Laparoscopic Completely Extraperitoneal Repair of Inguinal Hernia in Children; A Single Institute Experiences with 1,257 Repairs in Comparison with Cut-down Herniorrhaphy.
Aim of the study: Conventional open herniorrhaphy in children has been reported to have 2~3% recurrence and 10~20% postoperative contralateral hernia rates. We developed a unique technique to achieve completely extraperitoneal ligation of patent processus vaginalis (PPV) without any skip areas, sparing the spermatic cord and vessels under laparoscopic control. Our technique should be theoretically… Continue Reading
A Paradigm Shift in Ventral Hernia Repair. Laparoscopic Component Separation During Laparoscopic Ventral Hernia Repair.
Component separation is an important technique in the repair of ventral hernias because it allows restoration of the normal anatomic relationship of the rectus muscles while maintaining a tension-free repair. Our group has previously reported on fully laparoscopic component separation as an important tool in the repair of ventral hernias. This technique allows for protection… Continue Reading
Background: The surgical preference for inguinal hernia repair is still under debate and discussed controversial. Short- and long-term results are based on data of different surgical trials with diverse results. In this retrospective study the long-term results of the transabdominal preperitoneal (TAPP) hernia repair and the Lichtenstein technique were compared.Method: Between 2000 and 2005, the… Continue Reading
Introduction: The high rate of coincident or missed femoral hernias while or after mesh herniorrhaphy suggest is systematic search. We present our findings and results using the laparoscopic preperitoneal approach (TEP). Methods: Between April 2001 and February 2007, patients undergoing inguinal hernia repair were entered into a prospective database. The nature of their hernias in… Continue Reading
The Incidence of Occult Fascial Defects Discovered in Laparoscopic Ventral Hernia Repairs in 374 Patients
Objective: One aspect unique to the laparoscopic ventral hernia repair (LVHR) is the visualization and repair of occult fascial defects not recognized during open repairs. This recognition of occult fascial defects leads to wider mesh coverage of the areas that would likely go undetected (and un-repaired) at the time of open surgery. This study reviews… Continue Reading
Morbidly Obese Patients Do Not Have Increased Incidence of Early Recurrence After Laparoscopic Ventral Hernia Repair
INTRODUCTION: Previous studies have raised concern that morbid obesity is associated with a markedly increased risk of recurrence after repair of ventral hernias. This study compared the incidence of early post-operative recurrence after laparoscopic ventral hernia repair in morbidly obese patients and non-morbidly obese patients.METHODS: Case notes were reviewed for consecutive patients who underwent laparoscopic… Continue Reading
Objective: To determine mechanisms of ventral hernia recurrence following laparoscopic repair.Background: Laparoscopic ventral hernia repair techniques have demonstrated low recurrence rates in recent years. Mechanisms of recurrence following open repair are well-documented, but there is less data defining how laparoscopically-repaired hernias recur.Methods: We performed a retrospective analysis of 25 patients who had previously undergone at… Continue Reading
Introduction:We proposed a feasibility study to determine if biologic mesh may be safely placed in the abdomen in a transgastric fashion, as a precursor to attempting transgastric ventral hernia repair.Methods:Six swine underwent upper endoscopy after decontamination of the stomach with povidone-iodine (Betadine). Under endoscopic guidance the gastric wall was perforated. A plastic overtube was introduced… Continue Reading
Background: Kidneys harvested by laparoscopic donor nephrectomy regain normal function slightly later than laparotomy-harvested organs. Several factors affect the organs after laparoscopic recruitment, which could explain the relatively prolonged period of recovery. We investigate the role of CO2-induced pneumoperitoneum (PNP) on organ dysfunction as expressed by cell apoptosis.Methods: CO2-PNP was established in 24 anesthetized Wistar… Continue Reading
Polypropylene mesh (PPM) or Light weight mesh (LWM) in inguinal hernia surgery (TEP)- results of a prospective randomized controlled study
Objectives of study-Mesh application in endoscopic hernia surgery is universal. Textile, weight and pore size of mesh continue to be debated. LWMs with larger pores seem to address the concerns of host response. Aim of this study was to evaluate the advantages if any of LWMs over PPMs in totally extraperitoneal (TEP) repair of inguinal… Continue Reading
Objective: Current evidence suggests that the neurotransmitter Nitric Oxide (NO) plays a crucial role in the genesis of aboral propagative of esophageal peristalses during swallowing. However, direct evidence in this regard is lacking at present. The objective of this study was to measure changes in the level of NO within the intermuscular interstices of esophagus… Continue Reading
Background: The causes of obesity are multifactorial and may include dysregulation of certain genes, such as peroxisome proliferator activated receptor gamma (PPAR gamma). When activated, the PPAR gamma pathway promotes lipid metabolism. This study uses microarray technology to evaluate differential gene expression profiles in obese patients undergoing bariatric surgery versus non-obese controls. Methods: Blood samples… Continue Reading
Background: Following Roux-en-Y gastric bypass (RYGB), hyperglycemia dramatically improves in obese patients with Type II diabetes (T2D). For many patients, hypoglycemic agents and insulin are discontinued after RYGB. However, the exact mechanisms of this process are unknown. This unique study attempts to identify differences in gene expression profiles between pre- and post-operative T2D patients following… Continue Reading
C-reactive protein concentrations before and after gastric bypass surgery inversely correlate with omental gene expression of adiponectin.
Adipose tissue is a key regulator of C-reactive protein (CRP), an inflammatory marker linked to atherosclerosis. Adiponectin, the most abundant adipokine is also an importantl factor involved in the inflammatory state of obesity. The aim of the study was to assess the impact of gastric bypass surgery (GBS) on the CRP levels and its relation… Continue Reading
Study Aim: The risk of gastric spillage during transgastric surgery is a concerning potential complication of NOTES procedures. The aim of this study is to determine the risk of sepsis from gastric spillage in a rat survival model by measuring local and systemic inflammatory markers, adhesive disease, and clinical outcomes.Methods: Under IACUC approval, mini-laparotomy with… Continue Reading