Outpatient Care and Short Hospitalization for the Elderly Patient with Inguinal Hernia

Introduction: The surgery of hernial disease of abdominal wall and especially of the inguinofemoral hernia has increase but in fact its prevalence is unknown. The objective of present study was to assess the result of surgical treatment of the inguinofemoral region hernia in third-age patients seen in the "Dr. Enrique Cabrera" Teaching General Hospital. Methods: A study was conducted in 2186 third-age patients operated on of inguinofemoral hernia from January, 2000 to December, 2020 in the above mentioned hospital. In all cases patients had the alternative to be operated on in ambulatory way or with a short hospital stay. Also, were included the patients operated on as an urgency. From the patients operated on in an elective way were excluded those suffering of associated, cardiopulmonary or thromboembolic ASA-III type diseases (classification of the American Society of Anesthesiology). Results: The great incidence of the inguinal hernia was found in ages from 60-69 years (59,3%). The indirect right inguinal hernia was the more frequent. The Desarda's anatomical surgical technique was the more applied one in the inguinal hernia and theLichtenstein's prosthetic technique with the 32% was the following in frequency. There were 20 relapses (0,9%). Local anesthesia was applied in the 75,4% of patients, in ambulatory way in the 76,4%. The total of complications was of 78 (7,1%). Conclusions: The surgical treatment of inguinofemoral hernias, ambulatory or with a short hospital stay is a suitable procedure in third-age patients since to increase the comfort of patients, to decrease the hospital infection risk, to reduce the waiting lists and the hospital costs.

Augmentation mammoplasty: how it is done, recovery and frequent questions.

Cosmetic surgery to insert silicone prosthesis may be indicated when the woman has very small breasts, is afraid of not being able to breastfeed, has noticed a reduction in their size or has lost a lot of weight. But it can also be indicated when a woman has breasts with different sizes or needed to remove the breast or part of the breast due to cancer. This surgery can be done from the age of 15 with parental permission, and is performed under general anesthesia, taking about 45 minutes, and can be with a short hospital stay of 1 or 2 days, or even in an outpatient setting, when he is discharged on the same day.

Port site infection by Mycobacterium fortuitum after laparoscopic hysterectomy and its management– A case report

In the department of gynaecology vaginal hysterectomy and laparoscopic hysterectomy are popular methods of surgery. They involve less amount of blood loss, with short hospital stay. In recent times, laparoscopic hysterectomy is done commonly. Forty-two-year female was admitted in surgery ward, Tagore Medical College and Hospital, with pain in abdomen at the laparoscopic site and lower abdomen. Pus discharge through the port site, left loin for the last 3 months. The microbiological examination of the pus showed the presence of Mycobacterium fortuitum. After identification of atypical mycobacterium, the patient was administrated with amikacin injection for 3 months and clarithromycin and ofloxacin tablet for one year. Patient was discharged and was advised to come for periodical review.

Case Report: Hyperbilirubinemia in Gilbert Syndrome Attenuates Covid-19-Induced Metabolic Disturbances

Gilbert syndrome (GS) is a liver disorder characterized by non-hemolytic unconjugated hyperbilirubinemia. On the other hand, Coronavirus disease 2019 (Covid-19) is a recent viral infectious disease presented as clusters of pneumonia, triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Little is known on the association between SARS-CoV-2 and GS, despite different studies have recently stated a link between hyperbilirubinemia and SARS-CoV-2 severity. In this case-report study we described a 47-year-old man, a known case of GS since the age of 4, presented to the emergency department with fever (39.8°C), dry cough, dyspnea, headache, myalgia, sweating and jaundice diagnosed with Covid-19-induced pneumonia. Interestingly, GS patient exhibited a rapid clinical recovery and short hospital stay compared to other SARS-CoV-2 positive patient, seeming that hyperbilirubinemia may exert a protective effect of against Covid-19 induced-cardiometabolic disturbances. Data obtained here underlines that the higher resistance against Covid-19 evidenced by the GS patient seems to be due to the antioxidant, anti-inflammatory, and antiviral effects of unconjugated bilirubin.

Radical change in osteosarcoma surgical plan due to COVID-19 pandemic

A 17-year-old man with osteosarcoma of the proximal humerus was planned for possible limb salvage surgery after standard neoadjuvant chemotherapy. However, during the surgical phase of treatment, the COVID-19 or SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreak occurred changing the healthcare landscape due to uncertainty regarding the virus, risk of COVID-19 infection and complications, and implementation of an enhanced community quarantine restricting movement of people within cities. Instead of limb salvage surgery, the patient underwent a forequarter amputation. Exposure to the virus in a high-risk hospital setting was minimised with patient discharge after a short hospital stay and home convalescence monitored by video conferencing. Multidisciplinary sarcoma team meetings with family members and a sarcoma navigator nurse were crucial in managing expectations and deciding on appropriate treatment in the setting of a novel infectious disease causing a pandemic.

Mesh Migration Results in Asymptomatic Sigmoid Perforation as Long-Term Complication After Difficult TAPP: a Case Report

Hernia surgery is the most common surgical procedure worldwide. Complications are very rare and usually manifest in recurrence or chronic pain. We report a rare case of mesh migration 14 years after initially complicated transabdominal preperitoneal plastic for left-sided inguinal hernia. The mesh migration resulted in a covered sigmoid perforation, which was completely asymptomatic and only noticed as a chance finding in a staging CT scan prior to irradiation therapy. However, after the onset of immunosuppressive therapy, an exacerbation of chronic, localized inflammation was expected. Therefore, open surgical anterior rectum resection was performed, and after a short hospital stay, the patient could be discharged home free of complaints. This case report aims to raise awareness of possible long-term complications of hernia repair when using non-absorbable meshes.