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BACKGROUND Incisional hernia is a protrusion of abdominal viscera through the site of previous operation or traumatic wound of the abdominal wall. There are numerous methods of repair of abdominal incisional hernia. They are simple resuturing, shoe lace darn repair. Cattell’s and Maingot’s Kael repair, which are associated with recurrence. Since, the prosthetic graft has revolutionised the surgical field, the Prolene mesh is widely used to cover the defects in incisional hernia. This study is to determine wound complications and the length of hospital stay of inserting a wound drain during mesh repair compared with no wound drain. MATERIALS AND METHODS A sum of 30 patients with incisional hernia admitted in general surgical wards of Sivagangai Medical College. The clinical features symptomatology, investigations, operative findings, postoperative wound complications and length of hospital stay were analysed. Onlay Prolene mesh of size 15 x 15 cm is kept with Redivac drain in 15 patients and no drain in 15 patients. Parameters like wound seroma, wound infection, reoperation for wound healing complications and postoperative length stay. RESULTS From our comparative study, in a case of incisional hernia, during mesh repair, the usage of negative pressure Redivac suction drain helps in reducing wound infection rate, preventing the formation of seroma, reducing the number of secondary suturing, reducing the postoperative length of hospital stay. CONCLUSION Over the years, the advantages of the negative pressure therapy have been demonstrated as it improves healing times by increasing blood flow, extracting secreted fluid and maintaining the wound margins and protecting the wound from contamination.

Testicular ischemia and necrosis are quite rare complications following inguinal hernia repair. There is still no consensus on the mechanism of infarction and necrosis in the literature. We present a case with total testicular ischemia and necrosis in the early period following the inguinal hernia repair with prolene mesh, ending up with orchiectomy.

WOS: 000510401400003 PubMed: 32175206 Introduction Tension-free repair of groin hernias with synthetic material by video-endoscopic surgery is a widely accepted method that is performed by various approaches. We aim to present our results of video-endoscopic tension-free repair of groin hernias via the total extraperitoneal (TEP) approach. Methods Between September 2016 and December 2018, 124 patients with groin hernias underwent tension-free repair using prolene mesh by video-endoscopic surgery via the TEP approach. This is a retrospective analysis of 110 (88.7%) male and 14 (11.3%) female patients with a mean age of 48.1 years. Groin hernia types, locations of hernias, intraoperative and postoperative complications, results of the mean 24-month follow-up, and recurrence rate were reported. Results A total of 134 hernias were repaired in 124 patients who had 53 (42.7%) right, 61 (49.2%) left, and 10 (8.1%) bilateral groin hernias. The most common hernia type was an indirect inguinal hernia in 83/134 (62%) groin hernias. A total of 119 (88.8%) and 15 (11.2%) hernias were primary and recurrent, respectively. Seroma was detected in two (1.6%) patients in the early postoperative period. The mean duration of hospital stay was 1.4 (1-3) days. During the follow-up period, hernia recurrence was determined in three (2.4%) patients. Hernia recurrence was detected among patients who were operated on during the first half of the study. Conclusion Tension-free repair of groin hernias by video-endoscopic technique via the TEP approach can be performed with very low complication and recurrence rates. The success of the TEP approach increases parallel to increasing surgical experience. The results of hernia repair via the TEP approach are highly satisfactory and encouraging, especially when attention is paid to proper patient selection during the learning curve period.

The use of Prolene mesh for repair of various hernias is very common. As with any surgical procedure, it can be associated with complications such as seroma, hematoma and wound infection. However, it is uncommon to develop heterotopic ossification following incisional hernia repair with Prolene mesh. Herein, we report a case with chronic abdominal pain secondary to heterotopic ossification occurring after incisional hernia repair with Prolene mesh. It is crucial to report uncommon reactions to the mesh in order to aid in diagnosis of unexplained abdominal pain post hernia repair, after common etiologies are ruled out.

Background More than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. Surgical treatment is successful in the majority of cases, but recurrences necessitate reoperations in 10–15% and long-term disability due to chronic pain (pain lasting longer than 3 months) occurs in 10–12% of patients. Approximately 1–3% of patients have severe chronic pain. There were not enough guidelines recommended on choosing the type of prolene mesh for Lichtenstein open inguinal hernia repair. Methods This was a prospective study, which evaluated 25 cases of a unilateral inguinal hernia on both sex whose performed Lichtenstein open inguinal hernia repair using heavy and light weight prolene mesh from January till December 2018, divided into 2 groups. Post operative pain, chronic pain, time of return to daily activity and the evidence of recurrence were evaluated and recorded. 3 months follow up was done, the subject whose can not evaluate during this period of time was being excluded. Results During 3 months follow up between 2 groups (13 cases using heavy weight mesh and 12 cases using light weigh prolen mesh), there was no recurrence found on those groups. Post operative pain was the same between 2 groups. Chronic pain was less on light weight mesh hernia repair with VAS (visual analog score) 1–2 after 3 months compared with heavy weight mesh group (p Conclusions Light weight prolene mesh associated with a reduction in post operative pain after Lichtenstein Open Inguinal Hernia Repair and earlier time of return to daily activity. Pain, light weight prolene mesh, unilateral groin hernia

The repair of large abdominal defects remains a complex surgical problem of insufficient autogenous tissue for adequate reconstruction.

Introduction In high stage vaginal prolapse, recurrence risk patients, anterior and apical defects need to be addressed in the same procedure. The pre-molded commercial mesh kits are expensive and not always available. Alternative effective and safe treatment ways, with lower costs are desirable. Objective To present long term follow-up of patients treated with a homemade mesh shape to correct high stage prolapses. Materials and Methods We describe prospectively 18 patients with anterior and apical vaginal prolapses, stages III and IV, repaired using this specific design of mesh. All patients were submitted to pre-operative clinical evaluation and urodynamics. Prolapse was classified using the pelvic organ prolapse quantification (POP-Q). Intervention Prolapse surgery, using a six arms prolene mesh, through a single anterior vaginal incision. Outcome Measurements: POP-Q, patients satisfaction, descriptive statistical analysis. Results Between February 2009 and Oct 2010, 18 consecutive women underwent the above-mentioned surgery. Mean age was 68 years. At a mean follow-up of .,4 years (5 to 5.8 years), 16 (89%) patients were continent, mean Ba point came from +4.7cm to - 2.5cm, mean C point from +2.8cm to -6.6cm and mean Bp point from +1.3 to -1.7cm. There were two (11%) objective failures, but all the patients were considered success subjectively. There were two cases of mesh vaginal extrusion. Conclusions The homemade six arms prolene mesh allows concomitant correction of anterior and apical prolapses, through a single anterior vaginal incision, being an effective, safe and affordable treatment option when mesh is needed.

Objectives: To highlight an economical laparoscopic technique for rapidrecovery & early return to work especially for the 3rd world inguinal hernia patients. StudyDesign: Descriptive study. Setting: Surgical unit of Nishtar Hospital Multan. Period: 02 yearsi.e. from January 2014 to January 2016. Methods: There were 90 patients in the study. A prolenemesh of 15 x 15 cm used for the repair of inguinal hernia laparoscopiclly without the use ofspacer balloon & tacker (To make it cost effective). Results: Out of 90 patients only 3 patientsdevelop scrotal seroma. All the patients discharged on the 1st postoperative day & allowed toreturn to their normal routine work from the 3rd postoperative day onward. Conclusion: (e-TEP)without spacer balloon & tacker is an economical approach toward the inguinal hernia repair.

Suprapubic catheterization is common urological procedure. Rare complication (less than 10 cases reported) is herniation through trocar insertion site. In this case, 65 years Muslim male with history of urethral stricture presented with a reducible hernia in lower abdomen since 6 months following a trocar assisted suprapubic cystostomy done 1 year back. Lay open of pananterior urethra was done followed by 1 month later, prolene mesh hernioplasty.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.588-590

A 52-year-old man presented with lower urinary tract symptoms and intermittent haematuria for the last 6 months. He had undergone totally extraperitoneal right inguinal hernia repair a decade ago. The ultrasonography and an X-ray of the pelvis suggested a large radio-opaque shadow in the bladder. However, CT revealed an encrusted intravesical extension of the migrated mesh along the right anterolateral wall. The entire intravesical part of the migrated mesh with encrustations was successfully retrieved by endourological approach using holmium laser. The patient symptomatically improved and at follow-up, cystoscopy showed a complete re-epithelisation of the bladder mucosa. The intravesical extension of migrated mesh is a rare but challenging complication following mesh hernioplasty and can be successfully managed with a complete endoscopic approach.

Цель исследования. Улучшение качества выполнения резекции почки при новообразованиях при помощи оригинального способа ушивания почечной паренхимы. Материалы и методы. В исследование включено 90 пациентов с диагнозом: опухоль почки. Мужчин 57, женщин 33. Пациенты разделены (рандомизация) на II группы наблюдения. В I группу включено 45 пациентов. Средний возраст больных 64,7±3,14 лет. Средний размер опухоли в наибольшем измерении 3,8±0,81 см. Больным I группы резекция почки проводилась по классической методике. Во II группу включено 45 пациентов. Средний возраст больных 65,8±2,92 лет. Средний размер опухоли в наибольшем измерении 3,92±0,76 см. Больным II группы резекция почки проводилась по разработанной методике с применением сетчатого имплантата. В послеоперационном периоде оценивались следующие критерии: среднее время операции, среднее время ишемии органа при выполнении резекции почки, средняя кровопотеря; уровень азотемии (креатинин, мочевина): до операции, сразу после операции, через 1,5 месяца после операции. Оценивались послеоперационные осложнения по шкале Clavien-Dindo. Результаты. По времени операции, времени ишемии органа и послеоперационной кровопотери рассматриваемые методики резекции почки показали сопоставимые результаты. У больных II группы изменения уровня азотемии выражены в меньшей степени. При оценке количества осложнений выявлено, что у больных II группы в послеоперационном периоде нами в 1,75 раза реже зарегистрированы послеоперационные осложнения. Заключение. Резекция почки с применением сетчатого импланта высокоэффективный способ выполнения резекции почки, обеспечивающий качественный гемостаз при меньшей травматизации здоровой почечной паренхимы., Aim. Improving the quality of kidney resection during neoplasms using the original method of suturing the renal parenchyma. Materials and methods. The study included 90 patients with a diagnosis of kidney tumor. Men 57, women 33. Patients are divided (randomization) into the II observation group. Group I included 45 patients. The average age of patients is 64.7±3.14 years. The average tumor size in the largest dimension was 3.8±0.81 cm. Patients of group I had a kidney resection according to the classical technique. Group II included 45 patients. The average age of patients is 65.8±2.92 years. The average tumor size in the largest dimension was 3.92±0.76 cm. Patients of group II had a kidney resection according to the developed technique using a mesh implant. In the postoperative period, the following criteria were evaluated: average time of surgery, average time of organ ischemia when performing a kidney resection, average blood loss; level of azotemia (creatinine, urea): before surgery, immediately after surgery, 1.5 months after surgery. Clavien-Dindo postoperative complications were assessed. Results. According to the time of the operation, the time of organ ischemia and postoperative blood loss, the considered methods of kidney resection showed comparable results. In patients of group II, changes in the level of azotemia are less pronounced. When assessing the number of complications, it was revealed that in patients of group II in the postoperative period, we registered 1.75 times less postoperative complications. Conclusion. Kidney resection using a mesh implant is a highly effective way to perform kidney resection, providing high-quality hemostasis with less trauma to a healthy renal parenchyma., Вестник Национального медико-хирургического Центра им. Н.И. Пирогова, Выпуск 3 2019

Background: Inguinal hernia surgery is the most frequently performed operation in general surgery and so even modest improvements in clinical outcomes are important. This study has been taken as an initiative to compare the post-operative pain after conventional Lichtenstein’s meshplasty against two layered prolene mesh Hernia repair. Methods: This is a randomized control study done in our hospital over period of one year between December 2014 to December 2015. In this study out of 60 patients who underwent mesh repair 30 underwent two layered prolene mesh Hernia repair and 30 underwent conventional Lichtenstein mesh repair. All collected was tabulated and statically analyzed by using SPSS software. Results: All patients in both groups were male patients. Majority of the hernias were of the right side. Maximum pain score was seen at 2 weeks and minimum pain at 12 weeks. Pain at 2 weeks was 5.7±0.56 in MPHS group and 5.9±0.69 in CLMR group. At 12 weeks it was 1.0±0.30 and 1.1±0.35 respectively in both groups. The mean reduction of pain from 2 nd to 12 th week was 4.8±0.47 in TLPMR group and 4.7±0.70 in CLMR group. No statistical significant difference was noted as demonstrated by Mann Whitney U test. Wilcoxon signed ranks test also demonstrated that there was no statistically significant difference between the 2 groups. Conclusions: There is apparent advantage in the use of two layered prolene mesh repair over other conventional mesh repairs.

Background: Inguinal hernia repair is the most frequently performed operation in any general surgical unit. The complications of using the mesh has been the rationale to examine the role of mesh in hernia repair in detail and to begin investigating the biocompatibility of different mesh modifications and to challenge old mesh concepts. Therefore the present study is undertaken to compare the lightweight mesh (Ultrapro) with conventional prolene mesh in lichtenstein hernia repair. Methods: Thirty one patients with primary unilateral inguinal hernia was subjected either to lightweight mesh Lichtenstein’s hernioplasty or standard prolene mesh Lichtenstein’s hernioplasty. The patients were followed in the surgical OPD at 1 month, 6 months and 1 year for time taken to return to normal activities, chronic groin pain, foreign body sensation, seroma formation and recurrence. Results: Chronic pain among patients in standard prolene mesh group at 1 month, 6 month, and 1 year follow up was seen in 45.2%, 16% and 3.2% of the patients respectively, in light weight mesh group patients at 1 month, 6 month and 1 year follow up was 32.2%, 6.4% and none at one year respectively. Foreign body sensation in the light weight mesh group is significantly less compared to patients in standard prolene mesh group. Time taken to return to work was relatively shorter among patients in Light weight mesh group. There was no recurrence in both groups. Conclusion: Light weight mesh is an ideal choice in Lichenstein’s hernioplasty whenever feasible.

Herniation of abdominal viscera through drain site is not unusual. Small bowel, Appendix, Ovary, or even Gall bladder are reported as contents of these hernias with an exception of colon. We report a case presenting as acute intestinal obstruction, where the hepatic flexure of colon with omentum had been herniated through an open cholecystectomy drain site done nine years back. On emergency laparotomy, contents (hepatic flexure of colon and omentum) were reduced and found viable and parietal gap was closed from inside and reinforced with prolene mesh in preperitoneal space as well. Despite the decreasing use of intraperitoneal drains over the recent years, a multitude of patients had intraperitoneal drainage in former times. These patients face nowadays the risk of drain-site hernias with sometimes even unexpected structures inside.

Objetivo: La Técnica de Rives-Stoppa para las eventraciones de la línea media instala una malla retro rectal fijada en sus bordes con puntos percutáneos. Se han propuesto otras formas de fijación y en este estudio prescindimos de ella. Material y Método: El presente estudio observacional, descriptivo, prospectivo, se realizó en pacientes intervenidos consecutivamente entre los años 1995 y 2002. Se usó anestesia epidural con sedación profunda. Se usó la técnica estándar de Rives-Stoppa prescindiendo de la fijación perimetral. Los pacientes deambularon y se dieron de alta precozmente. Resultados: Se da cuenta de la evolución postoperatoria de 64 pacientes, 48 mujeres y 16 varones con una edad promedio de 58,9 (26-85) años. El 25% era hipertenso, el 9,3% diabético y el 80,2% obeso con un IMC > 30. La hospitalización promedio fue de 3,9 (2-16) días. Hubo 4 infecciones superficiales, un trombo embolismo pulmonar, un íleo abdominal prolongado y dos infecciones pulmonares. El seguimiento a largo plazo pudo realizarse en 48 pacientes (75%) comprobándose 5 recidivas (10,4%), ubicadas en el borde dista o proximal de la reparación herniaria, y 13,2% de dolor crónico moderado. A pesar de la recurrencia, el 97% de los pacientes se manifestó satisfecho o muy satisfecho con el tratamiento. Discusión: Los resultados son comparables con los dados a conocer con fijación de la malla. La modificación técnica propuesta disminuye el tiempo quirúrgico y el riego de infección y de neuralgia post operatoria. Para una ulterior disminución de las recidivas debe aumentarse el solapamiento cefálico y caudal de la malla.

We present a rare case of intercostal lung herniation due to blunt trauma. A 40-year-old man was admitted to our hospital with lung herniation due to falling off a donkey. Computed tomography demonstrated a fracture of the 8th left rib, a comminuted fracture of the 9th rib, and lung herniation into the 8th intercostal space. The herniation was repaired using a titanium prosthetic rib, a rib plate, and Prolene mesh via a thoracotomy.

Primary chondromyxoid fibroma is a benign bone tumor. Its localization in the sternum is quite rare; we found only 6 relevant reports. We report our diagnosis and treatment of a chondromyxoid fibroma in the sternum of a 63-year-old woman. The patient underwent subtotal sternectomy and chest-wall reconstruction with use of a titanium rib bridge system and Prolene mesh. The patient's clinical course was uneventful, and she had no local recurrence 41 months postoperatively. Our review herein of the 6 previous cases reveals that our patient is the oldest thus far to have been diagnosed with a sternal chondromyxoid fibroma.

Background: Early treatment of hernia is very important to reduce the risk of obstruction and or strangulation. Ventral hernias include umbilical, epigastric, and incisional hernias and represent 10-15% of all primary hernias. Conventionally, theses hernias are treated by suture repair with a substantial rate of recurrence and this increase the demand for a better technique of repair. There is no exact protocol or consensus on how the repair should be carried out. Aim of work: To present a new surgical technique for ventral hernia repair with least recurrence rate. Material and methods: This study was performed at a tertiary hospital and included 100 patients with uncomplicated ventral hernias and fit for surgery. Partial pre-peritoneal and partial subrectal insertion of prolene mesh was the new surgical technique done. Results: The study included 58 females and 42 males. The mean BMI was 28.6. The mean defect size was 30.3 cm (range 9-64). The mean operative time was 47.5 minutes (range 35- 62). The mean hospital stay was 2 days (range 2-4). Postoperative complications including wound infection (3 cases), seroma (7 cases) and hematoma (2 cases). Recurrence occurred in one case after 1 year. The efficacy rate was 98.75%. Conclusions: Pre-peritoneal and pre- posterior rectus sheath insertion of prolene mesh is a new surgical technique for ventral hernia repair with high efficacy and low recurrence rate.

PURPOSE The study objective is to compare the outcomes of laparoscopic to tally extraperitoneal repair using the standard-weight polypropylene mesh or a lightweight titanium-coated mesh. METHODS A retrospective review was conducted on 138 adult patients with unilateral inguinal hernias, who underwent totally extraperitoneal inguinal hernia repair between 2010 and 2013 using either a standard-weight polypropylene mesh (Prolene mesh, 80 g/m) or a lightweight titanium-coated mesh (Ti Mesh light, 35 g/m). RESULTS There was no difference in reported pain at 24 hours postoperatively. The difference in reported pain at follow-up (mean: 21 mo) was insignificant [PP vs. Ti: 7.8% (n=5) vs. 8.3% (n=3), P=0.92], the differences regarding chronic inguinal pain was also insignificant [PP vs. Ti: 14% (n=9) vs. 5.5% (n=2), P=0.191], and there was no difference in the development of hernia recurrence [PP vs. Ti: 1.5% (n=1) vs. 0, P=0.42]. CONCLUSIONS No statistically significant differences of the overall postoperative outcome were observed between the 2 mesh types.

BACKGROUND: Day case surgery is still in its infancy in India and inguinal hernia repair is one of the most common surgical procedures performed. Various techniques are advocated by different surgeons for repair of inguinal hernia repair. Present study was done to evaluate inguinal hernia repair with prolene mesh as day case surgery. MATERIALS AND METHODS : 40 patients underwent inguinal hernia repair in various surgical wards of Guru Nanak Dev hospital attached to Government medical college, Amritsar using polypropylene mesh under local anaesthesia on ambulatory basis. Patients were assessed for feasibility of repair under local anaesthesia on day case basis. RESULTS : We observed that most of the patients (90%) were operated upon under local anaesthesia and 75 % patients were discharged on the same day. CONCLUSION : Lichtenstein tension free hernia repair can be safely performed under local anaesthesia on day case basis. It is an inexpensive and effective procedure and the economic benefits are enhanced by low morbidity, low recurrence rate and early return to

The aim of this study was to determine the surgical success and complication rates of mixed type of mesh materials compared with Prolene mesh in sling surgery over a 4-year follow-up period.Between 2005 and 2007, broad-based double-forced sling operations were performed in 144 women with stress incontinence using three different types of mesh material. Group I consisted of 48 patients in whom Vypro® mesh (Ethicon, USA) was used; group II of 48 patients in whom Ultrapro® mesh (Ethicon) and group III of 48 patients in whom Prolene® light mesh (Ethicon) was used. The patients' data and the success of the operation were evaluated based on the 24 h pad test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scoring and Korman questionnaire analysis.The ICIQ-SF score, the number of pads used and the results of 24 h pad test were statistically lower in group II at postoperative month 48 (p0.05). The rate of postoperative complications was lower in Group II than in the other groups (p0.05). The continence rates of groups I, II and III were 84.7%, 91.6% and 85.1%, respectively, in the 48th postoperative month.Ultrapro mesh can be used in sling surgery owing to its higher success rates, and lower vaginal and urethral extrusion and de novo urgency rates, which have also been shown in clinical studies.

Nodular Fasciitis (NF) is a benign, self-limiting condition that is characterized by myofibroblast / fibroblast proliferation. It is commonly found in the trunk, upper limbs (volar aspect of the forearm), and the back. Patient who are diagnosed with this condition typically presents with a history of rapidly enlarging subcutaneous mass over several weeks or months [1]. NF often mimicks a malignant process due to its rapid growth clinically, its high mitotic activity and cellularity and nonspecific cytomorphologic findings which makes it diagnosis pretty challenging. We describe a case of NF of the left posterior chest wall that presented to us and underwent wide local excision followed by chest wall reconstruction using a prolene mesh.

Background and Objectives There are many surgical procedures for treating complete rectal prolapse ranging from complex abdominal interventions to simple perineal procedures with varying results. The ideal procedure suitable in all cases is still an enigma. Many surgeons believe that abdominal rectopexy has become the operation of choice not only in the young but even in the elderly patients, resulting in a low recurrence rate and restoration of continence in significant number of patients. The present study to evaluate clinical and functional results of abdominal rectopexy using prolene mesh for complete rectal prolapse in our centre. Method Fifteen patients with complete rectal prolapse underwent abdominal rectopexy using prolene mesh. They were followed up for a mean period of 7.3 months and was analysed for postoperative complications like haemorrhage, operative mortality, wound infection, bladder and erectile dysfunction recurrence of rectal prolapse, changes in bowel frequency and restoration or deterioration in continence were noted. Results There was no mortality or recurrence in any patient and (100%) improvement in continence in a lone patient with incontinence and decrease in bowel frequency in 2 patients (13%), postoperatively but this did not result in clinical constipation in any of the patient. Conclusion Abdominal rectopexy using prolene mesh is a simple operation with satisfactory low recurrence rate, good functional out come with low morbidity and mortality. This procedure can be considered in all patients who are considered fit to undergo an abdominal procedure.

Objective: To compare the results of Inguinal Hernia repair using commonly employed methods of Bassini’s and Mesh repair. Methodology: This study included 90 cases of hernia repair ranging over a period of 18 months from October 2008 to Mar 2010 at Social Security Hospital Lahore. All the cases were done by the consultants and senior surgeons. The methods of repair included Bassini’s and Hernioplasty with Prosthetic mesh. Results: Out of 90 patients, 88 were males (97.78%) and 02 were females (2.22%). Male – female ratio 45 : 1. The peak incidence was found in 3rd and 4th decades of life. 56(62.22%) had Rt.sided Inguinal hernia, 29 (32.22%) had Lt. sided and 5(5.56%) had bilateral Inguinal hernia. 72 patients (80%) had Indirect Inguinal hernia, 17 (18.89%) had direct inguinal hernia while 1(1.11%) had both types. All the cases were done under Spinal anaesthesia. The Bassini’s repair was performed in 50% cases, using non-absorble no. 1 Prolene interrupted suturing (Group- A). In the Group – B, 50% cases underwent Hernioplasty with prosthetic prolene mesh 6x11 cms. Post-operative follow up was done for a period of 01 year. In the group- A, 3 (6.67%) patients had recurrence and 3 (6.67%) had infection of the wound. In group – B, 01 patient (2.22%) got infected and none of the cases did not get recurrence over a period of 01 year. Conclusions: Hernioplasty with prosthetic mesh is a better treatment modality for inguinal hernia repair to get a low recurrence rate.

Incisional hernia is a complication in 10-20 % of patients after laparotomy. The standard flat mesh made from polypropylene has a tensile strength that is far greater than that required physiologically. Reducing the amount of polypropylene by increasing pore size produces a lighter weight mesh that may improve the functional properties and diminish local complications. The low-weight mesh was found to be feasible, with no additional short-term mesh-related complications in the experimental model and no negative side effect on biocompatibility. Also the introduction of the retromuscular, sublay technique using polypropylene meshes had significantly decreased the recurrence rates after open incisional hernia repair. The aim of this study: To evaluate the sublay technique using light weight Vypro mesh in comparison to the same technique using heavy weight Prolene mesh for moderate size midline incisional hernias, as regard operative difficulties and postoperative complications. Patient and method: Between Aug. 2008 and Aug. 2009, 30 patients with moderate size (5- 10cm) midline incisional hernias were randomized to receive lightweight composite (Vypro) mesh, or standard polypropylene (Prolene) mesh. The clinical course of all patients was registered during the hospital stay as well as 3, 6, 9, and 12 months after surgery. Results: No significant differences were determined concerning age and gender. In contrast, length of hospital stay was lower in the low-weight mesh group. Minor complications as seroma, mild wound infection and abdominal discomfort were significantly lower among patients in whom we used Vypro meshes in the repair than patients with prolene meshes. No hernia recurrences occurred in both studied groups.

Seventy-three patients who had incisional hernia repair at two hospitals, a government and a private, from 2000 to 2005 were reviewed. Fifty-nine (80.8%) patients were females and 52 (71.2%) patients were Saudi. Five (6.8%) patients had minor complications. Twenty-four (32.9%) patients had polypropylene mesh while 49 (67.1%) patients had Vypro mesh, both types where fixed intraperitoneally using absorbable Vicryl 2/0 interrupted suture. No differences in complications, duration of surgery, or hospital stay between patients using either Vypro or PROLENE mesh. Intraperitoneal mesh placement of incisional hernia is safe on short and long-term follow-up. Vypro mesh compares favorably with PROLENEmesh. The authors encountered no enterocutaneous fistula and experienced only 2 (2.7%) recurrences over one year.

Introducción: la zona crítica de sostén apical de la fascia vesicovaginal es el anillo pericervical, el cual no existe en el caso de mujeres histerctomizadas. Por lo tanto, el análisis y el desarrollo de posibilidades terapéuticas para el cistocele con menores recidivas posteriores es un tema crítico en la cirugía uroginecológica. Objetivo: presentar una nueva técnica quirúrgica para el tratamiento del colpocele anterior. Material y método: se presentan los primeros diez casos de pacientes operadas con una nueva técnica quirúrgica en el tratamiento por vía vaginal del colpocele anterior. La técnica denominada CATO (C-colposuspensión, A-anterior, TO-transobturatriz) se basa en la reparación del defecto del colpocele anterior (sea este central, medial o pericervical) mediante tejido propio, el cual se fija a una neoestructura dada por el emplazamiento de una cinta de malla de prolene por vía obturatriz posterior. Resultados: no se registraron complicaciones intraoperatorias; hubo un hematoma vesicovaginal posoperatorio inmediato. En cuanto a los resultados funcionales, no se registraron disfunciones vesicales. En el seguimiento se destaca que todas las pacientes presentan puntos Aa y Ba normales. No se registran complicaciones de la malla utilizada. La técnica resulta segura, respeta la anatomía funcional y es reproducible para el ginecólogo vaginalista entrenado y con conocimiento del abordaje transobturatriz posterior. El seguimiento a largo plazo demostrará si esta nueva técnica desarrollada por nuestro equipo tiene un lugar que ocupar en el arsenal quirúrgico del tratamiento de la patología del piso pélvico. Abstract Introduction: the critical area of apical support for the vesicovaginal fascia is the peri-cervical ring, which does not exist in women who have undergone hysterectomies. Thus, the analysis and development of new therapies for colpocele with smaller posterior relapse is critical for urogynecologic surgery. Objective: to present a new surgical technique for treatment of anterior colpocele Method: the study presents the first ten cases of women who were operated with a new surgical technique in treatment for anterior colpocele through the vagina. The technique under the name CATO (following the Spanish words: CATO (C-colposuspension, A-anterior, TO-transobturator) is based on repairing the anterior colpocele defect (central, medium or peri-cervical) using her own tissue, which is fixed to a new structure created by placing a mesh ribbon through a posterior transobturator. Results: no intraoperative complications were recorded; there was one case of immediate postoperative vesicovaginal hematoma. As to functional results, no vesical dysfunctions were recorded. Upon follow up, it is worth pointing out all patients show normal Aa and Bb stitches. Nos complications arose for the mesh used. The technique is safe, it respects functional anatomy and may be replicated by trained gynecologists who are familiar with the posterior transobturator approach. Long term follow up will reveal whether this new technique developed by our team may become part of the surgical toolkit for treating pelvic floor pathology. Resumo Introdução: a zona crítica do suporte apical da fáscia vesicovaginal é o anel pericervical, que não existe nas mulheres histerectomizadas. Portanto, a análise e o desenvolvimento de possibilidades terapêuticas para o cistocele com menores recidivas posteriores é uma tema crítico na cirurgia uroginecológica. Objetivo: apresentar uma nova técnica cirúrgica para o tratamento do colpocele anterior. Material e método: apresentam-se os dez primeiros casos de pacientes operadas com uma nova técnica cirúrgica para tratamento por via vaginal da colpocele anterior. A técnica denominada CATO (Colpossuspensão, A-anterior, TO-transobturatoria) está baseada na reparação do defeito do colpocele anterior (seja central, medial ou pericervical) utilizando tecido próprio, que se fixa a uma neoestrutura dada pela colocação de uma tira de malla de prolene por via obturatriz posterior. Resultados: não foram registradas complicações intra-operatórias ou hematoma vesicovaginal pós-operatório imediato. Com relação aos resultados funcionais, não foram registradas disfunções vesicais. No seguimento se destaca que todas as pacientes apresentam pontos Aa e Ba normais. Não foram registradas complicações da malha utilizada. A técnica é segura, respeita a anatomia funcional e é reproduzível por ginecologista vaginalista treinado e com conhecimento da abordagem transobturatoria posterior. O seguimento em longo prazo demonstrará se esta nova técnica desenvolvida por nosso grupo de trabalho tem um lugar no arsenal cirúrgico no tratamento da patologia do piso pélvico.

Introduction: Inferior Lumbar hernia is a rare abdominal hernia and clinical suspicion is necessary for diagnosis. Case presentation: We report the case of a 35-year-old lady with a reducible inferior lumbar hernia. The hernia was repaired with prolene mesh. The patient was free of recurrence at 6 months after the operation. Conclusion: A lumbar or flank mass should always raise suspicion of a lumbar hernia. Adequate surgical treatment should be planned on the basis of etiology and hernia size. Both open and laparoscopic techniques can be used with good results

Guneren, Ethem/0000-0002-5981-7010 WOS: 000231588800016 PubMed: 15950959 We present reconstruction of a wide anterior abdominal defect measuring 30X45 cm(2), the result of necrotising pancreatitis. After serial debridements and reconstruction of the peritoneum using a Prolene mesh support, a delayed extended groin flap was transposed. No complications were encountered afterwards. An extended groin flap can be used safety to cover a full-thickness defect of the abdominal watt encompassing all of the anatomic subunits. (c) 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.

Morbid obesity is a burgeoning health crisis. Significant morbidity is associated with the current gastric bypass, and, therefore, alternative surgical modalities are desired. A novel minimally invasive surgical technique, endoluminal gastric partitioning, is presented. Ten mongrel dogs underwent endolaparoscopic placement of intragastric mesh. Each circular prosthesis (Surgisis® or prolene mesh) was 8 cm in diameter with a 1.5 cm central aperture. The mesh was passed transorally into the gastric lumen and secured with a laparoscopic, intragastric suturing resulting in a 30 to 50 mL proximal gastric reservoir. The operation was successfully completed in all 10 animals. Nine of 10 animals were healthy at the scheduled sacrifice date. In 2 dogs, the intragastric mesh was 100% adherent to the gastric mucosa after 7 days. Four of the final 5 dogs demonstrated some degree of mucosal adherence after 1 week. Endoluminal placement of intragastric mesh appears feasible and safe. Long-term studies are necessary to demonstrate the efficacy and long-term weight loss of this, or alternate intraluminal gastric partitioning techniques.

Tension-free vaginal tape (TVT) is nowadays an established operation for the treatment of stress urinary incontinence. In this article, we will demonstrate our standardized TVT procedure and ways of possible postoperative correction. A tight vaginal tape can be individually expanded by a Prolene-interponate within days and also years after surgery. On the other hand, we developed a technique to shorten a loose vaginal tape. Moreover, we will discuss our approaches in the case of an eroded Prolene tape, local estrogen therapy, tape padding with vaginal tissue and blunt removal of the tape by a small vaginal incision.

INTRODUCTIONPelvic organ prolapse (POP) is a common gynecological problem. Repair with synthetic materials such as prolene mesh has become a popular approach in prolapsus surgery. Migration of synthetic materials can cause serious complications.PRESENTATION OF CASEA 69-year-old woman was admitted to the hospital with a complaint of sensation of fullness and a feeling of a foreign material protruding during defecation. The patient underwent exploratory laparotomy. Prolene mesh was detected in sacral region but resection of the mesh could not be conducted because of dense adhesions causing frozen pelvis. The migrated prolene mesh was resected transanally.DISCUSSIONGenital prolapse or genital hernia is described as the protrusion of pelvic organs along the vagina. It is one of the common gynecological conditions that affect the quality of life in women. Mesh migration is a well-known clinical pathology.CONCLUSIONMesh migration is a serious complication after sacral colpopexy. Surgical resection of migrated mesh can be difficult due to dense adhesions.

Alloplastic meshes are potential alternatives for reconstruction of irreparable rotator cuff tears. This study evaluates the biomechanical suitability at the tendon mesh interface of five different meshes. Twenty-five ovine infraspinatus tendons were repaired in five experimental groups (n 5) with an alloplastic mesh. The control group was repaired with sutures (n 5). Group 1 was repaired with a polypropylene mesh (Prolene), group 2 with a polypropylene/polyglactin mesh (Vypro), group 3 with a 1-mm thick ePTFE mesh, group 4 with a 2-mm ePTFE mesh (Gore-Tex), and group 5 with a 2.87-mm PTFE felt (Bard). The tendon–mesh interface was tested by a tensile testing machine until failure occurred. The control group failed at a mean (± SD) ultimate tensile strength of 98 ± 14 N with the sutures cutting out of the tendon. The Prolene mesh failed at 72 ± 12 N with the sutures cutting through the mesh. In the Vypro group, the repair failed at 75 ± 14 N. The 1-mm ePTFE mesh failed at 78 ± 9 N. The 2-mm ePTFE mesh failed at 109 ± 12 N and the PTFE felt at 111 ± 16 N with the sutures cutting through the tendon. There was a statistical significant difference (P < 0.01) between the 2-mm ePTFE mesh and the PTFE felt when compared with the other tested meshes. The ideal rotator cuff repair should possess high initial fixation strength and maintain mechanical stability over time. The 2-mm ePTFE mesh and the PTFE felt demonstrated significantly superior initial fixation strength at the mesh tendon interface when compared with the other tested meshes. INTRODUCTION

Background: The type of inguinal hernia repair used depends on many factors predominantly surgeon’s training, interpretation of the literature and personal preference. This prospective cohort study describes a consecutive series of open mesh inguinal hernia repairs (modified Lichtenstein technique) performed in this hospital with two different mesh types.Methods: Analysis was undertaken on 60 consecutive patients who underwent inguinal hernia repair during last one year. Short-term outcomes were compared between those repaired with conventional polypropylene mesh and those with Covidien Progrip mesh.Results: All patients were male, and the mean age was 60 years. The median operative time was 60 minutes for unilateral hernias and 90 minutes for bilateral hernias. The use of Covidien Progrip mesh reduced the operative time to 40 minutes for unilateral hernias and 60 minutes for bilateral hernias. After unilateral hernia repair, 10% of the patients repaired with Progrip mesh were discharged home within 1 day of operation. Almost 99% of Progrip repair cases were discharged within 48 hrs. Twenty-four hours postoperatively, 74% of the patients were either totally pain free or had minimal discomfort. At 4weeks, 99%of the patients were either pain free or had minimal discomfort. Patients who underwent unilateral inguinal hernia repair with progrip mesh had the most rapid return to normal activities. All these parameters are slight longer in polypropylene mesh repair cases.Conclusions: Open anterior mesh repair is safe and results in minimal postoperative pain and early return to normal activities. Progrip mesh resulted in a shorter operative time and more rapid return to normal activities and decrease in long term postoperative pain compared with polypropylene mesh.