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  • ISSN: 2379-0911
    Volume 4, Issue 1
    Case Report
    A. Reznichenko*
    Abstract: Large hiatal hernias represent a challenge for surgeons. Various biologic grafts were utilized for crural reinforcement during laparoscopic repair. Extracellular matrix scaffold was recently popularized in the treatment of difficult wounds. We present a case of successful reinforcement of the diaphragmatic crura during laparoscopic repair of large hiatal hernia with extracellular matrix scaffold.
    Luis Angel Medina Andrade*, Stephanie Serrano Collazos, Maria de los Angeles Martinez Ferretiz, Eduardo Vidrio Duarte, Maricela Jimenez Lopez, Enrique Rosales Casta├▒eda, Luis Manuel Souza Gallardo, Sheila Urbina Hernandez, Jessica Gonzalez Noriega and Uriel Maldonado Aparicio
    Background: Amyand's hernia is defined as an inguinal hernia containing vermiform appendix. Is a very infrequent pathology with an incidence of 0.4 to 0.6% of all inguinal hernias. The diagnosis is difficult and usually a surgery finding, needing surgeon's best knowledge about this pathology for better outcomes.
    Cases presentations: We report 3 cases of Amyand's hernia presented in different Medical Centers, with variations in clinical presentation, diagnosis and management, showing the lack of information in literature about the correct surgical treatment and different options available. Two of the cases were presented as an incarcerated inguinal hernia, one woman and one man. Woman presented ischemic appendix tip and ileum ischemia, with ileum reperfusion after manipulation and posterior reduction, appendectomy was developed and Rutkow-Robbins hernioplasty uneventfully. Men presented an 8 hours of evolution incarcerated right inguinal hernia, with nausea, vomiting and intense pain. Appendix was not affected and appendectomy was developed with a Rutkow-Robbins hernioplasty posteriorly. Third case was a 72 year-old-man with eight years inguinal hernia, hernioplasty was elective scheduled. Vermiform appendix was found in hernia sac, appendectomy and Rutkow-Robbins hernioplasty was scheduled. All patients were discharged uneventfully 24 to 48 hours later and without complications at 8, 4 and 4 months follow up respectively.
    Conclusion: The low incidence and lack of information about this pathology, management and outcomes with different surgical options make it difficult to select the better treatment for each case. Studies about results with different treatment options would be difficult to achieve for the low incidence of this pathology, but the cases presented and information reviewed would encourage appendectomy and use of mesh hernioplasty as a safe and feasible surgical option in all cases.
    Research Article
    Alejandro Weber-Sanchez*, Pablo Weber-Alvarez and Denzil Garteiz-Martinez
    Abstract: It is difficult to know the exact incidence of bilateral hernias in adults but, since the advent of laparoscopy, there have been several reports that show a significant increase. Currently we know that bilateral repair can be done simultaneously without increasing the recurrence rate, especially when mesh is used. Laparoscopic hernioplasty has shown to be effective in the early detection of contralateral defects, providing a less invasive approach without additional morbidity, with the advantages of less pain and early recovery. On the other hand, traditional open surgery requires two separate incisions either if the procedures are performed simultaneously or sequentially. It is important for surgeons to keep in mind that although the common presentation is a unilateral hernia, the frequency of bilateral hernias is high and that it is advisable to comment with the patients beforehand, that there could be a possibility to explore and repair both hernia sides if found necessary.
    Mehmet Giray Sonmez*, Bilgehan Cagdas Sonbahar, Gul Bora, Necdet Ozalp and Cengiz Kara
    Aim: The aim of this study is to evaluate sexual functions which emerge due to inguinal hernia and may change after hernia surgery.
    Material and Methods: A total of 47 patients who had Lichtenstein tension-free anterior repair and inguinal hernia surgery were evaluated for erectile function, intercourse function, sexual desire, overall satisfaction, and orgasmic satisfaction condition with International Index of Erectile function questionnaire (IIEF) scoring system before the surgery and in the first and sixth months after surgery. Parameters evaluated with IIEF score before the surgery and in the first and sixth months after surgery were compared statistically using Wilcoxon test.
    Results: Average age of 47 patients was measured 46,2┬▒11,2 years (range: 22-67). It was determined that all scores apart from sexual desire (p=0,08) significantly increased in postoperative first and sixth months compared to the preoperative period. It was measured that preoperative sexual desire score increased significantly in postoperative sixth month ( p<0.001). A significant score was detected when all scores in postoperative sixth month were compared to postoperative first month.
    Conclusion: Inguinal hernia surgery positively effects sexual functions compared to preoperative period. The addition of recovery in sexual parameters to the benefits of removing hernia and presence of no significant postoperative complications shows that this surgery can be made in a safe and useful way.
    Letter to the Editor
    Bilal Mirza*
    Abstract: Umbilicus is a frequent site of abdominal access in laparoscopic and robotic surgery. Curved incisions are placed around umbilicus to undertake various abdominal procedures for cosmetic intensions [1]. Umbilical hernia is a weakness in the umbilical fascia of anterior abdominal wall through which abdominal contents protrude out into the umbilicus [2]. After reduction of the hernial contents, the umbilicus can be invaginated into the abdominal cavity by inserting a finger into the umbilical ring. A trans-umbilical hernia finger sweep maneuver is being described here in a postoperative case of hydrocephalus.
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