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Hernia surgery

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https://www.readbyqxmd.com/read/29453466/effects-of-intrathecal-dexmedetomidine-as-an-adjuvant-to-hyperbaric-bupivacaine-for-spinal-anaesthesia-in-adults-undergoing-elective-infra-umbilical-surgery
#1
Binod Gautam, Sujata Niroula, Mona Sharma, Sushila Moktan Lama
INTRODUCTION: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. METHODS: In this randomized double-blind study 38 patients were allocated into each of two groups...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29451422/intraperitoneal-onlay-mesh-technique-for-spigelian-hernia-in-an-outpatient-and-short-stay-surgery-unit-whats-new-in-intraperitoneal-meshes
#2
María Carmen Fernández-Moreno, Elena Martí-Cuñat, Guillermo Pou, Joaquín Ortega
BACKGROUND: Spigelian hernia (SH) is a rare entity, but its surgical treatment is essential because of its high complication risk. Laparoscopic approaches have become the option in elective surgery because it has less morbidity and requires a shorter stay. Several laparoscopic techniques have been employed, but there is no gold standard technique for this kind of hernia. We report, in this study, our experience with intraperitoneal onlay mesh (IPOM) repair. MATERIALS AND METHODS: Fifteen patients underwent elective surgery for SH between 2008 and 2015 in a Short-Stay Surgical Unit...
February 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29451331/sliding-free-transverse-rectus-abdominis-myocutaneous-flap-for-closure-of-a-massive-abdominal-wall-defect-a-case-report
#3
Annika Senghaas, Thomas Kremer, Volker J Schmidt, Leila Harhaus, Christoph Hirche, Ulrich Kneser, Amir K Bigdeli
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration...
February 16, 2018: Microsurgery
https://www.readbyqxmd.com/read/29450803/a-rare-case-of-acute-presentation-of-trocar-site-hernia-from-robot-assisted-laparoscopic-partial-nephrectomy
#4
Zi Qin Ng, Richard Pemberton, Patrick Tan
Trocar site hernia is not a common acute complication encountered after robot-assisted surgery, especially in the urological cohort of patients. A few case reports of small bowel obstruction secondary to incarceration by trocar site hernia have been described in gynaecological surgery and prostatectomies. As the clinical presentation is non-specific, late diagnosis has significant implication on morbidity and mortality. Here, we present a rare case of a patient with recent robot-assisted laparoscopic partial nephrectomy for a renal cell carcinoma presented with features of impending bowel obstruction secondary to incarcerated small bowel in the trocar site...
February 15, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29450690/mortality-rates-of-patients-undergoing-emergency-laparotomy-in-an-irish-university-teaching-hospital
#5
Aoife C Kiernan, Peadar S Waters, Sean Tierney, Paul Neary, Maria Donnelly, Dara O Kavanagh, Bridget Egan
INTRODUCTION: Emergency laparotomy (EL) is a commonly performed operation with increased morbidity and mortality. Currently, there is a lack of published outcomes following emergency laparotomy within an Irish population. The aim of this study was to assess our outcomes and compare these to predefined outcomes from NELA. METHODS: A review of a prospectively maintained database of all patients who underwent an emergency laparotomy between January 1st 2015 and October 31st 2016 was performed...
February 15, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29444215/long-term-outcomes-of-laparoscopic-large-hiatus-hernia-repair-with-nonabsorbable-mesh
#6
A C Gordon, C Gillespie, J Son, T Polhill, S Leibman, G S Smith
The use of mesh to augment suture repair of large hiatus hernias remains controversial. Repair with mesh may help reduce the recurrence rate of primary repair, but concerns about the potential for serious complications, such as mesh erosion or stricturing, continue to limit its use. We aim to evaluate the long-term outcome of primary hiatus hernia repair with lightweight polypropylene mesh (TiMesh) specifically looking at rates of clinical recurrence, dysphagia, and mesh-related complications. From a prospectively maintained database, 50 consecutive patients who underwent elective primary laparoscopic hiatal hernia repair with TiMesh between January 2005 and December 2007 were identified...
February 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29442058/multiparametric-evaluation-of-risk-factors-associated-to-seroma-formation-in-abdominal-wall-surgery
#7
L Licari, G Salamone, Z Parinisi, S Campanella, C Sabatino, G Ciolino, P De Marco, N Falco, S Boventre, G Gulotta
INTRODUCTION: Incisional hernia is one of the main topics in the general surgery since there is not a unanimous consensus concerning to the best surgical methodology to adopt. It seems that prosthetic surgery is the best technique, even if responsible for the development of periprosthetic seroma. The aim of this study is to assess whether the preoperative abnormalities of the bio-humoral parameters may be considered as risk factors for seroma. PATIENTS AND METHODS: From July 2016 to July 2017 at the "Policlinico Paolo Giaccone", Palermo, Department of Emergency Surgery, 56 patients included in this study, underwent laparotomic mesh repair...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#8
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29439774/panniculectomy-after-bariatric-surgical-weight-loss-analysis-of-complications-and-modifiable-risk-factors
#9
Michael Derickson, Cody Phillips, Morgan Barron, John Kuckelman, Matthew Martin, Mia DeBarros
INTRODUCTION: Bariatric surgery results in massive weight loss, leaving many patients with redundant skin that can cause significant physical and psychosocial limitations. We sought to identify variables associated with postoperative complications and adjuncts associated with the mitigation of postoperative complications. METHODS: A retrospective review was performed of all post-bariatric surgery patients who underwent panniculectomy over a 10-year period. RESULTS: Total 706 patients included...
February 7, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29437528/impact-of-surgical-site-infections-on-elective-incisional-hernia-surgery-a-prospective-study
#10
Montserrat Juvany, Carlos Hoyuela, Miguel Trias, Fernando Carvajal, Jordi Ardid, Antoni Martrat
BACKGROUND: Although incisional hernia repair is classified as a clean surgery, it still has a high incidence of surgical site infection (SSI) (0.7%-26.6%). The presence of an SSI could increase early recurrence rates after incisional hernia repair. PATIENTS AND METHODS: Patients undergoing elective incisional hernia repair with no bowel contamination between January and December 2015 were assessed prospectively. Demographic and surgical data, local post-operative complications, and one-year recurrence rates in patients with and without SSI were compared...
February 13, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29435748/surgery-for-benign-esophageal-disorders-in-the-us-risk-factors-for-complications-and-trends-of-morbidity
#11
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Gastroesophageal reflux disease (GERD), paraesophageal hernia (PEH), and achalasia are the most frequent benign esophageal disorders that may need surgical treatment. We aimed to identify risk factors for postoperative complications and to characterize trends of morbidity for surgery for benign esophageal disorders in a national cohort. METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2013...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29435451/umbilical-hernia-repair-and-pregnancy-before-during-after%C3%A2
#12
REVIEW
Hakan Kulacoglu
Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29433380/acute-abdominal-pain-due-to-internal-herniation-of-the-sigmoid-colon-fallopian-tube-and-left-ovary-a-rare-presentation-of-allen-masters-syndrome
#13
C H Mazzetti, N Hock, S Taylor, J Lemaitre, K Crener, E Lebrun
In 1955, Allen and Masters describe a painful syndrome which associates traumatic delivery to laceration found on the posterior leaf of the broad ligament. Herniation through this defect is a rare entity, accounted for about 4-7% of all internal hernias. Normally, it involves the small bowel. The authors present the case of a multiparous woman admitted at emergency for constipation and abdominal pain. The CT scan showed an extremely rare case of internal hernia of the sigmoid colon, fallopian tube and left ovary through a large defect of the broad ligament...
February 12, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29430565/discharge-prescription-patterns-of-opioid-and-nonopioid-analgesics-after-common-surgical-procedures
#14
Michael J Nooromid, Eddie Blay, Jane L Holl, Karl Y Bilimoria, Julie K Johnson, Mark K Eskandari, Jonah J Stulberg
Introduction: Recent literature has shown a wide variation in the prescribing patterns of opioids after elective surgery. We conducted an evaluation of discharge opioid prescribing after elective surgical procedures to determine whether opioid-prescribing patterns varied at our institution. Method: A single academic medical center retrospective review of patients undergoing laparoscopic cholecystectomy, laparoscopic appendectomy, open umbilical hernia repair, simple mastectomy, or thyroidectomy between July 2015 and July 2016...
January 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29429444/safety-and-affordability-of-an-elective-saturday-list-at-pietersburg-hospital-limpopo-south-africa
#15
M M Z U Bhuiyan, R Mavhungu
BACKGROUND: The backlog of patients waiting for operations continues to be a problem in many public hospitals in South Africa (SA), with elective surgery procedures being postponed for up to 2 years. OBJECTIVE: To determine the rate of death in hospital or out of hospital within 30 days of an elective procedure performed on a Saturday, and to determine the cost incurred by paying staff members who perform these operations. METHOD: A prospective, observational descriptive cohort study of all patients undergoing inpatient general surgery operations during weekdays and weekends between 1 September 2015 and 31 August 2016 (1 year) at Pietersburg Hospital (PBH), Limpopo, SA...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29428693/do-acute-care-surgeons-need-bariatric-surgical-training-to-ensure-optimal-outcomes-in-obese-patients-with-nonbariatric-emergencies
#16
Andrea Pakula, Ruby Skinner
INTRODUCTION: Acute care surgeons care for the entire breadth of the American adult population, including obese patients. As the population gets heavier, more patients will present to acute case surgeons with nonbariatric surgical emergencies. Do these surgeons need bariatric training to properly care for obese population? OBJECTIVES: To evaluate our experience in obese population requiring acute surgery and compare outcomes based on surgeon expertise in bariatric surgery...
December 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29427147/anatomical-relation-between-the-accessory-process-and-pedicle-in-the-lumbar-vertebrae
#17
Ryutaro Shiboi, Shogo Hayashi, Shinichi Kawata, Zhong-Lian Li, Philipp Pieroh, Hisashi Koga, Yuichi Takano, Hirohiko Inanami, Masahiro Itoh
The pedicle screw is one of the most common medical devices used in spinal surgery. Although there are well-established insertion points based on anatomical landmarks, such as the mammillary process and the transverse process, morphological data on the relationship between the accessory process and the pedicle are still scarce. To clarify this relationship, we recruited 50 cases of hernia of lumbar intervertebral disc, diagnosed using three-dimensional computed tomography of the lumbar vertebrae. We identified the pedicle isthmus in a transverse plane parallel to the upper endplate and measured the angles and distances from the tip of the accessory process to the intersection points at the medial or lateral surface, or at the midpoint between the two intersection points...
February 9, 2018: Anatomical Science International
https://www.readbyqxmd.com/read/29426732/predictive-value-of-modic-type-ii-changes-in-the-choice-of-surgical-treatment-of-lumbar-disc-herniation
#18
R Figa, C Morera-Dominguez
OBJECTIVE: To evaluate the predictive value of Modic typeII changes on nuclear magnetic resonance (NMR) prior to intervention by discectomy for lumbar disc herniation in patients with radicular symptoms. MATERIAL AND METHOD: Retrospective descriptive study of 190 patients (58.2% men and 41.8% women) with a mean age of 43.5 years, treated between December 2005 and January 2013. They were divided into group 1, single disc herniation (n=85), and group 2, with disc herniation and changes Modic typeII (n=80)...
February 6, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29423159/pubic-and-inguinal-venous-collaterals-mimic-inguinal-hernia
#19
F Oldhafer, T Alten, J Klempnauer, N Emmanouilidis
Herein we report a case of a 38-year-old men who presented with acute suprapubic pain caused by a tubular, hypoechoic, non-compressible, inguinal mass with no flow evident on color Doppler sonography. The history of the patient, the clinical signs of local inflammation and tenderness on palpation as well as the results of the Doppler ultrasound examination led to the diagnose of an inguinal hernia with bowl incarceration. However, due to a remaining uncertainty whether a bilateral or unilateral hernia was immanent and whether the bowl incarceration was caused by a right or left sided hernia the on-call surgeon initiated a computed tomography (CT) scan...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29417340/trans-umbilical-two-port-laparoscopic-suturing-of-the-inguinal-hernia-defect-with-percutaneous-assistance-a-safe-and-efficient-scarless-surgery-for-pediatric-inguinal-hernia-repair
#20
T Shou, H Zhong, F Wang
PURPOSE: This study was aimed to describe the technique of the modified trans-umbilical two-port laparoscopic suturing (M-TTLS), and show its feasibility and efficacy to treat pediatric inguinal hernia (PIH). METHODS: After general anesthesia, the patient was placed in the Trendelenburg position. Two trocars were set on umbilicus and a pneumoperitoneum was established at 8-12 mmHg. Under direct vision, a long syringe needle was punctured into the preperitoneal space above the internal inguinal ring (IIR)...
February 7, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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