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Zarogoulidis P, Ioannidis A, Anemoulis M, Giannakidis D, Matthaios D, Romanidis K, Sapalidis K, Papalavrentios L, Kesisoglou I. Laparoscopic Surgery with Concomitant Hernia Repair and Cholecystectomy: An Alternative Approach to Everyday Practice. Diseases 2023; 11:diseases11010044. [PMID: 36975593 PMCID: PMC10047121 DOI: 10.3390/diseases11010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/02/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction: Concomitant surgeries have been performed previously in several centers with experience in laparoscopic surgeries. These surgeries are performed in one patient under one operation with anesthesia. Methods: We performed a retrospective unicenter study from October 2021 to December 2021 analyzing patients who underwent laparoscopic hiatal hernia repair with cholecystectomy. We extracted data from 20 patients who underwent hiatal hernia repair together with cholecystectomy. Grouping of data by hiatal hernia type showed 6 type IV hernias (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed, 19 were patients suffering from chronic cholecystitis and 1 patient presented with acute cholecystitis. The average operating time was 179 min. Minimum blood loss was achieved. Cruroraphy was performed in all cases, mesh reinforcement was added in five cases, and fundoplication was performed in all cases, with 3 Toupet, 2 Dor and 15 floppy Nissen fundoplication procedures performed. Fundopexy was routinely performed in cases of Toupet fundoplication. A total of 1 bipolar and 19 retrograde cholecystectomies were performed. Results: All patients had favorable postoperative hospitalization. Patient follow-up took place at 1 month, 3 months and 6 months, with no sign of recurrence of hiatal hernia (anatomical or symptomatic) and no symptoms of postcholecystectomy syndrome. In two patients, we had to perform colostomy. Conclusion: Concomitant laparoscopic hiatal hernia repair and cholecystectomy is safe and feasible.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd Department of Surgery, “AHEPA” University Hospital, Medical School, Aristotle University of Thessaloniki, 54453 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-697-727-1974
| | - Aris Ioannidis
- Surgery Department, Genesis Private Hospital, 54301 Thessaloniki, Greece
| | - Marios Anemoulis
- Surgery Department, General Clinic Euromedica, 54645 Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 1st Department of Surgery, Attica General Hospital “Sismanogleio-Amalia Fleming”, 57889 Athens, Greece
| | | | - Konstantinos Romanidis
- University Surgery Department, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, “AHEPA” University Hospital, Medical School, Aristotle University of Thessaloniki, 54453 Thessaloniki, Greece
| | | | - Isaak Kesisoglou
- 3rd Department of Surgery, “AHEPA” University Hospital, Medical School, Aristotle University of Thessaloniki, 54453 Thessaloniki, Greece
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Thapar VB, Thapar PM, Goel R, Agarwalla R, Salvi PH, Nasta AM, Mahawar K, Karthik A, Lakshman A, Amit A, Rishabh A, Manas A, Anmol A, Varadaraj AK, Murtaza A, Temsula A, Reddy AD, Srinivas A, Rambabu B, Rajendra B, Sarfaraz B, Manish B, Lovenish B, Lal BB, Rajandeep B, Rajesh B, Sharath B, Somendra B, Akshay B, Sonali B, Bhavneet B, Jatin B, Siddhartha B, Rajesh B, Bisht SD, Arjun B, Pankaj B, Vijay B, Prashanta B, Chandra BR, Chitra C, Kanhaiyya C, Sakthivel C, Bitan C, Shamita C, Tamonas C, Madeswaran CVC, Shreya C, Aditya C, Sourav C, Supriya C, Pradeep C, H CA, Ashwani D, Usha D, Abhay D, Chitta D, Ram DG, kumar DJ, Arupabha D, Rupjyoti D, Kunal D, Ashish D, Sumanta D, Monika D, Nilesh D, Poornima DB, Sanjay D, Easwaramoorthy S, Nishith E, Reddy EV, Naima G, Amitabh G, Apoorv G, Deep G, Thakut G, Pankaj G, Achal G, Rajkumar G, Rahul G, Shalu G, Shardool G, Lokesh HM, Nisar H, Sarath H, Bhaskar H, Vikas H, Srikantaiah H, Hariharasaran I, Mohammad I, Chaidul I, Samsul I, Mohammed I, Amit J, Mohit J, Parakash J, Sumita J, Advait J, Nikita J, Samrat J, James J, Yashpaul J, Abhijit J, Praveen J, Rejana J, Pooja K, Prasad K, Anirudhan K, Vishakha K, Adityakalyan K, Manmohan K, Abhimanyu K, Mayank K, Rohan K, Jaspreet K, Hosni K, Archana K, Ajay K, Khandelwal RG, Subhash K, Shashi K, Elbert K, Rajesh K, Suhail K, Shashank K, Uttam K, Shyam K, Prakash KC, Jyotsna K, Anil K, Bhartendu K, Durgesh K, Jitendra K, Shashidhar K, Saurabh K, Kshitiz K, Puneet K, Ranjith K, Hampher K, Krishnaswamy L, Suchitra L, Kona L, Nishanth L, Pawan L, Samuel L, Alfred L, Manjusha L, Lancelot L, Sushil L, Temsutoshi L, MuniReddy M, Vijaykumar M, Sivakumar M, Deepak M, Singh MM, Prasad MBV, Kumar MN, Suman M, Parth M, Shresth M, Faiz M, Alok M, Noushif M, Sadananda M, Magan M, Diksha M, Senthil M, Prakash MG, Lalan M, Subhash M, Taher M, Tarun M, kushal M, Rajan M, Abhiram M, Erbaz M, Rajashekar M, Ramya M, Khalid M, Sheetal AM, Majid M, Dileep N, Nikhil N, Ramprasanna NN, Madhavi N, Anand N, Govind N, Kumar NB, Barun N, Darshan N, Manjunath N, Rohit N, Ashok NO, Prabha O, Aashutosh P, Niranjan P, Hirak P, Chirag P, Roy P, Rakeshkumar P, Danesh P, Deepak P, Tejas P, Tanmaye P, Soumen P, Pratik P, Anshuman P, Pankaj P, Anand P, Arun P, Pallawi P, Gaurav P, Puneet P, Durai R, Santhosh R, Prashant R, Mohsinur R, Mahesh R, Ramesh BS, Gordon R, Prashanth R, Arshad R, Sandip R, Udipta R, Sameer R, Shyam R, Rajendar R, Anand S, ArunKumar S, DineshKumar S, Viswanath S, Amit S, Sajeesh S, Vishal S, Anurag S, Sauradeep S, Ankush S, Snehasish S, Harsh S, Shrenik S, Anil S, Abadhesh S, Meenakshi S, Varsha S, Nikhil S, Harsh S, Pravin S, Vikram SS, Ankur S, Pranav S, Arvind S, Abhishek S, Abhiyutthan S, Chandrapal S, Charan S, Gurbhaij S, Gurbachan S, Saurav S, Harmanmeet S, Pal SS, Kumar SN, Aalok S, Vandana S, Sanjai S, Sushama S, Pravin S, Om T, Fahad T, Ashwin T, Anuroop T, Abhishek T, K TS, Pradeep T, Lohith U, Peeyush V, Ashish V, Ravindra V, Kumar VR, Arunima V, Soumil V, Ajaz W, Sachin W, Amit Y, Kumar YA, Raghu Y, Mohammed Y. Evaluation of 30-day morbidity and mortality of laparoscopic cholecystectomy: a multicenter prospective observational Indian Association of Gastrointestinal Endoscopic Surgeons (IAGES) Study. Surg Endosc 2022; 37:2611-2625. [PMID: 36357547 PMCID: PMC9648883 DOI: 10.1007/s00464-022-09659-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/18/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Laparoscopic cholecystectomy (LC) is the standard of care for benign gallstone disease. There are no robust Indian data on the 30-day morbidity and mortality of this procedure. A prospective multicentre observational study was conducted by the Indian Association of Gastro-Intestinal Endo Surgeons (IAGES) to assess the 30-day morbidity and mortality of LC in India. MATERIALS AND METHODS Participating surgeons were invited to submit data on all consecutive LCs for benign diseases performed between 09/12/2020 and 08/03/2021 in adults. Primary outcome measures were 30-day morbidity and mortality. Univariate and multivariate analyses were performed to identify variables significantly associated with primary outcomes. RESULTS A total of 293 surgeons from 125 centres submitted data on 6666 patients. Of these, 71.7% (n = 4780) were elective. A total LC was carried out in 95% (n = 6331). Laparoscopic subtotal cholecystectomy was performed in 1.9% (n = 126) and the procedure were converted to open in 1.4% of patients. Bile duct injury was seen in 0.3% (n = 20). Overall, 30-day morbidity and mortality were 11.1% (n = 743) and 0.2% (n = 14), respectively. Nature of practice, ischemic heart disease, emergency surgery, postoperative intensive care, and postoperative hospital stay were independently associated with 30-day mortality. Age, weight, body mass index, duration of symptoms, nature of the practice, history of Coronavirus Disease-2019, previous major abdominal surgery, acute cholecystitis, use of electrosurgical or ultrasonic or bipolar energy for cystic artery control; use of polymer clips for cystic duct control; conversion to open surgery, subtotal cholecystectomy, simultaneous common bile duct exploration, mucocele, gangrenous gall bladder, dense adhesions, intraoperative cholangiogram, and use of drain were independently associated with 30-day morbidity. CONCLUSION LC has 30-day morbidity of 11.1%, 30-day mortality of 0.2%, conversion to open rate of 1.4%, and bile duct injury rate of 0.3% in India.
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Li Y, Guo Z, Qu Z, Rong L, Hong M, Chi S, Zhou Y, Tian M, Tang S. Laparoscopic simultaneous inguinal hernia repair and appendectomy in children: A multicenter study. J Pediatr Surg 2022; 57:1480-1485. [PMID: 35400489 DOI: 10.1016/j.jpedsurg.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/22/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Inguinal hernias (IHs) are sometimes encountered incidentally in children during laparoscopic appendectomy. This study aims to evaluate the efficacy and outcomes of laparoscopic simultaneous inguinal hernia repair and appendectomy in children. METHODS A multicentric study was performed in patients with AA and concurrent IH who received laparoscopic simultaneous inguinal hernia repair and appendectomy (study group), compared with patients who underwent two-stage laparoscopic procedures (control group) between September 2012 and January 2020. Intraoperative data, postoperative complications, and clinical outcomes were prospectively collected and retrospectively analyzed. RESULTS 189 patients with AA and concurrent IH (117 children in the study group, and 72 children in the control group) were enrolled. No significant differences in preoperative characteristics were identified between the two groups. Patients in the study group had a shorter total operative time and hospital stay than those in the control group (43.2 ± 8.1 vs 53.9 ± 7.3 min, p < 0.001; 1.5 ± 0.8 vs 2.2 ± 0.9 days, p = 0.023). The study group incurred lower costs than the control group (9198.7 ± 587.6 vs 14,392.5 ± 628.6 RMB, p < 0.001). During follow-up (range 1.5-6.0 years), three children in the study group and two children in the control group experienced wound infection. One child in the study group had recurrent IH. CONCLUSIONS Laparoscopic simultaneous procedures do not increase the incidence of wound infection or recurrent IH. Moreover, they avoid repeat anesthesia and hospitalization. Therefore, this approach is safe, feasible and cost-effective for children with AA and concurrent IH. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Yibo Li
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaokun Guo
- Department of Pediatric Surgery, Yichang Central People's Hospital, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei, China
| | - Zhenfan Qu
- Shiyan Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei, China
| | - Liying Rong
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei Hong
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuiqing Chi
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Zhou
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Tian
- Department of Hernia and Abdominal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaotao Tang
- Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Claus CMP, Ruggeri JRB, Ramos EB, Costa MAR, Andriguetto L, Freitas ACTD, Coelho JCU. SIMULTANEOUS LAPAROSCOPIC INGUINAL HERNIA REPAIR AND CHOLECYSTECTOMY: DOES IT CAUSE MESH INFECTION? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2021; 34:e1600. [PMID: 34669889 PMCID: PMC8521814 DOI: 10.1590/0102-672020210002e1600] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/29/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Repair of inguinal hernia concomitant with cholecystectomy was rarely performed until more recently when laparoscopic herniorrhaphy gained more adepts. Although it is generally an attractive option for patients, simultaneous performance of both procedures has been questioned by the potential risk of complications related to mesh, mainly infection. AIM To evaluate a series of patients who underwent simultaneous laparoscopic inguinal hernia repair and cholecystectomy, with emphasis on the risk of complications related to the mesh, especially infection. METHODS Fifty patients underwent simultaneous inguinal repair and cholecystectomy, both by laparoscopy, of which 46 met the inclusion criteria of this study. RESULTS In all, hernia repair was the first procedure performed. Forty-five (97,9%) were discharged within 24 h after surgery. Total mean cost of the two procedures performed separately ($2,562.45) was 43% higher than the mean cost of both operations done simultaneously ($1,785.11). Up to 30-day postoperative follow-up, seven (15.2%) presented minor complications. No patient required hospital re-admission, percutaneous drainage, antibiotic therapy or presented any other signs of mesh infection after three months. In long-term follow-up, mean of 47,1 months, 38 patients (82,6%) were revaluated. Three (7,8%) reported complications: hernia recurrence; chronic discomfort; reoperation due a non-reabsorbed seroma, one in each. However, none showed any mesh-related complication. Satisfaction questionnaire revealed that 36 (94,7%) were satisfied with the results of surgery. All of them stated that they would opt for simultaneous surgery again if necessary. CONCLUSION Combined laparoscopic inguinal hernia repair and cholecystectomy is a safe procedure, with no increase in mesh infection. In addition, it has important advantage of reducing hospital costs and increase patient' satisfaction.
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Quezada N, Maturana G, Pimentel E, Crovari F, Muñoz R, Jarufe N, Pimentel F. Simultaneous TAPP inguinal repair and laparoscopic cholecystectomy: results of a case series. Hernia 2018; 23:119-123. [PMID: 30259218 DOI: 10.1007/s10029-018-1824-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/14/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Cholecystectomy and inguinal hernioplasty are the most frequent surgeries in Chile and the world. Laparoscopic inguinal hernioplasty, being a clean surgery, reports mesh infection rates of less than 2% and adding a simultaneous laparoscopic cholecystectomy is controversial due to an increase in the risk of mesh infection. The aim of this paper is to report the results of simultaneous TAPP hernioplasty with laparoscopic cholecystectomy. METHOD Retrospective analysis of the digestive surgery database. We identified cases in which laparoscopic inguinal TAPP repair and simultaneous laparoscopic cholecystectomy were performed. Demographic, clinical information, hernia type and size, data from the surgery and its complications were also retrieved and analyzed. RESULTS We identified 21 patients, 86% male and with an average age of 61 years range 46-84. 72% of the hernias were unilateral, predominating indirect 50%, direct 28% and the remaining were femoral and mixed. The average hernia size was 2.2 cm. The meshes used were 56% polypropylene, 37% polyester and 5% PVDF. We report one gallblader perforation. At a median time of 40 months of follow-up (range 4-89 months), one hernia recurrence was found (3.7%), there were no reoperations at the time of the interview and there were no cases of mesh infection. Complications of surgery includes one ipsilateral testicular atrophy 4.8% and 1 ipsilateral inguinal seroma 4.8%. CONCLUSIONS In this series of cases, adding clean contaminated surgery to the inguinal TAPP hernioplasty was not associated with an increase in the infection of the mesh.
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Affiliation(s)
- N Quezada
- Department of Digestive Surgery, Medicine Faculty, Pontifical Catholic University of Chile, Diagonal paraguay 362, Santiago, Region Metropolitana, Chile.
| | - G Maturana
- Medicine Faculty, Pontifical Catholic University of Chile, Santiago, Chile
| | - E Pimentel
- Medicine Faculty, Pontifical Catholic University of Chile, Santiago, Chile
| | - F Crovari
- Department of Digestive Surgery, Medicine Faculty, Pontifical Catholic University of Chile, Diagonal paraguay 362, Santiago, Region Metropolitana, Chile
| | - R Muñoz
- Department of Digestive Surgery, Medicine Faculty, Pontifical Catholic University of Chile, Diagonal paraguay 362, Santiago, Region Metropolitana, Chile
| | - N Jarufe
- Department of Digestive Surgery, Medicine Faculty, Pontifical Catholic University of Chile, Diagonal paraguay 362, Santiago, Region Metropolitana, Chile
| | - F Pimentel
- Department of Digestive Surgery, Medicine Faculty, Pontifical Catholic University of Chile, Diagonal paraguay 362, Santiago, Region Metropolitana, Chile
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