Purpose To asses TAPP with external fixation against PHS and to find which is more suitable in primary inguinal hernia repair. Inguinal hernia repair is the most frequently performed operation in general surgery and so even modest improvements in clinical outcomes are important. The most important criteria for the choice of method are safety (morbidity and mortality), recurrence rates and convenience for the patient, including the risk of chronic groin pain. In recent years, great importance has been placed on the short-term comfort of the patient, measured by post operative pain and the length of convalescence. This is a retrospective study for 250 patients done years ago at

INTRODUCTIONLaparoscopic splenectomy was first performed in 1992 and has since gained popularity, particularly for hematological disorders of the spleen in adult and pediatric patients. Laparoscopic splenectomy is feasible, effective, and safe with low morbidity rates and has rapidly become the surgical approach of choice for patients that require elective splenectomy in the treatment of hematologic disorders. 2,3 That is primarily because patients undergoing laparoscopic splenectomy have less postoperative pain, a shorter length of hospital stay, and faster recovery when compared with patients who undergo open splenectomy. 4Laparoscopic splenectomy was associated with significantly fewer pulmonary, wound, and infectious complications. 5Methods like 3D virtual rendering in children before laparoscopic partial splenectomy was used to give high ABSTRACT Background: Laparoscopic splenectomy is feasible, effective, and safe with low morbidity rates, faster recovery when compared with patients who undergo open splenectomy. The aim of this study was to describe a new technique for laparoscopic partial splenectomy to decrease blood loss. Methods: This study started from May 2015 till April 2017. This retrospective study included total 20 adults containing 12 females, ten with hydatid cyst of the spleen with positive serological tests for Echinococcus granulosus (Indirect hemagglutination (IHA)) was used, and two cases with congenital splenic cysts with negative serology for Echinococcus granulosus and eight males with hydatid cyst positive serological tests for Echinococcus granulosus. Results: The mean time for laparoscopic resection was 150 minutes (range from 90 to 200 min). No bleeding, no postoperative pancreatic fistula or diaphragmatic injury. No conversion was necessary. The mean hospital stay was 4 days (range from 2 to 6 days). None of the patients needed postoperative blood transfusion. No post-splenectomy infections. Three weeks and after 6 months postoperatively, US Doppler was done and found normal vascularisation of the splenic remnant. Conclusions: Clipless, Sutureless laparoscopic partial splenectomy is feasible and safe. This surgical procedure offers advantages of decrease blood loss and preservation of splenic tissue, reducing the risk of post-splenectomy sepsis.

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