Background: The improvement of pediatric laparoscopic instruments and increased experience with laparoscopy technique, laparoscopic inguinal hernia repair in children become an important skill which the laparoscopist must be aware of. Laparoscopic repair of inguinal hernias in children is less invasive, more feasible and less painful. Additionally, this procedure is that, it could allow contra lateral hernia detection and repair in same setting. Aim: In our study we aimed to compare between the outcomes of the conventional opened repair and the laparoscopic repair of pediatric inguinal hernia. Materials and Methods: The current prospective study which included 30 patients with inguinal hernia who were divided in to two groups the first group included 10 patients and was managed by laparoscopic repair, while the second group included 20 patients and was managed by the conventional open repair. Results: The mean time of operation in laparoscopic repair is slightly shorter than that of opened repair but this was not statistically significant. Post-operative recovery was significantly faster in patients undergoing open repair than in laparoscopic repair (p = 0.003). Post-operative discharge was significantly faster in undergoing open repair than in laparoscopic repair (p = 0.025). Postoperative secondary hydrocele was common in laparoscopic repair that in open repair while scrotal edema was common in opened repair that laparoscopic repair (p = 0.049). Patient cosmetic Satisfaction was higher in group 1 with laparoscopic repair than in group 2 with opened repair (p = 0.012). Patient financial satisfaction was lower in group 1 with laparoscopic repair than in group 2 with opened repair (p = 0.046). Conclusion: Laparoscopic repair of inguinal hernias in children is less invasive, more feasible, less painful and it could allow contra lateral hernia detection and repair in same setting.
Background: As laparoscopic repair of groin hernia is gaining popularity; most surgeons argue over which mesh fixation techniques are the best. Objective: The present study was conducted to compare the outcomes of mesh fixation using fibrin glue versus tackers in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia, with the ultimate goal of bettering the health and happiness of inguinal hernia patients. Subjects and Methods: This study included a total of 24 inguinal hernia patients chosen for laparoscopic transabdominal preperitoneal repair with mesh fixation by fibrin glue versus tackers, attending at General Surgery Department, Zagazig University Hospitals. Patients were randomly divided into 2 equally groups: Group (A) A fibrin glue was used to fix the mesh and Group (B) Using tackers, to fixed the mesh. Results: There was a statistically significant difference between the groups investigated in terms of operative time, with the fibrin glue group taking significantly longer than the tackers group. Within-day pain and length of hospital stay did not differ significantly between the groups. While return to daily activity was faster in fibrin glue groups. The cost of all cases of fibrin glue group was lower than that of tackers group. Conclusion: It could be concluded that mesh fixation by fibrin glue is better than tacker as mesh fixation with glue causes less post-operative pain and less analgesia is needed as well as low financial cost.
This study was conducted to evaluate the results of the laparoscopic versus open appendectomy in females in childbearing period regarding operative time, operative findings, post-operative complications, hospital stay, postoperative analgesia as well as return of the patients to their normal activity. Aim of this study was to detect the suitability and benefit of either laparoscopic appendectomy or open appendectomy to decrease postoperative complications and improves postoperative results especially tubal adhesions in married females. Methods: This is a prospective randomized comparative study including married female patients from age 18-45 years suffering from acute appendicitis who presented to the Emergency Unit of Surgery Department of Zagazig University during the period from April 2015 to March 2018. These patients were randomly divided into two groups with each had its management approach, open appendectomy group: 27 patients and laparoscopic appendectomy group: 27 patients. The procedure was explained to the patients, and they were consented as regard to the postoperative follow up. Results: There was statistically significant difference between both groups as regards operative time, post-operative complications, hospital stay, postoperative analgesia as well as return of the patients to their normal activity (P value < 0.05). On the other hand, there was no statistical difference between the two groups as regard symptoms and signs according to modified Alvarado Score (P = 0.783), laboratory findings (P = 0.776), preoperative pelvi-abdominal U/S (P = 0.783), intra-operative findings (P = 0.843). Conclusion: laparoscopic appendectomy is considered a feasible and a safe method in acute appendicitis management and it is still better than open procedure, as it has a shorter duration of hospital stay, a less incidence of wound infection, the need for post-operative analgesia is less than open procedure and a faster patient's return to their daily activities.
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