Total Trans-Umbilical Laparoscopic Cholecystectomy And Inguinal Hernia Repair

10.5580/2437 ◽  
2010 ◽  
Vol 25 (1) ◽  
2004 ◽  
Vol 2 (1) ◽  
pp. 0-0
Author(s):  
Algimantas Stašinskas ◽  
Raimundas Lunevičius

Algimantas Stašinskas, Raimundas LunevičiusVilniaus universiteto Bendrosios ir kraujagyslių chirurgijos klinika,Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT–2043 VilniusEl paštas: [email protected], [email protected] Tikslinga priekinės pilvo sienos laukus žymėti pagal vieną sistemą ir ta sistema remtis atliekant laparoskopines operacijas. Centrinis priekinės pilvo sienos atskaitos taškas yra bamba (žymuo "O"). Priekinė pilvo siena skirstoma į keturis tradicinius kvadrantus A, B, C, D, o kiekvienas – į tris sektorius a, b, c ir tris zonas P, M, L. Dalijant į sektorius reikia pasinaudoti laikrodžio rodyklės sukimosi taisykle. Remiantis šia schema sutartiniais ženklais pažymimi 36 priekinės pilvo sienos taškai ir 36 laukai. Pateiktos keturios laparoskopinių operacijų – cholecistektomijos, apendektomijos, kirkšninės hernioplastikos ir duodenorafijos – kartogramos. Prasminiai žodžiai: pilvo sienos kartografija, pilvo sienos schema, laparoskopinė chirurgija Abdominal wall cartography and its significance in laparoscopic surgery Algimantas Stašinskas, Raimundas Lunevičius It is reasonable that the fields of the anterior abdominal wall should be marked according to one system which could be strictly preserved in laparoscopic surgery. A cartographic scheme of the anterior abdominal wall is presented in this paper. The umbilicus is the central point (mark "O"). The anterior abdominal wall was divided into four traditional quadrants, A, B, C, and D. Each of them was subdivided into 3 sectors, a, b, and c, as well as three zones P (proximal), M (middle), and L (lateral). The bourders of the sectors have to be subdivided according to a clockwise rule. Following this scheme, 36 points and 36 fields are marked. There are presented four cartographic maps for laparoscopic cholecystectomy, appendectomy, inguinal hernia repair and duodenorrhaphy. Keywords: abdominal wall cartography, abdominal map, laparoscopic surgery


2021 ◽  
pp. 204946372110329
Author(s):  
Collin Clarke ◽  
Andrew McClure ◽  
Laura Allen ◽  
Luke Hartford ◽  
Julie Ann Van Koughnett ◽  
...  

Purpose: Surgery is a major risk factor for chronic opioid use among patients who had not recently been prescribed opioids. This study identifies the rate of, and risk factors for, persistent opioid use following laparoscopic cholecystectomy and open inguinal hernia repair in patients not recently prescribed opioids. Methods: This retrospective population-based cohort study included all patients who had not been prescribed opioids in the 6 months prior to undergoing open inguinal hernia repair or laparoscopic cholecystectomy from January 2013 to July 2016 in Ontario. Opioid prescription was identified from the provincial Narcotics Monitoring System and data were obtained from the Institute for Clinical Evaluative Sciences. The primary outcome was persistent opioid use after surgery (3, 6, 9 and 12 months). Associated risk factors and prescribing patterns were also examined. Results: Among the 90,326 patients in the study cohort, 80% filled an opioid prescription after surgery, with 11%, 9%, 5% and 1% filling a prescription at 3, 6, 9 and 12 months, respectively. Significant variability was identified in the type of opioid prescribed (41% codeine, 31% oxycodone, 18% tramadol) and in regional prescribing patterns (mean prescription/region range, 135–225 oral morphine equivalents). Predictors of continued opioid use included age, female gender, lower income quintile and being operated on by less experienced surgeons. Conclusion: Most patients who undergo elective cholecystectomy and hernia repair will fill a prescription for an opioid after surgery, and many will continue to fill opioid prescriptions for considerably longer than clinically anticipated. There is important variability in opioid type, regional prescribing patterns and risk factors that identify strategic targets to reduce the opioid burden in this patient population.


The Physician ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Vikramman Vignaraja

Poster presented at BAPIO National Conference, London 2019 Peer reviewed by Subarna Chakravorty PhD & Sunil Daga PhD


2005 ◽  
Vol 63 (04) ◽  
pp. 325 ◽  
Author(s):  
K. Kantartzi ◽  
A. Polychronidis ◽  
M. Theodoridis ◽  
S. Perente ◽  
V. Vargemezis ◽  
...  

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24


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