical data and an estimate of the optimal surgical time per surgical session could be helpful to avoid both a low and excessive use of the ORs and therefore to increase the efficiency of the ORs. Key messages An accurate analysis of surgical procedures duration is crucial to optimize operating room utilization. A data-based approach can improve OR management efficiency without extra resources.

scholarly journals Comparison between Transepithelial Photorefractive Keratectomy versus Alcohol-Assisted Photorefractive Keratectomy in Correction of Myopia and Myopic Astigmatism

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ashraf M. Bakhsh ◽  
Shaaban A. M. Elwan ◽  
Ahsan A. Chaudhry ◽  
Tamer M. El-Atris ◽  
Taghleb M. Al-Howish
Keyword(s):  
Healing Time ◽  
Early Postoperative Period ◽  
Photorefractive Keratectomy ◽  
Control Group ◽  
Surgical Time ◽  
Pain Scores ◽  
The Mean ◽  
The Right ◽  
Myopic Astigmatism ◽  
Epithelial Healing

Purpose. The aim of the study was to compare visual acuity, refractive results, safety, and efficacy of TPRK with AAPRK as primary outcomes and surgical time, pain scores, haze levels, and healing time as secondary outcomes in TPRK and AAPRK groups.Setting. Security Forces Hospital, Ophthalmology Department, Riyadh, Kingdom of Saudi Arabia.Design. Prospective, nonrandomized case-control comparative study.Methods. A total of 200 eyes of 100 consecutive patients were included. One hundred eyes underwent TPRK in the right eye (study group), and 100 eyes underwent AAPRK in the left eye (control group). Ablations were performed with the Schwind Amaris excimer LASER750S. Clinical outcomes during 6 months’ follow-up were compared.Results. The mean age of patients was 28.3 ± 6.3, 77 were females and 23 males. The mean surgical time was 162.17 ±  14.827 s and 243.24  ±  98.69 s, respectively. At day 1, the UDVA mean was 0.7 in 87% of eyes in the TPRK group while it was 0.5 in 45% of eyes in AAPRK; at week 1, it was 0.9 in 88% of eyes in the TPRK group and 0.6 in 60% of eyes in AAPRK. The mean pain scores were less and lower incidence of corneal haze in the TPRK. Complete epithelial healing time was shorter in TPRK, 3.20 ± 0.686 and 4.60 ± 1.969 days, respectively.Conclusions. TPRK and AAPRK produce similar results 6 months postoperatively. However, in the early postoperative period, there were significant differences in UDVA, pain score, level of haze, and complete epithelial healing time. The pain scores were lower, level of haze was less, and healing time was shorter in the TPRK group which provided patient better felling and comfort in this period. Both of procedures are effective and safe for correction of myopia and compound myopic astigmatism. This trial is registered withNCT03569423.

scholarly journals Incarcerated femoral hernia treated with elective totally extraperitoneal repair: a case report

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Shigeo Ninomiya ◽  
Syunsuke Fujita ◽  
Tadashi Ogawa ◽  
Yoshitake Ueda ◽  
Norio Shiraishi ◽  
...  
Keyword(s):  
Femoral Hernia ◽  
Elective Surgery ◽  
Lower Abdominal Pain ◽  
Greater Omentum ◽  
Preperitoneal Space ◽  
Hernia Sac ◽  
Totally Extraperitoneal ◽  
The Right ◽  
Totally Extraperitoneal Repair ◽  
Incarcerated Groin Hernia

Abstract Incarcerated groin hernia is a common surgical emergency. However, reports of incarcerated femoral hernia treated with elective totally extraperitoneal repair are extremely rare. A 62-year-old woman visited our hospital with lower abdominal pain and bulging from a right groin lesion. The patient was diagnosed as having right incarcerated femoral hernia containing greater omentum by computed tomography. As there were no clear findings of intestinal obstruction and peritonitis, elective surgery was performed. Intraoperatively, the hernia sac had herniated into the right femoral canal. We could release the hernia sac using laparoscopic forceps. After reduction of the hernia sac, polypropylene mesh was placed in the preperitoneal space and fixed to Cooper’s ligament. The patient’s postoperative course was uneventful, and she was discharged 3 days after surgery. We consider elective totally extraperitoneal repair for incarcerated femoral hernia to be an effective procedure for selected patients who have been diagnosed accurately.

scholarly journals ORIF with Tension band wiring in transverse fractures of the patella-A prospective study

2021 ◽  
Vol 12 (1) ◽  
pp. 169-174
Author(s):  
Yeshwanth subash ◽  
Damodharan ◽  
Vishnu S
Keyword(s):  
Functional Outcome ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Effective Treatment Option ◽  
Surgical Time ◽  
The Mean ◽  
The Right ◽  
A Prospective Study ◽  
Patellar Fractures ◽  
Transverse Fractures

Fractures of the patella account for 1% of all fractures and can be managed by both conservative and surgical means. By this study, we aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of transverse patellar fractures with TBW (Tension band wiring). Thirty patients with patellar fractures who presented between June 2011 to June 2014 were managed surgically and were followed up for three years. Functional analysis was performed using the Lysholm scoring system. The patients in our study had a mean age of 42.86 years ranging from 19 to 71 years. There were 18 males and 12 females in our study with the right knee being more commonly affected. The mean surgical time was 57.66 minutes ranging from 45 to 70 minutes, and the average blood loss was 180.5 ml ranging from 160 to 210 ml We were able to achieve a 100% union rate in our series with the average time to fracture union being 11.83 weeks. The mean Lysholm score was 87.80±11.20. All patients were satisfied with the functional outcome and were able to return to activities of work and daily living to the best possible extent. ORIF with TBW is an effective treatment option in the management of transverse fractures of the patella, and it gives good radiological and functional outcomes to the patients.

scholarly journals Tapasztalataink a rekeszsérvek laparoszkópos sebészetével

2021 ◽  
Vol 162 (19) ◽  
pp. 754-759
Author(s):  
Máté Csucska ◽  
Mittal Sumeet K. ◽  
Balázs Kovács ◽  
Tamás Kremzer ◽  
Lilla Ozorai ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Elective Surgery ◽  
Transverse Dimension ◽  
Statistical Correlation ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Surgical Data ◽  
The Mean ◽  
The Right

Összefoglaló. Bevezetés: A hiatus hernia egy anatómiai betegség; gyakoribb előfordulása idősebbeknél jelezheti, hogy a betegség idővel előrehalad, súlyosbodik. Elhanyagolt esetben szövődmények alakulhatnak ki, melyek növelhetik a perioperatív mortalitást. Célkitűzés: A laparoszkópos hiatusrekonstrukciók sebészetében szerzett műtéti tapasztalataink ismertetése mellett igyekeztünk statisztikailag alátámasztható korrelációt találni a rekeszizom-defektus anatómiai paraméterei, valamint a betegek életkora között. Módszer: Retrospektív tanulmányunk keretében elemeztük azon betegeinket, akik laparoszkópos hiatus hernia műtéten estek át egy 58 hónapos (2016. január–2020. október) vizsgálati periódus során. A rekeszi defektus méreteit endoszkópos vonalzóval a műtét közben megmértük, a hiatus oesophagei felszínét standard matematikai formula segítségével számoltuk ki. A sürgősséggel műtétre kerülő betegeink adatait külön elemeztük. Statisztikai analízis: A defektus mérete és a betegek életkora és magassága közötti korrelációt a Spearman-féle ró (ρ)-korreláció segítségével állapítottuk meg. A szignifikanciaszint p≤0,05 volt. Eredmények: Az elektív csoportban 142 operált páciensből 47 beteg mérési adatai feleltek meg a kritériumoknak. Az átlagéletkor 64,7 ± 12,7 év volt, 33 páciens volt nő (70,2%), az átlagos testtömegindex 28,8 ± 5,5 kg/m2 volt. A defektus haránt átmérője és felszíne szignifikáns pozitív korrelációt mutatott a betegek életkorával (p≤0,05). Akut indikációval 5 beteg került műtétre; a defektus méretét illetően hasonló eredményeket tapasztaltunk, mint az elektív csoportnál, 2 esetben azonban súlyos szövődmények alakultak ki. Következtetés: A betegség mögött húzódó anatómiai okok jobb megértése és a megfigyeléseink alapján módosított sebésztechnika reményeink szerint csökkentheti a hosszú távú kiújulások számát a jövőben. Az időben elvégzett elektív beavatkozás alacsonyabb mortalitással, kevesebb szövődménnyel és rövidebb hospitalizációval jár együtt. Orv Hetil. 2021; 162(19): 754–759. Summary. Introduction: Hiatal hernia is an anatomical disease, and the higher incidence for elderly patients suggests that it is progressing over time. Neglected cases can cause serious complications, raising perioperative mortality. Objective: We are presenting our experience in laparoscopic hiatal reconstructions. Our main goal is to find a statistical correlation between the anatomical parameters of the hiatal defect and the patients age. Method: Surgical data were reviewed retrospectively for patients who underwent laparoscopic hiatal hernia repair between January 2016 and October 2020. Dimensions of the hiatal defect were measured intraoperatively with an endoscopic ruler. The defect size was calculated using a standard formula. The acute surgeries were analyzed as a separate arm of the study. Statistical analysis: The correlation between the patients age and the size of the defect were calculated using Spearman’s rho (ρ) correlation. The level of significance was p≤0.05. Result: In the elective group, out of 142 patients 47 met the inclusion criteria. The mean age was 64.7 ± 12.7 years, 33 patients were women, and the mean BMI was 28.8 ± 5.5 kg/m2. Patient age showed significant positive correlation with the transverse dimension and the size of the hiatal defect. 5 patients underwent surgery due to acute indications. We found similarities in the size of the defects; at 2 patients we documented severe complications. Conclusions: A better understanding of the underlying anatomical disorders and the consecutively modified surgical technique will hopefully reduce the long-term recurrencies in the future. The elective surgery performed in the right time results in lower mortality, less complications and shorter hospitalization time. Orv Hetil. 2021; 162(19): 754–759.

Carotid endarterectomy in patients with foetal-type posterior circle of Willis: Is there an indication for local anaesthesia?

VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 404-407
Author(s):  
Maras ◽  
Tzormpatzoglou ◽  
Papas ◽  
Papanas ◽  
Kotsikoris ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Local Anaesthesia ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Variable Degree ◽  
Operative Complications ◽  
The Right ◽  
Ica Stenosis ◽  
Symptomatic Stenosis

Foetal-type posterior circle of Willis is a common anatomical variation with a variable degree of vessel asymmetry. In patients with this abnormality, carotid endarterectomy (CEA) may create cerebral hypo-perfusion intraoperatively, and this may be underestimated under general anaesthesia. There is currently no evidence that anatomical variations in the circle of Willis represent an independent risk factor for stroke. Moreover, there is a paucity of data on treating patients with such anatomical variations and co-existing ICA stenosis. We present a case of CEA under local anaesthesia (LA) in a 52-year-old female patient with symptomatic stenosis of the right ICA and coexistent foetal-type posterior circle of Willis. There were no post-operative complications and she was discharged free from symptoms. She was seen again 3 months later and was free from complications. This case higlights that LA should be strongly considered to enable better intra-operative neurological monitoring in the event of foetal-type posterior circle of Willis.

DMSA-scintigraphy in paediatrics: Is the evaluation of the geometric mean necessary for the calculation of the differential renal function?

2001 ◽  
Vol 40 (04) ◽  
pp. 107-110 ◽  
Author(s):  
B. Roßmüller ◽  
S. Alalp ◽  
S. Fischer ◽  
S. Dresel ◽  
K. Hahn ◽  
...  
Keyword(s):  
Renal Function ◽  
Geometric Mean ◽  
Region Of Interest ◽  
Posterior View ◽  
Renal Abnormality ◽  
Anterior View ◽  
Differential Renal Function ◽  
The Mean ◽  
The Right ◽  
To Receive

SummaryFor assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimer-captosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256,300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Ctsdors x Ctsventr]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PFgeom and the PFdors was 1.5 ± 1.4%. A difference > 5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PFdors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differntial renal function in orthotopic kidneys, so that in these cases the anterior view is not necesssary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality.

Therapeutic Effects of Hab Shabyar on Open-Angle Glaucoma: A Double-Blinded, Randomized, Placebo-Controlled Trial

2019 ◽  
Vol 8 ◽  
pp. 1218
Author(s):  
Ebrahim Khalil BaniHabib ◽  
Ali Mostafai ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ghadir Mohammdi
Keyword(s):  
Placebo Group ◽  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Controlled Trial ◽  
Intervention Group ◽  
Therapeutic Effects ◽  
Open Angle ◽  
The Mean ◽  
The Right ◽  
Double Blinded

Background: Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma. Materials and Methods: In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group was received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group was received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared at before the intervention (t1), one month (t2), and two months (t3) after the intervention. Results: The mean decrease in intraocular pressure for the right eye at three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The patients in the intervention group expressed more satisfaction than the patients in the placebo group (P≤0.001). Conclusion: Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming of timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.[GMJ.2019;In press:e1218]

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