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 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 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 Circumcision With Plastic Clamb in Newborn Infants

2019 ◽  
Vol 1 (2) ◽  
pp. 49-55
Author(s):  
Yusuf Atakan Baltrak
Keyword(s):  
Average Length ◽  
Newborn Infants ◽  
Late Period ◽  
Average Hospital Stay ◽  
Surgical Operation ◽  
Average Hospital ◽  
Study Results ◽  
Operative Complications ◽  
Physical Examinations ◽  
Hospital Stay Duration

Various devices were used to carry circumcision operation out. It noted that these devices, especially the Plastic Clamp method, significantly decrease complications as long as basic surgical rules, are followed. This study aims to examine the application of Plastic Clamp circumcision in infants. Children whose physical examinations revealed circumcision contradictions excluded from the study. During the study period, a total of 485 children was circumcised using the plastic clamp method under sedated anesthesia and by a single pediatric surgeon. Measurements take before operations and plastic clamps with diameters ranging from 1.2 to 1.6 cm used. The duration of the surgical procedure, early and late period post-operative complications, the separation duration of the plastic clamp, and problems evaluated. Study Results, the average length of the surgical operation was determined to be 5.5 minutes. The average hospital stay duration of the patients was 2 hours. During the follow-ups, edemas were observed in mucosal areas of 24 (4.9%) patients, 48 hours after the clamp placed and edema and swelling recovered seven days after the circumcision at the latest. On average, it observed that plastic clamp separated on its own in 7.1 days. It noted that in 4 (0.8%) patients, the plastic clamp separated prematurely during 6 hours following the operation due to pulling. Conclusion study plastic Clamp (Alisklamp) is starting to gain popularity because it falls off on its own and that it can be applied quickly under local anesthesia

scholarly journals Outcome of Pcnl in Proximal Ureteric Stone: A Comparative Study With Laparoscopic Retrieval

2020 ◽  
Vol 21 (1) ◽  
pp. 25-30
Author(s):  
Tanvir Ahmed ◽  
Md Humayun Kabir ◽  
Md Khairuzzaman ◽  
Md Monirul Ahsan ◽  
Mirana Jahan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hospital Stay ◽  
Clearance Rate ◽  
Average Hospital Stay ◽  
Ureteric Stone ◽  
Stone Size ◽  
Average Hospital ◽  
Stone Clearance ◽  
Urinary Leakage ◽  
The Mean

A hundred-percent stone clearance was achieved in a hospital based prospective clinical trial in which 60 cases of upper ureteric stone were selected by purposive sampling for percutaneous nephroureterolithotomy & Laparoscopic ureterolithotomy between December 2012 and June 2014 in BSMMU. The mean age of the patients was 40.53±11.71 (19-61) and 41.23±10.76 (20-59) years old in PCNUL and LUL groups, respectively. The mean stone size in PCNUL group was 1.88±0.39 (1.06-2.45) cm and in LUL group was 1.97±0.42 (1.20-2.60) cm. The duration of the operations were 94.13 ± 17.34 (75-140) minutes, and 121.43 ± 19.91 (90-167) minutes (P =0.001); and the average hospital stay days were 3.73 ± 1.20 (3-8) and 4.80 ± 1.71 (3-9) days (P = 0.017) in groups PCNUL and LUL, accordingly. The mean Hb decrease in PCNUL group was 1.16±0.35 mg/dL and in LUL group was 0.77±0.31 mg/dL (P = <0.001). No statistically significant differences in terms of fever and post operative prolonged urinary leakage were detected in both groups. Therefore the compared outcome is better in percutaneous nephroureterolithotomy group although stone clearance rate was same in percutaneous nephroureterolithotomy & laparoscopic ureterolithotromy patients. Bangladesh Journal of Urology, Vol. 21, No. 1, January 2018 p.25-30

scholarly journals Comparison of Propofol and Thiopentone Anaesthesia (with Special Reference to Recovery Characteristics)

1987 ◽  
Vol 15 (4) ◽  
pp. 389-393 ◽  
Author(s):  
W. M. Weightman ◽  
M. Zacharias
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Day Case ◽  
Early Recovery ◽  
Day Case Surgery ◽  
Pain On Injection ◽  
High Incidence ◽  
Case Surgery ◽  
Repeated Doses ◽  
The Mean

Thiopentone and propofol were used for the induction and maintenance of anaesthesia in unpremedicated patients undergoing minor gynaecological procedures. There were no significant differences in the induction and maintenance characteristics except for a high incidence of pain on injection and a greater fall in the mean systolic blood pressure associated with propofol in comparison with thiopentone. Propofol was associated with a quicker early recovery as well as a faster psychomotor recovery, as tested by a peg-board. However, complete psychomotor recovery was not achieved for up to three hours in some patients receiving propofol and so caution is advised regarding the early street fitness of patients receiving repeated doses of the drug for day case surgery.

scholarly journals Scrotal reconstruction with superomedial fasciocutaneous thigh flap

2018 ◽  
Vol 45 (1) ◽  
Author(s):  
DANIEL FRANCISCO MELLO ◽  
AMERICO HELENE JÚNIOR
Keyword(s):  
Surgical Treatment ◽  
Complication Rate ◽  
Longitudinal Direction ◽  
Functional Results ◽  
Fasciocutaneous Flap ◽  
Surgical Time ◽  
Cross Sectional ◽  
Skin Loss ◽  
Scrotal Reconstruction ◽  
The Mean

ABSTRACT Objective: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier’s gangrene). Methods: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. Results: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48.9 years (28 to 66). Skin loss estimates in the scrotal region ranged from 60 to 100%. Definitive reconstruction was performed on average 30.6 days (22 to 44) after the initial surgical treatment. The mean surgical time was 76 minutes (65 to 90) to obtain the flaps, bilateral in all cases. Flap size ranged from 10cm to 13cm in the longitudinal direction and 8cm to 10cm in the cross-sectional direction. The complication rate was 26.6% (four cases), related to the occurrence of segmental and partial dehiscence. Conclusion: the superomedial fasciocutaneous flap of thigh is a reliable and versatile option for the reconstruction of open areas in the scrotal region, showing adequate esthetic and functional results.

scholarly journals Randomized controlled study comparing 2 surgical techniques for decompressive craniectomy: with watertight duraplasty and without watertight duraplasty

2018 ◽  
Vol 129 (4) ◽  
pp. 1017-1023 ◽  
Author(s):  
Eduardo Vieira ◽  
Thiago C. Guimarães ◽  
Igor V. Faquini ◽  
Jose L. Silva ◽  
Tammy Saboia ◽  
...  
Keyword(s):  
Wound Infection ◽  
Decompressive Craniectomy ◽  
Surgical Complications ◽  
Test Group ◽  
Csf Leak ◽  
Control Group ◽  
Surgical Time ◽  
Randomized Controlled ◽  
The Mean ◽  
Fluid Collections

OBJECTIVEDecompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors’ objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC).METHODSThe study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy. Patients were randomized by numbered envelopes into 2 groups: with watertight duraplasty (control group) and without watertight duraplasty (test group). After unilateral DC was completed, watertight duraplasty was performed in the control group, while in the test group, no watertight duraplasty was performed and the exposed parenchyma was covered with Surgicel and the remaining dura mater. Patients were then monitored daily from the date of surgery until hospital discharge or death. The primary end point was the incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections). The following were analyzed as secondary end points: clinical outcome (analyzed using the Glasgow Outcome Scale [GOS]), surgical time, and hospital costs.RESULTSFifty-eight patients were enrolled, 29 in each group. Three patients were excluded, leaving 27 in the test group and 28 in the control group. There were no significant differences between groups regarding age, Glasgow Coma Scale score at the time of surgery, GOS score, and number of postoperative follow-up days. There were 9 surgical complications (5 in the control group and 4 in the test group), with no significant differences between the groups. The mean surgical time in the control group was 132 minutes, while in the test group the average surgical time was 101 minutes, a difference of 31 minutes (p = 0.001). The mean reduction in total cost was $420.00 USD (a 23.4% reduction) per procedure in the test group.CONCLUSIONSRapid-closure DC without watertight duraplasty is a safe procedure. It is not associated with a higher incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections), and it decreased surgical time by 31 minutes on average. There was also a hospital cost reduction of $420.00 USD (23.4% reduction) per procedure.Clinical trial registration no.: NCT02594137 (clinicaltrials.gov)

What Is the Impact of Prior Authorization on the Incidence of Pediatric Tonsillectomy?

2020 ◽  
pp. 019459982096963
Author(s):  
Vanessa F. Torrecillas ◽  
Kaden Neuberger ◽  
Alexander Ramirez ◽  
Paul Krakovitz ◽  
Jeremy D. Meier
Keyword(s):  
Elective Surgery ◽  
Lag Time ◽  
Cross Sectional Study ◽  
Health Claims ◽  
Third Party ◽  
Prior Authorization ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
The Impact

Objective Third-party payers advocate for prior authorization (PA) to reduce overutilization of health care resources. The impact of PA in elective surgery is understudied, especially in cases where evidence-based clinical practice guidelines define operative candidacy. The objective of this study is to investigate the impact of PA on the incidence of pediatric tonsillectomy. Study Design Cross-sectional study. Setting Health claims database from a third-party payer. Methods Any pediatric patient who had evaluation for tonsillectomy from 2016 to 2019 was eligible for inclusion. A time series analysis was used to evaluate the change in incidence of tonsillectomy before and after PA. Lag time from consultation to surgery before and after PA was compared with segmented regression. Results A total of 10,047 tonsillectomy claims met inclusion and exclusion criteria. Female patients made up 51% of claims, and the mean age was 7.9 years. Just 1.5% of claims were denied after PA implementation. There was no change in the incidence of tonsillectomy for all plan types ( P = .1). Increased lag time from consultation to surgery was noted immediately after PA implementation by 2.38 days (95% CI, 0.23-4.54; P = .030); otherwise, there was no significant change over time ( P = .98). Conclusion A modest number of tonsillectomy claims were denied approval after implementation of PA. The value of PA for pediatric tonsillectomy is questionable, as it did not result in decreased incidence of tonsillectomy in this cohort.

TO ASSESS THE IDEAL TIME OF LAPAROSCOPIC CHOLECYSTECTOMY AFTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN CASES OF CHOLELITHIASIS WITH CHOLEDOCHOLITHIASIS

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Dhirendra Godara ◽  
Vineet Choudhary ◽  
Nitish Soni
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Sciences ◽  
Early Recovery ◽  
Endoscopic Retrograde ◽  
The Mean ◽  
Group 2 ◽  
Late Group ◽  
Group 1 ◽  
The Ideal

Background: Aims of this study was assess the ideal time of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in cases of cholelithiasis with Choledocholthiasis Methods: The present study was carried out on 150 patients admitted in Department of General surgery National Institute of Medical Sciences and Research, Jaipur, diagnosed with cholelithiasis along with choledocholithiasis  from 1stJanuary 2019 to 30thJune, 2020. Results: In group 1 out of 75 patients 7 patients developed complications in post operative period compared to 35 patients out of 75 patients developed complications in group 2. The The mean hospital stay (in day) in group 1 patients was 2.26, median 2 and the mean of group 2 was 5.26, median 5. Conclusion: To conclude in our study there has been found significant advantage of early laparoscopic cholecystecomy following ERCP over the late group to minimize complications and promote early recovery of the patients. Keywords: ERCP, Cholecystectomy, Endoscopic retrograde cholangiopancreatography

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