Background groin hernia repair is considered to be one of the most commonly performed operations by general surgeons however; there is no “gold standard” operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilaterality or bilaterality, primary or recurrent status, and type of anesthesia, occupation, and leisure activities. Aim of the Work is to compare the outcome results of the laparoscopic total extraperitoneal TEP hernia repair with mesh or the transabdominal preperitoneal repair (TAPP) with mesh to those of open repair with mesh. Patients and Methods this is a prospective study conducted on those who are diagnosed to have inguinal hernia (direct, indirect). 40 cases with direct, indirect, unilateral or bilateral inguinal hernia and will be divided into two groups: Group A 20 cases fixation a mesh with Tackers . Group B 20 cases fixation a mesh with intracorporeal sutures. The study will be Conducted at Ain Shams University hospitals (El-Demerdash) and other authorized hospitals under supervision of thesis supervisors. Results smoking appears to be a risk factor for hernia development since almost 55% of the study group A and 65% of the study group B were smokers, obesity also appears to be a risk factor since BMI was about 30.20± 7.82 among group A and 32.05 ± 5.98 among group B. This is in contrast to age which seems not to be as strongly related. Conclusion we found the rate of postoperative early and late complications comparable in both groups. But in the LAP group we were able to discharge them from the hospital faster than the OPEN group, they also resumed full activity early.

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Background: Abdominal trauma one of the main series proplem faced in emergency room it is management is directly related to the incidence of morbidity and mortality Laparoscopy approach has gained wide acceptance among all surgeon. Aim of the work:To study role of laparoscopy in management of violating abdominal stab wounds in hemodynamically stable patients regarding current applications, advantages, disadvantages and future developments. Patients and methods: This prospective nonrandomized clinical study included 80 patients who presented to Ain Shams emergency unit with anterior abdominal stab wound(s) during the period from January 2018 till January 2019. Informed consent regarding conservative management or the need for diagnostic laparoscopy / laparotomy was obtained from all patients. Results: In our study results of 80 patients showed 15 patients (18.8%) were negative without intraabdominal lesion. 65 patients (81.3%) had positive finding 46 patients (57.5%) were managed by laparoscopy and 19 patients (23.8%) were converted to open surgery. 46 patients were managed by laparoscopy 12 (15%) patients underwent repair of serosal and small tears with simple intracoporcal suturing. 10 patients (12.5%) with omental injury, cauterization was done to the 8 patients and clipping of omental bleeder in 2 patients was done. 8 patients (10%) with gastric tear were repaired by intracoporial suturing. 11 patients (13.8%) with liver injury, haemostasis was done by cauterization and gel foam. 5 patients with left colonic and sigmoid injuries underwent lap. colostomy. Conclusion: Exploratory laparoscopy applied to carefully selected hemodynamically stable penetrating trauma patients proved to be safe and technically feasible. It also reduced the negative and non-therapeutic laparotomies and offered profound therapeutic potential and cost effectiveness. So 61 patients (76.3%) ovoid unnecessary laparotomy [15 negative (8.8%) + 46 (57.5%) underwent laparoscopic management] so it's proved to both diagnostic and therapeutic role

Introduction: COVID-19 implied that a great number of infected individuals were hospitalized and possibly admitted to intensive care units. Cancer centers have rapidly changed models of care by delaying non-urgent surgeries. Breast surgeries were delayed for early breast cancer patients forcing clinicians to potentially alter treatment recommendations by neoadjuvant chemotherapy until appropriate conditions were established. Aim of the work: to assess conservative breast cancer surgery after neo-adjuvant therapy in early breast cancer patients in COVID-19 era as regard surgical outcome, complications and early recurrence comparing results with previous results when patients underwent primary conservative breast surgery. Patients and Methods: This is a cohort study that was conducted 52 patients with early breast cancer stage I and II a. Patients were divided into two groups (A) and (B). Group A included 26 patients who underwent primary conservative breast surgery. Group B included 26 patients who underwent conservative breast surgery after neo-adjuvant therapy during COVID-19 era. Results: Intra-operative re-excision was done in 5 patients (19.2%) in group A and 3 patients (11.5%) in group B. Two patients (7.7%) in group A and 1 patient (3.8%) in group B were converted to modified radical mastectomy. Sentinel lymph node (SLN) was done in all 26 patients in group A while only 25 patients in group B with 1 patient undergoing axillary dissection from the start. SLN was positive in 8 patients (30.8%) in group A & 6 (24 %) patients in group B. Consequently, 8 patients (30.8%) in group A and 7 patients (26.9%) in group B underwent axillary dissection. Conclusion: Conservative breast cancer surgery after neo-adjuvant therapy in early breast cancer patients in COVID-19 era has comparable results to primary conservative breast surgery. Thus, the obligatory decision to delay primary surgery during COVID-19 era by giving neoadjuvant chemotherapy was effective.