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Background: The aim of this study was to investigate the outcome of preperitoneal repair using laparoscopic (TEP) and open (OPM) approach in recurrent inguinal hernia. Methods: We performed a prospective controlled nonrandomized clinical study in 188 patients with 207 recurrent inguinal hernias over a period of 5years. TEP repair was employed for 86 repairs, and OPM was used in 121 procedures. The...
Late complications of mesh repair are commonly due to mesh migration and erosion into neighbouring visceri. We report the first case of a mesh repair of a lower midline laprotomy incisional hernia complicated by erosion of the mesh into the bladder which presented as haematuria.
Background: The standard polypropylene mesh used in Lichtensteins operation induces a strong foreign-tissue reaction with potentially harmful effects. A mesh with less polypropylene could possibly be beneficial. Patients and methods: Six hundred men with inguinal hernias were randomized to Lichtensteins operation with Prolene or VyproII in a single-blinded multicenter trial. The randomization was...
Closure of large incisional hernias with the Components Separation Method (CSM) could be explained by medial-caudal rotation of the internal and transverse oblique muscles around their centres of origin. In eight human cadavers, the CSM was performed, and translation of the rectus abdominis muscle was measured. Mean unilateral translation of the rectus abdominis in the lateral-medial direction measured...
Male veterans with unilateral primary inguinal hernia, classified intraoperatively as Gilbert Type III or IV, were randomized to subaponeurotic (Lichtenstein, n=126) or preperitoneal (Read-Rives, n=121) repair under general or spinal anesthesia. The two groups of patients were comparable in age, body weight index, comorbidities, and size and type of hernia. Of the 247 patients enrolled, 224 were followed...
Background: Our aim was to determine which patient-related factors influence the incidence of incisional hernia after vertical banded gastroplasty for morbid obesity. Methods: We reviewed the medical records of 80 morbidly obese patients operated on between 1986 and 1993. All the operations were performed by only one surgeon, and the midline laparotomy was closed by means of continuous polyglactin...
Background: Failed obliteration of processus vaginalis (PV) has recently been proposed to be due to persistence of the smooth muscle (SM), which is transiently present to generate the physical force to descend the testis. Sacs from hernia, hydrocele, or undescended testis reveal alterations in Ca2+ contents. Since Ca2+ signaling and some regulatory proteins are involved in programmed cell death (PCD),...
Presence of an appendix in a hernial sac (Amyands hernia) is a rare entity, still rarer is an inflamed appendix within the hernial sac. An endoscopic total extraperitoneal repair of a right-sided incarcerated inguinal hernia is described. The inguinal hernial sac contained an inflamed appendix. An associated small incisional hernia at the lower end of a midline suprapubic scar for a Millins prostatectomy...
Background. Recurrent inguinal hernias in early infancy are rare. We report on a case of a 3-month-old male infant suffering bilateral inguinal hernia recurrence (RINGH). Due to previous observations of an altered collagen metabolism in hernia patients, a severe connective-tissue pathology in the infant was hypothesised. Methods. Hernial sac tissue of the infant was analysed and compared to specimens...
Background: Umbilical hernias are a common surgical problem with a high recurrence rate using conventional suture techniques. This prospective study examined the feasibility of tension-free mesh repair as a day case using local anaesthetic (LA) for all primary umbilical hernias. Method: Fifty-four patients (eight women) were operated on; 49 using LA. Through a periumbilical skin incision the margins...
Despite universal acceptance of the value of elective hernia repair, many patients present with incarceration or strangulation, which are associated with significant morbidity and mortality. We reviewed 147 patients who underwent emergency surgery for incarcerated groin hernias during a 10-year period in order to analyze the presentation and outcome in our practice. Median age of the patients was...
Background: There is little available evidence on the optimal management of recurrent inguinal hernia, particularly if the original procedure involved the use of mesh. This study was a review of recurrent hernia repair in a district hospital, involving both laparoscopic and open procedures. Methods: The case notes of all patients who had a repair of a recurrent hernia between 1991 and 2000, inclusive,...
Background. The aim of this paper is to present a simple method for obturator hernia repair in two cases with strangulated obturator hernia. Methods. The authors report on two cases of mechanical bowel obstruction due to incarcerated obturator hernia in elderly, thin women. Both patients presented with clinical and radiological signs of small bowel obstruction. Neither of them had the Howship-Romberg...
We describe the whole cohort of patients operated on laparoscopically for ventral hernias at our institution. Information on early results, complications, and long-term follow-up was collected prospectively. Of 90 operations attempted, five (5.8%) required conversion. Of the remaining 85 patients, 65 (76%) had an incisional hernia, while 20 (24%) had primary defects. Three trocars were routinely employed...
Do we have true milestones along the hernia-classification route? I am not certain; modifications have been presented along the way, and each presentation (partially discussed herein) should be studied by every student of herniology and personal decisions made. In developing classifications, we should beware of too many hernia types. We must focus our attention and decisions upon each abdominal wall...
Background:. Numerous complications have been described following the implantation of synthetic meshes during hernia repair; one of the rarest, with only three reported cases, is giant mature fibrous cyst formation. Our clinical experience with this complication has led us to believe that it may be more common than previously thought. Methods:. Surgical operation notes and pathology archives were...
Background: It is generally accepted that most inguinal hernias should be operated on electively in order to avoid the high morbidity and mortality associated with incarceration and small bowel obstruction. The present study reassesses the indication for surgery in asymptomatic inguinal hernia patients. Methods: We analyzed profiles, separately, for elective and emergency inguinal herniorrhaphies...
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