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  • 1
    Electronic Resource
    Electronic Resource
    Primary inguinal hernia: The held-in mesh repair (1997)
    Springer
    Hernia 1 (1997), S. 37-40 
    Details
    ISSN: 1248-9204
    Keywords: Groin hernia surgery ; Outpatient surgery ; Prosthetic hernia repair ; Onlay mesh
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the last 10 years, in Italy a rapid evolution has occurred from the “traditional” herniorraphies (Bassini, Shouldice) toward prosthetic techniques and outpatient procedures under local anesthesia are now most commonly preferred. Since october 1992 we have adopted a personal modification of the sutureless mesh repair, which we call held in mesh repair. Basic steps of this technique are: the placement of a plug in the deep ring for direct and indirect hernias; the linking of the medial edge of the prosthesis to the suture flattening the trasversalis fascia; the closure of the gap for the spermatic cord. With this technique 930 primary groin hernias were operated on in 798 patients (132 were bilateral); outpatient surgery was performed in 486 patients (60.9%). Anesthesia was local in 761 patients (95.4%). The mesh, generally sized 4.5×10 cm, in all cases was composed of polypropylene (Marlex® or Prolene®). 682 patients (85.5%) required analgesics. One hernia recurred (0.1%) after two years; one femoral pseudorelapse (0.1%) occurred at the 6th postoperative month. Nine complications occurred, for a rate of 0.9%. They were: one hemorrhage; 2 hematomas; one testicular atrophy; one lymphorrea; 2 ilioinguinal neuralgias; 2 seromas. No wound infections occurred; in none was it necessary to remove the mesh. The favorable results of the held in mesh repair and the simplicity of the procedure suggest that it can be considered a safe and reliable technique for most primary inguinal hernias. The negligible rates of femoral pseudorelapse and of indirect recurrences do not justify the employment in primary hernias of more complex preperitoneal techniques implying more complex anesthesia procedures and a higher C/B ratio.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02426387
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  • 2
    Electronic Resource
    Electronic Resource
    Pediatric laparoscopic splenectomy: are there real advantages in comparison with the traditional open approach? (1997)
    Springer
    Pediatric surgery international 12 (1997), S. 509-510 
    Details
    ISSN: 1437-9813
    Keywords: Laparoscopy ; Splenectomy ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The hospital records of patients who underwent splenectomy during the last 2 years were reviewed to compare the advantages of the laparoscopic approach with traditional open splenectomy (OS). Between March 1994 and March 1996, 16 children underwent splenectomy, in 8 using an open approach and 8 by a laparoscopic procedure. Of the patients who underwent laparoscopic splenectomy (LS), 2 had a concomitant cholecystectomy. Ages ranged between 4 and 11 years (mean 6.4 years); there were 9 girls and 7 boys. The indications for splenectomy were: hereditary spherocytosis (7 cases); idiopathic thrombocytopenic purpura (4); sickle-cell disease (3); and β-thalassemia (2). The average operating time for OS was 100 min (range, 50–155), for LS 170 min (range 125–240). The hospital stay for patients who had OS ranged from 3 to 9 days (mean 4.7), for those who had LS from 2 to 5 days (mean 3). One OS patient developed a wound infection. In 3 of the LS patients, the spleen was removed via a 7-cm Pfannenstiel minilaparotomy in the suprapubic region; in 5 cases the spleen was captured into an extraction bag, crushed, and removed through the umbilical orifice. The authors believe that LS must be performed only when it is possible to use the extraction bag to remove the spleen from the umbilical orifice (spleens weighing less than 700 g) and when a concomitant procedure such as cholecystectomy is indicated; in other cases OS is preferable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01258713
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  • 3
    Electronic Resource
    Electronic Resource
    Pediatric laparoscopic splenectomy: are there real advantages in comparison with the traditional open approach? (1997)
    Springer
    Pediatric surgery international 12 (1997), S. 509-510 
    Details
    ISSN: 1437-9813
    Keywords: Key words Laparoscopy ; Splenectomy ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The hospital records of patients who underwent splenectomy during the last 2 years were reviewed to compare the advantages of the laparoscopic approach with traditional open splenectomy (OS). Between March 1994 and March 1996, 16 children underwent splenectomy, in 8 using an open approach and 8 by a laparoscopic procedure. Of the patients who underwent laparoscopic splenectomy (LS), 2 had a concomitant cholecystectomy. Ages ranged between 4 and 11 years (mean 6.4 years); there were 9 girls and 7 boys. The indications for splenectomy were: hereditary spherocytosis (7 cases); idiopathic thrombocytopenic purpura (4); sickle-cell disease (3); and β-thalassemia (2). The average operating time for OS was 100 min (range, 50–155), for LS 170 min (range 125–240). The hospital stay for patients who had OS ranged from 3 to 9 days (mean 4.7), for those who had LS from 2 to 5 days (mean 3). One OS patient developed a wound infection. In 3 of the LS patients, the spleen was removed via a 7-cm Pfannenstiel minilaparotomy in the suprapubic region; in 5 cases the spleen was captured into an extraction bag, crushed, and removed through the umbilical orifice. The authors believe that LS must be performed only when it is possible to use the extraction bag to remove the spleen from the umbilical orifice (spleens weighing less than 700 g) and when a concomitant procedure such as cholecystectomy is indicated; in other cases OS is preferable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01258713
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    XXIst EHS-GREPA International Congress, Madrid, Spain, november 4–6, 1999 (2000)
    Springer
    Hernia 4 (2000), S. 59-60 
    Details
    ISSN: 1248-9204
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01230596
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  • 5
    Electronic Resource
    Electronic Resource
    Splenectomy in childhood (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1445-1448 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Splenectomy — Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We set out to analyze the results of the first 19 laparoscopic splenectomies performed by our team in order to show the advantages and limitations of the laparoscopic approach to this kind of procedure in children. Methods: Between March 1994 and June 1997, 19 children underwent laparoscopic splenectomy; two of them also had a concomitant cholecystectomy. Their ages ranged between 4 and 14 years (median, 7.2 years). There were 14 girls and 5 boys. All the patients underwent elective laparoscopic splenectomy: seven children had hereditary spherocytosis, six were affected by a β thalassemia, five had an idiopathic thrombocytopenia purpura, and one presented with sickle cell disease. Results: Mean operating time was 145 min (range, 110–240 min). Hospital stay ranged from 2 to 5 days (median, 3 days). In three patients, the spleen was removed with a 7-cm mini-laparotomy, according to the technique of Pfannenstiell, in the suprapubic region. In the other 16 cases, the spleen was captured into a extraction bag, finger-fragmented, and removed from the umbilical orifice. Conclusions: Laparoscopic splenectomy can be performed only when the spleen can be removed through the umbilical orifice with an extraction bag. For this reason, preoperative ultrasonography is necessary to measure the exact spleen volume. When the spleen is very large, an open splenectomy is preferable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900879
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    Paper (German National Licenses)
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