Objective To explore the therapeutic effects of biofeedback in the treatment of faecal incontinence (FI) after surgery for anorectal malformation (ARM). Methods Clinical data were collected from paediatric patients for postoperative biofeedback due to FI caused by ARM between May 2017 and November 2021. The data included the duration of symptoms, the integrity of the anal sphincter, anorectal manometry parameters, and FI scores. These patients were divided into the low ARM group (group A) and the high ARM group (group B). Results A total of 45 paediatric patients were enrolled in the study. There were 28 cases in group A and 17 cases in group B. The differences in age, gender, and body weight were not statistically significant between the two groups ( p > 0.05). The differences in the clinical indicators were also not statistically significant between the two groups at the time of the initial evaluation. The duration of symptoms was 2.21 ± 0.71 years and 4.14 ± 1.89 years in groups A and B. There were 16 cases with an intact anal sphincter in group A and only two cases with an intact anal sphincter in group B. This difference was statistically significant between the two groups ( p < .05). The anal resting pressure, initial sensitivity threshold, defaecation sensitivity threshold, defaecation urge threshold, and FI scores were significantly improved in both groups post-treatment compared to pre-treatment ( p < .001). Strong impulses improved significantly in group A, while strong impulses did not improve significantly in group B. The multivariate logistic regression analysis with these variables further showed that symptom duration and anal sphincter integrity were the main factors influencing the therapeutic effects of biofeedback. Conclusion Biofeedback plays a positive role in the treatment of FI in paediatric patients following surgery for ARM. Symptom duration and anal sphincter integrity were found to be the main factors influencing the therapeutic effect of biofeedback.

Background Lateral incisional hernia surgery represents an underappreciated challenge for general surgeons. McBurney's incisional hernia (L3) after appendectomy is rare, with an incidence between 0.1 and 0.9%. Several studies have found fewer postoperative complications with the laparoscopic approach compared with open approach. Objective To show a video of a transabdominal preperitoneal (TAPP) approach for McBurney's incisional hernia associated with a small right lateral inguinal hernia. Method We report a case of a 52 years old man, with previous open appendectomy in 2013, diagnosed with McBurney's incisional hernia (L3W2R0) and small right inguinal hernia (L1M0F0P). The patient was scheduled for laparoscopic TAPP incisional hernia repair. Results The patient was operated as ambulatory surgery with no intraoperative complications. No recurrence nor other complications detected during short, 4th month, follow up after surgery. Conclusions Minimal invasive hernia repair with preperitoneal mesh of lateral abdominal hernias cause less postoperative pain, have a short hospital stay, lower incidence of surgical site and mesh infection, and possibly can reduce recurrence as a wider mesh overlap of the defect is possible. This technique has shown to be feasible and reproducible in selected cases.

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