Alfonso-Gamba Mm, Mosquera-Gonzalez Mf, Perdomo-Orozco Cf, A Ricaurte-Aragon
Background: Garengeot’s hernia is a rare presentation of a femoral hernia. Rarely, a Garengeot’s hernia is managed laparoscopically. Case report: We report a case of a 66 year-old male presented with an incarcerated groin hernia at the emergency department. He was taken in to laparoscopic hernia repair, with TAPP approach finding a right hernia femoral defect of 4 cm from which cecal appendix was reduced, in a suppurative phase. Discussion: This is the fourth case reported in the literature. A Garengot’s hernia can be managed laparoscopically. TAPP technique allows reducing the herniated appendix, repairing the hernia defect, determining the contamination of the abdominal cavity and the use of a mesh in the primary hernia repair. Introduction A femoral hernia is defined as a sac which projects through the femoral canal and presents clinically as a groin hernia below and laterals to the pubic tubercle or a finger breadth medial to the femoral artery below the inguinal ligament [1]. An inflamed appendix rarely can migrate in a hernia sac into the crural orifice and become incarcerated. The presence of the appendix in a femoral sac is known as a Garengeot’s hernia [2] due to a French Surgeon called Rene Jacques Croissant de Garengeot who first described a case in 1731 [1-4]. The first appendectomy of a Garengeot’s hernia was performed by Hevin in 1785 [2]. There is an incidence described in the literature from 0.08 to 1% [1,4]. A case of a Garengeot’s hernia managed laparoscopically is presented at surgical emergency department in a fourth level hospital. In a research done in pubmed, academic google, science direct and scielo databases there were 3 cases found. Case Report 66 year old men arrived to the emergency department with history of 8 hours of right groin pain, sense of mass, nausea and vomit. He underwent right inguinal herniorrhaphy 30 years ago. Clinical examination revealed good general conditions with normal vital signs and a non reductable painful mass in the right groin, without local inflammatory local changes such as erythema or edema and no signs of peritoneal irritation. Blood test with 16.000 leukocytes. There were no preoperative images done. With diagnosis of an incarcerated groin hernia he was taken in to laparoscopic hernia repair finding a right femoral defect of 4 cm from which cecal appendix was reduced, in a suppurative phase (Figure 1). Without peritoneal fluid or additional inflammatory changes in the groin. TAPP approach was done with an infraumbilical 12 mm trocar and other two trocars of 5 mm in right and left flanks. The appendix was easily reduced without perforating, mesoappendix was attached with ligasure and hemolock was placed at the base, appendix was extracted with endocath. We performed dissection of Bogro’s and Retziu’s space identifying Copper’s ligament, iliopubic tract and deep inguinal ring. The defect was corrected with a light polypropylene mesh of 15 × 15 cm fixed to the Cooper’s ligament with 3 Prot
背景:Garengeot疝是一种罕见的股疝。很少用腹腔镜治疗加朗乔疝。病例报告:我们报告一个66岁的男性在急诊科提出了一个嵌顿腹股沟疝。他被送往腹腔镜疝修补术，TAPP入路发现右侧疝股缺损4cm，盲肠阑尾缩小，处于化脓期。讨论:这是文献中报道的第四个病例。加伦戈氏疝可以通过腹腔镜治疗。TAPP技术可以减少阑尾疝，修复疝缺损，确定腹腔污染，并在原发性疝修补中使用补片。股疝的定义是通过股管突出的囊状物，临床表现为腹股沟韧带下耻骨结节下方及外侧或股动脉内侧一指宽处的腹股沟疝[1]。发炎的阑尾很少会在疝囊内迁移到脚孔并嵌顿。阑尾位于股囊内被称为Garengeot疝[2]，法国外科医生Rene Jacques Croissant de Garengeot于1731年首次描述了一个病例[1-4]。1785年Hevin进行了第一例Garengeot疝阑尾切除术[2]。文献中有0.08 ~ 1%的发生率[1,4]。在外科急诊科在一个四级医院腹腔镜下处理的一例加朗热疝。在pubmed，学术谷歌，science direct和scielo数据库中进行的一项研究发现了3个案例。66岁男性，因右腹股沟疼痛、肿块感、恶心呕吐8小时就诊急诊科。30年前他接受了右腹股沟疝修补术。临床检查一般情况良好，生命体征正常，右侧腹股沟处有一不可还原的疼痛肿块，局部无炎性局部改变，如红斑、水肿，腹膜无刺激征象。血液检查有16000个白细胞。术前未做影像学检查。诊断为嵌顿性腹股沟疝，患者接受腹腔镜疝修补术，发现右侧股骨缺损4cm，盲肠阑尾缩小，处于化脓期(图1)。腹股沟无腹膜积液或其他炎症改变。TAPP入路采用脐下12mm套管针和左右两侧另外两个5mm套管针。在不穿孔的情况下轻松复位阑尾，结扎阑尾系膜，底部止血，内腔取出阑尾。我们进行了Bogro’s和Retziu’s间隙的解剖，确定了Copper’s韧带、髂耻束和腹股沟深环。将一个15 × 15 cm的轻型聚丙烯网片用3个孔固定在Cooper’s韧带上，不闭合腹膜，另外3个孔避免网片与肠道接触。没有考虑安装排水系统。术后早期无并发症发生。手术后4小时，患者用止痛药出院。病理证实为急性化脓性阑尾炎。术后第7天患者恢复正常活动。我们报告一例罕见的腹腔镜下诊断和治疗的加朗乔疝。本病例为罕见的急性阑尾炎合并股疝，同时探查和治疗。这是哥伦比亚报告的首例病例。引用本文:Alfonso-Gamba MM, Mosquera-Gonzalez MF, Perdomo-Orozco CF, Ricaurte-Aragón a(2019)哥伦比亚腹腔镜下加伦戈特疝罕见病例。J Surgery Open Access 5(6): dx.doi.org/10.16966/2470-0991.201 2 Journal of Surgery: Open Access Open Access Journal在复杂急性阑尾炎患者中放置腹腔内引流管可能没有益处，甚至可能延长住院时间[5]。结论TAPP入路是诊断、评价腹腔、同时治疗炎症(急性阑尾炎)和股疝的良好选择。利益冲突作者报告没有利益冲突，也没有为此目的提供资金。
{"title":"A Rare Case of Garengot’s Hernia with Laparoscopic Approach in Colombia","authors":"Alfonso-Gamba Mm, Mosquera-Gonzalez Mf, Perdomo-Orozco Cf, A Ricaurte-Aragon","doi":"10.16966/2470-0991.201","DOIUrl":"https://doi.org/10.16966/2470-0991.201","url":null,"abstract":"Background: Garengeot’s hernia is a rare presentation of a femoral hernia. Rarely, a Garengeot’s hernia is managed laparoscopically. Case report: We report a case of a 66 year-old male presented with an incarcerated groin hernia at the emergency department. He was taken in to laparoscopic hernia repair, with TAPP approach finding a right hernia femoral defect of 4 cm from which cecal appendix was reduced, in a suppurative phase. Discussion: This is the fourth case reported in the literature. A Garengot’s hernia can be managed laparoscopically. TAPP technique allows reducing the herniated appendix, repairing the hernia defect, determining the contamination of the abdominal cavity and the use of a mesh in the primary hernia repair. Introduction A femoral hernia is defined as a sac which projects through the femoral canal and presents clinically as a groin hernia below and laterals to the pubic tubercle or a finger breadth medial to the femoral artery below the inguinal ligament [1]. An inflamed appendix rarely can migrate in a hernia sac into the crural orifice and become incarcerated. The presence of the appendix in a femoral sac is known as a Garengeot’s hernia [2] due to a French Surgeon called Rene Jacques Croissant de Garengeot who first described a case in 1731 [1-4]. The first appendectomy of a Garengeot’s hernia was performed by Hevin in 1785 [2]. There is an incidence described in the literature from 0.08 to 1% [1,4]. A case of a Garengeot’s hernia managed laparoscopically is presented at surgical emergency department in a fourth level hospital. In a research done in pubmed, academic google, science direct and scielo databases there were 3 cases found. Case Report 66 year old men arrived to the emergency department with history of 8 hours of right groin pain, sense of mass, nausea and vomit. He underwent right inguinal herniorrhaphy 30 years ago. Clinical examination revealed good general conditions with normal vital signs and a non reductable painful mass in the right groin, without local inflammatory local changes such as erythema or edema and no signs of peritoneal irritation. Blood test with 16.000 leukocytes. There were no preoperative images done. With diagnosis of an incarcerated groin hernia he was taken in to laparoscopic hernia repair finding a right femoral defect of 4 cm from which cecal appendix was reduced, in a suppurative phase (Figure 1). Without peritoneal fluid or additional inflammatory changes in the groin. TAPP approach was done with an infraumbilical 12 mm trocar and other two trocars of 5 mm in right and left flanks. The appendix was easily reduced without perforating, mesoappendix was attached with ligasure and hemolock was placed at the base, appendix was extracted with endocath. We performed dissection of Bogro’s and Retziu’s space identifying Copper’s ligament, iliopubic tract and deep inguinal ring. The defect was corrected with a light polypropylene mesh of 15 × 15 cm fixed to the Cooper’s ligament with 3 Prot","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131800353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mc Lean Il, Barber J, Varela Eb, Montoya D, Morris B, Costantino F, Poussif Cc
Objective: To assess the outcomes in patients undergoing implant-based immediate breast reconstruction assisted with polyglactin 910 mesh.
目的:评价聚乳酸蛋白910补片辅助植体乳房即刻重建的临床效果。
{"title":"Use of 910 Polyglactin 910 Meshes in Breast Reconstruction","authors":"Mc Lean Il, Barber J, Varela Eb, Montoya D, Morris B, Costantino F, Poussif Cc","doi":"10.16966/2470-0991.223","DOIUrl":"https://doi.org/10.16966/2470-0991.223","url":null,"abstract":"Objective: To assess the outcomes in patients undergoing implant-based immediate breast reconstruction assisted with polyglactin 910 mesh.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114643736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luisa Snla, Araujo-Lopez A, Cardona-Ochoa P, Pacheco Vhr, Paez Yac, Leon-Serna Rrd, Rios Lara-Y Lrl, T. R, Ugalde-Vitelly Ja
Introduction: Body contouring is commonly used to enhance abdominal aesthetics; however, managing post-surgical edema remains a challenge. Kinesiotherapy, involving continuous abdominal bandaging, may offer a solution. Objectives: This study aims to demonstrate the effectiveness of Kinesiotherapy in managing edema, ecchymosis, seroma, and post-surgical pain in abdominal liposuction. Material and Methods: In a clinical trial, 50 patients undergoing abdominal liposuction were evaluated over one year, with 25 in a control group and 25 in an experimental group. The study monitored the effects of Kinesiotherapy during the first 7 and 21 days post-surgery, using Nuclear Magnetic Resonance (NMR) to assess reductions in seroma, ecchymosis, edema, and pain. Results: The study showed a decrease in edema measured by cm2 in MRI, with an average reduction of 373 cm2 in the control group compared to 635 cm2 in the experimental group, leading to decreased edema, ecchymosis, pain, and seroma. Discussion: Liposuction is a widely used surgical technique for removing fat to improve body contour. However, some patients may experience an excessively flat abdomen. Kinesiotherapy, a daily-use intervention, has shown proactive benefits in managing post-surgical complications related to body contouring. Conclusions: Abdominal belts, used for controlled management of post-surgical edema, facilitate lymphatic and nervous recirculation, ultimately reducing seromas, fibrosis, ecchymosis, and paresthesias. This study highlights the importance of incorporating Kinesiotherapy for optimal patient outcomes.
{"title":"Abdominal Liposuction Post-Surgical Management Controlled with Kinesiotherapy","authors":"Luisa Snla, Araujo-Lopez A, Cardona-Ochoa P, Pacheco Vhr, Paez Yac, Leon-Serna Rrd, Rios Lara-Y Lrl, T. R, Ugalde-Vitelly Ja","doi":"10.16966/2470-0991.271","DOIUrl":"https://doi.org/10.16966/2470-0991.271","url":null,"abstract":"Introduction: Body contouring is commonly used to enhance abdominal aesthetics; however, managing post-surgical edema remains a challenge. Kinesiotherapy, involving continuous abdominal bandaging, may offer a solution. Objectives: This study aims to demonstrate the effectiveness of Kinesiotherapy in managing edema, ecchymosis, seroma, and post-surgical pain in abdominal liposuction. Material and Methods: In a clinical trial, 50 patients undergoing abdominal liposuction were evaluated over one year, with 25 in a control group and 25 in an experimental group. The study monitored the effects of Kinesiotherapy during the first 7 and 21 days post-surgery, using Nuclear Magnetic Resonance (NMR) to assess reductions in seroma, ecchymosis, edema, and pain. Results: The study showed a decrease in edema measured by cm2 in MRI, with an average reduction of 373 cm2 in the control group compared to 635 cm2 in the experimental group, leading to decreased edema, ecchymosis, pain, and seroma. Discussion: Liposuction is a widely used surgical technique for removing fat to improve body contour. However, some patients may experience an excessively flat abdomen. Kinesiotherapy, a daily-use intervention, has shown proactive benefits in managing post-surgical complications related to body contouring. Conclusions: Abdominal belts, used for controlled management of post-surgical edema, facilitate lymphatic and nervous recirculation, ultimately reducing seromas, fibrosis, ecchymosis, and paresthesias. This study highlights the importance of incorporating Kinesiotherapy for optimal patient outcomes.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134448005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meniere’s disease is a chronic inner ear disease characterized by fluctuating sensorineural hearing loss, recurrent vertiginous attacks, tinnitus with aural fullness. Whether hearing loss is secondary to natural progressive course of disease or due to interventions, noticeable number of patients with Meniere’s disease has unilateral non-serviceable hearing. So, cochlear implantation provides hope for those patients not only for hearing rehabilitation but also its positive effect on other non-auditory symptoms of Meniere’s disease. Our article aims to review the beneficial effects of implanting patients with Meniere’s disease regarding their hearing gain as measured by standard audiometric testing and discuss the effect of implantation on auditory and vestibular outcomes.
{"title":"Cochlear Implant Merits in Patients with Meniere’s Disease","authors":"Elgandy Ms","doi":"10.16966/2470-0991.182","DOIUrl":"https://doi.org/10.16966/2470-0991.182","url":null,"abstract":"Meniere’s disease is a chronic inner ear disease characterized by fluctuating sensorineural hearing loss, recurrent vertiginous attacks, tinnitus with aural fullness. Whether hearing loss is secondary to natural progressive course of disease or due to interventions, noticeable number of patients with Meniere’s disease has unilateral non-serviceable hearing. So, cochlear implantation provides hope for those patients not only for hearing rehabilitation but also its positive effect on other non-auditory symptoms of Meniere’s disease. Our article aims to review the beneficial effects of implanting patients with Meniere’s disease regarding their hearing gain as measured by standard audiometric testing and discuss the effect of implantation on auditory and vestibular outcomes.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132383214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soares Mb, Pupo Ja, Soares Iag, Viana T, Tavares Da, Viana N, Costalonga Hcc
Chronic constipation brings a great impact on quality of life. Colonic inertia is a rarely and extreme degree of constipation with difficult clinical treatment and often frustrating to the patient. Surgical treatment for colonic inertia is an interesting alternative and has a high success rate. We present the case of a patient with colonic inertia who underwent surgical treatment with total colectomy with ileorectal anastomosis by laparoscopy.
{"title":"Laparoscopic Total Colectomy in Colonic Inertia","authors":"Soares Mb, Pupo Ja, Soares Iag, Viana T, Tavares Da, Viana N, Costalonga Hcc","doi":"10.16966/2470-0991.197","DOIUrl":"https://doi.org/10.16966/2470-0991.197","url":null,"abstract":"Chronic constipation brings a great impact on quality of life. Colonic inertia is a rarely and extreme degree of constipation with difficult clinical treatment and often frustrating to the patient. Surgical treatment for colonic inertia is an interesting alternative and has a high success rate. We present the case of a patient with colonic inertia who underwent surgical treatment with total colectomy with ileorectal anastomosis by laparoscopy.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126363132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
González Rr, Alfonso Mam, Ramos Rj, Escobar Va, Poyato Sb, P. Mm
Introduction: Laparoscopic Heller myotomy is currently considered the choice treatment for relief of dysphagia in Esophageal Achalasia (EA), showing a low incidence of gastroesophageal reflux and evident improvement in Health-Related Quality of Life (HRQL). Objective: Evaluate Health-Related quality of life and clinic evolution after laparoscopic Heller myotomy and Dor fundoplication. Material and method: Prospective longitudinal descriptive observational study, through the application of the Gastrointestinal Quality of Life Index questionnaire (GIQLI) to patients underwent surgery for EA from January 2010 to December 2017 at the National Center for Minimally Invasive Surgery. The questionnaire was applied before surgery and one year later. Statistical analysis: Percentages for qualitative variables, mean ± standard deviation or median and range, as appropriate for quantitative variables, for the comparison of the questionnaire results, we used student’s t-test, with statistical significance level α=0.05. Results: 101 patients were included in the study, three of them were excluded. Age ranged from 18 to 78 years with an average of 47 years. The mean time of evolution of the symptoms was 62 months, with an average of 3.3 on the dysphagia scale and a Resting Pressure of the lower esophageal sphincter (mmHg) 38.7 ± 16.8, an initial GIQLI of 85 was obtained, 3 ± 20.4, which increased twelve months after surgery to 131.6 ± 10.5. Conclusions: Heller myotomy and Dor fundoplication improve Health-Related quality of life in patients with esophageal achalasia with good outcomes in time.
{"title":"Health-Related Quality of Life and Long-term Results after Laparoscopic Heller Myotomy and Dor Fundoplication","authors":"González Rr, Alfonso Mam, Ramos Rj, Escobar Va, Poyato Sb, P. Mm","doi":"10.16966/2470-0991.186","DOIUrl":"https://doi.org/10.16966/2470-0991.186","url":null,"abstract":"Introduction: Laparoscopic Heller myotomy is currently considered the choice treatment for relief of dysphagia in Esophageal Achalasia (EA), showing a low incidence of gastroesophageal reflux and evident improvement in Health-Related Quality of Life (HRQL). Objective: Evaluate Health-Related quality of life and clinic evolution after laparoscopic Heller myotomy and Dor fundoplication. Material and method: Prospective longitudinal descriptive observational study, through the application of the Gastrointestinal Quality of Life Index questionnaire (GIQLI) to patients underwent surgery for EA from January 2010 to December 2017 at the National Center for Minimally Invasive Surgery. The questionnaire was applied before surgery and one year later. Statistical analysis: Percentages for qualitative variables, mean ± standard deviation or median and range, as appropriate for quantitative variables, for the comparison of the questionnaire results, we used student’s t-test, with statistical significance level α=0.05. Results: 101 patients were included in the study, three of them were excluded. Age ranged from 18 to 78 years with an average of 47 years. The mean time of evolution of the symptoms was 62 months, with an average of 3.3 on the dysphagia scale and a Resting Pressure of the lower esophageal sphincter (mmHg) 38.7 ± 16.8, an initial GIQLI of 85 was obtained, 3 ± 20.4, which increased twelve months after surgery to 131.6 ± 10.5. Conclusions: Heller myotomy and Dor fundoplication improve Health-Related quality of life in patients with esophageal achalasia with good outcomes in time.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132493559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Araujo-Lopez A, Salazar-Del Pcp, Peña-González Rr, Cardona-Ochoa P, Gonzalez-Rodriguez M, Rios-Lara Rl, T. R, Ugalde-Vitelly Ja
Introduction: The current incidence of incisional hernia is up to 11%. Botulinum toxin type A shows atrophy in the extrafusal and intrafusal muscle fibers. With the addition of Muscle Paralysis and improving strength, it is possible to perform an effective posterior component separation. Objective: Describe an easy algorithm to treat complex abdominal wall reconstruction and improve the quality of adjacent tissues. Material and Methods: Fifty-nine patients were analyzed over 1 year in the General Surgery and Plastic and Reconstructive Surgery Service, patients with midline abdominal wall hernias, using the effective reconstruction algorithm, placing by ultrasound-guided botulinum toxin in the muscle transverse, 1 month later performing TAR, with Abdominoplasty for skin flap management, and comparing with the control group that did not apply botulinum toxin. Discussion: Botox is a neurotoxin derived from the bacterium Clostridium botulinum (botulinum toxin type A) that has been observed at the sensory level causing atrophy in the extrafusal and intrafusal muscle fibers. Repair of the abdominal wall after incisional hernias has been a great challenge with recurrence rates of 11%. Performing the release of the transverse muscle has a recurrence of 6%, as well as the compensation of skin flaps are ideal for proper management. Results: Within the observed analyzes, the results were divided into trans-surgical (99% of the patients closed the midline), immediate post-surgical (Pain, Seroma and Infection <1%) and late (with <3% recurrence) in the experimental group. Conclusions: Within the study, we will be able to analyze that lowering the recurrence rate <3% in patients properly protocolized, is translated as an adequate and totally reproducible method in our environment.
{"title":"Botulunim Toxin Type A Followed by TAR (Transversus Abdominal Release) with Abdominoplasty as the Best Combination for Big Hernia Repair","authors":"Araujo-Lopez A, Salazar-Del Pcp, Peña-González Rr, Cardona-Ochoa P, Gonzalez-Rodriguez M, Rios-Lara Rl, T. R, Ugalde-Vitelly Ja","doi":"10.16966/2470-0991.270","DOIUrl":"https://doi.org/10.16966/2470-0991.270","url":null,"abstract":"Introduction: The current incidence of incisional hernia is up to 11%. Botulinum toxin type A shows atrophy in the extrafusal and intrafusal muscle fibers. With the addition of Muscle Paralysis and improving strength, it is possible to perform an effective posterior component separation. Objective: Describe an easy algorithm to treat complex abdominal wall reconstruction and improve the quality of adjacent tissues. Material and Methods: Fifty-nine patients were analyzed over 1 year in the General Surgery and Plastic and Reconstructive Surgery Service, patients with midline abdominal wall hernias, using the effective reconstruction algorithm, placing by ultrasound-guided botulinum toxin in the muscle transverse, 1 month later performing TAR, with Abdominoplasty for skin flap management, and comparing with the control group that did not apply botulinum toxin. Discussion: Botox is a neurotoxin derived from the bacterium Clostridium botulinum (botulinum toxin type A) that has been observed at the sensory level causing atrophy in the extrafusal and intrafusal muscle fibers. Repair of the abdominal wall after incisional hernias has been a great challenge with recurrence rates of 11%. Performing the release of the transverse muscle has a recurrence of 6%, as well as the compensation of skin flaps are ideal for proper management. Results: Within the observed analyzes, the results were divided into trans-surgical (99% of the patients closed the midline), immediate post-surgical (Pain, Seroma and Infection <1%) and late (with <3% recurrence) in the experimental group. Conclusions: Within the study, we will be able to analyze that lowering the recurrence rate <3% in patients properly protocolized, is translated as an adequate and totally reproducible method in our environment.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128965884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical therapies and operative techniques for intra-nasal disease are constantly evolving; it is therefore imperative that outcomes from treatments and operative techniques can be objectively measured to ensure surgical efficacy. Investigations that measure the nasal airway can help to guide the management of sino-nasal diseases, which can subsequently have a significant impact on patients’ quality of life. Subjective methods of measurement include; anterior rhinoscopy, rigid nasendoscopy, VAS score and SNOT-22. Objective measures include; nasal peak flow testing, acoustic rhinometry, anterior/posterior rhinomanometry and imaging studies. Unfortunately, many objective measurement techniques correlate poorly with patients’ perceptions of disease severity, which questions the clinical relevance of these techniques. Robust, objective methods for measuring the nasal airway may help to guide future treatments, and should ideally correlate with patients’ symptoms to truly tackle the burden of nasal disease.
{"title":"A Review of Advancements in Nasal Airway Measurement","authors":"K. Hamlett, Kumar Bn","doi":"10.16966/2470-0991.196","DOIUrl":"https://doi.org/10.16966/2470-0991.196","url":null,"abstract":"Medical therapies and operative techniques for intra-nasal disease are constantly evolving; it is therefore imperative that outcomes from treatments and operative techniques can be objectively measured to ensure surgical efficacy. Investigations that measure the nasal airway can help to guide the management of sino-nasal diseases, which can subsequently have a significant impact on patients’ quality of life. Subjective methods of measurement include; anterior rhinoscopy, rigid nasendoscopy, VAS score and SNOT-22. Objective measures include; nasal peak flow testing, acoustic rhinometry, anterior/posterior rhinomanometry and imaging studies. Unfortunately, many objective measurement techniques correlate poorly with patients’ perceptions of disease severity, which questions the clinical relevance of these techniques. Robust, objective methods for measuring the nasal airway may help to guide future treatments, and should ideally correlate with patients’ symptoms to truly tackle the burden of nasal disease.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130163447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Cope, Christopher Anglin, Arrionna Dryden, J. Hawthorne, Kellen Choi
Background: Female urethral diseases are sparsely discussed within the literature when compared to urethral diseases affecting men. While, the male urethra is impacted more frequently secondary to the comparative increase in average length, presence of the prostate and considerations of carrying genetic material-disease process of the female urethra impose significant distress to affected patients and also potential for malignancy. The clinical presentation and management strategies often differs from the male counterpart and therefore it is important to consider disease processes of the female urethra unto their own right for evaluation and successful management. It is to that end this publication is put forth.
{"title":"Female Urethral Disease: A Contemporary Review of Presentation, Diagnosis and Current Management Strategies","authors":"Z. Cope, Christopher Anglin, Arrionna Dryden, J. Hawthorne, Kellen Choi","doi":"10.16966/2470-0991.228","DOIUrl":"https://doi.org/10.16966/2470-0991.228","url":null,"abstract":"Background: Female urethral diseases are sparsely discussed within the literature when compared to urethral diseases affecting men. While, the male urethra is impacted more frequently secondary to the comparative increase in average length, presence of the prostate and considerations of carrying genetic material-disease process of the female urethra impose significant distress to affected patients and also potential for malignancy. The clinical presentation and management strategies often differs from the male counterpart and therefore it is important to consider disease processes of the female urethra unto their own right for evaluation and successful management. It is to that end this publication is put forth.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"627 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116469201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stolarski A, He K, Carlson S, O’Neal P, Hess Dt, Whang E, Kristo G
Background: Surgical residents may be perceived as silent violators of duty hours as they try to balance patient care and regulatory compliance. Methods: In order to examine the perspective of general surgery interns on their reporting of work hours, a survey questionnaire was distributed between May 6 and June 3, 2019 to first year surgical trainees at four major academic institutions near the end of their internship year. Results: A total of 25 of 59 interns participated in our survey (42.4% response rate). Work-life balance was consistently rated as the most significant challenge facing surgical interns. All (100%) interns had at one time under-reported work hours, while 28% did so “often”, and 32% “occasionally”. Interestingly, one in five surgical interns reported receiving external pressure from their residency program to under-report working hours. Conclusion: Surgical interns have difficulties adequately balancing their life with the rigorous work of a surgical resident, and that nearly all surgical interns both violate and under-report their work hours. Understanding the reasons why surgical trainees decide to under-report duty hours would help surgical educators develop innovative, non-punitive methods to improve work hour compliance.
{"title":"Multi-Institutional Survey Suggests Duty Hour Violations and UnderReporting by Surgical Interns","authors":"Stolarski A, He K, Carlson S, O’Neal P, Hess Dt, Whang E, Kristo G","doi":"10.16966/2470-0991.224","DOIUrl":"https://doi.org/10.16966/2470-0991.224","url":null,"abstract":"Background: Surgical residents may be perceived as silent violators of duty hours as they try to balance patient care and regulatory compliance. Methods: In order to examine the perspective of general surgery interns on their reporting of work hours, a survey questionnaire was distributed between May 6 and June 3, 2019 to first year surgical trainees at four major academic institutions near the end of their internship year. Results: A total of 25 of 59 interns participated in our survey (42.4% response rate). Work-life balance was consistently rated as the most significant challenge facing surgical interns. All (100%) interns had at one time under-reported work hours, while 28% did so “often”, and 32% “occasionally”. Interestingly, one in five surgical interns reported receiving external pressure from their residency program to under-report working hours. Conclusion: Surgical interns have difficulties adequately balancing their life with the rigorous work of a surgical resident, and that nearly all surgical interns both violate and under-report their work hours. Understanding the reasons why surgical trainees decide to under-report duty hours would help surgical educators develop innovative, non-punitive methods to improve work hour compliance.","PeriodicalId":115205,"journal":{"name":"Journal of Surgery: Open Access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130404390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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