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Inguinal hernia
Published in Prem Puri, Newborn Surgery, 2017
Thambipillai Sri Paran, Prem Puri
Laparoscopic hernia repair in infancy has gained support over the last decade. In recent years, several authors have reported that laparoscopic hernia repair in infants is feasible, safe, and effective. 41–44Laparoscopic percutaneous techniques utilize just one port as opposed to three, and appear to work well in selected children.45 Some authors have reported up to 20% contralateral herniotomies with the laparoscopic approach39 and highlight the increased intervention based on appearance of patent processus, which is known not to cause any hernias in vast majority of children. Though some surgeons prefer the laparoscopic approach in very small infants and achieve excellent results, cosmesis should not be put ahead of safety in preterm and small birth weight children.
Complications of Laparoscopy in General Surgery
Published in Stephen M. Cohn, Matthew O. Dolich, Complications in Surgery and Trauma, 2014
James G. Bittner, J. Esteban Varela
Several studies, including a large meta-analysis involving more than 2400 patients, demonstrate that both types of laparoscopic repair are associated with less postoperative pain and more rapid recovery rates compared to open repair [35,36]. A randomized controlled trial reported a significantly lower rate of recurrence at 5 years after laparoscopic TAPP (3%) than Shouldice repair (8%) [36]. Equivalent rates of recurrence (2%–3%) and long-term postoperative pain (2%–3%) are reported for laparoscopic and tension-free repairs [35]. For primary unilateral inguinal hernia, TEP is associated with an increased risk of recurrence relative to open mesh repair but TAPP is not. TAPP is associated with increased risk of perioperative complications relative to open mesh repair. Laparoscopic inguinal hernia repair has a reduced risk of chronic pain and numbness relative to open mesh repair [37]. In general, complications of laparoscopic hernia repair include hematomas, seromas, and hydroceles (8%–10%), urinary retention (1%–2%), cutaneous nerve injuries (2%), and persistent pain (2%–3%) [36,37].
Parastomal Hernias
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Arun Prasad, Sanjiv Haribhakti
The various types of PH repair are associated with a wide range of recurrence rates due to variations of the definition of a PH recurrence, either radiographic, clinical, or symptomatic; type of stoma; size of hernia defect; indications for a repair; and length of time of follow-up. Recurrence rates for primary suture repair are high, ranging from 30% to 76%. In a systematic review, primary suture repair significantly increased the risk for recurrent hernia compared to mesh repair [23]. There were no significant differences between open and laparoscopic hernia repair for recurrence; the open Sugarbaker technique had significantly fewer recurrences compared with the keyhole technique, but this was not the case for the laparoscopic approach. The following recurrence rates were noted: Primary suture repair: 69.4%Onlay mesh: 17.2%Sublay mesh: 6.9%Open, intraperitoneal mesh Sugarbaker: 15%Keyhole: 7.2%Laparoscopic mesh Sugarbaker: 11.6%Keyhole: 11.6%Sandwich: 2.1%
De Garengeot hernias. Over a century of experience. A systematic review of the literature and presentation of two cases
Published in Acta Chirurgica Belgica, 2022
Michail Chatzikonstantinou, Mohamed Toeima, Tao Ding, Almas Qazi, Niall Aston
There are 87 patients with reported data on length of hospital stay. Most of the patients were discharged uneventfully 4.82 days later (0–29, SD 5.05). The mean LOS is 5.3 (SD 5.39) and 3.45 (SD 3.45) days for open and laparoscopic appendicectomy, respectively (p = .316). For open and laparoscopic hernia repair, the mean LOS is 4.88 (SD 5.59) and 3 (SD 2.65) days, respectively (p = .714). The mean length of stay after the operation for patients with suture repair is 5.45 (SD 5.59), synthetic mesh 3.45 (SD 2.62) days (p = .599) and that for patients using biologic mesh is 2 days (p = .582) (Table 3). The global p values for the regression analysis are p = .265 for the method of appendicectomy, p = .305 for open vs laparoscopic hernia repair and p = .754 for the method of hernia repair.
Gastroparesis managed with peroral endoscopic pyloromyotomy
Published in Baylor University Medical Center Proceedings, 2020
Jessica S. Clothier, Steven G. Leeds, Ahmed Ebrahim, Marc A. Ward
Once the tunnel was completed, the myotomy was performed on the pylorus muscle using the triangle-tip knife. The myotomy was extended until the visible pyloric bar was fully divided, which was confirmed by reaching the thin duodenal musculature. This was performed with care in order to avoid a full-thickness injury. To conclude the procedure, the mucosotomy was closed with six endoscopic hemoclips. A redo laparoscopic hernia repair with fundoplication was also indicated and immediately followed her POP procedure. At this time, it became evident that both vagal nerves had been transected during one of her previous hiatal hernia repairs. This provided an explanation for her severe delayed gastric emptying and significant symptoms, which were likely exacerbating her pre-existing gastroesophageal reflux disease symptoms as well.
Ultrasound-guided serratus plane block with continuous postoperative drug delivery system for acute nociceptive and neuropathic pain after mastectomy
Published in Egyptian Journal of Anaesthesia, 2020
ElKaradawy S. A., ElFakharany M. A., Ahmed Y., Khaled M. A. T
In the previous study, LP versus placebo patch was used with IV morphine patient-controlled analgesia (PCA) and ketorolac every 6 hours for postoperative pain relief after radical retropubic prostatectomy, where patients reported significantly less pain at rest and on coughing and significantly better pain relief in LP group. Furthermore, pain interfering with walking or deep breathing and mood was significantly less than the patients in the placebo group [20]. LP was used effectively to reduce pain after laparoscopic surgeries; Kwon et al. reported significantly less pain score in patients received LP as a part of multimodal analgesia at different intervals for 36 hours after laparoscopic gynaecologic surgery compared to placebo [21]. Furthermore, a superior analgesic effect of LP over no patch was reported for laparoscopic hernia repair [22]. A recent randomised controlled study conducted on 48 patients for total knee replacement investigated the analgesic effect of LP versus no patch, as an adjuvant to standard analgesics, for 28 postoperative days. The study concluded that LP was effective in reducing pain and decreasing tramadol consumption during the period of the study, and added an analgesic value when used with other multimodal analgesic modalities [23].