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P J Odwyer - One of the best experts on this subject based on the ideXlab platform.
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chronic groin sepsis following tension free inguinal Hernioplasty
British Journal of Surgery, 2002Co-Authors: S G Taylor, P J OdwyerAbstract:Background: Chronic groin sepsis requiring mesh removal is said to be a rare complication of tension-free inguinal Hernioplasty. The aim of this study was to determine the number of surgeons performing tension-free inguinal Hernioplasty in the West of Scotland and assess the frequency with which chronic groin sepsis was encountered. Methods: A questionnaire was sent to all consultant surgeons performing inguinal hernia repair in the region and follow-up of patients with chronic groin sepsis following tension-free inguinal Hernioplasty was undertaken. Results: Of 80 consultants who replied to the questionnaire, 79 were performing tension-free Hernioplasty. Of these, 76 were performing only open repairs while three were also undertaking laparoscopic repairs. Sixteen consultants reported 20 patients with groin sepsis after mesh repair. Twelve patients were traced; eight had chronic sinuses and four had groin abscesses. The median interval between repair and presentation was 4 months (range from 2 weeks to 39 months). All have required complete (11 patients) or partial (one) removal of mesh to resolve the symptoms. Conclusion: Tension-free inguinal Hernioplasty has become the operation of choice for surgeons in the region. Chronic groin sepsis may be more frequent than reported previously. Complete removal of mesh is required to treat this condition. © 1999 British Journal of Surgery Society Ltd
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chronic groin sepsis following tension free inguinal Hernioplasty
British Journal of Surgery, 1999Co-Authors: S G Taylor, P J OdwyerAbstract:BACKGROUND: Chronic groin sepsis requiring mesh removal is said to be a rare complication of tension-free inguinal Hernioplasty. The aim of this study was to determine the number of surgeons performing tension-free inguinal Hernioplasty in the West of Scotland and assess the frequency with which chronic groin sepsis was encountered. METHODS: A questionnaire was sent to all consultant surgeons performing inguinal hernia repair in the region and follow-up of patients with chronic groin sepsis following tension-free inguinal Hernioplasty was undertaken. RESULTS: Of 80 consultants who replied to the questionnaire, 79 were performing tension-free Hernioplasty. Of these, 76 were performing only open repairs while three were also undertaking laparoscopic repairs. Sixteen consultants reported 20 patients with groin sepsis after mesh repair. Twelve patients were traced; eight had chronic sinuses and four had groin abscesses. The median interval between repair and presentation was 4 months (range from 2 weeks to 39 months). All have required complete (11 patients) or partial (one) removal of mesh to resolve the symptoms. CONCLUSION: Tension-free inguinal Hernioplasty has become the operation of choice for surgeons in the region. Chronic groin sepsis may be more frequent than reported previously. Complete removal of mesh is required to treat this condition.
S Bringman - One of the best experts on this subject based on the ideXlab platform.
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Early results of a randomised trial comparing Prolene and VyproII-mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias
Hernia, 2006Co-Authors: T Heikkinen, S. Wollert, J. Österberg, S. Smedberg, S BringmanAbstract:The purpose of this study was to compare a lightweight mesh to a standard polypropylene hernia mesh in endoscopic extraperitoneal Hernioplasty in recurrent hernias. A total of 140 men with recurrent unilateral inguinal hernias were randomised to a totally extraperitoneal endoscopic Hernioplasty (TEP) with Prolene or VyproII in a single-blinded multi-center trial. The randomisation and all data handling were performed through the Internet. 137 patients were operated as allocated. Follow-up was completed in 88% of the patients. The median operation times were 55 (24–125) min and 53.5 (21–123) min for the Prolene and VyproII groups, respectively. The meshes had comparable results in the surgeon’s assessment of the handling of the mesh, return to work, return to daily activities, complications, postoperative pain and quality of life during the first 8 weeks of rehabilitation, except in General Health (GH) SF-36, where the VyproII-group had a significantly better score ( P =0.045). The use of Prolene and VyproII-meshes in endoscopic repair of recurrent inguinal hernia seems to result in similar short-term outcomes and quality of life.
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tension free inguinal hernia repair tep versus mesh plug versus lichtenstein a prospective randomized controlled trial
Annals of Surgery, 2003Co-Authors: S Bringman, Stig Ramel, T Heikkinen, Tord Englund, Bo Westman, Bo AnderbergAbstract:Surgery for a groin hernia is the most common operation in general surgery. 1 The recurrence rate in nonspecialized centers is high, 2 and postoperative pain and discomfort are common. 3 With the use of open tension-free hernia surgery with mesh, the recurrence rate has decreased and the rehabilitation period has been reduced compared to sutured repairs. 4 Many different tension-free techniques have been developed, 4–8 and the use of mesh is common and increasing. 9–11 In Sweden and Denmark the most frequently used hernia repair is the Lichtenstein procedure. 12 During the last decade minimally invasive hernioplasties have been developed using either a laparoscopic or an open technique. 6,7,13–16 The learning curve in laparoscopic Hernioplasty is long, 17–21 whereas the open operation with a mesh-plug and patch is easier to perform. 7,22 The results from this method have been promising though not yet published in large randomized studies. 23–25 This study was designed to compare three tension-free methods of Hernioplasty: laparoscopic totally extraperitoneal Hernioplasty (TEP), herniorrhaphy with mesh-plug and patch, and Lichtenstein’s operation. The primary aim was to compare the postoperative rehabilitation variables, with sick leave and time to full recovery as the main variables. The secondary aim was to evaluate if there were any differences in the early recurrence rate or complications.
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is a dissection balloon beneficial in totally extraperitoneal endoscopic Hernioplasty tep a randomized prospective multicenter study
Surgical Endoscopy and Other Interventional Techniques, 2001Co-Authors: S Bringman, Eva Haglind, T J Heikkinen, Anders Kald, F Kylberg, Stig Ramel, Conny Wallon, B AnderbergAbstract:Background: Laparoscopic Hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to facilitate the creation of the initial working space in totally extraperitoneal endoscopic Hernioplasty (TEP), but their use adds to the cost of the operation. Methods: A total of 322 men with unilateral, primary, or recurrent inguinal hernias were randomized to undergo TEP with or without a dissection balloon. Results: In the group with the balloon, three of 161 patients (2.5%) required conversion to transabdominal preperitoneal Hernioplasty (TAPP), or open herniorraphy, whereas 17 of 161 patients (10.6%) were converted to TAPP or open herniorraphy in the group without the balloon (p = 0.002). The mean operation time was 55 min in the group with the balloon and 63 min in the group without the balloon (p = 0.004). There was no difference between them in postoperative morbidity, and there were no major complications in either group. The recurrence rate was 3.1% in the group with the balloon and 3.7 % in the group without the balloon (p = 0.8). Conclusion: The use of a dissection balloon in TEP reduces the conversion rate and may be especially beneficial early in the learning curve.
Parviz K Amid - One of the best experts on this subject based on the ideXlab platform.
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the lichtenstein repair in 2002 an overview of causes of recurrence after lichtenstein tension free Hernioplasty
Hernia, 2003Co-Authors: Parviz K AmidAbstract:Lichtenstein tension-free Hernioplasty began in 1984. Based on our own mistakes, in the late 1980s, we established a set of key principles and reported the causes of our recurrences. Recently, other authors analyzing the causes of their own recurrences with tension-free repair are drawing the same conclusions. This indicates that others are repeating our previously reported mistakes. To prevent recurrence, the mesh size was increased to 7.5x15 cm to extend well beyond the boundary of the inguinal floor and give the mesh a dome-shaped laxity to compensate for the increased intra-abdominal pressure and mesh shrinkage. Wide extension of the mesh beyond the inguinal floor and the dome-shaped laxity of the mesh served to further reduce recurrence rate. Following the key principles of the Lichtenstein tension-free Hernioplasty, which can be facilitated by using a recently developed prosthesis that addresses all the key principles of the procedure, achieves the best result.
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long term result and current status of the lichtenstein open tension free Hernioplasty
Hernia, 1998Co-Authors: Parviz K Amid, Irving L LichtensteinAbstract:The tension-free Hernioplasty project began in 1984 at the Lichtenstein Hernia Institute. The method consists of complete reinforcement of the inguinal floor with a large sheet of mesh, with adequate mesh tissue interface beyond the boundary of the inguinal floor and creation of a new internal ring made of prosthesis. The preliminary report of this operation was published in 1989, with no recurrence at that point in time. Shortly after the submission of the report, several recurrences were encountered. Based on the lesson learned from those recurrences, the operation was slightly modified and reported in 1991 [Amid 1993]. Since then, the Lichtenstein technique has gained world-wide popularity. Outcome measures identical to ours and other authors have been achieved by even those surgeons who have no special interest or expertise in herniology. The purpose of this article is to report the current state of the open tension-free Hernioplasty for the repair of primary and recurrent inguinal hernias.
S G Taylor - One of the best experts on this subject based on the ideXlab platform.
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chronic groin sepsis following tension free inguinal Hernioplasty
British Journal of Surgery, 2002Co-Authors: S G Taylor, P J OdwyerAbstract:Background: Chronic groin sepsis requiring mesh removal is said to be a rare complication of tension-free inguinal Hernioplasty. The aim of this study was to determine the number of surgeons performing tension-free inguinal Hernioplasty in the West of Scotland and assess the frequency with which chronic groin sepsis was encountered. Methods: A questionnaire was sent to all consultant surgeons performing inguinal hernia repair in the region and follow-up of patients with chronic groin sepsis following tension-free inguinal Hernioplasty was undertaken. Results: Of 80 consultants who replied to the questionnaire, 79 were performing tension-free Hernioplasty. Of these, 76 were performing only open repairs while three were also undertaking laparoscopic repairs. Sixteen consultants reported 20 patients with groin sepsis after mesh repair. Twelve patients were traced; eight had chronic sinuses and four had groin abscesses. The median interval between repair and presentation was 4 months (range from 2 weeks to 39 months). All have required complete (11 patients) or partial (one) removal of mesh to resolve the symptoms. Conclusion: Tension-free inguinal Hernioplasty has become the operation of choice for surgeons in the region. Chronic groin sepsis may be more frequent than reported previously. Complete removal of mesh is required to treat this condition. © 1999 British Journal of Surgery Society Ltd
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chronic groin sepsis following tension free inguinal Hernioplasty
British Journal of Surgery, 1999Co-Authors: S G Taylor, P J OdwyerAbstract:BACKGROUND: Chronic groin sepsis requiring mesh removal is said to be a rare complication of tension-free inguinal Hernioplasty. The aim of this study was to determine the number of surgeons performing tension-free inguinal Hernioplasty in the West of Scotland and assess the frequency with which chronic groin sepsis was encountered. METHODS: A questionnaire was sent to all consultant surgeons performing inguinal hernia repair in the region and follow-up of patients with chronic groin sepsis following tension-free inguinal Hernioplasty was undertaken. RESULTS: Of 80 consultants who replied to the questionnaire, 79 were performing tension-free Hernioplasty. Of these, 76 were performing only open repairs while three were also undertaking laparoscopic repairs. Sixteen consultants reported 20 patients with groin sepsis after mesh repair. Twelve patients were traced; eight had chronic sinuses and four had groin abscesses. The median interval between repair and presentation was 4 months (range from 2 weeks to 39 months). All have required complete (11 patients) or partial (one) removal of mesh to resolve the symptoms. CONCLUSION: Tension-free inguinal Hernioplasty has become the operation of choice for surgeons in the region. Chronic groin sepsis may be more frequent than reported previously. Complete removal of mesh is required to treat this condition.
Luca Ansaloni - One of the best experts on this subject based on the ideXlab platform.
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assessment of 126 913 inguinal hernia repairs in the emilia romagna region of italy analysis of 10 years
Hernia, 2014Co-Authors: Luca Ansaloni, Fausto Catena, Federico Coccolini, Daniela Fortuna, S Di Saverio, L M B Belotti, Rita Maria MelottiAbstract:Purpose Inguinal Hernioplasty could be used as an indicator of the surgical quality offered in different health institutions and countries, thereby establishing a scientific basis from which the procedure can be critically assessed and ultimately improved. Quality assessment of hernioplasties could be conducted using two different methods: either analyzing dedicated regional/national databases (DD) or reviewing administrative databases (AD).
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inguinal hernia repair with porcine small intestine submucosa 3 year follow up results of a randomized controlled trial of lichtenstein s repair with polypropylene mesh versus surgisis inguinal hernia matrix
American Journal of Surgery, 2009Co-Authors: Luca Ansaloni, Filippo Gazzotti, Fausto Catena, Federico Coccolini, Luigi Dalessandro, Antonio Daniele PinnaAbstract:Abstract Background The aim of this study was to evaluate the safety and efficacy of Lichtenstein's Hernioplasty using Surgisis Inguinal Hernia Matrix (SIHM; Cook, Bloomington, Indiana) compared with polypropylene (PP; Angiologica, Pavia, Italy). Methods This was a prospective, randomized, double-blind trial comparing Lichtenstein's inguinal Hernioplasty using SIHM versus PP. Results Seventy male patients underwent Lichtenstein's Hernioplasty (n = 35 in the SIHM group and n = 35 in the PP group). At 3 years after surgery, there were 2 deaths (5.7%) in the PP group and 1 death (2.9%) in the SIHM group (not significant [NS]). Although the study was underpowered to evaluate the recurrence rate, only 1 recurrence (2.9%) was seen in the PP group (NS). Although a significant decrease in postsurgical pain incidence was never observed among patients in the SIHM group, a significantly lower degree of pain was detected at rest and on coughing at 1, 3, and 6 months and on movement at 1, 3, and 6 months and 1, 2, and 3 years. A significant decrease in postsurgical incidence and degree of discomfort when coughing and moving were observed among patients in the SIHM group at 3 and 6 months and at 1, 2, and 3 years after surgery. Comments SIHM Hernioplasty seems to be a safe and effective procedure.
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lichtenstein repair of inguinal hernia with surgisis inguinal hernia matrix soft tissue graft in immunodepressed patients
Hernia, 2005Co-Authors: Fausto Catena, Filippo Gazzotti, S Agrusti, Sara Peruzzi, Angelo De Cataldis, Stefania Gagliardi, Antonio Leone, Luke Dalessandro, Luca Ansaloni, Mario TaffurelliAbstract:While polypropylene mesh remains the preferred prosthesis material for hernioplasties, there are some problems with infections, intestinal obstruction and fistulization, and migration particularly in immunodepressed patients. A new degradable and reabsorbable material, the porcine small intestinal submucosa (Surgisis) has been developed for hernia repairs in humans. This prospective study evaluated the safety and efficacy of Lichtenstein Hernioplasty using the Surgisis inguinal hernia matrix soft-tissue graft as a mesh in ten immunodepressed subjects. Six subjects were HIV-positive in the immunodepressive phase, and the other four had undergone transplantation (three kidney, one liver). There were no intraoperative or postoperative complications, recurrences, or wound infections. Thus Lichtenstein’s Hernioplasty using the Surgisis inguinal hernia matrix soft-tissue graft in immunodepressed patients promises safety and efficacy.