Inguinal hernia is a common disease. Many researches were done to evaluate the different methods of treatment yet there is no ideal method for treatment till now. Since the use of laparoscopy in hernia repair evolved, it is probably becoming the treatment of choice for hernia.Objectives: This is a prospective randomized trial that aimed at comparing the outcome of using absorbable versus non-absorbable tacks as mesh fixation devices in patients undergoing laparoscopic transabdominal inguinal hernia repair (TAPP) regarding postoperative groin pain and early recurrence.Patients and Methods: Thirty patients were enrolled in this study. The patients were divided into two groups: Group A included 15 patients who underwent TAPP with mesh fixation by non absorbable tack (NAT) and group B included 15 patients who underwent TAPP with mesh fixation by absorbable tack (AT). Follow up was done at the first day, second week, sixth month and one year postoperatively. Results:The 2 groups had similar features regarding demographics, operation time, postoperative hospital stay and morbidity. The 2 fixation methods were found similar for postoperative pain and recurrence with no significant difference.

Introduction: Although laparoscopic sleeve gastrectomy (LSG) is an effective treatment for morbid obesity, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. Although improvement of GERD symptoms following LSG has been reported in some studies, others have shown a 9-34.6 % increase in the prevalence of GERD symptoms during the first year following LSG.Aim: This study was aiming to evaluate the changes of GERD symptoms and erosive esophagitis (EE) in morbidly obese patients who underwent LSG.Patients and methods: Pre-and post-operative details of forty morbidly obese patients (body mass index (BMI) more than 40 kg/m 2 or 35 kg/m 2 with other comorbidities) with and without GERD who underwent laparoscopic sleeve gastrectomy and were followed up in Ain Shams University hospitals between September 2014 and May 2016 were recorded.Results: After surgery, significant decreases were reported in mean body mass index (44.3±3.8 vs. 36.5±5.3 kg/m 2 ). Conversely, an insignificant increase was observed in the prevalence and severity of GERD symptoms and EE after LSG. 1 patient (20%) developed denovo symptomatic GERD within the 6 months follow-up. Conclusion:Although LSG can achieve significant weight loss and improvement of comorbidities in severely obese patients, the prevalence and severity of GERD symptoms and EE increase after the operation mandates that it should be carefully investigated pre-operatively and other bariatric surgery options should be considered.

Introduction: Colorectal cancer (CRC) is the third most common cancer in men and second in women worldwide. It is one of the leading causes of cancer death all over the world. Right-sided colon cancer represents approximately 15% of all cases of CRC. This study was designed to compare the short-term surgical outcomes of laparoscopic-assisted right colectomy (LARC) and totally laparoscopic right colectomy (TLRC) for right sided cancer colon. Aim of the study:This study was designed to show whether there was any advantage or disadvantage between LARC and TLRC for right sided cancer colon as regard the short term surgical outcomes.Patients and methods: A consecutive series of 40 patients underwent elective surgery for right-sided colon cancer from April 2014 to October 2015 in Ain Shams University hospitals, Cairo, Egypt and in Al Hamadi hospital, Riyadh, Saudi Arabia. Patients were treated by laparoscopic right colectomy through a medial to lateral approach. In 20 patients a TLRC was performed and in 20 patients LARC was performed. Perioperative care plan, operative steps and surgical instrumentations were standardized. Data on the patients' demographics, disease features, operative details and follow up were recorded and analyzed.Results: There was no significant difference in term of demographic characteristics, co-morbidities, site of tumor and stage of disease between the two groups. There were 3 cases of conversion to laparotomy. Median operative time (179.7±16.95 minutes versus 179.85±17.16 minutes; not significant (NS)) and estimated blood loss (67±16.73 ml versus 65.25±16.42 ml; NS) were statistically not significant in both groups. Timing of first defecation (2.75±0.79 days versus 2.6±0.75 days; NS) and length of hospital stay (4.85±0.81 days versus 4.7±1.8 days; NS) were statistically not significant. A significantly longer length of skin incision characterized LARC group compared with TLRC group (6.3±0.99 cm versus 5.4±0.76; P 0.0016). Both groups achieved an adequate number of lymph nodes harvested (15.6±1.19 versus 16.8±1.5 nodes; P 0.008) and oncological resection of the tumor (proximal margin 9.1±3.22 cm versus 9.55±2.8 cm; NS with distal margin 11.2±2.35cm versus 12.4 ±2.3cm; NS). Post-operative complications were statistically comparable in both groups. No readmission within 30 days of discharge was observed.Conclusions: Meanwhile most surgeons prefer LARC because it's less technically demanding than TLRC. Both are feasible and safe techniques, with comparable results as regard operative time, preservation of oncologic principles and post operative short-term outcome. Yet, TLRC is superior regarding specimen extraction in both the length and site of skin incision required for specimen extraction.

Introduction: Laparoscopic Sleeve Gastrectomy (LSG) has become the most commonly performed bariatric procedure. LSG is known for its safety and effectiveness, shorter operative time, feasibility, and easiness of revision and conversion to a malabsorptive surgery. Surgeons are tailoring different techniques to avoid complications from arising. Twisting of the sleeved gastric tube is one of the causes of sleeve obstruction and persistent nausea and vomiting. This study aims to compare between the postoperative complications in sleeve gastrectomy with and without posterior fixation. Patients and methods:In this prospective comparative cohort study 643 patients were included; divided into two groups according to the surgical technique. Group 1 included 364 LSG operations without fixation and Group 2 included 279 LSG with sleeve fixation. The operations were performed at Ain Shams University Hospitals between June 2017 and June 2021. Fixation of the sleeve was performed by two or three absorbable stitches to the prepancreatic fascia and root of the mesocolon. Incidence of postoperative complications were compared in each group.Results: There were no statistically significant differences in baseline characteristics between the two groups included in the study. Group 2 showed highly significant increase in operative time (p<0.001) the overall incidence of complications was significantly less in the fixation group (p <0.0001). Incidence of vomiting, bleeding, GERD and re-operation was significantly lower in group 2 (p<0.05).Seven patients from group 1 were diagnosed with gastric twist as post operative complication with one patient suffering from leakage compared to three patients in group 2. There were no mortalities in both groups. Conclusion:Adding posterior fixation to LSG ensures decreases incidence of complications. Many randomized controlled trials are needed to draw a solid outcome.

Background: Surgery is the only treatment for symptomatic saccrococcygeal pilonidal sinus. Various surgical techniques are described in literature; yet, the ideal technique is still controversial because of the high recurrence rate that is associated with the majority of the techniques. Aim of the work:To evaluate Limberg flap closure for the treatment of primary pilonidal sinus by comparing its operative and postoperative outcome with open excision and healing by secondary intention.Methods: This is a prospective randomized trial which enrolled eighty patients with primary pilonidal sinus from May 2015 to April 2018. The patients were divided into two groups. Group A included forty patients who underwent excision and the wound was left to heal by secondary intention. Group B included forty patients who underwent rhomboid excision and Limberg flap repair. Results:The operative time was significantly longer in group B. Duration for complete wound healing and return to work were significantly longer in group A. There was no statistically significant difference between both groups neither in recurrence nor in postoperative complications. Conclusion:Although recurrence was the same with in healing by secondary intention and Limberg flap, yet rhomboid excision and Limberg flap closure for the management of primary pilonidal sinus is better option in terms of wound healing and early return to work.