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Background: Ventral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also increased incidence of obesity in females. Objective: To assess incisional hernia repair using two different techniques: on-lay mesh and sub-lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma and flap necrosis. Patients and Methods: The Pubmed, web of science and Scopus were searched on 15 March, 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, polypropylene. Results and Conclusion: According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time consuming. Regarding post-operative complications there is no statistical difference in recurrence, seroma, hematoma, flap necrosis and infection but there is a statistical difference regarding in hospital stay as patients with sublay repair stays less than onlay.

Background: Liver transplantation is considered an important solution to patients with end stage liver disease and a glimpse of hope for some patients with terrible quality of life due to the morbidity of such disease. Living donor liver transplantation procedures has now become widely done worldwide and many studies have been done to improve its outcome and improve the quality of the patients’ lives. Objective: to help identify the factors that affects the size of spleen after living donor liver transplantation and promotes the reduction in its size which greatly affects the patients’ and graft survival rate. Patients and Methods: This is a retrospective study including patients underwent living donor liver transplantation to be conducted in Ain Shams university hospitals to determine the factors promoting reduction of spleen size after living donor liver transplantation. This study was conducted at Ain-Shams University Hospitals, in the period from January 2008 to June 2021. Results: In our study we found that from 100 patients who had splenomegaly before transplantation, 54% of patients had persistent splenomegaly after liver transplantation, while 46% of patients had normal spleen size after transplantation within 1 year. The spleen size decreased significantly after transplantation in general, from a range of 13.3- 25 cm with a mean of 18.06 cm +/- 7 pre-operative, to a range of 9-18 cm with a mean of 14.1 cm +/- 2.65. By analyzing this data and dividing it into two groups, it has been found that the group with persistent splenomegaly (54% of patients) had higher range of spleen size before transplantation with a range of 16.7-25 cm with a mean of 19.75 cm +/- 2.169, while the group of normal spleen size after transplantation ranged from 13.3-17 cm with a mean of 15.3 +/- 1.018 before transplantation. Also patients with dilated portal vein and portal vein thrombosis have higher chances of persistent splenomegaly post-operative. It has been found that in 93.4% of patients (43 patients)with reduced spleen size after transplantation had patent portal vein with average diameter, while only 6.5% (3 patients) had dilated portal vein and zero patients with attenuated portal vein. On the other hand, 44.4% of patients with persistent splenomegaly had dilated portal vein, 38.9% had patent portal vein, and 16.67% had attenuated portal vein pre-op. Our study also showed the effect of spleen after transplantation on platelets levels and liver function. The normal spleen size was associated with better recovery of platelets number, in the group of patients with normal spleen size it ranged from 32 -189 10^3/uL with a mean of 80 10^3/uL pre-op, it increased to a mean of 163.95 10^3/uL post op. While in the splenomegaly group the mean platelets count pre-op was 75.27 10^3/uL in increased to 156.88 10^3/uL post op. It has also been found that the decrease in spleen size greatly affects the liver functions, where in aspartate aminotransferase AST and Alanine transaminase ALT levels pre-operative in patients with normal spleen with a mean of 38.37 and 57.8 respectively. It decreased to a mean of 27 and 29.7 and difference of 11.2 and 28.1 respectively. Conclusion: The spleen size after living donor liver transplantation is affected by the size of the spleen before transplantation and by the diameter portal vein before transplantation. Also the reduction in the spleen size after the living donor liver transplantation does not statistically affect the patient's platelets count and the liver functions such as liver enzymes with the total and the direct bilirubin .But it does statistically affect the albumin level.

Background: The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The idea of the Laparoscopic inguinal hernia repair is to repair the defect and put artificial/biological mesh. There is too many types of meshes differs from shape ,size and material of the mesh . Objective: To assess laparoscopic inguinal hernia repair using two different meshes: The conventional polyprolene mesh and the three-dimensional (3D) mesh, as regard the operative application time and post-operative complications including seroma , chronic pain, ,and recurrence using meta-analysis approach. Patients and Methods: In our study ten trials included, three trials regarding 3d mesh versus conventional mesh in laparoscopic inguinal hernia repair , three trials regarding 3d mesh and four trials regarding polyprolene mesh. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Results: There is significant heterogeneity among trials (P = 0.002, I2 = 84%), mean difference 1.17, 95% CI -2.18, 4.52 and there is no statistically significance z=0.49. Conclusion: There is no difference between conventional polyprolene and 3d mesh regarding intra-operative difficulties (operative time) and post-operative complications (chronic pain, recurrence, operative time and seroma).

Background: Ventral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also increased incidence of obesity in females. Objective: To assess incisional hernia repair using two different techniques: on-lay mesh and sub-lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma and flap necrosis. Patients and Methods: The Pubmed, web of science and Scopus were searched on 15 March, 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, polypropylene. Results and Conclusion: According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time consuming. Regarding post-operative complications there is no statistical difference in recurrence, seroma, hematoma, flap necrosis and infection but there is a statistical difference regarding in hospital stay as patients with sublay repair stays less than onlay.