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Zhiyuan Dai - One of the best experts on this subject based on the ideXlab platform.

  • laparoscopic Inguinal Ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse
    Journal of Obstetrics and Gynaecology Research, 2019
    Co-Authors: Zhiyuan Dai, Huimin Shu
    Abstract:

    Aim To demonstrate the efficacy and safety of a modified technique of laparoscopic Inguinal Ligament suspension (LILS) with hysterectomy for the treatment of uterovaginal prolapse. Methods A total of 57 patients were treated by LILS combined with hysterectomy between Jan 2014 and Feb 2016. The perioperative parameters, such as operative time, estimated blood loss, length of stay and intra- and postoperative complications were recorded. The Pelvic Organ Prolapse questionnaire classification was applied to evaluate the Pelvic Organ Prolapse stage, and Patient Global Impression of Improvement scale was used to determine the patients' satisfaction. Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire were used to evaluate the functional improvement. All data were collected preoperatively and then at 12 months postoperatively. Results The mean surgical time was 130.4 (82-190) min, the average blood loss was 50.4 (10-300) mL and the mean hospitalization was 5.3 (4-8) days. The rates of intra- and postoperative complications were low. After a minimal of 12 months follow-up, the anatomical success rate was 85.5%, and the subjective satisfaction rate was 92.7%. The functional measures also presented a significant improvement with no recurrence of prolapse. Conclusion LILS combined with hysterectomy was a safe and effective technique and might be considered as an alternative treatment for patients with uterovaginal prolapse.

  • laparoscopic Inguinal Ligament suspension a novel procedure to repair uterine prolapse
    International Urogynecology Journal, 2019
    Co-Authors: Zhiyuan Dai, Huimin Shu, Xiaohong Guan, Kai Zhang
    Abstract:

    Traditionally, surgical treatment for uterine prolapse has included hysterectomy. However, more patients now prefer a uterine-preserving operation because of concerns about fertility or sexual dysfunction. In this video, we describe a novel approach to correcting uterine prolapse in an attempt to demonstrate an alternative option for patients. A 42-year-old woman with symptomatic stage I-IV uterine prolapse (POP-Q: Aa +2, Ba +2, C + 3, gh 6.5, pb 3, TVL 8.5, Ap 0, Bp 0, D 0) underwent Inguinal Ligament suspension. The principle steps and techniques to complete the operation are outlined in the video. Prolapse repair was successfully completed without any intraoperative complications. The uterus was restored to its anatomic position. During the 12-month follow-up, neither recurrence nor postoperative complications, such as mesh exposure, de novo incontinence or bowel obstruction, etc., occurred. Laparoscopic Inguinal Ligament suspension is a safe and feasible alternative for correcting the uterine prolapse. This surgery could be an attractive choice for patients who prefer a uterine-sparing surgery.

  • laparoscopic Inguinal Ligament suspension with uterine preservation for pelvic organ prolapse a retrospective cohort study
    International Journal of Surgery, 2018
    Co-Authors: Huimin Shu, Zhiyuan Dai
    Abstract:

    Abstract Objective To introduce an alternative surgical technique of laparoscopic Inguinal Ligament suspension (LILS) with uterine preservation and evaluate its efficacy and safety for patients with severe pelvic organ prolapse (POP). Methods Between June 2014 and December 2015, 35 patients with symptomatic stage III or IV were treated by LILS with uterine preservation. The perioperative parameters including surgical time, blood loss, hospital stay and complications were recorded. The anatomical cure rate was evaluated according to the Pelvic Organ Prolapse Questionnaire (POP-Q) assessment. The anatomical points were analyzed by dynamic Magnetic Resonance Imaging (MRI). Validated questionnaire of the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic organ prolapse urinary Incontinence Sexual Questionnaire (PISQ-12) were recorded to evaluate the symptom severity, quality of life and sexual activity. Results The mean surgical time was 163.8 ± 42.3 min (range: 120–280 min), the mean estimated blood loss was 48.6 ± 60.5 ml (range: 10–200 ml), and the mean hospital stay was 5 days (range: 3–7 days). No intra-operative complications were encountered. The anatomical success rate at postoperative 6-month and 12-month was 97.1% and 94.3%, respectively. The postoperative anatomical points on straining showed a significant improvement on dynamic MRI as compared to baselines. The symptom severity, quality of life and sexual activity also presented significant improvement both 6-month and 12-month after surgery. After a minimal 12 months follow-up, no postoperative complications occurred and the recurrence prolapse were low. Conclusion LILS with uterine preservation is a feasible, effective and safe surgical alternative in the treatment of POP for patients who desire to reserve uterus. Longer follow-up data from larger studies are required to confirm the benefits of LILS with uterine preservation as a minimally invasive surgical approach.

  • laparoscopic Inguinal Ligament suspension versus laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse study protocol for a randomized controlled trial
    Trials, 2018
    Co-Authors: Zhiyuan Dai, Huimin Shu
    Abstract:

    Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of Inguinal Ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse. As a new surgical technique for POP, a prospective randomized controlled trial comparing the LILS with the standard technique of LSC is necessary. Therefore, we will conduct a trial. The trial is a randomized controlled trial. It compares LILS with LSC in women with stage 2 or higher uterine prolapse. The primary outcomes of this study are perioperative parameters, including surgical time, blood loss, intraoperative complications, and hospital stay as well as surgical anatomical results using the pelvic organ prolapse questionnaire (POP-Q) classification at 6 weeks, 6 months, 12 months, and annually till 5 years after surgery. Secondary outcomes are subjective improvement in urogenital symptoms and quality of life, postoperative complications, postoperative recovery, sexual functioning, and cost-effectiveness at each follow-up point. Validated questionnaires will be used and the data will be analyzed according to the intention-to-treat principle. Based on an objective success rate of 90%, a noninferiority margin of 15%, and a dropout of 20%, 107 patients are needed in each arm to prove the hypothesis with a 95% confidence interval. The trial is a randomized controlled, multicenter, noninferiority trial that will provide evidence whether the efficacy and safety of LILS is noninferior to LSC in women with symptomatic stage 2 or higher uterine prolapse. China Trial Register (CTR): ChiCTR-INR-15007408 . Registered on 9 November 2015.

  • Laparoscopic Inguinal Ligament suspension versus laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse: study protocol for a randomized controlled trial
    'Springer Science and Business Media LLC', 2018
    Co-Authors: Zhiyuan Dai, Huimin Shu
    Abstract:

    Abstract Background Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of Inguinal Ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse. As a new surgical technique for POP, a prospective randomized controlled trial comparing the LILS with the standard technique of LSC is necessary. Therefore, we will conduct a trial. Methods The trial is a randomized controlled trial. It compares LILS with LSC in women with stage 2 or higher uterine prolapse. The primary outcomes of this study are perioperative parameters, including surgical time, blood loss, intraoperative complications, and hospital stay as well as surgical anatomical results using the pelvic organ prolapse questionnaire (POP-Q) classification at 6 weeks, 6 months, 12 months, and annually till 5 years after surgery. Secondary outcomes are subjective improvement in urogenital symptoms and quality of life, postoperative complications, postoperative recovery, sexual functioning, and cost-effectiveness at each follow-up point. Validated questionnaires will be used and the data will be analyzed according to the intention-to-treat principle. Based on an objective success rate of 90%, a noninferiority margin of 15%, and a dropout of 20%, 107 patients are needed in each arm to prove the hypothesis with a 95% confidence interval. Discussion The trial is a randomized controlled, multicenter, noninferiority trial that will provide evidence whether the efficacy and safety of LILS is noninferior to LSC in women with symptomatic stage 2 or higher uterine prolapse. Trial registration China Trial Register (CTR): ChiCTR-INR-15007408. Registered on 9 November 2015

Huimin Shu - One of the best experts on this subject based on the ideXlab platform.

  • laparoscopic Inguinal Ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse
    Journal of Obstetrics and Gynaecology Research, 2019
    Co-Authors: Zhiyuan Dai, Huimin Shu
    Abstract:

    Aim To demonstrate the efficacy and safety of a modified technique of laparoscopic Inguinal Ligament suspension (LILS) with hysterectomy for the treatment of uterovaginal prolapse. Methods A total of 57 patients were treated by LILS combined with hysterectomy between Jan 2014 and Feb 2016. The perioperative parameters, such as operative time, estimated blood loss, length of stay and intra- and postoperative complications were recorded. The Pelvic Organ Prolapse questionnaire classification was applied to evaluate the Pelvic Organ Prolapse stage, and Patient Global Impression of Improvement scale was used to determine the patients' satisfaction. Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire were used to evaluate the functional improvement. All data were collected preoperatively and then at 12 months postoperatively. Results The mean surgical time was 130.4 (82-190) min, the average blood loss was 50.4 (10-300) mL and the mean hospitalization was 5.3 (4-8) days. The rates of intra- and postoperative complications were low. After a minimal of 12 months follow-up, the anatomical success rate was 85.5%, and the subjective satisfaction rate was 92.7%. The functional measures also presented a significant improvement with no recurrence of prolapse. Conclusion LILS combined with hysterectomy was a safe and effective technique and might be considered as an alternative treatment for patients with uterovaginal prolapse.

  • laparoscopic Inguinal Ligament suspension a novel procedure to repair uterine prolapse
    International Urogynecology Journal, 2019
    Co-Authors: Zhiyuan Dai, Huimin Shu, Xiaohong Guan, Kai Zhang
    Abstract:

    Traditionally, surgical treatment for uterine prolapse has included hysterectomy. However, more patients now prefer a uterine-preserving operation because of concerns about fertility or sexual dysfunction. In this video, we describe a novel approach to correcting uterine prolapse in an attempt to demonstrate an alternative option for patients. A 42-year-old woman with symptomatic stage I-IV uterine prolapse (POP-Q: Aa +2, Ba +2, C + 3, gh 6.5, pb 3, TVL 8.5, Ap 0, Bp 0, D 0) underwent Inguinal Ligament suspension. The principle steps and techniques to complete the operation are outlined in the video. Prolapse repair was successfully completed without any intraoperative complications. The uterus was restored to its anatomic position. During the 12-month follow-up, neither recurrence nor postoperative complications, such as mesh exposure, de novo incontinence or bowel obstruction, etc., occurred. Laparoscopic Inguinal Ligament suspension is a safe and feasible alternative for correcting the uterine prolapse. This surgery could be an attractive choice for patients who prefer a uterine-sparing surgery.

  • laparoscopic Inguinal Ligament suspension with uterine preservation for pelvic organ prolapse a retrospective cohort study
    International Journal of Surgery, 2018
    Co-Authors: Huimin Shu, Zhiyuan Dai
    Abstract:

    Abstract Objective To introduce an alternative surgical technique of laparoscopic Inguinal Ligament suspension (LILS) with uterine preservation and evaluate its efficacy and safety for patients with severe pelvic organ prolapse (POP). Methods Between June 2014 and December 2015, 35 patients with symptomatic stage III or IV were treated by LILS with uterine preservation. The perioperative parameters including surgical time, blood loss, hospital stay and complications were recorded. The anatomical cure rate was evaluated according to the Pelvic Organ Prolapse Questionnaire (POP-Q) assessment. The anatomical points were analyzed by dynamic Magnetic Resonance Imaging (MRI). Validated questionnaire of the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic organ prolapse urinary Incontinence Sexual Questionnaire (PISQ-12) were recorded to evaluate the symptom severity, quality of life and sexual activity. Results The mean surgical time was 163.8 ± 42.3 min (range: 120–280 min), the mean estimated blood loss was 48.6 ± 60.5 ml (range: 10–200 ml), and the mean hospital stay was 5 days (range: 3–7 days). No intra-operative complications were encountered. The anatomical success rate at postoperative 6-month and 12-month was 97.1% and 94.3%, respectively. The postoperative anatomical points on straining showed a significant improvement on dynamic MRI as compared to baselines. The symptom severity, quality of life and sexual activity also presented significant improvement both 6-month and 12-month after surgery. After a minimal 12 months follow-up, no postoperative complications occurred and the recurrence prolapse were low. Conclusion LILS with uterine preservation is a feasible, effective and safe surgical alternative in the treatment of POP for patients who desire to reserve uterus. Longer follow-up data from larger studies are required to confirm the benefits of LILS with uterine preservation as a minimally invasive surgical approach.

  • laparoscopic Inguinal Ligament suspension versus laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse study protocol for a randomized controlled trial
    Trials, 2018
    Co-Authors: Zhiyuan Dai, Huimin Shu
    Abstract:

    Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of Inguinal Ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse. As a new surgical technique for POP, a prospective randomized controlled trial comparing the LILS with the standard technique of LSC is necessary. Therefore, we will conduct a trial. The trial is a randomized controlled trial. It compares LILS with LSC in women with stage 2 or higher uterine prolapse. The primary outcomes of this study are perioperative parameters, including surgical time, blood loss, intraoperative complications, and hospital stay as well as surgical anatomical results using the pelvic organ prolapse questionnaire (POP-Q) classification at 6 weeks, 6 months, 12 months, and annually till 5 years after surgery. Secondary outcomes are subjective improvement in urogenital symptoms and quality of life, postoperative complications, postoperative recovery, sexual functioning, and cost-effectiveness at each follow-up point. Validated questionnaires will be used and the data will be analyzed according to the intention-to-treat principle. Based on an objective success rate of 90%, a noninferiority margin of 15%, and a dropout of 20%, 107 patients are needed in each arm to prove the hypothesis with a 95% confidence interval. The trial is a randomized controlled, multicenter, noninferiority trial that will provide evidence whether the efficacy and safety of LILS is noninferior to LSC in women with symptomatic stage 2 or higher uterine prolapse. China Trial Register (CTR): ChiCTR-INR-15007408 . Registered on 9 November 2015.

  • Laparoscopic Inguinal Ligament suspension versus laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse: study protocol for a randomized controlled trial
    'Springer Science and Business Media LLC', 2018
    Co-Authors: Zhiyuan Dai, Huimin Shu
    Abstract:

    Abstract Background Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of Inguinal Ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse. As a new surgical technique for POP, a prospective randomized controlled trial comparing the LILS with the standard technique of LSC is necessary. Therefore, we will conduct a trial. Methods The trial is a randomized controlled trial. It compares LILS with LSC in women with stage 2 or higher uterine prolapse. The primary outcomes of this study are perioperative parameters, including surgical time, blood loss, intraoperative complications, and hospital stay as well as surgical anatomical results using the pelvic organ prolapse questionnaire (POP-Q) classification at 6 weeks, 6 months, 12 months, and annually till 5 years after surgery. Secondary outcomes are subjective improvement in urogenital symptoms and quality of life, postoperative complications, postoperative recovery, sexual functioning, and cost-effectiveness at each follow-up point. Validated questionnaires will be used and the data will be analyzed according to the intention-to-treat principle. Based on an objective success rate of 90%, a noninferiority margin of 15%, and a dropout of 20%, 107 patients are needed in each arm to prove the hypothesis with a 95% confidence interval. Discussion The trial is a randomized controlled, multicenter, noninferiority trial that will provide evidence whether the efficacy and safety of LILS is noninferior to LSC in women with symptomatic stage 2 or higher uterine prolapse. Trial registration China Trial Register (CTR): ChiCTR-INR-15007408. Registered on 9 November 2015

Erol Cengiz - One of the best experts on this subject based on the ideXlab platform.

  • Lichtenstein Inguinal herni onarımı sonrası postoperatif değişikliklerin saptanmasında bilgisayarlı tomografinin kullanımı
    'Bezmialem Vakif University', 2015
    Co-Authors: Hasbahçeci Mustafa, Erol Cengiz
    Abstract:

    Objective: This study aimed to evaluate the effect of computed tomography to visualize the post-operative changes after Lichtenstein Inguinal hernia repair. Methods: Patients with Lichtenstein Inguinal hernia repair and post-operative computed tomography scans were included. There were 11 male patients with 14 hernias; the mean age was 63.9±9.2 years. Time interval between Inguinal hernia repair and imaging was 186±70 days (median, 211 days). After multiplanar reformatting, images were reviewed with respect to the postoperative changes and visualization of anatomic structures that were found in the Inguinal region. Results: The inferior epigastric artery and vein, Inguinal Ligament, spermatic cord, and pubic tubercle were clearly detected in all the males. Small fluid collections were observed only during early post-operative period in two patients (14.3%). Minimal thickening of the Inguinal Ligament with fatty streaks and completely normal appearance were present in eight (57%) and six (43%) Inguinal regions, respectively. Conclusion: Multiplanar reformatting helps physicians in visualizing the Inguinal anatomy in the patients with hernia post surgery. Lichtenstein Inguinal hernia repair may be regarded as the gold standard technique for Inguinal hernia repair because of the lack of any destructive anatomical changes.Amaç: Bu çalışmanın amacı Lichtenstein Inguinal herni onarımı sonrası oluşan postoperatif değişikliklerin görüntülenmesindeki bilgisayarlı tomografi etkisini değerlendirmektir. Yöntemler: Lichtenstein Inguinal herni onarımı yapılan ve postoperatif bilgisayarlı tomografi taraması olan hastalar dahil edildi. Yaş ortalaması 63,9±9,2 yıl olan 11 erkek hastanın toplam 14 fıtık bölgesi vardı. Inguinal herni onarımı ve görüntüleme arasında geçen süre 186±70 gün (ortanca 211 gün) idi. Çok düzlemli yeniden biçimlendirme sonrası, görüntüler postoperatif değişiklikler ve Inguinal bölgede bulunan anatomik yapıların görüntü- lenmesi açısından incelendi. Bulgular: İnferior epigastrik arter ve ven, Inguinal Ligament, spermatik kord ve pubik türkül her hastada net bir şekilde tespit edildi. Küçük sıvı koleksiyonları iki hastada (%14,3) sadece ameliyat sonrası erken dönemde görüldü. Yağlı çizgilenme ile birlikte Inguinal Ligamentte minimal kalınlaşma ve tamamen normal görünüm sırası ile sekiz (%57) ve altı (%43) Inguinal bölgede görüldü. Sonuç: Çok düzlemli yeniden biçimlendirme hekimlere Inguinal herni cerrahisi sonrası hastaların Inguinal anatomisinin görüntülenmesine yardımcı olur. Lichtenstein Inguinal herni onarımı, kalıcı anatomik değişikliklerin olmaması nedeniyle Inguinal herni onarımı için altın standart teknik olarak kabul edilebilir

  • Primer Inguinal herni ayrımında bilgisayarlı tomografinin yararlılığı
    'Baishideng Publishing Group Inc.', 2015
    Co-Authors: Hasbahçeci Mustafa, Erol Cengiz
    Abstract:

    Objective: The perception of Inguinal anatomy during hernia formation may be an important issue for the evaluation of hernias. This study was conducted to describe detailed anatomy of Inguinal region in patients with primary Inguinal hernia by using computed tomography. Methods: Study group included 18 Inguinal hernia patients with computed tomography images. Images with multi-planar reformatting were evaluated with regard to anatomical landmarks found in Inguinal region. Results: Visualization of Inguinal Ligament and inferior epigastric artery was possible in all patients. Type of Inguinal hernia was defined correctly in all patients by using inferior epigastric artery as an anatomic landmark. Pubic tubercle and lateral crescent sign in differentiation between direct and indirect Inguinal hernias had variable sensitivity and specificity (0.69 and 0.60 for pubic tubercle, and 0.69 and 0.80 for lateral crescent sign, respectively). Conclusion: Multi-planar reformatting helps physicians to differentiate types of Inguinal hernia by using the inferior epigastric artery as an anatomic landmark.Amaç: Herni oluşumu sürecinde Inguinal bölge anatominin algılanması, hernilerin değerlendirilmesi için önemli bir sorun olabilir. Bu çalışma, bilgisayarlı tomografi tardımı ile primer Inguinal herni hastalarındaki Inguinal bölge anatomisinin detaylı bir şekilde tanımlanması için düzenlenmiştir. Yöntemler: Çalışma grubu bilgisayarlı tomografi görüntüleri olan 18 Inguinal herni hastasından oluşmakta idi. Çok kesitli yeniden biçimlendirme ile elde edilen görüntüler, Inguinal bölgede bulunan anatomik belirleyiciler gözönüne alınarak değerlendirildi. Bulgular: Inguinal Ligament ve inferior epigastrik arterin görüntülenmesi hastaların tamamında gerçekleşti. Hastaların tamamında, inferior epigastrik arterin anatomik belirleyici olarak kullanılması ile herni türü doğru bir şekilde belirlendi. Direkt ve indirekt herni ayrımında pubik tüberkül ve lateral hilal bulgularının özgüllük ve duyarlılığı değişkenlik göstermekte idi (pubik tüberkül bulgusu için 0.69 ve 0.60; lateral hilal bulgusu için 0.69 ve 0.80). Sonuç: Çok kesitli yeniden biçimlendirme, anatomik belirleyici olarak inferior epigastrik arterin kullanılması ile Inguinal herni tiplerinin belirlenmesinde hekimlere yardımcı olmaktadır

  • Primer Inguinal herni ayrımında bilgisayarlı tomografinin yararlılığı
    'Gazi University', 2015
    Co-Authors: Hasbahçeci Mustafa, Erol Cengiz
    Abstract:

    WOS: 000217478800010Objective: The perception of Inguinal anatomy during hernia formation may be an important issue for the evaluation of henias. This study was conducted to describe detailed anatomy of Inguinal region in patients with primary Inguinal hernia by using computed tomography. Methods: Study group included 18 Inguinal hernia patients with computed tomography images. Images with multi-planar reformatting were evaluated with regard to anatomical landmarks found in Inguinal region. Results: Visualization of Inguinal Ligament and inferor egigastric artery was possible in all patients. type of Inguinal hernia was defined correctly in all patients by using inferior egipastric artery as an anatomic landmark. Public tuberlce and lateral crescent sign in differentiation between direct and indirect Inguinal hernias had variable sensivtivity and specificity (0.69 and 0.60 for public tuberlce and 0.69 and 0.80 for lateral crescent sign, respectively). Conclusion: Multi-planar reformatting helps physicians to differentiate types of Inguinal hernia by uising the inferior eepigastric artery as an anatomic landmark.Amaç: Herni oluşumu sürecinde Inguinal bölge anatominin algılanması, hernilerin değerlendirilmesi için önemli bir sorun olabilir. Bu çalışma, bilgisayarlı tomografi tardımı ile primer Inguinal herni hastalarındaki Inguinal bölge anatomisinin detaylı bir şekilde tanımlanması için düzenlenmiştir. Yöntemler: Çalışma grubu bilgisayarlı tomografi görüntüleri olan 18 Inguinal herni hastasından oluşmakta idi. Çok kesitli yeniden biçimlendirme ile elde edilen görüntüler, Inguinal bölgede bulunan anatomik belirleyiciler gözönüne alınarak değerlendirildi. Bulgular: Inguinal Ligament ve inferior epigastrik arterin görüntülenmesi hastaların tamamında gerçekleşti. Hastaların tamamında, inferior epigastrik arterin anatomik belirleyici olarak kullanılması ile herni türü doğru bir şekilde belirlendi. Direkt ve indirekt herni ayrımında pubik tüberkül ve lateral hilal bulgularının özgüllük ve duyarlılığı değişkenlik göstermekte idi (pubik tüberkül bulgusu için 0.69 ve 0.60; lateral hilal bulgusu için 0.69 ve 0.80). Sonuç: Çok kesitli yeniden biçimlendirme, anatomik belirleyici olarak inferior epigastrik arterin kullanılması ile Inguinal herni tiplerinin belirlenmesinde hekimlere yardımcı olmaktadır

Kai Zhang - One of the best experts on this subject based on the ideXlab platform.

  • laparoscopic Inguinal Ligament suspension a novel procedure to repair uterine prolapse
    International Urogynecology Journal, 2019
    Co-Authors: Zhiyuan Dai, Huimin Shu, Xiaohong Guan, Kai Zhang
    Abstract:

    Traditionally, surgical treatment for uterine prolapse has included hysterectomy. However, more patients now prefer a uterine-preserving operation because of concerns about fertility or sexual dysfunction. In this video, we describe a novel approach to correcting uterine prolapse in an attempt to demonstrate an alternative option for patients. A 42-year-old woman with symptomatic stage I-IV uterine prolapse (POP-Q: Aa +2, Ba +2, C + 3, gh 6.5, pb 3, TVL 8.5, Ap 0, Bp 0, D 0) underwent Inguinal Ligament suspension. The principle steps and techniques to complete the operation are outlined in the video. Prolapse repair was successfully completed without any intraoperative complications. The uterus was restored to its anatomic position. During the 12-month follow-up, neither recurrence nor postoperative complications, such as mesh exposure, de novo incontinence or bowel obstruction, etc., occurred. Laparoscopic Inguinal Ligament suspension is a safe and feasible alternative for correcting the uterine prolapse. This surgery could be an attractive choice for patients who prefer a uterine-sparing surgery.

  • a new laparoscopic technique of Inguinal Ligament suspension for vaginal vault prolapse
    International Journal of Surgery, 2017
    Co-Authors: Zhiyuan Dai, Xipeng Wang, Huimin Shu, Kai Zhang, Chenyun Dai
    Abstract:

    Abstract Introduction The aim of the study was to evaluate the efficacy and safety of laparoscopic Inguinal Ligament suspension (LILS) as a new surgical technique for the treatment of vaginal vault prolapse. Methods From Feb 2014 to Mar 2016, 21 symptomatic women with grades III-IV vaginal vault prolapse were enrolled. All patients underwent LILS procedure in which a bifurcated mesh was used to suspend the vaginal vault to Inguinal Ligament. The perioperative parameters including surgical time, blood loss, and hospitalization time were recorded. At a minimal 12-month follow-up, the primary outcome measures, such as the anatomical cure rate and patients' satisfaction were respectively evaluated according to Pelvic organ prolapse questionnaire (POP-Q) and Patient Global Impression of Improvement (PGI-I) scale. The secondary outcomes including the impact on symptom severity, quality of life and sexual activity were also recorded. Results The mean surgical time was 130.71 ± 16.07 min, the mean estimated blood loss was 53.57 ± 48.43 ml, and the mean hospital stay was 6 days (range: 5–8 days). After a minimal 12-month follow-up (range: 12–36 months), the rate of anatomical success and the subjective satisfaction were 100% and 90.5%. The symptom severity, quality of life and sexual activity also presented significant improvement. In addition, no serious peri- and postoperative complications occurred. Conclusions LILS was a potential method for the treatment of vaginal vault prolapse. The technique could be performed easily and might be an alternative to other POP surgeries. However, further studies were required to focus on its long-term efficacy.

A L Dellon - One of the best experts on this subject based on the ideXlab platform.

  • documenting neuropathy of the lateral femoral cutaneous nerve using the pressure specified sensory testing device
    Annals of Plastic Surgery, 2003
    Co-Authors: J H Coert, A L Dellon
    Abstract:

    Entrapment of the lateral femoral cutaneous nerve has been difficult to document. The variability of the anatomic location of this nerve makes it difficult to measure with traditional electrodiagnostic studies. At the same time, anatomic variability increases the likelihood for this nerve to become entrapped within the Inguinal Ligament. The current study reports the ability to document the presence of this nerve entrapment in 24 patients, compared with 10 asymptomatic control subjects, by using nonpainful and noninvasive computer-assisted neurosensory testing with the Pressure-Specified Sensory Device.

  • anatomical course of the lateral femoral cutaneous nerve and its susceptibility to compression and injury
    Plastic and Reconstructive Surgery, 1997
    Co-Authors: Oskar C Aszmann, E S Dellon, A L Dellon
    Abstract:

    The anatomy of the lateral femoral cutaneous nerve was investigated through dissection of 52 human anatomic specimens. The variability of its course and locations as it exists the pelvis is described and related to soft-tissue and bony landmarks. Five different types are identified: type A, posterior to the anterior superior iliac spine, across the iliac crest (4 percent); type B, anterior to the anterior superior iliac spine and superficial to the origin of the sartorius muscle but within the substance of the Inguinal Ligament (27 percent); type C, medial to the anterior superior iliac spine, ensheathed in the tendinous origin of the sartorius muscle (23 percent); type D, medial to the origin of the sartorius muscle located in an interval between the tendon of the sartorius muscle and thick fascia of the iliopsoas muscle deep to the Inguinal Ligament (26 percent); and type E, most medial and embedded in loose connective tissue, deep to the Inguinal Ligament, overlying the thin fascia of the iliopsoas muscle, and contributing the femoral branch of the genitofemoral nerve (20 percent). The results of this study suggest that the lateral femoral cutaneous nerve is most susceptible to mechanical trauma when the nerve is type A, B, or C.