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Introduction: An incision is a slit or cut used to get access to deeper tissues. Electro cautery is a medical procedure that involves burning a specific portion of the body to remove or close it. Although worries of severe scarring and slower wound healing have limited its use for skin incision, electro-cautery is becoming increasingly often used for tissue dissection. Materials and methods: In this prospective randomised study, 60 patients undergoing mesh plasty for inguinal hernia were divided into two groups. In Group A, a skin incision is produced using electrocautery, while Group B uses a scalpel. The two groups are compared in terms of postoperative discomfort, wound complications, and the use of analgesics. Finally, the Mann-Whitney U Test is used to assess and compare the results for the two groups. Results: Pain will be measured six, twelve, and twenty-four hours after surgery using a graphical visual analogue scale. In the event that the pain score exceeds 4, INJ.DICLOFENAC 50 mg IM will be administered. In the post-operative phase, complications recorded in hospital stay are quantified by means of Seroma-discharge of serous collection at suture site, and Hematoma-blood collection. Conclusion: The outcomes of both groups, namely the diathermy and Scalpel groups, have been proven to be equivalent based on the findings of this research of the following: 1) postoperative pain, 2) the need for analgesics, and 3) wound complications after surgery. [ABSTRACT FROM AUTHOR]

Cement spacer as a reconstruction technique in proximal humerus resections in malignant and benign conditions is well established. Functional outcome of any reconstruction is decided by how well soft tissue reconstruction has been carried out. The cement spacer technique allows soft tissue reattachment at any site required as compared to prosthetic reconstruction, but such reattachment sites have to be decided before setting of the cement. Here we describe a technique in which a prolene mesh is used as a mould for the cement. The outer prolene mesh gives the surgeon the opportunity to anchor soft tissues during closure at any area desired. The mesh creates a porous surface over the stem which will aid in better healing by fibrosis for the muscle as compared to healing over smooth cement. Mesh fibrosis is another added point of stability at the bone-construct junction. Post-operative shoulder range of motion was easier to achieve in such patients. [ABSTRACT FROM AUTHOR]

Introduction: Indeed, even extreme inguinal hernia fix is among the commonest activities in everyday medical procedure, the decision for an ideal methodology repeat rates and low commonness of entanglements, strain free lattice increased activity has become the standard strategy in inguinal hernia medical procedure, altogether diminishing hernia repeat rates. Materia & Methods: Study conducted on 110 patients admitted in MGM Medical & M.Y. Hospital Indore. Total 110 consecutive patients who will undergo inguinal hernia repair at the Surgical Department & who fulfills the inclusion criteria were included. Clinical details, rate of post-op wound infection and post-op pain were noted. Observation & Results:-Total 110 patients enrolled in study most patients belonging to 51-65 years of age. Total 76 patients managed by suture fixation and 34 patients managed by Progrip mesh. Most patients found to have moderate pain. Wound infection rate came out to be 13%.Conclusion: The point of our investigation is to think about the result after Lichtenstein's inguinal hernia fix utilizing ordinary lattice v/s self-focusing Pro grasp network. The essential endpoint of the examination will be the occurrence of post-operative pain. Open Inguinal hernioplasty utilizing Self Gripping Mesh (Pro hold) has better result as far as usable time, Post-usable torment, Hospital stay, Early re-visitation of expert life and ongoing agony. [ABSTRACT FROM AUTHOR]

Background: Incisional hernia remains one of the most prevalent post operative surgical complication with long term incidence of 10-20%, which represent the evidence of poor wound healing in these patients. Objective: To study the risks associated with prolene mesh repair for incisional hernias, how they are managed, and how these risks compare to those in previous research. Setting: Al- Jumhoori Teaching Hospital, Mosul. From Jan. 2006 to Dec. 2007. Materials&Methods: A prospective study of fifty cases with incisional hernia that were treated by prolene mesh repair after elective or emergency surgical operations with follow up between (12-36) months to account for the complications of prolene mesh repair and the management and outcome of these complications was conducted. Results: In 22% of the patients, complications were noted. These complications were categorized as seroma in 8%, deep SSI in 8%, superficial SSI in 4%, and hematoma in 2%. During the observation period of twelve to thirty-six months, there was no sign of a recurrence. Conclusions: The number of complications that arose from our research was manageable and comparable to those of previous investigations. The production of seromas and subsequent infections at the surgical site are the most often reported consequences. The vast majority of these problems are amenable to non-invasive treatments such as wound care in the affected area and antibiotic medication. [ABSTRACT FROM AUTHOR]

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Background: Recurrent inguinal hernia constitutes a significant problem for the surgical community. Incidence of recurrence and chronic groin pain after hernia repair require continuous audit, participation in a register and follow-up by selective physical examination provides a solid basis for quality control. Objective: Description of cases with recurrent inguinal hernia, type of previous repair, factors contributed to recurrence of hernia and type of repair used with the study of post-operative complications in the early postoperative period. Patients and Methods: Descriptive studies on patients with recurrent inguinal hernia were evaluated and data collected. History; age, occupation, time of previous operation, predisposed factors extracted from the previous operation and change of lifestyle. General examination; the presence of predisposing factors, comorbid factors, obesity. Local examination: to describe the type of hernia. Local examination: to describe the type of hernia. Results: In our study 18(40%) patients had an indirect recurrent hernia, 24 patients with recurrent direct inguinal hernia, and 3 patients presented with pantaloon hernia. Males constitute 93.33% of cases. Smoking and chronic cough were the most common predisposing factors. The right side constitutes 80% of cases and the other 20% on the left side. The interval between the previous operation and clinical presentation of recurrence is the highest number presented after 2-5 years. Conclusion: Mesh repair was superior to other types of repair (less no. of patients with previous mesh repair and less post-operative complications).

Background: Chest wall chondrosarcoma is the most common primary tumor of chest wall. Radical excision with wide safety margin and optimal reconstruction of chest wall by prosthetic material is a corner stone in management. Aim of this study is to evaluate our surgical technique in management of thoracic chodrosarcoma Patients and Methods: Over a period of 5 years, 24 cases with chest wall chondrosarcoma were reviewed and evaluated in Cardiothoracic Surgery Department in Mansoura University. Results: in this study, 16 males and 8 females presented by rib chondrosarcoma (87.5%) and sternal chondrosarcoma (12.5%). Patients presented by painful mass were (62.5%) while those with mass only were (37.5%). Wide excision with safety margin of 4-5 cm was done, reconstruction was done by prolene mesh only in 33.3% and by prolene mesh with bone cement in (66.6%) Minimal complications in the form of fever (12.5%), seroma (8.3%) and infection (4.2%) were reported. Conclusion: We advise aggressive resection of chrondrosarcoma with wide safety margin and prosthetic material reconstruction of chest wall as it is the concept to expect high survival and low recurrence rates. [ABSTRACT FROM AUTHOR]

Background and objectives: Inguinal hernia repair is the most frequently performed operation in any general surgical unit. Reports on the outcome of inguinal hernia surgery show that recurrence rate 5 years after operation can vary from 0.1 to over 20%. The aim of the present study is to compare Lichtenstein’s tension free hernia repair with the Modified Bassini’s herniorraphy in terms of immediate complications like technical difficulty, seroma formation, wound infection rate, recurrence rate at one year and chronic pain. Methods:100 cases admitted to BELAGAVI INSTITUTE OF MEDICAL SCIENCES BELGAVI DISTRICT HOSPITAL from June 2021 to May 2022 with primary unilateral inguinal hernia were randomly subjected either to Modified Bassini’s herniorraphy or Lichtenstein hernioplasty. All the hernia repairs were performed under spinal anaesthesia. In case, of any associated conditions like hypertension, diabetes mellitus were present, treatment was first given for these associated conditions. A note was taken of any technical difficulty during surgery.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, patient’s satisfaction and recurrence. Results:Technical difficulty was encountered in 4 patients (i.e. 8%) undergoing Modified Bassini’s herniorraphy. No technical difficulty was encountered in any of the patients in Lichtenstein group. At 1 month follow up, 20 patients (i.e. 40%) of Modified Bassini’s herniorraphy group patients had mild pain whereas 14 patients (i.e. 28%) had mild pain in the Lichtenstein group. However, none of the patients in X any of the two groups had any degree of pain at 6 months and 1 year. There was one recurrence (i.e. 2%) in Modified Bassini’s herniorraphy. However, no recurrence was seen in Lichtenstein group. Time to return to work was relatively shorter in Lichtenstein group. Interpretation and Conclusion: Lichtenstein is a easy, straightforward technique for inguinal hernia repair with fewer recurrences, less hospital stay and less duration of surgery. However, amongst the pure tissue repairs Modified Bassini’s herniorraphy still remains relevant. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcomes of prolene macroporous mesh with Parietex Composite® mesh in patients undergoing Laparoscopic hernioplasty for management of Paraumbilical hernia. Study Design: Prospective Comparative study. Setting: Jinnah Hospital Lahore. Period: 1st January 2016 to 1st January 2018. Material & Methods: A total of 100 patients with diagnosis of Paraumbilical hernia, aged >18 years were included. There were two groups. In group A (n=50) prolene macroporous mesh (Covidien) was placed. In group B (n=50) Parietex Composite® mesh (Covidien) was placed. After hernioplasty all patients were followed for a period of 2 years for evaluation of primary procedure and any complications like seroma, hematoma and intestinal obstruction. Results: The mean length of stay was 2.74±2.13 days in group A, versus 2.23±1.25 in group B (p-value 0.15). Seroma formation was seen in 4 (8.0%) patients in group A versus in 02 (4.0%) patients in group B (p-value 0.40). Hematoma formation was seen in 01 (2.0%) patients in group A versus 0.0% patients in group B (p-value 0.10). There was no recurrence and intestinal obstruction in any group in two years follow up. Conclusion: There was no difference in surgical outcome and the complication between two groups of patients undergoing laparoscopic Paraumbilical hernia repair with prolene macroporous and Parietex Composite mesh. Moreover, parietex composite mesh are difficult to insert and much expensive. Therefore, prolene mesh can be safely used in patients undergoing Laparoscopic Paraumbilical hernioplasty. [ABSTRACT FROM AUTHOR]

Objective: To assess the outcome of Prolene mesh-abdominoplasty, as compared to abdominoplasty alone, in multiparous women with severe musculo-aponeurotic laxity. Subjects and Methods: The present retrospective study included 135 multiparous (4 or more children) women who presented with an abdomen that resembled a full-term pregnancy in the erect posture. Their ages ranged between 27 and 59 years with a mean of 41.26±13.15 years. Forty-three (31.9%) patients suffered from low back pain, 52 patients (38.52%) had an associated ventral hernia, and 88 (65.19%) had previous abdominal surgery. Eighty-four patients (62.2%) underwent mesh-abdominoplasty (Group 1) while the remaining 51 (37.8%), who refused mesh application, underwent standard abdominoplasty (Group 2). The follow-up period ranged from18 months to 11 years with an average of 61 months. Results: Both groups were comparable regarding their demographic and clinical parameters. All repaired hernias did not recur, and abdominal pain was relieved in all patients of both groups. With mesh-abdominoplasty, low-back pain was completely relieved in 71.4% (20/28) of patients as compared to 80% (12/15) with abdominoplasty. No mortality or major complications were encountered. Wound complications occurred in 22 patients (26.19%) in Group 1 versus 7 (13.73%) in Group 2 (X2=2.923, p=0.087). With mesh-abdominoplasty (Group 1), ten patients (11.90%) required a second operation for refashioning of lower abdominal skin laxity, dog-ears or umbilical scar as compared to 16 patients (31.37%) in patients with abdominoplasty only (Group 2) (X2=7.734, p=0.005). Recurrence was significantly higher among patients who underwent abdominoplasty alone (X2=22.768, p [Arch Clin Exp Surg 2019; 8(2.000): 33-42]

Adequate reconstruction of the soft tissue defect following resection of bone tumors is challenging. Prolene mesh, despite being a useful tool, is not widely used due to the fear of deep infection. The aim of this study was to evaluate the functional outcome and complications of using a Prolene mesh in oncological reconstructions. A retrospective study was conducted in bone tumor patients with soft tissue reconstruction using Prolene mesh between January 2017 and June 2019. Functional evaluation was done using MSTS 93 score. Complications were recorded and were classified as mechanical (dislocation and extension lag) or biological failure (wound problems and deep infection). Comparison was performed between groups with and without biological failure to identify predictive variables. Of 116 patients, 68 were males and 48 were females, with median age of 22.5 years. Thirty nine patients had tumors of proximal tibia, 23 of proximal femur, 25 of proximal humerus, 24 of pelvis, and five tumors at other sites. Approximately two-thirds (62.9%) of our patients underwent endoprosthetic reconstruction while the rest underwent either biological or cement spacer reconstructions. Excellent or good functional outcomes were reported in 98.3% patients as per MSTS 93 scoring. Complications were noted in 22 patients (18.9%), of which 16 had biological failure, with four patients requiring debridement and mesh removal. Dislocation of prosthesis occurred in 2 patients of proximal femur replacement. Overall re-surgery rate was 5.1% (6 patients). There was no statistically significant difference between the groups with or without biological failure with respect to demographics, site of tumor, type of procedure, blood loss, duration of surgery and history of chemotherapy. Prolene mesh is a useful tool to reconstruct the soft tissue defects following bone tumor resections. It is readily available, reliable and provides reproducible results, with no added risk of wound complications. [ABSTRACT FROM AUTHOR]

Amaç: Çalışmamızda sütür (primer ve Mayo tekniği ile onarım) ve mesh ile (prolen ve ventralex hernia patch (VHP) ile herni onarımı) ameliyat edilen hastaların sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya ASA 1 ve 2 kategorisinde ve umblikal herni yanında ek ameliyat girişimi yapılacak patolojisi olmayan hastalar alındı. Küçük herniler suture tekniği, orta ve büyük herniler mesh ile onarıldı. Hastalar cinsiyet, yaş, vücut kitle indeksi, ek hastalık varlığı, herni onarım teknikleri, postoperative komplikasyonlar, postoperative tekniğe göre nüks oranları açısından değerlendirildi. Hastalar ameliyat sonrası 1. Hafta ve 6. Ay nüks ve diğer komplikasyonlar açısından muayene ve/veya ultrasonografi ile kontrol edildi.Bulgular: Çalışmaya toplam 153 hasta alındı. Primer onarım, Prolen mesh grubunda seroma oranı diğer üç gruptan belirgin yüksek bulundu. Primer onarım uygulanan 25 hastadan 4' ünde (16%), Mayo takviye yapılan 69 hastadan 3' ünde (4.3%) nüks görüldü. Primer onarım yapılan grupta nüks oranı diğer gruplardan istatistiksel olarak belirgin yüksek bulundu. Sonuç: Çalışmamızda umbilical herni onarımı sonrası nüks oranı %4.57 olarak bulundu. Prolen ve VHP mesh ile umblikal herni onarımı sonrası çalışmamızda nüks saptamadık. Komplikasyon ve nüks oranı düşüklüğü bu tekniği 2 cm ve altındaki umbilical herni ameliyatları için iyi bir yöntem olarak düşündürmektedir. Umbilikal fıtık onarımlarında; mesh ile onarım, non-mesh/doku-dikiş onarımından daha üstün gözükmektedir.

Reconstruction modalities described after distal fibula resection varies from no reconstruction to size matched allograft or reconstruction with ipsilateral proximal fibula. Every procedure has their own limitation. We used Prolene mesh to reconstruct lateral restraint (Meshplasty) after distal fibulectomy. Is a minimal reconstruction using prolene mesh (meshplasty) adequate to restore ankle stability and function post distal fibula resection? This retrospective analysis was performed in patients who underwent distal fibulectomy at the tertiary cancer hospital in India, between 01/01/2006 and 31/12/2016. Distal fibulectomy was performed through standard lateral approach. A prolene mesh was anchored to distal tibia and talus using screws or Ethibond sutures. Rehabilitation protocol included below knee cast for 6 weeks followed by gradual full weight bearing mobilization and ankle range of motion. Total 9 patients with mean age of 25 years (range: 13–43) got operated for distal fibulectomy during this period. Mean resection length was 13.3 cm (range: 9–20). Seven patients were available for final assessment at a median follow-up duration of 78 months (range: 34–161 months). Two patients developed local recurrence. Two patients developed distant recurrence both died of disease. One patient of GCT developed local recurrence in soft tissue at 30months, which was excised. Another patient of OGS developed local recurrence after 8 months along with distant recurrence. One patient of PNET developed distant recurrence at 3 months. One patient had a valgus deformity at 55 months follow up without any restriction of activity while the others had a stable ankle without any deformity. The mean MSTS score was 28 (24–29). "Meshplasty" after distal fibulectomy is an easy, reproducible, time and cost effective reconstruction modality with minimal complications. It adequately restores ankle function while providing results comparable to other procedures. IV. [ABSTRACT FROM AUTHOR]

Introduction: Enterovesical fistula (EVF) is uncommon, cancer of colon being the commonest cause, and the others being inflammatory, iatrogenic and trauma. The commonest type of EVF is colovesical; others rectovesical, ileovesical, and appendicovesical. Case description: A 61-year-old Malay male was admitted for cystoscopy and bilateral retrograde pyelogram (RPG) and stenting with open vesicolithotomy and sigmoid colectomy. He had underwent laparoscopic bilateral hernioplasty 10 years earlier, and a couple of years later, was found to have urinary bladder stone but refused hospital treatment; opting for traditional medicine. He later presented with 4-day suprapubic swelling and 2-week constipation. Colonoscopy and cystoscopy showed no evidence of fistula, but abdominopelvic CT scan suggest vesico-colic fistula. He was treated with continous bladder drainage (CBD) silicone; changed twice weekly until fistula dries up. A plan was made for an open vesicolithotomy but cancelled as his stoma was swollen with 3-day prolapse. The stoma progressively increased in size and stoma refashioning was done. Months later, he had stoma prolapse though still functioning. He complaint of passing out stone fragments in the CBD. Later, cystogram showed distension of the urinary bladder with irregular wall thickening and perivesical fat stranding. Large, calcified density seen in the bladder with fistulous communication between anterior bladder wall with adjacent sigmoid colon, but no evidence of intraperitoneal collection. Prostate is enlarged. CT scan showed vesico-colic fistula with large bladder calculus. Discussion: When RPG stenting and open vesicolithotomy and sigmoid colectomy was finally conducted, intraoperative findings found stone embedded within the mesh and the mesh has eroded into the bladder from left side into the left anterior bladder; the mid sigmoid colon herniating into left inguinal internal ring and into the inguinal canal with mesh erosion into the anterior bladder with associated large, impacted bladder stone occupying almost the entire bladder. This is indeed a rare case of EVF which came from vesical calculus and aggravated by a prolene mesh from earlier hernioplasty. [ABSTRACT FROM AUTHOR]

Purpose: Hernia repair for large and complex hernias presents challenges related to the availability of larger mesh sizes. When sizes beyond those manufactured are required, multiple meshes (MM) may be sutured to create a larger graft. With the availability of large polypropylene mesh up to 50 × 50 cm (LM), abdominal wall reconstruction (AWR) may be accomplished with a single mesh. This study evaluates clinical and economic outcomes following AWR with component separation utilizing MM and LM.Methods: A retrospective study was performed with review of health records and cost accounting data. Patients that underwent AWR with LM were case matched 1:1 with patients undergoing MM repair based upon comorbidities, defect size and wound class.Results: Twenty-four patients underwent AWR with LM. Twenty patients (10F, 10 M) who underwent AWR with LM were matched with 20 MM AWR (11F, 9 M). Age, BMI, ASA 3 + , never smoker, diabetes, and hernia characteristics were similar between LM and MM. Operative cost ($4295 vs $3669, p = 0.127), operative time (259 min vs 243 min, p = 0.817), length of stay (5.5 vs 6.2, p = 0.484), wound complication (30% vs 20%, p = 0.716), infected seroma (5% vs 5%, p = 1), and readmission (5% vs 15%, p = 0.605) were similar between LM and MM, respectively.Conclusions: This is the first report of patients undergoing AWR with a large 50 × 50 cm prolene mesh. In this small cohort, clinical outcomes were similar between those undergoing repair with multiple sutured mesh sheets and a single large mesh. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of our technique in laparoscopic repair of ventral hernias. Summary background data Laparoscopic ventral hernia repair (LVHR) was first reported in 1993. The successful application of laparoscopic techniques for the repair of ventral hernias has been well accepted. The recurrence rate after standard repair of ventral hernias may be as high as 10%, and the wide surgical dissection required often results in wound complications. Use of a laparoscopic approach may decrease rates of complications and recurrence after ventral hernia repair. Patients and methods Data on all patients who underwent LVHR performed using our procedure between February 2013 and February 2015 were collected retrospectively. Results LVHR was completed in 27 of the 30 patients (nine men and 21 women) in whom it was attempted. The patients' mean BMI was 36.5; the mean defect size was 3.2 cm. Mesh averaging 6.3 cm was used in all cases. Mean operating time was 105 min, and hospital stay averaged 1.9 days. Our complication rates were 16.6%. The most common complications were ileus (6.6%) and prolonged seroma (6.6%). During a mean follow-up time of 12 months, the hernia recurrence rate was 3.3%. Overall, 10% of patients had pain for 1 month. Recurrence was associated with vigorous exercise within the first 3 months postoperatively. Conclusion In this series, the preperitoneal laparoscopic technique for ventral hernia repair had a low rate of conversion to open surgery, a short hospital stay, a moderate complication rate, and a low risk of recurrence avoiding the potential complications related to intraabdominal mesh position. [ABSTRACT FROM AUTHOR]

Background: Genital prolapse is one of the most difficult-to-solve problems of gynecology. Rates of relapse after surgical correction of this disorder amounts to 33–40%.Aim: To analyze the use of alloplastic materials for correction of severe forms of ptosis and prolapse of internal genitals in the elderly.Materials and methods: 228 females aged from 60 to 70 with genital prolapse grade III–IV (according to classification by Baden-Walker) were divided into 3 groups depending on the leading anatomical structure in the prolapse. In all patients, extraperitoneal colpopexy with a prolene mesh was performed, with additional perineal plastics, in 165 patients from Group 1 (mean age, 63 years) being an anterior plastics, in 47 patients from Group 2 (mean age, 65 years) – posterior, in 12 patients from Group 3 (mean age, 68 years) – total. Efficacy of surgery was assessed at 2 to 4 months according to degree of genital prolapse, absence of erosions of vaginal walls and absence of the alloplast shrinkage and/or displacement.Results: Almost in 50% patients, a latent form of urine incontinence was diagnosed that required an urethropexy by a free synthetic loop through a transobturator approach. Frequency of intraoperational complications was low (n = 1). Among post-operation complications, 60% patients from Groups 1 and 3 had urination disorders that resolved by days 4–5 after surgery with anti-inflammatory treatment and with the use of agents increasing the detrusor tone. Frequency of vaginal wall erosions and of a partial prosthesis expulsion was 4.2% each in Groups 1 and 2. There were no vaginal wall erosions in Group 3. Clinically insignificant partial shrinkage of the prolene mesh was noted in 4.5, 4.2 and 5.9% of cases in Groups 1, 2 and 3, respectively. After the surgical correction, in 100% of patients from Groups 1 and 3 and in 70.6% of patients from Group 2 their genital prolapse was assessed as having grade I according to Baden-Walker, and in 29.4% of patients from Group 2, as grade II. However, there were many cases of prolapse progression of the contralateral vaginal wall: in 72 (44%) of patients in Group 1 and in 4 (23,5%) in Group 2, that in some cases (18,4%) necessitated the surgery to be repeated.Conclusion: The use of prolene mesh for extraperitoneal strengthening of the pelvic fundus in the elderly is an effective way of treatment. With strict adherence to proper surgical technique it is associated with a minimal number of complications that are mainly easily eliminated.

Antecedentes: La reparación del prolapso vaginal anterior presenta una alta tasa de recurrencia. La colporrafia anterior con malla de prolene es una buena alternativa quirúrgica que ha obtenido buenos resultados a largo plazo. Objetivo: Evaluar el resultado anatómico y la evolución de la colporrafia anterior con malla de prolene. Método: Estudio de cohorte prospectivo para evaluar el resultado quirúrgico. Resultados: Ingresaron 35 pacientes con una edad promedio de 61,4 años; 85,7% de ellas estaba en postmenopausia y 3% utilizaba terapia hormonal de reemplazo. La principal patología asociada fue la incontinencia de orina de esfuerzo (54,3%). El estado del piso pelviano preoperatorio correspondió a 31,4% cistocele grado II, 48,6% cistocele grado III y 20% cistocele grado IV. Se asoció prolapso uterino en 88,6% de los casos y 74,3% con prolapso de la pared posterior. No hubo complicaciones intraoperatorias. Hubo complicaciones postoperatorias en 4 pacientes (11,4%). Una paciente presentó erosión de la malla (2,9%). El seguimiento fue de 1 a 11 meses. En la evaluación postoperatoria de las pacientes con cistocele grado II 80% corrigió a grado 0; para cistocele grado III 72% corrigió a grado 0. Un 11% llegó a grado I y 17% grado II. Para el grupo con cistocele grado IV, 71% resultó en grado 0 y 29% grado II. Conclusión: La técnica presentada solucionó un severo problema de calidad de vida de las pacientes afectadas. Se requiere un mayor número de casos y tiempo de seguimiento para su recomendación definitivaBackground: Repair of anterior vaginal prolapse present a high rate of recurrence. Anterior colporrhaphy plus prolene mesh is a surgical option with optimal long term results. Objective: To evaluate anatomical results and evolution of anterior colporrhaphy with prolene mesh. Method: A prospective cohort study was made to evaluate the surgical outcomes. Results: 35 patients were recruited with a median age of 61.4 years. 85.7% of them were in postmenopausal status and 3% were using hormone replacement therapy. Stress urinary incontinence was associated in 54.3% of the cases. The pelvic floor stage at entry was 31.4% cysthocele stage II, 48.6% stage III and 20% cysthocele stage IV. Uterine prolapse was present in 88.6% of cases and the posterior wall was compromised in 74.3%. There were no intraoperatory complications. Postoperatory complications occurred in 4 patients (11.4%). Only in one case the mesh eroded (2.9%). The follow up was from 1 to 11 months. Of the patients with cysthocele stage II at the moment of evaluation, 80% were at stage 0. For cysthocele stage III 72% turned to stage 0. 11% turned to stage I and 17% to stage II. The cases that presented cysthocele stage IV 71% were at stage 0 and 29% at stage II. Conclusion: This technique solved an important quality of life problem of the affected patients. A higher number of cases and time of follow up is needed to recommend this technique definitely

The aim of this study was to investigate whether enoxaparin ( ENX) administration would increase seroma risk and worsen mesh tissue recovery in an experimental rat hernia repair model. Fifty-six adult male Wistar-Albino rats were included in the study. Rats were equally and randomly separated into seven groups: Group 1, Control, only subcutaneous dissection was performed; group 2, Sham, Hernia defect was primary sutured; Group 3, Prolene mesh; Group 4, Dual mesh; Group 5, ENX + Sham; Group 6, ENX + Prolene mesh; Group 7, ENX + Dual mesh. ENX was subcutaneously injected at a dose of 180 U/kg per day for 7 days. Rats were killed after the amount of subcutaneous seroma was determined by ultrasound on day 7 following the surgical procedure. Mesh-tissue healing was evaluated using histopathological and immunohistochemical ( CD31) staining methods. The mean seroma amount significantly increased in Groups 5-7 compared to Groups 2-4. CD31 immunostaining showed a reduction in neovascularization in Groups 6 and 7, compared to Groups 3 and 4. Neovascularization decreased and hemorrhage, necrosis and oedema findings remarkably increased in Groups 6 and 7, when compared to Groups 3 and 4. Fibroblastic activity and inflammation were more prominent in Groups 3 and 4. It should be kept in mind that ENX interferes with inflammation, which is desired in the early period of healing and leads to an increase in overall seroma amount with anti-coagulant effects, which in turn may disrupt wound healing and mesh-tissue adhesions, as was indicated in our study. [ABSTRACT FROM AUTHOR]

Congenital diaphragmatic hernia is a congenital defect of the diaphragm through which intestine and other viscera herniate into the chest. In extreme form of diaphragmatic maldevelopment, there might be a complete agenesis of diaphragm. A 45-day old male infant was presented with fever, cough and respiratory distress for a week. Chest radiograph showed right-sided congenital diaphragmatic hernia. The patient underwent surgical exploration and found to have an unusual and large defect of right hemidiaphragm. The diaphragm was absent on anterior and lateral aspects of the chest wall and only a small rim of diaphragm was present on posterior aspect. The defect was identified as agenesis of right hemidiaphragm and successfully managed by suturing the posterior rim of diaphragm to the intercostal muscles and ribs. This report describes successful management of hemidiaphragmatic agenesis without incorporating a prosthetic material.

Extremity muscle hernias are rare pathologies, most of which are managed conservatively. In symptomatic cases, surgical intervention may be required. This study represents a case of a rarer muscle hernia, semimembranosus, in a 43-year-old patient and describes the surgical technique of grafting with synthetic nonabsorbable polypropylene surgical mesh as well as the review of the literature about extremity muscle hernias., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Değer et al.)

Introduction: The objective is to study the pregnancy outcomes and the recurrence of pelvic organ prolapse (POP) following laparoscopic sacrocolpopexy (SCP) with uterine preservation in patients who are considering future fertility., Methods: This is a retrospective study in single teaching hospital. The study included six young women who conceived spontaneously, after laparoscopic SCP. Data were retrieved from the medical records of patients who underwent laparoscopic SCP and became pregnant after surgery., Results:  A total of six women conceived spontaneously. Two of them got pregnant twice. The total number of pregnancies was considered to be eight. Two pregnancies ended in spontaneous miscarriages; one of them required dilatation and curettage. Five pregnancies were carried out to term, and one pregnancy ended by preterm delivery at 32 weeks. All the neonates were at appropriate weight as per their respective gestational ages except the one preterm delivery, which was small for gestational age. No intraoperative difficulties were reported during all cesarean sections. Follow-up was documented by objective assessment for more than four years post laparoscopic SCP. No recurrent apical prolapse was found. Only one patient had a recurrent, symptomatic, grade two cystocele that required reoperation., Conclusion:  Patients who desired fertility and presented with symptomatic high-grade POP were good candidates for laparoscopic SCP. Our findings demonstrate the visibility of laparoscopic SCP as an effective surgical intervention that not only levitates symptomatic POP but preserves fertility in young women., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alsary et al.)

ugmentation mentoplasty is a cosmetic surgical procedure to correct chin retrusion or microgenia which usually requires placement of an alloplastic material over the pogonion, and which results in increased chin projection and a more aesthetically balanced facial profile. Polypropylene mesh is easy to purchase, widely available in a general hospital and most commonly used by general surgeons. In this series of 192 patients, we wanted to demonstrate our simple mentoplasty technique using prolene mesh that can easily be combined with a rhinoplasty procedure, with possible causes of infection and the rationale for using prolene mesh in such procedures. [ABSTRACT FROM AUTHOR]

Background: The purported advantage of lightweight large-pore meshes is improved biocompatibility that translates into lesser postoperative pain and earlier rehabilitation. However, there are concerns of increased hernia recurrence rate. We undertook a prospective randomized clinical trial to compare early and late outcome measures with the use of a lightweight (Ultrapro) mesh and heavyweight (Prolene) mesh in endoscopic totally extraperitoneal (TEP) groin hernia repair. Methods: A prospective study was performed on 402 patients (191 in Ultrapro and 211 in Prolene group) with bilateral groin hernias who underwent endoscopic TEP groin hernia repair from March 2006 to June 2007. All operations were performed by five consultants following a standardized operative protocol. Chronic groin pain and hernia recurrence were evaluated as primary outcome measures. Secondary outcome measure were early postoperative pain, operative time, number of fixation devices required to fix the mesh, return to normal daily activities of work, seroma, and testicular pain. Results: At 1-year follow-up, incidence in Ultrapro versus Prolene group for chronic groin pain was 1.6% vs. 4.7% ( p = 0.178) and recurrence was 1.3% vs. 0.2% ( p = 0.078). In Ultrapro versus Prolene group, mean visual analogue score for postoperative pain at day 7 was 1.07 vs. 1.31 ( p = 0.00), mean return to normal activities was 1.82 vs. 2.09 days ( p = 0.00), and mean number of fixation devices per patient required to fix the mesh was 4.22 vs. 4.08 ( p = 0.043). Conclusion: Lightweight meshes appear to have advantages in terms of lesser pain and early return to normal activity. However, more patients had hernia recurrence with lightweight meshes, especially for larger hernias. We surmise that the lightweight meshes have greater tendency to get displaced from their intended position during desufflation at the conclusion of endoscopic TEP repair. [ABSTRACT FROM AUTHOR]

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