scholarly journals Femoral Hernia: Open and Laparoscopic Surgery Approaches

2021 ◽  
Author(s):  
Muhammad Shamim
Keyword(s):  
Femoral Hernia ◽  
Open Surgery ◽  
Abdominal Cavity ◽  
Surgical Techniques ◽  
Rectus Muscle ◽  
Inguinal Ligament ◽  
Preperitoneal Repair ◽  
Advantages And Disadvantages ◽  
Vertical Incision ◽  
Total Extraperitoneal

Femoral hernia comes out of abdominal cavity through the femoral canal and descends vertically to saphenous opening, and once escapes this opening it expands considerably, sometimes rising above the inguinal ligament. Due to its tortuous course, the hernia is usually irreducible and liable to strangulate. There are different open surgery choices. In low (Lockwood) operation, the sac is dissected out below the inguinal ligament via a groin-crease incision. In high (McEvedy) operation, the hernia is accessed via a horizontal (or vertical) incision made in lower abdomen at the lateral edge of rectus muscle. In Lotheissen’s operation, the hernia is approached through the inguinal canal. The last one is my preferred approach, as it also helps in dealing if the contents are strangulated. The laparoscopic approaches include both transabdominal preperitoneal repair (TAPP) and total extraperitoneal repair (TEP). This chapter will give an account of the advantages and disadvantages of these different surgical techniques.

scholarly journals Hohe Myopie und Innenschielen: ein Update zum Heavy-Eye-Syndrom

2020 ◽  
Vol 6 (4) ◽  
pp. 178-179
Author(s):  
Santa Heede ◽  
Stephan Johannes Linke
Keyword(s):  
Differential Diagnosis ◽  
Current Literature ◽  
Surgical Techniques ◽  
Rectus Muscle ◽  
Pulley System ◽  
Important Type ◽  
Hohe Myopie ◽  
Salient Features

Heavy eye syndrome is an important type of myopia-induced strabismus. We provide an overview of heavy eye syndrome, from its history to its most salient features. The theory of the orbital and rectus muscle pulley system as it relates to heavy eye syndrome and the prevailing theories on the pathophysiology of heavy eye syndrome in the current literature are discussed. We also highlight the presentation of heavy eye syndrome, its typical features on imaging, and differential diagnosis. Finally, we provide an overview on the management of heavy eye syndrome, including a description of several current surgical techniques.

Nasal Dermoids in Children: Factors Influencing the Distant Result

2021 ◽  
Author(s):  
Michal Kotowski ◽  
Paulina Adamczyk ◽  
Jaroslaw Szydlowski
Keyword(s):  
Pediatric Patients ◽  
Surgical Techniques ◽  
Intracranial Extension ◽  
Recurrence Rates ◽  
Local Conditions ◽  
Aesthetic Result ◽  
Factors Influencing ◽  
Vertical Incision ◽  
External Rhinoplasty

AbstractThe aim of the study was to present a single institution’s treatment strategy for nasal dermoids and to identify factors influencing distant results. The study covered 24 surgically treated pediatric patients with nasal dermoids (NDs). The medical data concerning demographics, preoperative local inflammations and surgical procedures, form of the abnormality, imaging, surgical techniques, and a role of osteotomies and reconstructions were analyzed. The recurrence rates and distant aesthetic outcomes were assessed. The surgical approach included vertical incision in 21 patients, the external rhinoplasty approach in 2 cases, and bicoronal incision in 1 child. The intracranial extension was confirmed in 6 patients. Seven out of 8 cases with preoperative local inflammations and 3 out of 4 with secondary fistulization were < 4 years old. Nine patients required osteotomies. Three children required reconstruction of the nasal skeleton. None of the distant cosmetic results was described as hideous or unsatisfactory. The incidence of local inflammatory complications is unrelated to the age of the patients. The distant aesthetic result depends on both the initial extent of the disease and preoperative local conditions or interventions. Prompt surgical intervention is highly recommended.

Advantages and disadvantages of main surgical approaches for robot-assisted radical prostatectomy

2020 ◽  
Vol 10 (4) ◽  
pp. 347-354
Author(s):  
Dmitriy M. Il’in ◽  
Vladimir A. Makeev
Keyword(s):  
Radical Prostatectomy ◽  
Abdominal Cavity ◽  
Prostate Gland ◽  
Clinical Situation ◽  
Surgical Approaches ◽  
Robot Assisted ◽  
Scientific Databases ◽  
Advantages And Disadvantages ◽  
Robotic Assisted Surgery ◽  
History Of

The introduction of robotic-assisted surgery into clinical practice has opened up new possibilities for the surgical treatment of urological patients. Robot-assisted radical prostatectomy (RARP) is one of the most commonly performed robot-assisted surgery. The review is devoted to the main surgical approaches for RARP. An analysis of publications on this topic was carried out using the search engines of the scientific databases PubMed, Medscape, Google Scholar, eLibrary when writing the article The article presents an overview of the advantages and disadvantages of the existing four access options for RARP: anterior, perineal, lateral and posterior, as well as oncological and functional outcomes of operations. It has been shown that a surgeon with different approaches can choose the most suitable one for a given clinical situation, focusing on the stage of the disease, the patients age, anatomical features of the prostate gland, the state of the patients erectile function, and the history of operations on the abdominal cavity and pelvic organs.

scholarly journals Incarcerated Femoral Hernia Repair with Ventralex™ Hernia Patch through Same Skin Incision and Suprainguinal Laparotomy

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
David Aranovich ◽  
Veacheslav Zilbermints ◽  
Oleg Kaminsky
Keyword(s):  
Hernia Repair ◽  
Femoral Hernia ◽  
Bowel Resection ◽  
Abdominal Cavity ◽  
Skin Incision ◽  
Operative Approach ◽  
Easy Access ◽  
Midline Laparotomy ◽  
Femoral Ring

Purpose. To report our experience with incarcerated femoral hernia procedure, which allows laparotomy through same inguinal skin incision, inspection and resection of compromised bowel, and preperitoneal tension-free transabdominal repair with Ventralex™ Hernia Patch.Materials and Methods. The suprainguinal laparotomy was performed via same groin incision without compromising iliopubic tract. The femoral ring was sealed with Ventralex™ Hernia Patch pulled through the abdominal cavity and secured outside. Five consecutive patients diagnosed with incarcerated femoral hernias were operated. All of them required laparotomy, either for bowel resection (n=3) or for inspection of viability (n=2).Results. All patients tolerated the procedure well. There were no wound or mesh infections, incisional hernias, or recurrences during follow-up.Conclusions. Our easy-to-master operative approach to incarcerated femoral hernia allows easy access to abdominal cavity through same groin incision without compromising iliopubic tract or midline laparotomy. Reduction of incarcerated bowel and its inspection and resection can be safely performed. The femoral ring defect can be effectively obliterated with Ventralex™ Hernia Patch.

scholarly journals Clinical study on complicated presentations of groin hernias

2017 ◽  
Vol 5 (8) ◽  
pp. 3303 ◽  
Author(s):  
Hariprasad S. ◽  
Teerthanath Srinivas
Keyword(s):  
Femoral Hernia ◽  
Groin Hernia ◽  
Cumulative Risk ◽  
Surgical Techniques ◽  
Postoperative Outcome ◽  
Subsequent Treatment ◽  
High Rate ◽  
Age Group ◽  
Female Ratio ◽  
Groin Hernias

Background: Groin hernia is a very common type abdominal wall hernia encountered in surgical practice. Irreducibility, obstruction and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of post-operative complications even with better care, improved anaesthetic management and advanced surgical techniques. The aim of this study was to determine the various modes of presentation, clinical finding, diagnostic and therapeutic strategies and to evaluate the postoperative outcome in complicated groin hernia surgeries in our set up.Methods: The study was carried out among 40 patients of groin hernia, who had complicated clinical presentation like irreducibility, strangulation and obstruction in the department of general surgery, during the period from March 2012 to June 2014. Patients were enrolled into the study after proper consent for detailed clinical examination, investigation and subsequent treatment. The Data obtained included demographic characteristics, presentation, operative findings and outcome. The patients were followed up for immediate and late complications for once a week for 1 months, once every month for the next 6 months. After data collection, analysis was done with help of by SPSS software version 21.Results: A total of 40 groin hernia patients with complicated presentation were evaluated during the study period. Among these cases 38 cases had inguinal hernias and two cases had femoral hernia. Majority of the patients were in 5th and 6th decade. Complicated presentation of groin hernia was commonly seen in males (95%) than in females (5%) with male to female ratio of 19:1. Inguinal hernia complications were seen predominantly in males and femoral hernia complications in females. Right sided hernias were more common. Incarceration was the commonest complication seen in 70% of case followed by strangulation (30%). Incarceration was high (17.5%) in the age group of 64-73 years and 44 - 53 years. Strangulation was high in the age group of 54-63 years. The duration of hernia varied for 1-2 years in 42.5% of cases and 3-6 years in 27.5% of cases. Majority of the patients (30%) presented with localized groin pain, vomiting, constipation and abdominal distension. All patients presented with swelling in the inguinoscrotal region, which was tender, and there was no impulse on coughing and 35% of patients had cardiorespiratory illness. Majority of the cases (34 numbers) were operated as emergency procedure. Viable bowel was seen in 77.5% of cases. Bowel resection and end-to-end anastomosis was done in all cases of non-viable bowel and orchidectomy in atrophied and gangrenous testis. The commonest postoperative complication encountered in the study was wound infection (22.5%) and scrotal seroma (17.50%). There was no evidence of recurrence in any of the operated cases.Conclusions: Complicated presentations of groin hernias like, incarceration and strangulation are seen in low and middle socio-economic category of people and may be associated with chronic illness. The cumulative risk of strangulation increases with time and type of hernias. Timely diagnosis and prompted surgical repair is essential to prevent the complications. 

scholarly journals The application of C2 transpedicular screw, C1 laminar hook fixation and bone graft in the atlantoaxial instability

2021 ◽  
Vol 38 (2) ◽  
pp. 94-98
Author(s):  
Şükrü ORAL
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Surgical Techniques ◽  
Atlantoaxial Instability ◽  
Posterior Arch ◽  
X Rays ◽  
Advantages And Disadvantages ◽  
Transpedicular Screw ◽  
Flexion Extension ◽  
Laminar Hooks

Traumatic atlantoaxial instability usually results from a motor vehicle accident, falls and motorcycle accidents. Atlantoaxial instability can lead to spinal cord compression and neck pain, but, spasticity and radicular symptoms as well. The purpose of surgery is to remove the compression and stabilize the joint permanently. To date, several surgical techniques have been described to remedy C1-C2 instability. In this study, the clinical and radiological outcomes of patients who operated with the C1 (Atlas bone) laminar hooks fixation and bilateral C2 (Axis bone) trans-pedicular screw technique were shown. Also, the advantages and disadvantages of this technique are discussed. From March 2010 to December 2017, 12 patients who have atlantoaxial instability were surgically treated by modified fixation technique which consists C1 laminar hooks fixation and bilateral C2 transpedicular screw. Twelve patients were operated with this procedure from March 2010 to December 2017. All the patients were checked with flexion-extension x-rays at the end of the twelfth week. The posterior bony fusion formation was observed on imaging in all patients. C2 bilateral pedicle screw combined with C1 laminar hook system is a good method for atlantoaxial instability in the conditions which is not convenient for insertion of C1 lateral mass and C2 trans-articular screw. However, this method may not be available in some cases such as traumatic, infection, neoplastic or degenerative pathologies in which the posterior arch of the atlas is damaged.

Cartilage Scales Embedded in Fibrin Gel

2017 ◽  
Vol 33 (02) ◽  
pp. 225-232 ◽  
Author(s):  
Milos Kovacevic ◽  
Frank Riedel ◽  
Jochen Wurm ◽  
Gregor Bran
Keyword(s):  
Regenerative Medicine ◽  
Surgical Techniques ◽  
Fibrin Gel ◽  
Platelet Rich Fibrin ◽  
Preliminary Results ◽  
Advantages And Disadvantages ◽  
The Past ◽  
Dorsal Nasal Augmentation ◽  
Diced Cartilage ◽  
Nasal Augmentation

Multiple techniques have been described for dorsal nasal augmentation in rhinoplasty. In this article, we review common surgical techniques for raising the dorsum or eliminating dorsal irregularities, by highlighting inherent advantages and disadvantages of each method. Within the past few years, the use of diced cartilage grafts has become the workhorse in this field of interest. To overcome drawbacks of methods based on diced cartilage, we present a new concept for autologous augmentation, using regenerative medicine protocols. A mix of cartilage scales with cartilage pâté was embedded in platelet-rich fibrin (PRF). Since December 2015, a total of 48 patients were treated with this technique. Based on our preliminary results, cartilage scales in PRF appear to be a promising and reliable alternative to existing procedures for dorsal nasal augmentation.

scholarly journals The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review

2020 ◽  
Vol 17 (18) ◽  
pp. 6894
Author(s):  
Li-Hsuan Wang ◽  
Kok-Min Seow ◽  
Li-Ru Chen ◽  
Kuo-Hu Chen
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Operative Time ◽  
Surgical Techniques ◽  
Systemic Review ◽  
Fetal Head ◽  
Advantages And Disadvantages ◽  
Cesarean Deliveries ◽  
Fundal Pressure

Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the use of vacuum devices other than traditional fundal pressure to assist in the delivery of the fetal head and the techniques of uterine repair used during cesarean deliveries. There are two well-described techniques for suturing the uterus: The uterus can be repaired either temporarily exteriorized (out of abdominal cavity) or in situ (within the peritoneal cavity). Numerous studies have attempted to compare these two techniques in different aspects, including operative time, blood loss, and maternal and fetal outcomes. This review provides an overview of the assistive method of vacuum devices compared with fundal pressure, and the two surgical techniques for uterine repair following cesarean delivery. This descriptive literature review was performed to address important issues for clinical practitioners. It aims to compare the advantages and disadvantages of the assistive methods and surgical techniques used in cesarean deliveries. All of the articles were retrieved from the databases Medline and PubMed using the search terms cesarean delivery, vacuum, and exteriorization. The searching results revealed that after exclusion, there were 9 and 13 eligible articles for vacuum assisted cesarean delivery and uterine exteriorization, respectively. Although several studies have concluded vacuum assistance for fetal extraction as a simple, effective, and beneficial method during fetal head delivery during cesarean delivery, further research is still required to clarify the safety of vacuum assistance. In general, compared to the use of in situ uterine repairs during cesarean delivery, uterine exteriorization for repairs may have benefits of less blood loss and shorter operative time. However, it may also carry a higher risk of intraoperative complications such as nausea and vomiting, uterine atony, and a longer time to the return of bowel function. Clinicians should consider these factors during shared decision-making with their pregnant patients to determine the most suitable techniques for cesarean deliveries.

Training Skills in Minimally Invasive, Robotic and Open Surgery: Brain Activation as an Opportunity for Learning

2020 ◽  
Vol 61 (1) ◽  
pp. 34-50
Author(s):  
Gloria Pelizzo ◽  
Lucilla Cardinali ◽  
Lilla Bonanno ◽  
Silvia Marino ◽  
Carlo Cavaliere ◽  
...  
Keyword(s):  
Surgical Training ◽  
Open Surgery ◽  
Surgical Techniques ◽  
Learning Curves ◽  
Surgical Instruments ◽  
Open Group ◽  
Control Group ◽  
Steady Increase ◽  
Motor Training ◽  
Starting Point

Introduction: The advantages of the robotic approach in surgery are undisputed. However, during surgical training, how this technique influences the learning curve has not been described. We provide a tentative model for analyzing the learning curves associated with observation and active participation in learning different surgical techniques, using functional imaging. Methods: Forty medical students were enrolled and assigned to 4 groups who underwent training in robotic (ROB), laparoscopic (LAP), or open (OPEN) surgery, and a control group that performed motor training without surgical instruments. Surgical/motor training included six 1-h sessions completed over 6 days of the same week. All subjects underwent functional magnetic resonance imaging (fMRI) scanning sessions, before and after surgical training during. Results: Twenty-three participants completed the study. The 3 surgical groups exhibited different learning curves during training. The main effects of the day of training (p < 0.01) and the group (p < 0.01) as well as a significant interaction of day of training group (p < 0.01) were observed. The performance increased in the first 4 days, reaching a peak at day 4, when all groups were considered together. The OPEN group showed the best performance compared to all other groups (p < 0.04). The OPEN group showed a rapid improvement in performance, which peaked at day 4 and decreased on the last day. Similarly, the LAP group showed a steady increase in the number of exercises they completed, which continued for the entire training period and reached a peak on the last day. However, the participants training in ROB surgery, after a performance initially indistinguishable from that of the LAP group, had a dip in their performance, quickly followed by an improvement and reaching a plateau on day 4. fMRI analysis documented the different involvement of the cortical and subcortical areas based on the type of training. Surgical training modified the activation of some brain regions during both observation and the execution of tasks. Conclusions: Differences in the learning curves of the 3 surgical groups were noted. Functional brain activity represents an interesting starting point to guide training programs.

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