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Article
Shoelace Darn Repair of Abdominal Incisional Hernias

Author: Talib A. Majid
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 3 Pages: 198-202
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Abdominal incisional hernias are a common condition in practice. Numerous surgical procedures have been used to repair them with different results.OBJECTIVE:This study aims to find the place of shoelace darn in the repair of incisional hernias.METHOD:One hundred patients with abdominal incisional hernias have been managed by a shoelace darn repair., The details of the operative technique have been described.RESULTS:shoelace darn repair was an easy procedure associated with some complications, and followed by recurrence in 4 patients. The age, sex, clinical presentation, the type of previous surgery, the type of incisional hernia, the body built of the patients were discussed .CONCLUSION:Shoelace darn repair have got a good place in managing abdominal incisional hernias


Article
3- OUTCOME OF LARGE INCISIONAL HERNIA REPAIR WITH POLYPROPYLENE MESH

Authors: Safwan A Taha --- Mazin H Alhawaz --- Nezar A Almahfooz --- Sadiq Galib Kadum
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 8-19
Publisher: Basrah University جامعة البصرة

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Abstract

Incision hernia remains a frequent complication of abdominal surgeries with a reportedincidence of (2-20%). Repair of large incision hernia is a difficult surgical problem with short andlong term complications, severity of these complications are related in part to the type ofoperative technique adopted.The aim of this study is to evaluate the outcome of repair of large incision hernia with the (onlaytension free) mesh technique.This is a retrospective study includes 46 patients who underwent mesh repair for large incisionhernia during the period from January 1997 to December 2004. The operations were done bythe same surgeon and by the same procedure (i.e; onlay tension free polypropylene mesh withtwo points fixation). Data regarding relevant patients with big ventral incision hernia with (onlaymeshrepair) in Basrah teaching hospital and private hospital were revised. The presentingcondition, hernia description, associated systemic and local factors, procedure of repair andfollow up duration were all taken in consideration. Possible complications like; hematoma,seroma, wound infection, intestinal obstruction and enterocutaneous fistula were recorded anddiscussed once they occurred. The follow up period ranged from 4 to 21 months.Forty six patients were included in the study: 20 females and 26 males with median age of 50.5year (range 35-68 year). Eleven patients (23.91%) were overweight and had body mass index"BMI" equal to more than 30, four patients (8.69%) had controlled diabetes mellitus, five(10.86%) had controlled hypertension and two (4.34%) suffered from chronic obstructive air waydisease, there were eleven smokers (23.91%). Sixteen patients made regular visits thatextended up to 12 months, 12 patients made regular visits up to 6 months, one made regularvisits up to 18 month mainly due to partial intestinal obstruction., one patient was followed-up to17 month because of multiple wound sinuses while 8 patients made irregular visits up to 21month due to causes other than the hernia, eight patients lost from follow-up after 4 months.The original operation was bowel related in 18 cases, gynecological in twelve,hepatopancreatobiliary in 10, repair of paraumbalical hernia in six patients. The old incisionswere long midline in 23 cases, paramedian in 17 and transverse in six patients. The mainpostoperative complications were seroma formation (13.04 %), wound haematoma (6.52 %),wound infection (4.34 %). no recurrence of hernia and no enterocutanous fistula were reportedduring our follow-up period.In conclusion, tension free onlay mesh repair is a feasible operative procedure for repair of largeincision hernia with no significant major morbidity.


Article
PORT SITE INCISIONAL HERNIA AFTER MINIMAL ACCESS SURGERY

Authors: Sadiq Kassim Jassim --- Mazin H AL-Hawaz --- Jasim D Saod
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 2 Pages: 37-44
Publisher: Basrah University جامعة البصرة

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Abstract

Incisional hernia is a common sequel to open abdominal surgery, affecting 5–15% of patients. The introduction of laparoscopic surgery into clinical routine more than 20 years ago has dramatically changed the field of surgery. It is commonly held that the frequency of incisional hernia has been reduced since the introduction of minimal access surgery. The incidence of port site hernia ranges from 1% to 6%. The aim of this study is to identify most common causes of port site incisional hernia. This is a retrospective study of 2116 patients who underwent laparoscopic surgery between January 2006 and December 2010. The information obtained according to indication of surgery, onset of hernia, clinical risk factors for incisional hernia like age& sex, BMI, co-morbidity, and those related to surgical factors such as port site, port size, port site infection and abdominal access techniques. The data were retrieved for patients who developed port-site incisional hernia (PSIH). The incisional hernia rate for the entire series was 2.5%. Most port site hernias developed in the 10 mm port, in the umbilical and supra umbilical, midline and 0% for the off-midline. There was statistically significant difference in patient’s related risk factors regarding age, BMI and wound infection with development of port site hernias. Conclusion: In this series, the 10mm port in midline site is a significantly higher cause for incisional hernia than the off-midline and smallest port size. Open first access technique, obesity and port site infection also significantly increase the incidence of port site incisional hernia.Introductio


Article
General Assessment For Predisposing Factors Of

Author: Munthir Al-Obaidi F.R.C.S د. منذر العبيدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 2 Pages: 181-185
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background:Incisional hernia is frequently occurring post operative complication after general surgery with occurance rate 2%-----11%,, it is either appear soon after operation or late occurring incisional hernia..Patient &methods: This is a prospective study that was conducted on 84 patients who were admitted at Baghdad Teaching Hospital during the period from Oct. 1999 to Aug. 2001 for repair of incisional hernias. Their ages were ranging from 24-74 years with mean age of (48 ±12). Sixty-nine patients were elective and 15 patients were urgent. Assessment of the patients for the predisposing factors influencing the development of incisional hernia was done and in our study these factors were: -Results:.Wound infection in 66%, midline incision in 58.3%, obesity 55%, chronic obstructive pulmonary disease (COPD), with, respiratory tract infection (RTI) in 44%, multiparty with gynecological and obstetric procedures were 42.9%, diabetes mellitus (D.M) 28.9%, Old age in 21.4%, contaminated bowel surgery 21.4% & finally wound dehiscence with re-suturing in 7.1%. Simple repair was performed in 57 patients and prolene mesh repair was used for 27 patients and follow-up was continued for 6 months except for 8 patients who were lost from follow-up. Results of simple repair was associated with many complications including recurrence in 4 patients, wound infection in 10 patients, seroma in 3 patients deep venous thrombosis (DVT) in one patient.Whereas Mesh repair was followed with minimal complications of seroma in 3 patients and deep venous thrombosis (DVT) in one patient and no recurrence was recorded.Conclusion: wound infection,,obesity,emergency surgery ,type of suture material & type of wound all areimportant factors leading to I.H. Key word: incisional hernia causes,,simple or mesh repair.__________________________________________________________________________________________


Article
The Low Transverse Abdominal Pfannenstiel Incision and the Prevalence of Incisional Hernia

Authors: Ali Latief Ali د.علي لطيف علي --- Jwan Najib Sulaiman د. جوان نجيب سلمان
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 2 Pages: 147-152
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Pfannenstiel incision is the commonest type of incision performed in the gynecological operations, although post operative incisional hernia is low, but should not be underestimated.Objective: To determine the prevalence of incisional hernia in patients with a low transverse Pfannenstiel incision.Design: Prospective study on patients from January 2007-to December 20008.Setting: Elwiyah Maternity Teaching Hospital.Patients & Methods: All adult women, operated on, between January 2007 to December 2008 using a Pfannenstiel incision by many gynecologist and obstetricians, were studied for general and local risk factors of incisional hernia development and were followed for two years at the out patients department or private clinic, all patients were subjected to physical examination focusing on the presence of incisional hernia. Results: (1.76%) of the patients developed incisional hernia in a period of 6-24 months.Conclusion: Incisional hernia is a rare complication of Pfannenstiel incision, besides it's cosmetically more acceptable than the lower midline incision.Key wards: Incisional hernia, prevalence in a low transverse abdominal Pfannenstiel incision

ان استعمال الجرح المستعرض في اجراء العمليات الجراحية النسائية هو افضل من استعمال الجرح العمودي؛ لان نسبة حدوث الفتق تكاد ان تكون نادرة في الاول. ومهم جدا الانتباه للاعصاب الموجودة في منطقة اسفل البطن عند اجراء عملية الجرح المسستعرض وخاصة اذا كان الجرح المستعرض طويلا او اذا كان الجرح المستعرض قد اجري في مكان اوطئ مما يجب، لانه قد يؤدي الى حدوث فتق مغبني بعد العملية.ان استخدام الخيوط الجراحية المناسبة(الغير قابلة للامتصاص) في خياطة النسيج الليفي للعضلة البطنية قد تؤدي الى تقليل نسبة حصول الفتق ،وان استعمال المضادات الحيوية بعد العمليات ومعالجة الامراض مثل فقر الدم وداء السكر واتسعال المزمن قبل اجراء العملية تؤدي الى تقليل نسبة حصول الفتق بعد العمليات الجراحية النسائية


Article
Review of 87 Patients with Incisional Hernia and its Risk Factors
مراجعة 87 حالة فتق جراحي وعوامل الخطوره التي تساعد على حدوثه

Authors: Issam Salih Al-Janabi د. عصام صالح الجنابي --- Haydar Mohammed Ali د. حيدر محمود علي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 4 Pages: 341-346
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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AbstractBackground: Incisional hernia is a common complication of abdominal surgeries and more following emergency than elective surgery with many risk factors playing role in its occurrence.Objectives: To show the important risk factors and their relation to the occurrence of incisional hernia in the present cases Patients and methods: Eighty seven patients with incisional hernia who were admitted in the fifth floor (third unit)/department of surgery in Baghdad Teaching Hospital were included in this case series study during the period from Jan 2007 to Jan 2009; they were inquired about their history and were examined for their scars.Results: Seventy eight patients out of 87 (89.6%) patients are presented for elective repair, and 9 patients (10.3%) were presented with complicated incisional hernia undergo emergency surgery. Vertical incision found in 59 patients (67.8%) and emergency surgery had been done in 55 patients (63.2%).Conclusion: Vertical incision and emergency surgery were the more frequent risk factors for incisional hernia in the study. With prolong time interval (between the presentation with incisional hernia & the remedy surgery) for more than 6 years, age >60 years or defect >10cm increases the risk for emergency presentation of incisional hernia.Keywords: Incisional hernia, risk factor

الخلاصه:-الخلفية: الفتق الجراحي هو أحد المضاعفات الشائعة لعمليات فتح البطن، والاكثر شيوعاً بعد العمليات الطارئة... وهناك عوامل أخرى تساعد على حدوثه.الغاية: لإظهار عوامل الخطورة وعلاقتها بحدوث الفتوق الجراحية. الطرق والمرضى: سبعة وثمانون مريض مصابين بالفتق الجراحي تم أدخالهم الى الطابق الخامس، مستشفى بغداد التعليمي تم إدخالهم في البحث من الفترة ك2 2007 الى ك2 2009 وتم دراسة التاريخ المرضي وأجراء الفحوصات اللازمة لهم.النتائج: ثمانية وسبعون مريض من 87 (89.6%) تم إجراء عمليات أختيارية (غير طارئة) .. وتسعة مرضى تم اجراء عمليات لهم كحالة طارئة، الجرح العمودي وجد في 59 حالة (67.2%). الحالات الطارئة كانت لخمسة وخمسون حالة ( 63.2%).الاستنتاج: الجرح العمودي والجراحة الطارئة هي أكثر عوامل الخطورة شيوعاً في هذه الدراسة مع طول الفترة بين ظهور الفتق وأجراء الجراحة التقويمية، والعمر أكثر من ستون سنة، وزيادة فجوة الفتق لأكثر من عشرة سنتمترات يزيد من حدوث الجراحة الطارئة للفتوق الجراحية.الكلمات المفتاحية: الفتق الجراحي/ عوامل الخطورة.


Article
Evaluation of Sublay Mesh Repair in Comparison with Onlay Mesh Repair for Incisional Hernias

Author: Haider Abdulhussein Ahmed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 180-184
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Incisional hernia after abdominal surgery is a well-known complication and the incidence of incisional hernias continues to be 2-11% after laparotomy. The repair of incisional hernia has always been a challenge to the surgeon. Various operative techniques for the repair of incisional hernia are in practice; however, the management is not standardized. The sublay technique, popularized by Rives and Stoppa in Europe, has been reported to be quite effective, with low recurrence rates and minimal complications.OBJECTIVE: To study the advantage and complications of sublay mesh repair of incisional hernias in comparison to onlay mesh repair.METHODS: Record of 110 patients undergoing repair of incisional hernia from 1st Jun 2013 to 1st Jun 2015, excluding very large incisional hernia with defect more than 10 cm. 62 cases of incisional hernias were managed by onlay mesh repair and 48 cases of incisional hernia were managed by sublay mesh repair.RESULTS: Post-operative complications like seroma and wound infection were comparable in both groups. In sublay group, Seroma formation was 2 patients (4.3%) . wound infection was 2 patients (4.3%). No septic mesh was removed in the series. In onlay group seroma formation was in 12 patients (19.4%) most of seroma occur in large incisional hernias repair, wound infection was in 5 patients (8.1%) and 2 septic mesh was removed. In sublay, recurrence rate was one patient (2.1%), in onlay, recurrence rate was in 5 patients (8%). CONCLUSION: Sublay mesh although it is more time consuming and technically more difficult, however it carries low recurrence rate and few post-operative wound complication ..


Article
Open Onlay Mesh Repair for Abdominal Incisional Hernia
تصنيع الفتق الجراحي بأستعمال الشبكة

Authors: Adil Karim Alhamdani د.عادل كريم الحمداني --- Jasim Abed Albedr د. جاسم عبد البدري --- Hadeel J. Abd د.هديل جاسم البدري
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 4 Pages: 347-351
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract Background: The incisional hernias still continue to be a serious problem and challenge for surgeons.Objective: To see the relative effectiveness of open Onlay mesh repair for incisional hernia in terms of clinical outcome, quality of life and rate of recurrence.Patients and methods: The study conducted at Al- Yermouk Teaching Hospital, Baghdad. Between April2006 - July 2009 out of fifty four patients operated upon for incisional hernia by open Onlay mesh graft type of repair. There were 19females and 35 males, with a mean age of 50. The clinical, surgical, and follow-up data were analyzed.Results: Mean operating time was 130 min, with an average hospital stay of 8 days. There was no mortality. Postoperative complications occurred in 33.25% of the patients. Most common complications were surgical site infection (SSI) 11.11%, recurrence of 9.25% and seroma 7.4%, respiratory complications 5.5%, DVT 1.85% were found after follow-up of 12- 18 months.Conclusion: The incisional hernia recurrence, morbidity & complications are significantly low in onlay mesh repair.Key words: Incisional hernia, open onlay repair, complications.

الخلفية:- عملية تصنيع الفتق الجراحي تشكل تحدي للجراحين. الغرض:- دراسة التأثيرات النسبية بأستعمال الشبكة لتصنيع الفتق الجراحي من الناحية السريرية, نوع حياة المريض ونسبة رجوع المرض.المرضى والطرق:- أجريت دراسة أستباقية في مستشفى اليرموك/ بغداد لاكثر من ثلاث سنوات من نيسان 2006 م-تموز 2009 م على 54 مريض, 35 رجال 19 أناث. متوسط العمر 50 سنة مع متابعة المريض 12-18 شهر بعد العملية. النتائج:- معدل وقت العملية 130 دقيقة ,معدل رقود المريض 8 أيام, لم تحدث حالة وفاة, هناك 33.25%مضاعفات منها 11.11%التهاب الجرح, 9.25% رجوع الفتق, 7.4% تجمع سوائل تحت الجرح, .55% التهاب المجاري التنفسية, 1.85% تخثر الاوردة العميقة. الأستنتاج:- رجوع الفتق ومعاناة المريض قليلة نسبيأ بأستعمال الشبكة لتصنيع الفتق الجراحي. مفتاح الكلمات:-الفتق الجراحي , تصنيع الفتق ,المضاعفات.


Article
Incidence of incisional hernia in relation to the site of previous abdominal incisions and other related factors
حدوث فتق الجراحي بالنسبة للموقع من شقوق في البطن السابقة والعوامل الأخرى ذات الصلة

Authors: Waleed Q. Rajab --- Makki K. Alaw --- Hamid Hindi Sarhan
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2008 Volume: 1 Issue: 141 Pages: 63-70
Publisher: Tikrit University جامعة تكريت

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Abstract

Incisional hernia is a breakdown of the musculo-aponeurotic layer of the surgical scar with a creation of a potential sac that protrudes as a result of increased intra-abdominal pressure through the facial defect. This study was achieved to assess the incidence of incisional hernia in relation to the site of the previous abdominal incision and some other related factors. A prospective study of 75 patients with incisional hernias. A detailed history and clinical examination of every patient was recorded in a special form for data collection, in order to find out the underlying predisposing factor that correlates between the incidence of incisional hernia and the site of the original abdominal wall incision and the rest of the predisposing factor. Incisional hernias were common in age group (41-50) years among female patients but the incidence was more common among the age group of (41-60) in male patients. Fifty four (72%) patients operated on electively. The most common site of previous incision was lower midline. Wound infection was the most frequent risk factor predispose to the development of incisional hernia. Incidence of incisional hernias more in vertical incisions than in oblique or transverse incisions. Re-incising at the same site of the previous incision increases the weakness of the area and predisposes to incisional hernia. Wound infection is blamed for the occurrence of high percentage of cases of incisional hernia. Presentation of patients with incisional hernia is usually within the first 3 years post operatively

الفتق الجراحي هو انهيار طبقة عضلية، سفاقي للندبة الجراحية مع اقامة كيس المحتملة التي يبرز نتيجة الضغط داخل البطن من خلال زيادة الخلل في الوجه. وتحقق هذه الدراسة لتقييم حدوث فتق الجراحي بالنسبة للموقع من شق البطن السابقة وبعض العوامل الأخرى ذات الصلة. دراسة مستقبلية من 75 مريضا مع الفتق الجراحي. وسجل التاريخ المفصل والفحص السريري من كل مريض في شكل خاص لجمع البيانات، من أجل معرفة العوامل الكامنة وراء المهيئة أن يرتبط بين حدوث فتق الجراحي وموقع من شق جدار البطن الأصلي وبقية المؤهبة عامل. وكان الفتق الجراحي مشترك في الفئة العمرية (41-50) سنة بين المرضى من النساء ولكن وقوع كان أكثر شيوعا بين الفئة العمرية من (41-60) في المرضى الذين يعانون من الذكور. تعمل أربعة وخمسين (72٪) من المرضى على electively. وكان موقع الأكثر شيوعا من شق السابقة أدنى خط الوسط. وكانت عدوى الجرح عامل الخطر الأكثر شيوعا يؤهب لتطوير الفتق الجراحي. حدوث الفتق الجراحي في أكثر من الشقوق العمودية في شقوق مائلة أو عرضية. إعادة شقها في نفس الموقع من شق السابقة يزيد من ضعف في المنطقة ويمهد لفتق الجراحي. ويلقى باللوم على عدوى الجرح لحدوث نسبة عالية من حالات الفتق الجراحي. عرض المرضى الذين يعانون من فتق الجراحي عادة ما يكون ضمن أول 3 سنوات ما بعد الجراحة

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