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  • ISSN: 2379-0911
    Current Issue
    Volume 5, Issue 1
    Review Article
    Marcio Crisostomo*
    The number of grafts that can be achieved in one surgery by the main harvesting techniques, FUE and FUT, has a limit. For the surgical treatment of advanced baldness (Norwood V, VI) usually more than one procedure is needed to transplant the amount of hair necessary for the coverage of the bald area. This article discusses the combination of FUT and FUE to achieve more grafts and offer the possibility of cover more areas with higher density in one procedure.
    Case Report
    René Gordon Holzheimer*
    Chronic postoperative groin pain is considered as complication of inguinal hernia repair. However, in most studies the analysis of the development of chronic pain is often weak or inconsistent. Occult groin pain may have serious impact on the quality of life of patients. Inguinodynia, a synonym for chronic groin pain, may have several, possibly overlapping, causes, e.g., pre- and postoperative nerve entrapment, mesh associated tissue reaction, injury by tacks or staples, delayed infection, which may cause difficulty in reaching a diagnosis. Some authors believe the incidence of chronic postoperative groin pain – 2%-12% in studies – is therefore underreported. Laparoscopic inguinal hernia repair seem to have less postoperative pain than open inguinal hernia repair which led to the conclusion it may be useful in pain prophylaxis. Trocar injury to intra-abdominal or abdominal wall vessels may occur, although there are only a few reports on trocar injury available. The direct injury to the ilioinguinal nerve by trocar insertion has not been published as case report. However, the risk of direct trocar injury to the cutaneous nerves of the lumbar plexus is evident, especially with regard to the variations in anatomic distribution. In this case report the history of a patient who suffered from severe chronic pain in relation to direct ilioinguinal nerve injury in the left groin after TAPP inguinal hernia treatment of a median suprapubic and right inguinal hernia for 10 years. The evidence for direct trocar injury of the ilioinguinal nerve is presented. Unfortunately this patient may suffer from a resistent complex regional pain syndrome (CRPS). Awareness of the risk of trocar injury may help to avoid this complication.
    Marcus Vinicius Ponte de Souza Filho*, Sidia Renata Holanda Coelho Bizarria, Sara de Almeida Siqueira, Ivanilson Ranieri de Brito, Romero Marques Catao, and Milena Alves Guerra de Araujo
    Basal cell carcinoma (BCC) is the most common coetaneous cancer. In the literature, there are few reports of the presence of BCC in the breast region. BCC should be treated by wide ressection. Such surgery can treat cancer, but the aesthetic appearance may not be assured. This article will detail the patient treatment undergoing breast reconstructionfollowing wide ressection of BCC located in the upper central region of the breast.
    Nicola Cerasani*, Andreas Türler, Markus Maria Heiss, and Dirk Rolf Bulian
    Giant inguinoscrotal hernias with loss of abdominal domain are a significant limitation of life quality in patients and represent a demanding surgical problem. A 68-year-old male patient presented with a giant right sided inguinoscrotal hernia existing for two years. Due to the “loss of domain” problem we decided, to perform a preoperatively condition of the abdominal by using a progressive pneumoperitoneum before the actual treatment of the hernia. In the scope of laparoscopy, a central venous catheter was inserted into the abdominal cavity. After placing the catheter in the right abdominal cavity first intraoperative ambient air insufflations of 2500 ml was ensued. On day seven after the beginning of the air insufflations, we performed the actual surgical treatment of the hernia according to the Lichtenstein procedure with a 20x15cm large Ultra-Pro Mesh™. The patient showed regular postoperative progress with non irritated wounds during the time. With regular bowel movements we were able to discharge the patient on the fifth postoperative day. The procedure with preoperative pneumatic dilatation of the peritoneal space allows hernia reconstruction even in giant inguinoscrotal hernias with a “loss of domain” problem.
    Research Article
    Bashiru Ismaila*, Alexander Ale, Emmanuel Ojo, Michael Misauno, and Augustine Sule
    Hiatus hernia is considered to be rare in Nigerians. Older radiological studies utilizing barium suggest 0.39% prevalence. More recent retrospective endoscopic studies in Nigeria suggest that the prevalence ranges from 2% to 28% but it is unclear how the diagnosis was made.
    A prospective study examining consecutive videos of the retroflexed view of patients undergoing endoscopy was carried out to determine grades of gastro-esophageal disruption. The fundal area was also examined for paraesophageal hernia.
    Of 193 patients who had endoscopy in the study period, after excluding repeat endoscopies and patients with proximal obstructing lesions, 151 had clear unobstructed retroflexed views. Grade IV gastro-esophageal junction disruption (hiatus hernia) was seen in 5 (3.3%) patients while 4 (2.6%) had grade III disruption. Twenty-five (16.6%) had grade II while 117(77.5%) of the patients had grade I (normal). None of the patients had paraesophageal hernia.
    Hiatus hernia and major gastro esophageal junction disruption are relatively rare in Nigerian patients who underwent endoscopy.
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