Chronic pain after laparoscopic transabdominal preperitoneal hernia repair: a randomized comparison of light and extralight titanized polypropylene mesh.
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Does the Pain-free hospital certification improve the management of pain following hernioplasty?
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BACKGROUND: Postoperative pain still poses a serious problem for 80% of patients undergoing surgery. We assessed the effects of the implementation of standards of postoperative analgesia, according to the guidelines of the "Pain-free hospital" project, and PROSPECT group recommendations, in the daily practice of a general surgical hospital ward. METHODS: One hundred adult patients, scheduled for elective inguinal or umbilical hernia surgery, were included in the study and allocated to two groups, to receive analgesics on demand (control), or postoperative analgesia according to the introduced programs. The number of additional interventions and patients' satisfaction were chosen as primary end points to assess the clinical value of the introduced standards. Additionally, the type and dose of analgesics, and duration of hospital stay were noted. RESULTS: One additional intervention (2%) was required in the treated group, and 9 (18%) - in the control group (p=0.023). In the treated group, the patient satisfaction (0 to 10) score was rated 9 by 39 patients (78%) and 10 by 11 patients (22%). The duration of hospitalisation was similar in both groups. CONCLUSION: We confirmed the success of introducing the standards of pain treatment into the daily practice of a surgical ward. (+info)
The use of mesh in acute hernia: frequency and outcome in 99 cases.
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Volvulus of the small intestine associated with left paraduodenal hernia: a case report.
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AIM: To report a rare case of a left paraduodenal hernia presenting as volvulus of the small intestine associated to an intestinal malrotation. CASE REPORT: A 2 months-old girl presented with history of bilious vomiting, sonography showed signs of volvulus and emergency laparotomy was performed and confirmed left paraduodenal hernia containing a part of the ileon, coecum with right colon and volvulus of the small intestine out of the hernia sac. CONCLUSION: Paraduodenal hernia is an uncommon cause of small bowel volvulus. It can be suspected by clinical and radiological findings, surgery is always required to prevent small bowel necrosis and to repair the defect. (+info)
New method of laparoscopic incisional hernia repair with double circumferential transfascial sutures.
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BACKGROUND: Although, laparoscopic incisional hernia repair (LIHR) provides an alternative method for managing incisional hernias, the ideal procedure for reducing the incidence of postoperative complications remains unclear. PATIENTS AND METHODS: We have developed a new method of LIHR that involves a double transfascial suture and does not require the use of spiral tackers. We performed this procedure consecutively in five patients (four males and one female with a mean age of 65.6 years). We describe our new method of LIHR, and present preliminary clinical results. RESULTS: The mean defect size was 26.2 +/- 15.8 cm(2), and the mesh size that was used was 121.7 cm(2) in all cases. An occult hernia was found in one patient during laparoscopic observation. The mean operative time was 198.4 +/- 49.3 minutes with a blood loss of 12.2 +/- 24.6 mL. Postoperative courses were uneventful with a median postoperative hospitalization period of 8 days. No patient required mesh removal and none developed a recurrent hernia during the median follow-up period of 13 months. CONCLUSION: Although, larger number of patients and longer follow-up will be required to prove the operative adequacy of our new procedure, it appears to represent a feasible option for LIHR. (+info)
Routine preoperative typing and screening: a safeguard or a misuse of resources.
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