Background: With attention to patient outcome after open inguinal hernia chronic inguinal region pain and discomfort are major complains due to nerve compression by sutures used for mesh fixation. Objectives to compare outcomes of mesh fixation with metallic versus delayed absorbable suture material in inguinal hernia through laparoscopic surgery. Methods: This was prospective study conducted at department of general surgery in a Prime hospital, Dubai during the period of January 2022 to December 2022. Prior approval of local ethical committee was obtained. Total 100 male patients who underwent laparoscopic surgery were included in the study. Patients were split into two groups of 50 each. Metallic suture material (Tantallum 1-0) was used to fix the mesh in group 1 while mesh fixation was used in group 2 was completed with Vicryl 2-0, a delayed absorbable suture material. SPSS was used for analysis. Results: There was appearance of post-operative pain in 20 patients, 10 patients, and 7 patients after 10 days, after 1 month and after 3 months, respectively in group 1 while for group 2, post-operative pain appeared in 12 patients, 4 patients, and 2 patients after 10 days, after 1 month and after 3 months, respectively. As such there was no statistically significant difference was found between two groups except for the appearance of the post-operative pain after 1 month (p<0.05). Conclusions: The recurrence rates for the two approaches are statistically equivalent. As a result, delayed absorbable material may be an effective mesh fixation substitute.

Background: Our current treatment of an appendiceal mass is initially conservative, followed by an interval appendectomy. The necessity of this routine interval appendectomy is debatable.  Aim was to evaluate whether surgical factors and pathological features of the excised appendices support interval appendectomy. Methods: It was a retrospective study conducted for a period of 5 years (2017-2022). To assess the number of patients with appendicitis and a peri-appendiceal mass, all patients in both hospitals encoded for appendicitis were listed. Over this period of 5 years a total of 2,090 patients were diagnosed with acute appendicitis. Of these, 230 patients were operated through Interval appendectomy. All medical records of these patients were then reviewed and relevant variables were registered. Results: It was found that clinical findings alone were not specific enough to diagnose an appendiceal mass; 47% had a palpable abdominal mass and the median temperature was 38.2°C ranging from 36 to 40.5°C. Ultrasound examination was done in 70% of patients and showed an appendiceal mass in 72%. During the interval period, 4 patients presented with an appendiceal mass needing drainage, and 3 with acute appendicitis requiring emergency appendectomy.  Conclusions: We conclude that when causes for the appendiceal mass other than appendicitis are excluded, interval appendectomy seems unnecessary in patients who respond well to initial conservative treatment.

A 40-year-old male patient reported to our outpatient department with complaints of left inguinal swelling noted since 12weeks. He had associated complaints of occasional dragging pain on the left side. There were no associated co morbidities; he was operated before more than 2years as case of open left varicocele. The patient had a body mass index of 24.45 (height 168cm and weight 69kg). His vitals were stable and systemic examination did not reveal any abnormality. On clinical examination, he had a left inguinal hernia. The routine pre-operative investigations including complete blood count, random blood sugar, serum creatinine, prothrombin time, chest X-ray, and electrocardiogram were within normal limits.

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