Volume : 7, Issue : 3, March - 2018
Result of Laparoscopic Primary Suturing and Mesh Fixation in Incisional Hernia
Dr. Sanjay Chaube, Dr. A. K. Sanwal, Dr. M. Jain, Dr. Rajkumar Verma
Abstract :
<p> </p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size: 12.0pt;line-height:115%;font-family:"Times New Roman","serif";color:black; mso-themecolor:text1;mso-ansi-language:EN-IN">Background:<span style="mso-spacerun:yes"> </span></span></b><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";color:black;mso-themecolor: text1;mso-bidi-font-weight:bold">Incisional<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>is<span style="mso-spacerun:yes"> </span>any<span style="mso-spacerun:yes"> </span>abdominal<span style="mso-spacerun:yes"> </span>wall<span style="mso-spacerun:yes"> </span>gap<span style="mso-spacerun:yes"> </span>with<span style="mso-spacerun:yes"> </span>or<span style="mso-spacerun:yes"> </span>without<span style="mso-spacerun:yes"> </span>a<span style="mso-spacerun:yes"> </span>bulge<span style="mso-spacerun:yes"> </span>in<span style="mso-spacerun:yes"> </span>the<span style="mso-spacerun:yes"> </span>area<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>postoperative<span style="mso-spacerun:yes"> </span>scar<span style="mso-spacerun:yes"> </span>perceptible<span style="mso-spacerun:yes"> </span>or<span style="mso-spacerun:yes"> </span>palpable<span style="mso-spacerun:yes"> </span>by<span style="mso-spacerun:yes"> </span>clinical<span style="mso-spacerun:yes"> </span>examination<span style="mso-spacerun:yes"> </span>or<span style="mso-spacerun:yes"> </span>imaging.<span style="mso-spacerun:yes"> </span>Incisional<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>repair<span style="mso-spacerun:yes"> </span>is<span style="mso-spacerun:yes"> </span>a<span style="mso-spacerun:yes"> </span>most<span style="mso-spacerun:yes"> </span>common<span style="mso-spacerun:yes"> </span>operations.<span style="mso-spacerun:yes"> </span>Open<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>laparoscopic<span style="mso-spacerun:yes"> </span>surgery<span style="mso-spacerun:yes"> </span>are<span style="mso-spacerun:yes"> </span>procedures<span style="mso-spacerun:yes"> </span>for<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>repair.</span><b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1;mso-ansi-language:EN-IN"><o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph;mso-layout-grid-align:none;text-autospace: none"><b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman","serif";color:black;mso-themecolor:text1;mso-ansi-language: EN-IN">Aims<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>objective:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1;mso-ansi-language:EN-IN"><span style="mso-spacerun:yes"> </span></span><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";color:black;mso-themecolor: text1;mso-bidi-font-weight:bold">The<span style="mso-spacerun:yes"> </span>aim<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>the<span style="mso-spacerun:yes"> </span>current<span style="mso-spacerun:yes"> </span>study<span style="mso-spacerun:yes"> </span>was<span style="mso-spacerun:yes"> </span>to<span style="mso-spacerun:yes"> </span>analyze<span style="mso-spacerun:yes"> </span>that<span style="mso-spacerun:yes"> </span>primary<span style="mso-spacerun:yes"> </span>defect<span style="mso-spacerun:yes"> </span>closure<span style="mso-spacerun:yes"> </span>&<span style="mso-spacerun:yes"> </span>mesh<span style="mso-spacerun:yes"> </span>fixation<span style="mso-spacerun:yes"> </span>will<span style="mso-spacerun:yes"> </span>gives<span style="mso-spacerun:yes"> </span>good<span style="mso-spacerun:yes"> </span>result<span style="mso-spacerun:yes"> </span>in<span style="mso-spacerun:yes"> </span>incisional<span style="mso-spacerun:yes"> </span>hernia.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size: 12.0pt;line-height:115%;font-family:"Times New Roman","serif";color:black; mso-themecolor:text1;mso-ansi-language:EN-IN">Materials<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>Methods:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1;mso-ansi-language:EN-IN"><span style="mso-spacerun:yes"> </span>A<span style="mso-spacerun:yes"> </span>total<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>84<span style="mso-spacerun:yes"> </span>patients<span style="mso-spacerun:yes"> </span>with<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>enrolled<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>all<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>treated<span style="mso-spacerun:yes"> </span>with<span style="mso-spacerun:yes"> </span>laparoscopic<span style="mso-spacerun:yes"> </span>repair<span style="mso-spacerun:yes"> </span>procedure.<span style="mso-spacerun:yes"> </span></span><span style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1">All<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>repaired<span style="mso-spacerun:yes"> </span>with<span style="mso-spacerun:yes"> </span>primary<span style="mso-spacerun:yes"> </span>closure<span style="mso-spacerun:yes"> </span>with<span style="mso-spacerun:yes"> </span>mesh.</span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1;mso-ansi-language:EN-IN"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size: 12.0pt;line-height:115%;font-family:"Times New Roman","serif";color:black; mso-themecolor:text1;mso-ansi-language:EN-IN">Results:<span style="mso-spacerun:yes"> </span></span></b><span lang="EN-IN" style="font-size: 12.0pt;line-height:115%;font-family:"Times New Roman","serif";color:black; mso-themecolor:text1;mso-ansi-language:EN-IN;mso-bidi-font-weight:bold">38<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>male<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>46<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>female<span style="mso-spacerun:yes"> </span>patients<span style="mso-spacerun:yes"> </span>from<span style="mso-spacerun:yes"> </span>84<span style="mso-spacerun:yes"> </span>enrolled<span style="mso-spacerun:yes"> </span>patients.<span style="mso-spacerun:yes"> </span>Patient’s<span style="mso-spacerun:yes"> </span>age<span style="mso-spacerun:yes"> </span>was<span style="mso-spacerun:yes"> </span></span><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";color:black;mso-themecolor: text1;mso-bidi-font-weight:bold">43<span style="mso-spacerun:yes"> </span>±<span style="mso-spacerun:yes"> </span>41.01</span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1;mso-ansi-language:EN-IN;mso-bidi-font-weight: bold"><span style="mso-spacerun:yes"> </span>years<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>age.<span style="mso-spacerun:yes"> </span></span><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";color:black;mso-themecolor: text1">Out<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>84<span style="mso-spacerun:yes"> </span>patients<span style="mso-spacerun:yes"> </span>28<span style="mso-spacerun:yes"> </span>had<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>on<span style="mso-spacerun:yes"> </span>upper<span style="mso-spacerun:yes"> </span>abdominal<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>56<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>on<span style="mso-spacerun:yes"> </span>lower<span style="mso-spacerun:yes"> </span>abdominal.<span style="mso-spacerun:yes"> </span>Size<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>hernia<span style="mso-spacerun:yes"> </span>was<span style="mso-spacerun:yes"> </span><span style="mso-bidi-font-weight: bold">6.5<span style="mso-spacerun:yes"> </span>±<span style="mso-spacerun:yes"> </span>4.95</span><span style="mso-spacerun:yes"> </span><span style="mso-bidi-font-weight:bold">cm<sup>2</sup></span>.<span style="mso-spacerun:yes"> </span>Total<span style="mso-spacerun:yes"> </span>mean<span style="mso-spacerun:yes"> </span>operation<span style="mso-spacerun:yes"> </span>time<span style="mso-spacerun:yes"> </span>was<span style="mso-spacerun:yes"> </span><span style="mso-bidi-font-weight:bold">109<span style="mso-spacerun:yes"> </span>±<span style="mso-spacerun:yes"> </span>100.41</span><span style="mso-spacerun:yes"> </span>min.<span style="mso-spacerun:yes"> </span>Post-operative<span style="mso-spacerun:yes"> </span>stay<span style="mso-spacerun:yes"> </span>was<span style="mso-spacerun:yes"> </span>3.5<span style="mso-spacerun:yes"> </span><span style="mso-bidi-font-weight:bold">±<span style="mso-spacerun:yes"> </span>2.12</span><span style="mso-spacerun:yes"> </span>days.<span style="mso-spacerun:yes"> </span>Out<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>84<span style="mso-spacerun:yes"> </span>patients,<span style="mso-spacerun:yes"> </span>2<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>converted<span style="mso-spacerun:yes"> </span>to<span style="mso-spacerun:yes"> </span>open<span style="mso-spacerun:yes"> </span>surgery.<span style="mso-spacerun:yes"> </span>2<span style="mso-spacerun:yes"> </span>cases<span style="mso-spacerun:yes"> </span>were<span style="mso-spacerun:yes"> </span>found<span style="mso-spacerun:yes"> </span>for<span style="mso-spacerun:yes"> </span>recurrence<span style="mso-spacerun:yes"> </span>out<span style="mso-spacerun:yes"> </span>of<span style="mso-spacerun:yes"> </span>84<span style="mso-spacerun:yes"> </span>enrolled<span style="mso-spacerun:yes"> </span>patients.</span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; color:black;mso-themecolor:text1;mso-ansi-language:EN-IN"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><b><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";color:black;mso-themecolor: text1">Conclusion:</span></b><span style="font-size:12.0pt;line-height:115%; font-family:"Times New Roman","serif";color:black;mso-themecolor:text1"><span style="mso-spacerun:yes"> </span>Laparoscopic<span style="mso-spacerun:yes"> </span>primary<span style="mso-spacerun:yes"> </span>defect<span style="mso-spacerun:yes"> </span>closure<span style="mso-spacerun:yes"> </span>by<span style="mso-spacerun:yes"> </span>mesh<span style="mso-spacerun:yes"> </span>fixation<span style="mso-spacerun:yes"> </span>gives<span style="mso-spacerun:yes"> </span>a<span style="mso-spacerun:yes"> </span>good<span style="mso-spacerun:yes"> </span>approximation<span style="mso-spacerun:yes"> </span>and<span style="mso-spacerun:yes"> </span>does<span style="mso-spacerun:yes"> </span>not<span style="mso-spacerun:yes"> </span>show<span style="mso-spacerun:yes"> </span>postoperative<span style="mso-spacerun:yes"> </span>bulging<span style="mso-spacerun:yes"> </span>that<span style="mso-spacerun:yes"> </span>gives<span style="mso-spacerun:yes"> </span>more<span style="mso-spacerun:yes"> </span>satisfaction<span style="mso-spacerun:yes"> </span>to<span style="mso-spacerun:yes"> </span>the<span style="mso-spacerun:yes"> </span>patient.<o:p></o:p></span></p>
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Article:
Download PDF Journal DOI : 10.15373/2249555XCite This Article:
Dr. Sanjay Chaube, Dr. A.K. Sanwal, Dr. M. Jain, Dr. Rajkumar Verma, Result of Laparoscopic Primary Suturing and Mesh Fixation in Incisional Hernia, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-7, ISSUE-3, MARCH-2018


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