PROSPECTIVE STUDY OF ALTERATION IN TESTICULAR PERFUSION AND VOLUME IN LAPAROSCOPIC TOTALLY EXTRAPERITONEAL HERNIA REPAIR

2021 ◽  
pp. 122-124
Author(s):  
Sajad Hussain Malik ◽  
Ferkhand Mohi Ud Din ◽  
Hanief Mohammad Dar ◽  
Irshad Ahmad Kumar
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Tertiary Care ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Testicular Volume ◽  
Care Hospital ◽  
Diastolic Velocity ◽  
Testicular Perfusion

PURPOSE:- The objective of this study was to assess the effect of Totally extra-peritoneal inguinal hernia repair on testicular perfusion and testicular volume. METHODS: - After obtaining ethical clearance from institutional ethical committee, the present Prospective study was conducted on 48 male patients with unilateral inguinal hernia in a tertiary care hospital. RESULTS: - The study was conducted on 48 patients over a period of 2 years from august 2017 to august 2019 after meeting inclusion and exclusion criteria. Their mean age was 45.70 years (range 21-72 years). In our study comparison of preoperative and postoperative values at third and sixth month in the patients did not show any statistically signicant alteration in the variables studied like testicular volume (p-0.987) and blood ow perfusion parameters Peak systolic velocity (p-0.591); End Diastolic velocity (p-0.526); Resistance index (p-0.415). CONCLUSION: - No alteration in testicular volume and arterial ow over a six-month period was observed among patients who underwent laparoscopic extra-peritoneal surgical correction using polypropylene prosthesis for inguinal hernia

scholarly journals Cynoacrylate surgical glue as an alternative to suturing for mesh fixation in lichtenstein hernia repair

2018 ◽  
Vol 5 (5) ◽  
pp. 1882
Author(s):  
Deepak Jaiswal ◽  
TRV Wilkinson ◽  
Murtaza Akhtar
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Tertiary Care ◽  
Operating Time ◽  
Recurrent Hernia ◽  
Care Hospital ◽  
Lichtenstein Hernia Repair ◽  
Average Pain

Background: Tension free repair using mesh in open hernia repair has become more popular in recent years. Chronic pain remains a frequent complication after Lichtenstein inguinal hernia repair. The use of sutures to fix the mesh has been implicated. Fixing the mesh using cynoacrylate glue could avoid this complication. The purpose of the present study is to study the incidence of pain and other complications following inguinal hernia repair performed by the Lichtenstein technique with mesh fixation by cyanoacrylate surgical glue.Methods: T This study was conducted at tertiary care hospital. Inclusion criteria were all patients coming to the hospital with inguinal or inguinoscrotal hernias diagnosed clinically. Exclusion criteria were all complicated inguinal hernia namely obstructed, strangulated, and large hernias with scrotal abdomen, recurrent hernia. Patient not fit for surgery or not consenting to join the study. The patients will be informed about the surgery and thereafter requested to sign an informed consent. Primary outcome was postoperative pain. Secondary endpoints were operating time, surgical site infection and recurrence rate.Results: Total number of 31 cases enrolled in the study of which twenty-two had unilateral and seven had bilateral inguinal hernias. Average pain score on POD 1, 3, 7 was 5.75; 4.53; 3.32 respectively. One patient developed seroma which was managed conservatively. No evidence of recurrence during study period.Conclusions: Cyanoacrylate surgical glue is a reliable method and can be used as an alternative for conventional Lichtenstein hernia repair.

scholarly journals Inguinal hernia repair – TEP or TAPP?? A comparative analysis between both the laparoscopic procedures in a tertiary care center

2020 ◽  
Vol 11 (6) ◽  
pp. 84-88
Author(s):  
Atia Zaka Ur Rab ◽  
Sheikh Saif Alim ◽  
Wasif Mohammad Ali ◽  
Syed Amjad Ali Rizvi
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Normal Work

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.

scholarly journals Comparison of Laparoscopic VS Open Inguinal Hernioplasty in a Tertiary Care Hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 17-22
Author(s):  
Md Mahfuzul Momen ◽  
Ashok Kumar Sarker ◽  
Deb Prosad Paul ◽  
Debasis Das ◽  
Sonia Akhter ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Laparoscopic Group ◽  
Open Group ◽  
Care Hospital ◽  
Laparoscopic Hernioplasty ◽  
The Mean

Background: Inguinal hernia repair is one of the most common surgical procedures in Bangladesh. The option of surgical treatment remains controversial. Laparoscopic hernia repair has all the benefits of a tension free repair. We aimed to compare postoperative outcome and cost between laparoscopic and open inguinal hernia repair. Objective: This study was conducted with an objective to compare the effectiveness of each procedure and complications if any. Materials and Methods: Fifty cases of inguinal hernia admitted in the tertiary care center were selected by nonprobability (purposive) sampling method. All patients with uncomplicated hernia treated by open or laparoscopic method were included. The age/sex, incidence, mode of presentation, surgical treatment and postoperative complications were evaluated and compared with standard published literature. Results: Postoperative wound infection developed in three cases of open hernioplasty and one case in laparoscopic surgery. Hematoma and seroma at the operated site were found in one case of laparoscopic hernioplasty and in two cases of open hernioplasty. Orchitis was more prevalent in the laparoscopic hernioplasty patient with incidence among two cases as compared to one in open group. The mean duration of hospitalization was 59.62±6.11 hours in case of laparoscopic hernioplasty while 53.33±8.26 hours in open hernioplasty. The mean duration of procedure was 72.33 minutes in laparoscopic group while 64.62 minutes in open surgery. The mean cost for the laparoscopic repair group was around taka 63000/= whereas in the open group it was around 42000/= only with significant difference. Prolonged groin pain was seen in four cases in open group as compared to one in laparoscopically operated cases. Conclusion: There were less post-operative complications in the laparoscopic group. J Enam Med Col 2020; 10(1): 17-22

scholarly journals Cerebral Hemodyanamics in Stable Preterm Infants Before and After Packed Cell Transfusion

2020 ◽  
Author(s):  
Chinmay Chetan ◽  
Nyein Zaw ◽  
Pradeep Suryawanshi ◽  
Nishant Banait ◽  
Prince Pareek ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Interquartile Range ◽  
P Value ◽  
Care Hospital ◽  
Doppler Study ◽  
Diastolic Velocity ◽  
Before And After

Abstract BACKGROUND In a year around 3.5 million preterm deliveries occur in India alone. Some of these babies will require packed cell volume (PCV) transfusion. There is a paucity of robust data on effect of blood transfusions on the cerebral hemodynamic from India. This study was done to see the effect of PCV transfusion on blood flow velocities and resistive index (RI) of anterior cerebral artery (ACA) in stable preterm infants. METHOD A prospective observational study was conducted in a tertiary care hospital in Pune, India. All stable preterm infants (<37 weeks) receiving PCV transfusion were enrolled. USG Doppler study of ACA was done before and after PCV transfusion. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and RI were measured pre and post PCV transfusion. RESULTS Thirty infants were included in the study, with median gestation age of 28.8 [interquartile range {IQR}, 27-30.55] weeks and median birth weight of 970 [interquartile range {IQR}, 869.5-1190] grams. There was a significant decrease in PSV pre and post PCV transfusion - 58.46 (±18.44) cm/sec and 46.34 (±13.93) cm/sec respectively (p value <0.001). Changes in RI and EDV were non-significant.CONCLUSION PCV transfusion significantly decreased PSV, reflecting improved cerebral oxygenation, and decreased cardiac output after correction of anaemia. Laboratory threshold for PCV transfusion in stable preterm infants are not known. USG Doppler study has the potential to provide one of the objective criteria for PCV transfusion in these infants though large scale randomized controlled trials are needed to prove its efficacy.

scholarly journals Study of testicular perfusion after Lichtenstein hernioplasty in uncomplicated inguinal hernia

2018 ◽  
Vol 5 (3) ◽  
pp. 1104
Author(s):  
Prabhu Nath ◽  
Subhajeet Dey ◽  
Tanweer Karim ◽  
Atul Jain ◽  
Vivek Kumar Katiyar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Test Analysis ◽  
Lichtenstein Hernioplasty ◽  
Significant Difference ◽  
Testicular Ischemia ◽  
Testicular Perfusion ◽  
One Year

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures in the world. The aim is to achieve a recurrence free hernia repair with minimum of complications. In mesh inguinal hernia repair testicular cord structures are in direct contact with the mesh. Testicular ischemia usually manifests within 48-72 hours after surgery. Aims of the study was to asses any changes in perfusion of ipsilateral testis after Lichtenstein hernioplasty and establish a baseline testicular perfusion pattern in the study population. This study was conducted in the Department of Surgery for one year at a tertiary care teaching hospital in Delhi.Methods: All consenting adult male patients undergoing Lichtenstein inguinal hernioplasty for unilateral inguinal hernia fulfilling the inclusion and exclusion criteria. A sample size of 50 was included in study.Results: In this study patients were above 18 and below 60 years of age with mean age of 43.58 years.  The paired T-test analysis revealed no statistically significant difference between pre and post-operative values of SV, DV, RI, PI and TV.Conclusions: Lichtenstein tension free mesh repair for uncomplicated inguinal hernia does not impair testicular perfusion after the procedure.

scholarly journals Prospective study on the effects of a polypropylene prosthesis on testicular volume and arterial flow in patients undergoing surgical correction for inguinal hernia

2007 ◽  
Vol 22 (4) ◽  
pp. 266-271 ◽  
Author(s):  
Edgar Valente de Lima Neto ◽  
Alberto Goldenberg ◽  
Mário Jorge Jucá
Keyword(s):  
Inguinal Hernia ◽  
Pulsatility Index ◽  
Resistance Index ◽  
Surgical Correction ◽  
Testicular Volume ◽  
Arterial Flow ◽  
Prospective Clinical Study ◽  
Diastolic Velocity ◽  
Male Patients ◽  
Nyhus Classification

PURPOSE: To evaluate testicular volume and arterial flow in patients undergoing surgical correction for inguinal hernia, with polypropylene prosthesis. METHODS: This was an observational prospective clinical study on 39 male patients with unilateral inguinal hernia of types III A and III B according to the Nyhus classification who underwent surgical correction with implantation of a polypropylene prosthesis by means of the Lichtenstein technique. The patients were evaluated using Doppler ultrasound before the operation and selectively at the third and sixth months after the operation. The variables studied were testicular volume, systolic and diastolic velocity, resistance index and pulsatility index. RESULTS: No statistically significant alterations in the variables studied were observed over the course of time: testicular volume (p= 0.197); systolic velocity (p= 0.257); diastolic velocity (p= 0.554); resistance index (p= 0.998); and pulsatility index (p= 0.582). CONCLUSION: No alteration in testicular volume and arterial flow over a six-month period was observed among patients who underwent surgical correction for inguinal hernia using a polypropylene prothesis.

scholarly journals Early Outcome of Lichtenstein Technique for Inguinal Hernia Repair in Tertiary Care Hospital

2019 ◽  
Vol 10 (1) ◽  
pp. 62-69
Author(s):  
ASM Anwarul Kabir ◽  
Mahbuba Sharmin ◽  
Khaleda Akhter ◽  
Farjana Akhter ◽  
Md Rashidul Haq ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Oral Feeding ◽  
Drain Tube ◽  
Care Hospital ◽  
Lichtenstein Technique ◽  
Medical College

Background: Inguinal hernia repair are very common in day to day general surgical practice. Results of surgical repair are often satisfactory but recurrences following surgery is troublesome both for surgeon and patient. Lichtenstein technique is now the most widely performed technique in groin hernia repair. The aim of this study was to assess short term outcome of inguinal hernia repair by Lichtenstein technique. Methods and materials: In this prospective study, 30 inguinal hernia repairs were performed by Lichtenstein technique between January 2015 and December 2017 in surgery department of Holy Family Red Crescent Medical College Hospital. Patients were scheduled for follow up visits at 1st week, three months and six months in out- patient department. The main outcome measure was early recurrence, groin pain and other complications. Results: In this study age of the patients ranged from 30 years to 78 years, The mean age was 51.93 (±SD 10.12) years. Regarding personal habit, more than half of the patients of inguinal hernia were found to be non-smoker and about 37% of the patients were current smokers. Most of the hernia were of indirect type (18/30) followed by direct type (9/30). In indirect type 55.6% of the hernias were in the right side and the rest were in left side. On an average each operation lasted for 1.18 hours and oral feeding started 12.69 hours after the operation. Two patients (6.7%) had a prolonged recovery and presented with abdominal distention after operation. Postoperative hospital stay that was 2.27 days. 6 (20%) patients developed postoperative urinary retention. Scrotal haematoma formation was observed in 5(17%) cases and local haematoma or seroma formation in incision site was reported in 4 (13%) cases. In 6 patients (20%) we used suction drain tube at tissue plane where mesh was placed for draining of blood or seroma and that drain tube was removed 2nd or 3rd postoperative period. Periincisional skin echymosis, abdominal distension and superficial wound infection, postoperative pyrexia were the other complications reported. No recurrence or mesh rejection or mesh infection were observed within short time postoperative follow up period. Conclusion: Lichtenstein technique is easy to learn, simple to perform and very rationale to perform and recurrence rate is low. Multi-centre studies with larger sample and longer duration of study and more sound study design could bring more insight regarding this issue. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 62-69

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