Objective: Umbilical hernia and paraumbilical hernia are ventral herniae that occur in infants and adults. According to current evidence, mesh repair is the treatment of choice to avoid recurrence. The aim of this study is to analyze the surgical methods, the types of meshes used, and their benefits. Material and Methods:A retrospective analysis of patients diagnosed with umbilical hernia and paraumbilical hernia was performed. The patients' consent was obtained retrospectively. The various surgical techniques and different meshes used were analyzed. Forty-three patients were selected for the study. Of these, 23 patients underwent open mesh repair, 12 patients underwent laparoscopic intraperitoneal onlay mesh repair repair, and eight patients underwent open intraperitoneal onlay mesh repair repair. The duration of the surgery, mesh used, number of days of hospital stay, type of anesthesia, and postoperative complications were analyzed. Results:Of the 43 patients, the patients who underwent open intraperitoneal onlay mesh repair had shorter postoperative hospital stays compared to other methods (median=1 day; range=1 to 2 days). The duration of surgery was longer for laparoscopic intraperitoneal onlay mesh repair and open mesh repair compared to the open intraperitoneal onlay mesh repair technique (p<0.05). Conclusion:The open intraperitoneal onlay mesh repair technique had advantages over the other methods for small-defect umbilical hernia and paraumbilical hernia. The duration of surgery was long for laparoscopic intraperi- INTRODUCTIONUmbilical hernia (UH) and paraumbilical hernia (PUH) are ventral herniae that occur in the region of the umbilicus or around the umbilicus (1, 2). UH accounts for 10% of abdominal herniae (3). UH occurs in infants and children, while PUH occurs in adults. UH rarely occurs in adult patients with ascites, obesity, and massive abdominal distention from various causes. There are advantages to the management of UH and PUH using meshes MATERIAL AND METHODSA retrospective analysis of patients who underwent operations for UH and PUH at the Institute of General Surgery, Madras Medical College, was performed. Patients who underwent surgery for UH and PUH over a period of four months, from November 2015 to February 2016, were chosen for the study. Institutional ethical committee clearance was obtained to collect the data. Informed consent was obtained from the chosen patients. Fifty-four patients were diagnosed with UH and PUH. Of these, five patients underwent open anatomical suture repair operations as an emergency procedure and another six patients underwent open mesh repair with associated bowel pathology, for which bowel surgery was performed. Excluding these 11 cases, 43 patients with UH and PUH in whom different types of mesh were used were chosen for the study. All the patients were euthyroid before and after surgery. Of the 43 patients who underwent mesh repair, 23 patients underwent open mesh repair using Prolene mesh, 12 patients underwent laparoscopic IPOM using composite dual...

Background: Perianal fistula is a common surgical problem which poses great discomfort to patients and causes prolonged morbidity when improperly managed or developed complications. Its management protocols are ill defined, and the efficacy of newer treatment modalities are not well established. The aim of the study was to study the clinicopathology of Perianal fistula and its prognostic factors.Methods: This was a prospective study conducted at the Department of General Surgery, Rajiv Gandhi Government General Hospital between August 2014 and July 2015. Purposive sampling method was used select patients with fistula in ano. After obtaining informed consent, patient details were collected in pre-tested structured questionnaire. Data entry and analysis were done using SPSS software.Results: Males between thirty and fifty years were the most affected population. Most of the patients had no co-morbidities while Diabetes Mellitus was the prevalent co-morbid factor, seen especially in the elderly. MRI fistulogram was the investigation of choice. Fistulotomy was the preferred procedure. Recurrence of fistula was an unavoidable morbidity.Conclusions: Proper preoperative evaluation which includes MRI fistulogram and planning the treatment is essential to prevent complications. Fistulotomy is the preferred treatment especially in patients with trans-sphincteric fistula and those with evidence of infection or secondary tract.  The prognosis, if properly managed is very good, so proper management protocols need to be established.