Internal hernia is a rare cause of intestinal obstruction. We present a case of 43-year-old woman without any prior surgical history who was referred as a case of obstructed para-umbilical hernia from a satellite clin...Internal hernia is a rare cause of intestinal obstruction. We present a case of 43-year-old woman without any prior surgical history who was referred as a case of obstructed para-umbilical hernia from a satellite clinic. The objective is to highlight the occurrence of such a rare clinical problem and to provide an insight into decision making especially when there is discordance between an obvious pathology and clinical features.展开更多
Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our...Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our technique in which central zone of mesh is fixed only after closure of hernial defect. Patients and Methods: This study included 27 males patients (14 indirect inguinal hernias, 9 direct inguinal hernias, 4 both direct and indirect inguinal hernias on the same side). These cases are undergoing tension-free mesh repair after closure of hernial defect, and the mesh is fixed only at its central zone using Gulbran 2, between April 2011 and March 2013. The follow-up period ranged from 6 to 30 months. The intra and postoperative complications were recorded. Results: Mean hospital stay was 1 day. The age of this group of patients ranged from 23 to 63 years (mean, 47 years). The operative time ranged from 30 to 100 minutes (mean, 45 minutes). The intraoperative complications were in form of mild bleeding in 7 patients (25.9%) during hernial sac dissection. Postoperative complications were mild inguinal pain in 4 patients (14.8%) for three weeks. Mild hydrocele in 3 patients (11%) was recorded. No recurrence or bulging at hernia site was noticed during the period of follow-up. Conclusion: Laparoscopic inguinal hernia repair with central mesh fixation after closure of hernial defect is effective, easy and free of complications.展开更多
Objective: To present our technique of laparoscopic repair of giant para-oesophageal hernia with biological prosthesis (porcine dermis). Method: Our technique involves creating a pneumoperitoneum with standard port pl...Objective: To present our technique of laparoscopic repair of giant para-oesophageal hernia with biological prosthesis (porcine dermis). Method: Our technique involves creating a pneumoperitoneum with standard port placement for anti-reflux surgery, mediastinal sac dissection and excision, crura-plasty, tension free placement of the biological prosthesis for hiatal reinforcement, fundoplication and gastropexy. Conclusion: Our technique of laparoscopic repair of giant para-oesophageal hernia with biological mesh is feasible and safe with acceptable morbidity and outcome.展开更多
Incisional hernias are a prevalent problem in abdominal surgery and occur in 11% of patients who undergo laparotomy. Primary suture clo-sure of incisional hernias results in a 31%-58% chance of recurrence. The additio...Incisional hernias are a prevalent problem in abdominal surgery and occur in 11% of patients who undergo laparotomy. Primary suture clo-sure of incisional hernias results in a 31%-58% chance of recurrence. The addition of a pros-thetic mesh implant decreases recurrence rates to 8%-10%. Popularized in Europe by Rives and Stoppa, the sublay technique has proven to be very effective, with low recurrence rates (0%-23%) and minimal complications. The pur-pose of the study was to evaluate the experi-ence of a single surgeon at a large tertiary care center performing a modified Rives-Stoppa re-pair for abdominal incisional hernias. To do this, the records of all patients undergoing a modi-fied Rives-Stoppa incisional hernia repair be-tween January 2000 and August 2003 were ret-rospectively reviewed. Outpatient clinic notes, discharge summaries, operative reports, and laboratory data were reviewed for patient demographics, surgical data and postoperative complications. Univariate analysis was per-formed in order to identify predictors for recur-rence. During the study period, 83 patients un-derwent a modified Rives-Stoppa incisional hernia repair. Nineteen patients were excluded due to incomplete medical records. No patients required postoperative exploration for an in-tra-abdominal catastrophe. Twenty-five percent (n=16) of patients had a complication as a result of the hernia repair. Only two patients (3.1%) developed recurrent incisional hernias. History of diabetes (p=0.007) and benign prostatic hy-perplasia (p=0.000) were the only significant predictors for recurrence. The results presented here confirm that the modified Rives-Stoppa retromuscular repair is an effective method for the repair of incisional hernias. The complica-tion and recurrence rates compare favorably to results for currently popular alternative tech-niques.展开更多
Gluteal hernias are extremely uncommon and occur as a result of deficiency or defect in the gluteal musculature. Our case reports one such incidence in a one year old girl with review of available literature. The clin...Gluteal hernias are extremely uncommon and occur as a result of deficiency or defect in the gluteal musculature. Our case reports one such incidence in a one year old girl with review of available literature. The clinical presentation and imaging findings are discussed comprehensively. We thus lay emphasis on the importance of real-time ultrasonography as the method of choice to identify hernia contents, peristalsis and obstruction if any.展开更多
Intraparietal Hernias are hernias occurring in the anterior abdominal wall at different anatomical planes. An interparietal hernia has a hernial sac that passes between the layers of the anterior abdominal wall. Appen...Intraparietal Hernias are hernias occurring in the anterior abdominal wall at different anatomical planes. An interparietal hernia has a hernial sac that passes between the layers of the anterior abdominal wall. Appendectomy is a very common surgical procedure, and post appendectomy incisional hernia is a very rare complication. Here we present a case of a 24-year-old male with swelling in the right hypochondrium and lumbar region with an open appendectomy scar. He was diagnosed to have an interparietal hernia in the anterior abdominal wall. After obtaining consent patient was taken up for surgery. At surgery, the patient was found to have a defect in the transverse abdominis muscle with a medial leaf far from the incision site. Open repair of the defect along with double breasting of external oblique done. Interparietal hernias are rare in post appendectomy scar and this case is of significance since it Highlights a rare interstitial type incisional hernia, as a complication of post appendectomy scar, and not many cases reports are mentioned in literature.展开更多
文摘Internal hernia is a rare cause of intestinal obstruction. We present a case of 43-year-old woman without any prior surgical history who was referred as a case of obstructed para-umbilical hernia from a satellite clinic. The objective is to highlight the occurrence of such a rare clinical problem and to provide an insight into decision making especially when there is discordance between an obvious pathology and clinical features.
文摘Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our technique in which central zone of mesh is fixed only after closure of hernial defect. Patients and Methods: This study included 27 males patients (14 indirect inguinal hernias, 9 direct inguinal hernias, 4 both direct and indirect inguinal hernias on the same side). These cases are undergoing tension-free mesh repair after closure of hernial defect, and the mesh is fixed only at its central zone using Gulbran 2, between April 2011 and March 2013. The follow-up period ranged from 6 to 30 months. The intra and postoperative complications were recorded. Results: Mean hospital stay was 1 day. The age of this group of patients ranged from 23 to 63 years (mean, 47 years). The operative time ranged from 30 to 100 minutes (mean, 45 minutes). The intraoperative complications were in form of mild bleeding in 7 patients (25.9%) during hernial sac dissection. Postoperative complications were mild inguinal pain in 4 patients (14.8%) for three weeks. Mild hydrocele in 3 patients (11%) was recorded. No recurrence or bulging at hernia site was noticed during the period of follow-up. Conclusion: Laparoscopic inguinal hernia repair with central mesh fixation after closure of hernial defect is effective, easy and free of complications.
文摘Objective: To present our technique of laparoscopic repair of giant para-oesophageal hernia with biological prosthesis (porcine dermis). Method: Our technique involves creating a pneumoperitoneum with standard port placement for anti-reflux surgery, mediastinal sac dissection and excision, crura-plasty, tension free placement of the biological prosthesis for hiatal reinforcement, fundoplication and gastropexy. Conclusion: Our technique of laparoscopic repair of giant para-oesophageal hernia with biological mesh is feasible and safe with acceptable morbidity and outcome.
文摘Incisional hernias are a prevalent problem in abdominal surgery and occur in 11% of patients who undergo laparotomy. Primary suture clo-sure of incisional hernias results in a 31%-58% chance of recurrence. The addition of a pros-thetic mesh implant decreases recurrence rates to 8%-10%. Popularized in Europe by Rives and Stoppa, the sublay technique has proven to be very effective, with low recurrence rates (0%-23%) and minimal complications. The pur-pose of the study was to evaluate the experi-ence of a single surgeon at a large tertiary care center performing a modified Rives-Stoppa re-pair for abdominal incisional hernias. To do this, the records of all patients undergoing a modi-fied Rives-Stoppa incisional hernia repair be-tween January 2000 and August 2003 were ret-rospectively reviewed. Outpatient clinic notes, discharge summaries, operative reports, and laboratory data were reviewed for patient demographics, surgical data and postoperative complications. Univariate analysis was per-formed in order to identify predictors for recur-rence. During the study period, 83 patients un-derwent a modified Rives-Stoppa incisional hernia repair. Nineteen patients were excluded due to incomplete medical records. No patients required postoperative exploration for an in-tra-abdominal catastrophe. Twenty-five percent (n=16) of patients had a complication as a result of the hernia repair. Only two patients (3.1%) developed recurrent incisional hernias. History of diabetes (p=0.007) and benign prostatic hy-perplasia (p=0.000) were the only significant predictors for recurrence. The results presented here confirm that the modified Rives-Stoppa retromuscular repair is an effective method for the repair of incisional hernias. The complica-tion and recurrence rates compare favorably to results for currently popular alternative tech-niques.
文摘Gluteal hernias are extremely uncommon and occur as a result of deficiency or defect in the gluteal musculature. Our case reports one such incidence in a one year old girl with review of available literature. The clinical presentation and imaging findings are discussed comprehensively. We thus lay emphasis on the importance of real-time ultrasonography as the method of choice to identify hernia contents, peristalsis and obstruction if any.
文摘Intraparietal Hernias are hernias occurring in the anterior abdominal wall at different anatomical planes. An interparietal hernia has a hernial sac that passes between the layers of the anterior abdominal wall. Appendectomy is a very common surgical procedure, and post appendectomy incisional hernia is a very rare complication. Here we present a case of a 24-year-old male with swelling in the right hypochondrium and lumbar region with an open appendectomy scar. He was diagnosed to have an interparietal hernia in the anterior abdominal wall. After obtaining consent patient was taken up for surgery. At surgery, the patient was found to have a defect in the transverse abdominis muscle with a medial leaf far from the incision site. Open repair of the defect along with double breasting of external oblique done. Interparietal hernias are rare in post appendectomy scar and this case is of significance since it Highlights a rare interstitial type incisional hernia, as a complication of post appendectomy scar, and not many cases reports are mentioned in literature.
