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Article
11- ONLAY MESH IN THE MANAGEMNT OF LARGE OR COMPLEX INCISIONAL HERNIA

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 53-56
Publisher: Basrah University جامعة البصرة

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The aim of this study is to evaluate the use of onlay mesh in the management of large orcomplex incisional hernia. A prospective study of 80 patients with incisional herniaoperated on at al-Sadr Teaching Hospital treated with onlay mesh between Jan 2001 toJan 2006. Thorough history and physical examination was done, data sheet wasdesigned include numerous factors that effect operative and healing process. Of 80patients, 61.2% female &38.8 % male with median age 40.1 years for female & 53years for male. Patients were with different associated medical problems. Main incisionwas lower midline incision 26.2% &main post operative complications was seroma7.5% & wound infection 7.5% while recurrence of hernia observed in 2.5%.This studyshowed that, the big incisional hernias can be efficiently treated by the onlaypositioning of polypropylene mesh.

Keywords

MESH --- INCISIONAL --- HERNIA


Article
Early Post-Operative Ultrasonographic Appearance of Implanted Mesh for Abdominal Wall Hernia Repair

Author: Falah D Salih
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2674-2679
Publisher: Kerbala University جامعة كربلاء

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background: Mesh herniorrhaphy (open method or through laparoscopic approach) is a common surgical procedure. Identification of the mesh is necessary when abdominal ultrasound is performed. Scanty studies had been involved in the Ultrasonographic appearance of mesh in the early post-operative period. Aim: to assess the ultrasonographic appearance of polypropylene meshes used for anterior abdominal wall hernia repair.Patients and methods: Sixty five patients with different types of anterior abdominal wall hernias (epigastric, umbilical, inguinal and incisional) treated with mesh herniorrhaphy, were examined with ultrasound in the early post-operative period. Ultrasonographic appearance of the mesh including visibility of the mesh, regularity, twinkling and posterior acoustic shadowing were assessed.Results: Sixty five patients were examined and most of them were males. All meshes were visible. Most meshes were wavy and showed posterior acoustic shadowing. Twinkling was rare. Conclusion: Ultrasound is very useful in identification of the meshes implanted for hernia repair within the early post-operative period and can identify all implanted meshes.

Keywords

ultrasonography --- hernia --- mesh


Article
Tension –Free Inguinal Hernia Repair Comparing 'Mesh' with 'Darn' A Prospective Randomized Clinical Trial

Authors: Ali M.Al-Saiegh --- Raad S. Al-Saffar --- Haider T. Al-Khassaki***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 3 Pages: 220-227
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Lichtenstein tension free hernioplasty(mesh repair) and Moloney darn repair are commonly practiced repairs for inguinal hernias with acceptably low recurrence rates. Mesh repair is considered more recent than darn repair and both of them are tension free.OBJECTIVE:To compare the number of postoperative complications and early recurrence between Mesh repair and Darn repair, for inguinal hernia.PATIENTS AND METHODS:The study was conducted at Department of Surgery, Al-Sadur teaching hospital in An-Najaf from 1st august 2007 to 1st august 2008 . A total of 104 patients were selected. 51 patients were treated with Lichtenstein tension free hernioplasty (Group A) and 53 with Darn repair (Group B). Cases were followed up for three months to one year. The study design was quasi experimental.RESULT:The male to female ratio was 51:1. The mean hospital stay was 37.18 hours in group A and 47.17 hours in group B. there was statistically significant difference between the groups ( p< 0.05).The mean operative time was 44.7 minutes in group A and 50.9 minutes in group B. There was statistically significant difference between the groups ( p< 0.05). the The total number of postoperative complications was reported in 36 patients, 15 ( 29.42%) complications occurring in group A and 21( 39.62%) in group B. Scrotal swelling was the most common complication followed by urinary retention and wound infection in both study groups. Postoperative complications like scrotal swelling ( 11.77% vs. 16.98%), haematoma ( 5.88% vs. 3.77%), urinary retention (5.88% vs. 9.43%), wound infection ( 1.96 vs. 7.55%) and scar pain ( 3.92% vs. 1.89%) were unsignificantly low in Lichtenstein tension free hernioplasty as compared to Darn repair (P > 0.05). There were no recurrences noted till date in any of the two groups under study.CONCLUSIONOpen inguinal hernia repair with a nylon darn was equivalent to polypropylene mesh with respect to early measures of postoperative outcome and recurrence at 1 year. The mesh was superior to darn in operative time and hospital stay

Keywords

inguinal hernia --- mesh --- darn --- repair.


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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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
Proline Mesh (Patch And Plug) Repair Of Inguinal Hernia Under General Versus Local Anaesthesia : Early And Long-Term Outcomes

Author: Jawad Kadhim Al-Dhahiry جواد كاظم الظهري
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2014 Volume: 10 Issue: 18 Pages: 71-77
Publisher: Al-Qadisiyah University جامعة القادسية

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Background: There is minimal data regarding the feasibility of Proline (patch and plug) inguinal hernia repair under local anaesthesia and patient acceptability.This study compares outcomes of Proline ( patch and plug) inguinal hernia repair under local anaesthesia versus general anaesthsia . Place and Duration of Study: The study was conducted in Department of Surgery,Al-Karama Teaching Hospital,Medical college/Wasit University,Iraq ,from 1st Faruary 2008 to 30th June 2012 and included 124 male patients. Follow-up period ranged from 6 months to 53 months .Study Design: The study design was a prospective study.Methods: This is a prospective study ,included 124 male patients(female patients were not included in this study ) with inguinal hernias that were repaired with Proline (patch and plug) over a 4.5 year period. The outcome (parameters) measures were, the type of anaesthesia used, early and late postoperative complications, and the patient satisfaction. Results: One hundred twenty four inguinal proline mesh hernioplasties were analyzed. Eighty two hernioplasties were performed under local anaesthesia (group A) and fourty two were performed under general anaesthesia (Group B). Patients with a body mass index >30 were 17 (14%) of group A and 8 (6%) of group B, respectively, (p = 0.7). Day cases were higher in the local-anaesthesia group (75 days vs. 16 days, p = 0.001). Early complications were similar in the two groups. 18 (26%) patients in the local anaesthesia and 6 (19%) in the general anaesthesia developed chronic groin pain (p = 0.6). One recurrence was noted in the local anaesthesia group. Patient satisfaction was high with both anaesthetic techniques. Conclusions: Proline (patch and plug) inguinal hernia repair under local anaesthesia resulted in increased day cases with similar complication rate when compared to general anaesthesia. Both anaesthetic techniques were associated with good outcomes and excellent patient satisfaction.

هنالك معلومات وبيانات قليلة حول جراحة الفتوقات المغبنية باستخدام شبكة البرولين تحت التخدير الموضعي والتخدير العام. تمت الدراسة خلال فترت اربع سنوات ونصف السنة في مستشفى الكرامة التعليمي في مدينة الكوت ,من الاول من شباط 2008 الى الثلاثين من حزيران 2012 واحصيت النتائج من مجموعة التخدير الموضعي وقورنت بمجموعة التخدير العام من حيث المضاعفا ت المبكرة والمتاخرة ونسب رجوع الفتوق, فوجدت النتائج متماثلة من حيث المضاعفات المبكرة والمتاخرة للمجموعتين مع زيادة مهمة بعدد الحالات التي تجرى تحت التخدير الموضعي ويتم اخراج المرضى من المستشفى في نفس اليوم مع موافقة و قبول من قبل المرضى من حيث طرق التخدير .فترة المتابعة تراوحت ستة اشهر – الى-ثلاثة وخمسين شهرا .


Article
Is it essential to put a drain in patients with Cholecystectomy?
حصيلة اصلاح الفتق المغبني بواسطة الشبكة. سلسلة حالات مكونة من ستة وتسعون مريض

Author: Hayder Assim حيدر عاصم
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2012 Volume: 2 Issue: 1 Pages: 84-90
Publisher: Diyala University جامعة ديالى

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Background: Improvements in surgical technique for hernia repair, together with the development of new prosthetic materials and a better understanding of how to use them, have significantly improved outcomes for many patients.Objectives: In this case series we aimed to determine the acceptability, practicality, effectiveness, and safety of inguinal hernia repair using Lichtenstein tension-free mesh repair in Iraq.Patients and methods: Ninety-six adult patients with inguinal hernia were included in this study. The age range of patients was 20-70 years. The study was conducted in Al-Karama Teaching Hospital-Baghdad for the period from October 2002 to October 2009. Herniae were repaired with Prolene mesh as a tension-free Lichtenstein-style. All patients had prophylactic antibiotics, and were followed for surgical wound infection, induration, pain, recurrence, and other complications. Three (3.1%) Surgical operations were done entirely under spinal, and one (1.0%) under epidural anesthesia. Results: All the procedures were completed safely. No patient had complications directly attributable to or affecting the implanted mesh. One patient developed infection treated by antibiotic. No recurrence occurred during a maximum follow up period of seven months. Seroma occurred in two cases (2.0%), one patient had the procedure after failure of laparoscopic repair, and no removal of the mesh was needed during this period. Most of the patients were discharged on the next day or on the same day.Conclusions: Lichtenstein tension-free mesh repair appears quite acceptable, practical, effective and safe for inguinal hernia repair in our environment.

تمهيد: في سلسلة الحالات هذه، وللفترة من تشرين الاول 2002 ولغاية تشرين الاول 2009، كان هدفنا هو معرفة مقبولية وجدوى وفاعلية وسلامة اصلاح الفتوق المغبنية بطريقة زراعة الشبكة الجراحية في العراقالمرضى وطريقة العمل: ستة وتسعون مريض باعمار تتراوح بين العشرين سنة والسبعين سنة اجريت لهم هذه العملية. جميع المرضى استلموا مضادات حيوية وقائية، وتمت متابعتهم من ناحية، التهابات جرح العملية، الالم، رجوع الفتق، وأية مضاعفات او اختلاطات اخرى. ثلاثة مرضى (3,1%) تم اجراء التداخل الجراحي لهم تحت تاثير التداخل الشوكي، وحالة واحدة (1,0%) تحت تاثير تخدير فوق الجافية.النتائج: كل العمليات تمت بدون مشاكل خلال فترة العملية، لم يعاني أي مريض من اختلاطات ذات علاقة مباشرة او اثرت على زرع الشبكة، مريض واحد عانى من التهاب في جرح العملية تمت معالجته بواسطة المضادات الحيوية، لم تلاحظ حالات رجوع للفتوق خلال فترة المتابعة، سيروما حدثت في حالتين (2,0%)، مريض واحد اجريت له العملية بعد فشل في محاولة اصلاح الفتق بواسطة الناظور الجراحي، ولا توجد أي حالة احتاجت الى رفع للشبكة بعد زراعتها، معظم المرضى تم اخراجهم من المستشفىفي اليوم الذي يلي يوم اجراء العملية، قسم منهم تم اخراجهم في نفس اليوم.الاستنتاجات: وجدنا بانه زراعة الشبكة هي طريقة مقبولة، عملية، وفعالة، وأمينة لعلاج واصلاح الفتوق المغبنية في ظروفنا البيئية مع الاخذ بعين الاعتبار بان تكاليف وسعر الشبكات لم تدخل ضمن الدراسة، كذلك اجراء دراسات مستقبيلة ولعينات اكبرهي من ضمن الاحتياجات لاجراء مقارنة بين نتائج زراعة الشبكة الجراحية والطرق التقليدية لاصلاح الفتوق المغبنية وبموضوعية اكثر في ظروفنا البيئية.


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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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
Using mesh hernioplasty to patient with inguinal Hernia

Author: Fadhil A. Mohialdeen
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2012 Volume: 8 Issue: 14 Pages: 32-43
Publisher: Al-Qadisiyah University جامعة القادسية

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To clinically evaluate the outcome of Inguinal Hernioplasty in terms of haematoma, wound infection and recurrence, with special reference to surgery done by trainee surgeons. A total of 50 patients with inguinal hernia were operated during the study period. The result of the present study concluded that using mesh for surgical operation of hernia is much better than the ordinal operation of hernia because this technique reduces the recurrence of the disease, while the classical operation is related to recurrence of the disease. Also Mesh can reduce the appearing of hematomas, Wound infections after the operation, while the classical operation is related to appearing of the hematomas and Wound infections after the operation. Further more there is no significant difference between the two methods regarding appearing of seromas after the operation however, its appear among those patients which did a classical operation more than those which using mesh for operation. So In our set-up Mesh Hernioplasty has proven to be effective with low complication and recurrence rates.

يهتم البحث في تقييم النتائج السريرية لعمليات ترقيع الفتق الأربي من حيث التجمع الدموي ,خمج الجروح، وامكانية تكرارالفتق مجددا، مع إشارة خاصة إلى العمليات الجراحية التي يتم اجرائها من قبل الجراحين المتدربين. لقدتم اجراء ما مجموعه خمسون عملية للمرضى الذين كانو يعانون من فتق أربي خلال فترة الدراسة. واستخلص نتيجة لهذه الدراسة أن استخدام الشبكة(mesh) في عملية ترقيع الفتق هو أفضل بكثير من العملية التقليدية و يقلل من تكرار لهذا المرض، في حين ترتبط هذه العملية الكلاسيكية إلى تكرار لهذا المرض. أيضا يمكن أن تقلل من ظهور القيلة ،و خمج الجروح، في حين ترتبط العملية الكلاسيكية إلى ظهور التجمعات الدموية والتهابات الجروح ما بعد العملية. ليس هناك فرق كبير بين الطريقتين فيما يتعلق بظهور المصول seromas) ).


Article
The Outcomoe Of Suture Versus Mesh Repair Of Primary Small Umbilical Hernias In Adults

Author: Saad Ramadhan Jawad سعد رمضان جواد
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 1 Pages: 45-48
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: There are a different methods of umbilical hernia repair and there is controversy about which repair is better for small umbilical hernias. Aim : Is to compare which method is superior the mesh or suture repair for small umbilical hernias in terms of clinical outcome and recurrence rate. Methods: In this study , 120 patients were treated surgically using either suture or mesh repair for their umblical hernias from march 2013 to march 2015 at Al Imam Ali hospital.In 67 patients, the hernia was repaired by prolene suture and 53 patients their hernias were repaired by mesh. Both groups were followed for complications and recurence rate. The data was analysed statistically for significance using Fishers exact test. Results: 89 patients (74.16%) were females,31 (25.84%) were males . ages of the patients were ranged between 21 to 67 years, mean age was (36.17).There was no significant difference statistically between two groups regading recurrence after one year follow up, 467 (6%)in suture repair and 153(1.9%)in the mesh repair.5patients(7.46%) got seroma in the suture repair group while 4 patients (7.54%) in the mesh repair.Hematoma developed in 2patients( 3%) in the suture repair group and nil in the mesh repair group.Regarding infection 3 (4.5%)in suture repair and 2patients (3.7%) in the mesh repair group .3patients (4.5%) treated by suture repair complained of chronic pain while only 2 (3.7%)in the mesh repair group.Conclusion: This study showed no significant difference between two methods of repair regarding short term complications and recurrence rates.

Keywords

umbilical hernia --- repair --- suture --- mesh --- recurrence


Article
Text Hiding in 3D Object

Authors: Luma Fayeq Jalil --- Muna M. Laftah
Journal: Engineering and Technology Journal مجلة الهندسة والتكنولوجيا ISSN: 16816900 24120758 Year: 2016 Volume: 34 Issue: 5 Part (B) Scientific Pages: 683-690
Publisher: University of Technology الجامعة التكنولوجية

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Abstract

In this research was to propose a new way to hide data from the text in the tri-dimensional images type depending on the geometric style is proposed, this can be done via the manipulation of the location of the (vertex) in most areas of softness in the triangular object dimensions of any of the many details areas so we make sure not to detect the presence of the data eye human. The experimental results showed, a high rate of failure note the presence of hidden data depending on the scale "RMS" Tripartite-dimensional images, and the way showed good resistance to the types of geometric attack such as "translation"," rotation" and "scaling" and out where he was retrieving a full hidden data without any destruction and this is what boosted "BER".

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