Background: Trans abdominal preperitoneal (TAPP) a novel approach for inguinal hernia was introduced by Arregui (1991) and Dion in early 1990’s has brought the revolutionary change in the era of hernia surgery over open preperitoneal inguinal hernia repair procedure introduce by Stoppa. Based on this we have done single institution retrospective study of TAPP and open preperitoneal procedure for inguinal hernia.Methods: This study was single institution retrospective study, where we have analyzed the data of 93 male and 7 female patients out of which 50 underwent standard TAPP procedure and 50 patients who underwent open preperitoneal procedure for inguinal hernia, with median 1 year of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.Results: 100 patients with mean age of 55 years, median ASA of 1, ratio of left: right: bilateral for open 18:30:2 and for laparoscopic 26:20:4. Mean time for surgery was 102.3 min for open and 142.4 mins for TAPP. There was surgical site infection in 3 patients operated by open procedure and 2 patients in TAPP procedure. 4 patients from open procedure group and no one with TAPP group developed seroma which were managed conservatively and resolved at 6 weeks and 8 weeks. One recurrence in TAPP group patient at the 1 week follow.Conclusions: Open preperitoneal repair is hence a technique as effective as laparoscopic hernia repair with a minimal learning curve, ability to be performed under regional anaesthesia and cost effective. It can hence be used to carry out inguinal hernia repairs effectively in rural areas.
Background: The combined Rives-Stoppa technique has been adopted as the gold standard for open incisional hernia repair. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia. Based on this we have done single institution retrospective study of IPOM and open rectrorectus mesh repair for ventral hernia with size less than 5 cm.Methods: This study was single institution retrospective study, where we have analyzed the data of 30 patients in each group of ventral hernia, with median 18 months of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.Results: Our study consists of 30 heterogenous population with similar age distribution in each group, mean time for surgery was 70.83 min for open and 66.33 minutes for IPOM. There was surgical site infection in 3 patients operated by open procedure and 2 patients in IPOM procedure. Duration of hospital stay which is more in open retrorectus repaired patients, 5.47 (mean) days and less in laparoscopic IPOM repaired patients, 5.07 (mean) days. Recurrence in both groups of patients is not seen in 6 months follow up in our study.Conclusions: Study supports safety in terms of duration of surgery, postoperative pain, surgical site infection, duration of hospital stays and efficacy in terms of return of normal activity and recurrence, equally effective in both open retrorectus and laparoscopic IPOM repair of ventral hernia with size less than 5 cm.
Background: Trauma and trauma related deaths are a major health concerns in any country of which half of the deaths are due to head injuries. Yet reliable statistics are difficult to discover from routinely collected data. This study helps to analyse the epidemiology, mortality and morbidity of traumatic head injury patients in a tertiary care hospital in Mumbai.Methods: Retrospective data of one year (1st January 2019 to 31st December 2019) was collected from Medical records department. Demographic data, mode of injury, severity of injury, interventions done, duration of hospital stay, mortality and morbidity were recorded.Results: Of the total 944 cases recorded, 785 (83%) were males. More than half of the patients were below 40 years of age. The leading cause of trauma was RTA (79%) followed by accidental fall (18%). Of all the trauma patients 110 (11%) were found to be under influence of alcohol. 77 patients (8%) on admission had poor GCS (0-3), while 766 (81%) on admission had good GCS (8 and above). 153 patients (16%) underwent neurosurgical intervention. Average length of hospital stay of most patients (545) was 4 to 7 days. Total mortality was 111 (12%). Mortality was high in patients with poor GCS on admission.Conclusions: The above study gives statistics regarding the epidemiology, morbidity and mortality of patients of traumatic head injuries in a tertiary care hospital which can be used for future references in designing management policies to prevent traumatic head injuries.
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