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Andrew C Eppstein, Bryan Sakamoto
Opioids are important for surgical pain control but may not be appropriate for patients with narcotic abuse histories or opioid intolerance. We describe a laparoscopic bilateral inguinal herniorrhaphy performed without perioperative or postoperative narcotics. Postoperative analgesia involves a novel technique using 2 different bupivacaine formulations that act synergistically to avoid lag time and provide extended pain relief during the acute surgical recovery phase.
November 2016: Journal of Clinical Anesthesia
Pertti Pere, Jukka Harju, Pekka Kairaluoma, Veikko Remes, Päivi Turunen, Per H Rosenberg
STUDY OBJECTIVE: Comparison of local anesthetic infiltration (LAI), spinal anesthesia (SPIN) and total intravenous anesthesia (TIVA) for open inguinal herniorrhaphy. We hypothesized that patients receiving LAI could be discharged faster than SPIN and TIVA patients. DESIGN: Randomized, prospective trial. SETTING: University hospital day-surgery center. PATIENTS: 156 adult male patients (ASA 1-3) undergoing day-case open inguinal herniorrhaphy...
November 2016: Journal of Clinical Anesthesia
Shigehiro Kojima, Tsuguo Sakamoto, Masayuki Honda, Dal Ho Kim
INTRODUCTION: A transmesosigmoid hernia is defined as small bowel herniation through a complete defect involving both layers of the sigmoid mesentery. Blunt trauma injury to the sigmoid mesocolon has been reported only rarely. We herein report a case of a strangulated transmesosigmoid hernia associated with a history of a fall from a height. PRESENTATION OF CASE: A 43-year-old woman presented to our hospital for evaluation of vomiting. She had no history of abdominal surgery but had sustained a complete spinal cord injury and pelvic fracture secondary to a fall from a height 25 years earlier...
2016: International Journal of Surgery Case Reports
Y Peng, C Li, Z Han, X Nie, W Lin
PURPOSE: Single-port laparoscopic herniorrhaphy is widely employed for indirect inguinal hernia repair in children. However, few surgeons utilize the single-port technique to repair such hernias with concealed deferent ducts. The aim of this study was to assess the application of the modified single-port laparoscopic technique (MSPT) in cases with concealed deferent ducts and to compare the results to those obtained with the two-port technique (TPT). METHODS: Between January 2006 and January 2012, all consecutive cases were retrospectively studied...
September 6, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
D Čadanová, J P van Dijk, R M H G Mollen
BACKGROUND: Position of the mesh and the method of fixation are important in the occurrence of chronic pain in inguinal herniorrhaphy. An RCT was conducted to evaluate chronic pain after transinguinal preperitoneal (TIPP) repair compared with a Lichtenstein-like repair with a semi-resorbable self-fixing mesh (ProGrip). METHODS: Patients with a primary unilateral inguinal hernia were randomized either to the TIPP (PolySoft mesh) or to repair with a ProGrip mesh. Primary objective was the occurrence of chronic pain after surgery...
August 18, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
J Geng, M Li
A patient with previous L3-4 posterior lumbar interbody fusion, pedicle screws instrumentation and L3-4 decompression, was scheduled for left total hip arthroplasty. Two years ago, due to poor landmarks palpation, the patient experienced a failed lumbar puncture after multiple attempts before herniorrhaphy. His plain radiography showed bilateral partial laminectomy at L3-4 level, and between L3 and L4, two posterior pedicle screws connected by metal rods on both sides. This time, we used ultrasound to locate L4-5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
J N Harr, F Brody
PURPOSE: Sports hernias, or athletic pubalgia, is common in athletes, and primarily involves injury to the fascia, muscles, and tendons of the inguinal region near their insertion onto the pubic bone. However, management varies widely, and rectus and adductor tenotomies have not been adequately described. The purpose of this manuscript is to demonstrate a suture repair and a rectus and adductor longus tenotomy technique for sports hernias. METHODS: After magnetic-resonance-imaging confirmation of sports hernias with rectus and adductor tendonitis, 22 patients underwent a suture herniorrhaphy with adductor tenotomy...
August 6, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Gholam Reza Khalili, Amir Shafa, Ramin Yousefi
BACKGROUND: Postoperative pain management is a critical concern in pediatric surgery. Acetaminophen is the safest and most widely used analgesic in children. The present study compared the analgesic efficacy of intravenous (IV) and rectal acetaminophen versus placebo in children undergoing inguinal herniorrhaphy. METHODS: A total of 120 children, who were candidate for elective surgical repair of unilateral inguinal hernia, were enrolled and randomly allocated to four groups of 30 patients each to receive IV acetaminophen, acetaminophen suppository, IV placebo, and placebo suppository during surgery...
June 2016: Middle East Journal of Anesthesiology
Hamid Hajigholam Saryazdi, Omid Aghadavoudi, Amir Shafa, Amin Masoumi, Parnian Saberian
INTRODUCTION: Postoperative pain due to tissue damage caused during surgery not only causes discomfort for the patients, but can also result in prolonged hospitalization, increased morbidity and respiratory disorders, and readmission to the hospital. For postoperative pain control, numerous methods and medications have been suggested, such as non-steroidal anti-inflammatory drugs (NSAIDs) and narcotics. Pethidine, as a narcotic analgesic, and ketorolac, as an NSAID, are widely used for pain control...
June 2016: Middle East Journal of Anesthesiology
Anatoli Stav, Leonid Reytman, Michael-Yohay Stav, Anton Troitsa, Mark Kirshon, Ricardo Alfici, Mickey Dudkiewicz, Ahud Sternberg
OBJECTIVES: We hypothesized that preoperative (pre-op) ultrasound (US)-guided posterior transversus abdominis plane block (TAP) and US-guided ilioinguinal and iliohypogastric nerve block (ILI+IHG) will produce a comparable analgesia after Lichtenstein patch tension-free method of open inguinal hernia repair in adult men. The genital branch of the genitofemoral nerve will be blocked separately. METHODS: This is a prospective, randomized, controlled, and observer-blinded clinical study...
2016: Rambam Maimonides Medical Journal
Julio C U Coelho, Christiano M P Claus, Antonio C L Campos, Marco A R Costa, Caroline Blum
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites...
July 27, 2016: World Journal of Gastrointestinal Surgery
F P Buckley, H E Vassaur, D C Jupiter, J H Crosby, C J Wheeless, J L Vassaur
PURPOSE: Single-incision laparoscopic surgery (SILS) has been demonstrated to be a feasible alternative to multiport laparoscopy, but concerns over port-site incisional hernias have not been well addressed. A retrospective study was performed to determine the rate of port-site hernias as well as influencing risk factors for developing this complication. METHODS: A review of all consecutive patients who underwent SILS over 4 years was conducted using electronic medical records in a multi-specialty integrated healthcare system...
October 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
M Galukande, O Kituuka, E Elobu, J Jombwe, J Sekabira, Elissa Butler, J Faulal
Introduction. Surgical camps are preplanned activities where volunteer surgical teams congregate at specified place(s) and perform a wide range of mostly elective procedures for a limited period of time. This is usually at no cost to the patients, who belong to vulnerable (poor and hard to reach) communities. We describe a surgical camp model and its challenges as a means of improving access to surgical services. Methods. A cross-sectional descriptive study. Data from a recent Association of Surgeons of Uganda surgical camp were collected and analyzed for demographics, costs, procedure types, and rates and, in addition, challenges encountered and solutions...
2016: Surgery Research and Practice
Katherine E Law, Rebecca D Ray, Anne-Lise D D'Angelo, Elaine R Cohen, Shannon M DiMarco, Elyse Linsmeier, Douglas A Wiegmann, Carla M Pugh
OBJECTIVE: The study aim was to determine whether residents' error management strategies changed across 2 simulated laparoscopic ventral hernia (LVH) repair procedures after receiving feedback on their initial performance. We hypothesize that error detection and recovery strategies would improve during the second procedure without hands-on practice. DESIGN: Retrospective review of participant procedural performances of simulated laparoscopic ventral herniorrhaphy...
June 29, 2016: Journal of Surgical Education
Joshua S Winder, Jerome Lyn-Sue, Allen R Kunselman, Eric M Pauli
INTRODUCTION: Posterior component separation herniorrhaphy via transversus abdominis release (TAR) permits midline reapproximation of large fascial defects. To date, no report delineates the reduction in tensile force to reapproximate midline fascia following TAR. We hypothesized that open and laparoscopic TAR would provide similar reductions in midline reapproximation forces in a porcine model. METHODS: Under general anesthesia, a 20-cm midline laparotomy was created and bilateral lipocutaneous flaps were raised to expose the anterior rectus sheath...
June 28, 2016: Surgical Endoscopy
Xuebi Tian, Ping Yang, Tiefen Su, Jing Yu, Shiwen Zhao, Guifang Xiang, Donghai Yu, Wen Zhang, Anne Manyande, Feng Gao, Yuke Tian, Hui Yang
BACKGROUND: Postoperative pain can cause physiological distress, postoperative complications, and extended lengths of hospitalized stay. In children, management of postoperative pain is still recognized as being inadequate. OBJECTIVE: The aim of this trial was to investigate the effects of intraperitoneal ropivacaine on postoperative pain, and recovery of bowel function and emetic events after laparoscopic herniorrhaphy in toddlers. METHODS: Seventy-six children aged from 9 months to 3 years were recruited between August 2013 and June 2014 at Tongji Hospital and randomly assigned into two groups...
September 2016: Paediatric Anaesthesia
Selim Sözen, Süleyman Çetinkünar, Seyfi Emir, Fatih Mehmet Yazar
PURPOSE: The aim of this study is to evaluate pain and further disabling complications in patients undergoing Lichtenstein technique for primary inguinal hernia repair by fixing the mesh with fibrin sealant versus sutures. METHODS: This study was carried out on 116 patients between January 2009 and July 2009. All patients were male, between the ages of 20 and 75 years. Lichtenstein, using a polypropylene mesh as prosthetic material. A total of 116 hernias were operated on...
2016: Annali Italiani di Chirurgia
Sergio Huerta, Prachi M Patel, Ali A Mokdad, Jonathan Chang
BACKGROUND: The present single-institution, single-surgeon experience interrogated morbidity as well as predictors of inguinodynia, recurrence, and metachronous hernias in 953 consecutive inguinal herniorrhaphies between 2005 and 2015. METHODS: Data were prospectively collected and retrospectively analyzed from patient medical records at the VA North Texas Health Care System. RESULTS: Ninety-nine percent of our patients were male, 73% Caucasian, 60...
September 2016: American Journal of Surgery
Tetsuya Sakai, Hiroaki Murata, Tetsuya Hara
The genitofemoral neuropathy is one of the most common causes of groin pain after surgery. Especially, the groin pain induced by genitofemoral nerve injury during herniorrhaphy is a well-known complication. In contrast, much attention is not paid for groin pain induced by genitofemoral nerve injury after pelvic surgery, and there have been few reports in males, although it has been reported in females. We report a 59-year-old male patient who suffered from scrotal pain caused by presumed genitofemoral nerve injury during radical cystectomy and bilateral pelvic lymphadenectomy for bladder cancer...
August 2016: Journal of Clinical Anesthesia
Preethi Chintamaneni, Heather L Stevenson, Shahid M Malik
Bupivacaine is an established and efficacious anesthetic that has become increasingly popular in postoperative pain management. However, there is limited literature regarding the potential for bupivacaine-induced delayed liver toxicity. Describe cholestasis as a potential adverse reaction of bupivacaine infusion into a surgical wound. Retrospective review of patients' medical records. We report the cases of 3 patients with new onset of cholestatic injury after receiving bupivacaine infusion for postoperative herniorrhaphy pain management...
August 2016: Journal of Clinical Anesthesia
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