Guidelines in hernia surgery – friend or foe M Pawlak, B East, H Gok, AC de Beaux International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):75-77 |
Teaching and learning laparoendoscopic hernia in the Philippines problems and solutions Jose Macario Faylona International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):78-82 Laparoendoscopic hernia surgery in the Philippines has been constantly growing in terms of training, education, and skills acquisition. Since hernia surgery is one of the more common operations done by a general surgeon, it is important to know the current problems, pitfalls, and solutions in the training of a laparoendoscopic hernia surgeon. The pitfalls identified are the following: (1) absence of a standard curriculum for teaching laparoendoscopic hernia surgery, (2) no hernia centers for education and teaching, (3) inadequate hernia specialists who will train, (4) opportunities for laparoscopic hernia surgery education for surgeons and residents, (5) competency assessment of trained laparoendoscopic hernia surgeons, (6) centers and trainers for more advanced laparoendoscopic hernia surgery, and (7) lack of credentialing and auditing of laparoendoscopic hernia surgery outcomes. Hernia surgery is one of the fastest developing subspecialties in general surgery. With more complex operations being done and more advanced techniques being utilized. It is recommended that there has to be a standardized way of teaching and learning the different types of hernia surgical conditions and their management. From basic to advanced hernia operations, a standardized curriculum and a standardized form of teaching are recommended in order to have good outcomes. Finally, all of these have to evaluated and audited in order to assure good surgical outcomes for both the surgeon and the patients. |
Impact of institutional hernia programme on guideline conformity of surgical approach and mode of anesthesia for inguinal hernia repair and analysis of the outcomes Keerthi Rajapaksha, L JCM Silva, Anuruddha Herath, MJ D Anandappa, T MIG Bandara International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):83-88 AIM: The objective of this study is to elucidate the guideline conformity of surgical approach and mode of anesthesia for inguinal hernia (IH) treatment together with analysis of the outcomes on the implementation of “guideline-based treatment for IH” as a part of institutional hernia programme (IHP) in a single surgical unit. METHODS: This is a retrospective analysis of health records of the male patients who underwent surgery for IH at a single surgical center, during the period May 1, 2015–May 1, 2016, where the surgeons adhered to “guideline-based treatment for IH.” Health records of the patients who underwent surgery for IH from May 1, 2014, to April 30, 2015, too were collected for comparison. Data related to demographics, surgical approach, mode of anesthesia, and surgical complication were analyzed. RESULTS: Sixty-two male patients with a mean age of 33.5 (range: 22–54) years and 99 male patients with a mean age of 32.84 (range: 22–70) years have undergone IH repair before the IHP and during the IHP, respectively. The overall use of local anesthesia (LA) for unilateral IH had increased from 3.5% (n = 2) to 83.12% (n = 65) (P ≤ 0.0001) during IHP. The laparoscopic approach was used in 83.34% of patients with bilateral IH during IHP (P = 0.0007). All (n = 3) the recurrences following open repair were attempted to treat laparoscopically during the IHP. Laparoscopic approach was not utilized to treat IH before the IHP. Overall recurrence rate increased to 4.04 (n = 4) during IHP from 0% (P = 0.299). Overall complication rate increased from 3.22% (n = 2) to 8.08% (n = 8) during IHP (P = 0.319). CONCLUSION: Surgical approach and mode of anesthesia for IH treatment showed high conformity with the guidelines during the IHP. The increased recurrence and complication rates were statistically insignificant. |
A comparative analysis of ventral hernia repair with a porcine hepatic-derived matrix and porcine dermal matrix Job Tharappel, John E Wennergren, Eun Y Lee, Vashisht V Madabhushi, Margaret A Plymale, John Scott Roth International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):89-95 PURPOSE: Complex abdominal wall hernia repairs present unique challenges for patients and surgeons, often requiring mesh placement. Biologic materials may be utilized in repairs with high risk for postoperative complications. Porcine dermal meshes (PDM) are among the most commonly utilized biologic grafts. Porcine hepatic biologic mesh (PHM) was developed due to its unique characteristics. This study investigates outcomes following acute ventral hernia repair with a porcine-derived hepatic biologic mesh (Miromesh®) and porcine dermis (Strattice™) in a porcine animal model. MATERIALS AND METHODS: Twenty Yucatan pigs underwent hernia creation followed by immediate retrorectus ventral hernia repair and were survived for 1 (n = 4), 2 (n = 6), 6 (n = 5), or 12 (n = 5) months. Animals underwent excision of the anterior abdominal wall and immediate repair with both PDM and PHM positioned in the retrorectus space with 3 cm between grafts. Animals were survived and evaluated for tensiometric strength, histology, and protein analyses. RESULTS: Twenty animals underwent successful hernia creation and repair. Tensiometric strength was similar between repair groups at 1 (63.8 vs. 67.0 N, NS) and 2 months (80.0 vs. 76.1 N, NS), whereas at 6 (72.2 vs. 44.9 N, P= 0.01) and 12 months (66.7 vs. 46.3, P= 0.004), repair strength was greater in PHM. Histological evaluation demonstrated greater inflammation and fibrosis at 12 months in the PHM repairs. Collagen 1 deposition was greater in PHM at 1 (P = 0.1) and 2 (P = 0.015) months. There was no difference in collagen 3 deposition between groups. CONCLUSIONS: Ventral hernia repair with a porcine hepatic mesh results in greater repair strength than repair with porcine dermal grafts. |
Most cited 100 articles in herniology: Bibliometric study Hakan Kulacoglu International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):96-104 BACKGROUND: Being cited by another article is valuable for scientific publications. Citation analysis of previously published papers by bibliometric methodology have been performed in different disciplines do date. The present study was done with the purpose of listing the most cited articles in the field of abdominal wall hernias, in other words herniology. MATERIALS AND METHODS: A search was conducted through all databases in the Web of Science to determine the most cited articles related to the abdominal wall hernias. RESULTS: The total number of citations of the top 100 articles in herniology was 26.316. The mean number of citations was 263.16. The top 100 articles originated from 13 countries, and were published in 37 journals. The most productive decade was 2000-2009 with 55 papers. Journal impact factors correlated with citation counts positively. Inguinal hernia and incisional hernia were the leading topics in 41 and 40 related articles. The number of the authors also did not show any correlation with citation counts. There was no relationship between the number of the cited references and the citations counts of the articles. CONCLUSION: Citation counts of the articles about abdominal wall hernias are somewhat lower than those in other fields. Most articles in the top 100 list are related to inguinal and incisional hernias. BACKGROUND: Being cited by another article is valuable for scientific publications. Citation analysis of previously published papers by bibliometric methodology have been performed in different disciplines do date. The present study was done with the purpose of listing the most cited articles in the field of abdominal wall hernias, in other words herniology. MATERIALS AND METHODS: A search was conducted through all databases in the Web of Science to determine the most cited articles related to the abdominal wall hernias. RESULTS: The total number of citations of the top 100 articles in herniology was 26.316. The mean number of citations was 263.16. The top 100 articles originated from 13 countries, and were published in 37 journals. The most productive decade was 2000-2009 with 55 papers. Journal impact factors correlated with citation counts positively. Inguinal hernia and incisional hernia were the leading topics in 41 and 40 related articles. The number of the authors also did not show any correlation with citation counts. There was no relationship between the number of the cited references and the citations counts of the articles. CONCLUSION: Citation counts of the articles about abdominal wall hernias are somewhat lower than those in other fields. Most articles in the top 100 list are related to inguinal and incisional hernias. |
Medico-legal implications in hernia surgery Reinhard Bittner International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):105-113 AIM: Litigation is always a severe burden for every surgeon who is involved. The study aims to show the most important reasons for an allegation and how to prevent a lawsuit. METHODS: Based on the own experience as a medical advisor, ten medico-legal cases are analyzed and a systematic overview of the corresponding literature is given. RESULTS: Allegation for malpractice is not very frequent; in hernia surgery, <1% of the patients are involved. Furthermore, only in 20%–40% of these cases, the decision is in favor of the claimant. However, every case is associated with compensation ranging from roughly between $19,000 and $8,000,000. Totally the author had to perform 10 reports in legal cases for the court: In three cases, compensation had been refused, because informed consent had correctly been done, and the operative situs was clearly documented, and in the third case, the preoperative diagnostics and the operative performance had been according to the medical standard. The claim was successful in three patients because of technical failure, in two cases because of wrong indication, and in two cases because of delayed reoperation. DISCUSSION: There are five key features in the prevention of a lawsuit in surgery: (1) “informed consent:” Take the time, use a standard form, show pictures and make handwritten notes to explain in detail the indication for surgery, the technical performance of the planned intervention, and the steps of aftercare; (2) “technical performance” of the operation should follow the generally accepted medical standard. Deep knowledge of anatomy is an indispensable precondition of perfect operation; (3) a “delay in timely response” to a complication is not excusable; (4) “careful documentation” of all steps of the treatment may possibly avoid a legal case; and (5) “establishing an empathic relationship” between the surgeon and the patient and his/her relatives as well is essential for avoiding an accusation. CONCLUSION: Medico-legal implications in hernia surgery are rare, but a severe burden for every surgeon concerned and may be associated with damage to the reputation of the surgeon and high costs. The best ways of preventing such a disaster are the correct indications and operative performance according to the current medical standard and empathic aftercare. |
Uterus-containing inguinal hernia caused by undue tension on round ligament Junsheng Li, Tao Cheng International Journal of Abdominal Wall and Hernia Surgery 2019 2(3):114-117 The presence of uterus in inguinal hernia sac is a rare condition, the cause for this disease has not been clarified, and the contributions to this condition could be multiple. In this report, we described a case of a 78-year-old multiparous female with left recurrent inguinal hernia, during the transabdominal preperitoneal repair (TAPP); the well-formed uterus was found in the hernia sac, and the uterus could only be completely reduced after the division of the left round ligament. To the best of our knowledge, there have been no reports in the literature on adult recurrent hernias containing well-formed uterus in adult females. The aim of this case report is to call attention to the proper management of round ligament when performing inguinal hernia repair in female patients. |
ΩτοΡινοΛαρυγγολόγος Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,
Translate
Ετικέτες
Δευτέρα 2 Σεπτεμβρίου 2019
Αναρτήθηκε από
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
στις
1:21 π.μ.
Ετικέτες
00302841026182,
00306932607174,
alsfakia@gmail.com,
Anapafseos 5 Agios Nikolaos 72100 Crete Greece,
Medicine by Alexandros G. Sfakianakis
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Αρχειοθήκη ιστολογίου
-
►
2023
(278)
- ► Φεβρουαρίου (139)
- ► Ιανουαρίου (139)
-
►
2022
(1962)
- ► Δεκεμβρίου (107)
- ► Σεπτεμβρίου (158)
- ► Φεβρουαρίου (165)
- ► Ιανουαρίου (163)
-
►
2021
(3614)
- ► Δεκεμβρίου (152)
- ► Σεπτεμβρίου (271)
- ► Φεβρουαρίου (64)
- ► Ιανουαρίου (357)
-
►
2020
(3279)
- ► Δεκεμβρίου (396)
- ► Σεπτεμβρίου (157)
- ► Φεβρουαρίου (382)
- ► Ιανουαρίου (84)
-
▼
2019
(11718)
- ► Δεκεμβρίου (265)
-
▼
Σεπτεμβρίου
(545)
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Raise awareness of the global burden of viral he...
- A dream machine – The EU Health Programme tur...
- Aggressive Digital Papillary Adenocarcinoma Init...
- Tackle the Changes of Aging,
- Non-Invasive Hemodynamic Monitoring of Cocaine-I...
- Healthcare Satisfaction and Unmet Needs Among Be...
- Urinary prostaglandin D2 and E2 metabolites asso...
- Fundamental Voice Frequency: Acoustic, Electrogl...
- JDDG: Journal der Deutschen Dermatologischen Ges...
- Preface to the third issue of Heart India 2019Al...
- Clinical Medicine Insights: Pediatrics, ...
- Clinical Medicine Insights: Endocrinology and D...
- Clinical Medicine Insights: Case Reports, ...
- Announcing the first novel class of rapid-onset ...
- Clinical Pathology , Brief Report
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Radiotherapy and Oncology
- Clinical Neurology and Neurosurgery
- Head and Neck
- Journal of Neurosurgical Anesthesiology - Publis...
- Alcohol,
- Nanomaterials, Vol. 9, Pages 1392: Low Refle...
- Journal of Clinical Medicine
- International Journal of Environmental Research ...
- Cancers, Vol. 11, Pages 1461: Arl13b Regulat...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- The journey to zero deep-vein thrombosis in crit...
- Shunt care: More than what beats the eyeDattatra...
- Ethics and End-of-Life CareJozef KeseciogluJourn...
- Exercise in congenital heart disease: A contempo...
- Brexit and UK citizens with HIV residing in Spai...
- Does Single-Dose Preemptive Intravenous Ibuprofe...
- Flow cytometric assessment of CD30 expression in...
- Validation of Transtek TMB-1776 according to Eur...
- A Prospective Outcome Assessment After Bronchosc...
- Εκδρομή στην Βόρειο Ήπειρο, Η «Ένωση τέκνων, σ...
- Health Care Policy and Quality Ethical Dilemmas...
- Age and preoperative velar closure ratio are sig...
- Strategies in anti-Mycobacterium tuberculosis d...
- Molecular Systems BiologyVolume 15, Issue 9Septe...
- Time-related outcome in patients with traumatic ...
- The effectiveness of a novel cable-driven gait t...
- A MAPP Network Case-Control Study of Urologic Ch...
- One-Year Prognosis of Kidney Injury at Discharge...
- Strengthening prevention and control activities ...
- World Social Psychiatry: A Dream Coming True, bu...
- General Anesthesia Versus Conscious Sedation in ...
- Nieuwe beeldvormende technieken bij de diagnosti...
- Roles of TGFβ1 in the expression of phosphoinosi...
- World NCD Federation guidelines for prevention, ...
- Multiple congenital colonic stenosis – A case re...
- NECK AND HEAD SUPPORT,
- Bronchial-arterial-circulation-sparing lung pres...
- Antithymocyte Globulin Antibody Titer Congruent ...
- Science, realism, and unconceived alternatives: ...
- Utility of a smartphone-enabled otoscope in the ...
- Outcomes of Infants Supported With Extracorporea...
- Intelligent Exercise Guidance System Based on Sm...
- // EXPERT OPINION, ESMO 2019: Recommendation...
- Dimitsana is a mountain village and a former munic...
- A multiplex pharmacogenetics assay using the Min...
- Musculoskeletal Injuries and Depression in Athle...
- MRI in early detection of prostate cancerPurpos...
- Reintroduction of quazepam: an update on compara...
- Endoscopic Management of the Large Benign ...
- Management of Early Pregnancy Loss Management of...
- Get Vaccinated to #FightFlu The best st...
- ► Φεβρουαρίου (1143)
- ► Ιανουαρίου (744)
-
►
2017
(2)
- ► Φεβρουαρίου (1)
- ► Ιανουαρίου (1)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου