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Research Article
Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique
Diakite Sandaly*
,
Camara Fode Lansana,
Soumaoro Labile Togba,
Diakite Saikou Yaya,
Fofana Naby,
Kondano Saa Yawo,
Condé Ansoumane,
Camara Mariame,
Condé Ousmane,
Diallo Mamadou Saliou,
Ousmane Abakar,
Yom Petang Steve Cyrille,
Toure Aboubacar
Issue:
Volume 12, Issue 1, June 2024
Pages:
1-5
Received:
28 February 2024
Accepted:
18 March 2024
Published:
2 April 2024
Abstract: Introduction: An inguinal hernia is a protrusion of abdominal cavity contents or pre-peritoneal fat through a hernial defect in the inguinal region. Desarda's technique is an aponeuroplasty, based on closure of the posterior wall of the inguinal canal by a flap of the external oblique fascia. This technique has the advantage over prosthetic cures in that it is a tension-free cure and does not require an implant. The aim of this study is to demonstrate the feasibility of curing inguinal hernias using the Desarda technique, and to evaluate the initial results in our practice. Material And Method: This is a prospective study over a 2-year period (January 2017 - December 2018), covering 100 cases of uncomplicated inguinal hernia cure in 98 patients operated on by aponeurotic plasty (Desarda technique), in the general surgery department of Ignace DEEN Hospital. Selection criteria were: informed consent, age over 15 years, uncomplicated primary inguinal hernias, normal prostate ultrasound and PSA results for adult males over 50 years of age. Results: The study included 100 cases of uncomplicated inguinal hernia repair in 94 patients operated on by aponeurotic plasty (Desarda technique). The patients were 88 men (94%) and 6 women (6%), with a mean age of 44.7 years and extremes of 19 and 78 years. The majority of patients (37 or 39.36%) were blue-collar workers. The hernia was unilateral in 88 patients and bilateral in 6. One woman had a bilateral hernia. The hernia was located only on the right in 72 cases and only on the left in 20. According to the Nyhus classification, type IIIb 45% was the most frequent. The patients were operated on under spinal anesthesia in 68 cases. On the first postoperative day, nine patients (9.57%) were assessed as having moderate pain. Beyond the third month, pain assessment revealed five cases of chronic pain. Surgical site infection was the most frequent complication. With an average follow-up of 17 months, no cases of recurrence were noted.
Abstract: Introduction: An inguinal hernia is a protrusion of abdominal cavity contents or pre-peritoneal fat through a hernial defect in the inguinal region. Desarda's technique is an aponeuroplasty, based on closure of the posterior wall of the inguinal canal by a flap of the external oblique fascia. This technique has the advantage over prosthetic cures i...
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Research Article
Prosthetic Management of Inguinal Hernias Using the Lichtenstein Technique in 100 Cases
Diakite Sandaly*,
Diallo Mamadou Saliou,
Camara Fode Lansana,
Soumaoro Labile Togba,
Diakite Saikou Yaya,
Barounga Djaoussa Mahamat,
Fofana Naby,
Oulare Ibrahima,
Bangoura Mamadou Saliou,
Condé Ansoumane,
Camara Mariame,
Condé Ousmane,
Toure Aboubacar
Issue:
Volume 12, Issue 1, June 2024
Pages:
6-10
Received:
17 March 2024
Accepted:
27 March 2024
Published:
17 April 2024
Abstract: Introduction: There has always been a plethora of hernia repairs in the absence of consensus. Techniques described as ancient, such as the Bassini, Mac Vay or Shouldice procedures, are still widely practised. Aponeurotic plasty has proved its worth in our practice. Prosthetic plasty, which has reduced recurrence by half, has become the gold standard. The aim of this study was to report on the feasibility of prosthetic management of inguinal hernias using the Lichtenstein technique. Material and method: This was a prospective fifteen (15)-month study: from July 1, 2022 to September 30, 2023. Study variables were sociodemographic, clinical and therapeutic. Results: During the study period, 173 patients underwent surgery for inguinal hernia. We noted one hundred (100) patients operated on according to the Lichtenstein procedure, i.e. 58% of all patients operated on for inguinal hernias in the department. We noted 98 men and 02 women. The mean age was 48.8 years (extremes: 20-91). The category of heavy laborer (laborer, farmer, etc....) accounted for % of cases. The hernia was exclusively right in 9 cases, left in 21 and bilateral in 10. A strangulated hernia was present in 9 patients. NYHUS classification was dominated by type IIIA (38.9%). Therapeutically, spinal anesthesia was the most common treatment: 8 cases. 40% of patients were pain-free in the immediate post-operative period, according to the analogue pain scale. The main complications were chronic pain in 10 patients and seroma in 02. After a minimum follow-up of three months for each patient, we noted no recurrence. Conclusion. The Lichtenstein technique is a relatively new procedure in our practice. Today, it is the technique of choice, with little postoperative morbidity.
Abstract: Introduction: There has always been a plethora of hernia repairs in the absence of consensus. Techniques described as ancient, such as the Bassini, Mac Vay or Shouldice procedures, are still widely practised. Aponeurotic plasty has proved its worth in our practice. Prosthetic plasty, which has reduced recurrence by half, has become the gold standar...
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Research Article
Orthopedic Joint Preservation: A Comprehensive Review
Bilal Mohamad Ali Obeid*
Issue:
Volume 12, Issue 1, June 2024
Pages:
11-22
Received:
20 February 2024
Accepted:
18 March 2024
Published:
28 April 2024
Abstract: This comprehensive review article delves into the intricate realm of orthopedic joint preservation with a focus on surgical techniques, innovative treatments, rehabilitation protocols, and long-term outcomes. Within the orthopedic landscape, joint preservation plays a crucial role in enhancing patient quality of life and functional outcomes. The article delivers a detailed exploration of various surgical techniques utilized for joint preservation, encompassing arthroscopy, cartilage repair, osteotomy, and ligament reconstruction. By scrutinizing the indications, outcomes, and potential complications associated with these procedures, the article aids in providing a comprehensive understanding for practitioners. Moreover, it delves into the realm of cutting-edge treatments such as regenerative medicine, stem cell therapy, and biologic agents, shedding light on their significant role in promoting joint preservation and fostering tissue healing. Rehabilitation protocols for joint preservation are also thoroughly evaluated, underlining the pivotal role of early mobilization, tailored physical therapy regimens, and patient education in fostering optimal outcomes while averting potential complications. Through an assessment of long-term outcomes post joint preservation interventions including functional improvements, pain management, and patient contentment, the article endeavors to gauge the efficacy and longevity of these interventions. By offering a nuanced overview of the current state of joint preservation in orthopedics, the article extends valuable insights to orthopedic surgeons, researchers, and healthcare professionals actively engaged in managing joint disorders.
Abstract: This comprehensive review article delves into the intricate realm of orthopedic joint preservation with a focus on surgical techniques, innovative treatments, rehabilitation protocols, and long-term outcomes. Within the orthopedic landscape, joint preservation plays a crucial role in enhancing patient quality of life and functional outcomes. The ar...
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Research Article
Management of Abdominal Surgical Emergencies at the Coyah District Hospital (Guinea)
Oulare Ibrahima,
Bangoura Mohamed Saliou,
Traore Bakary,
Kourouma Mohamed 1,
Cisse Aly,
Dioubate Oumar,
Soumaoro Labilé Togba*,
Fofana Housein,
Toure Aboubacar
Issue:
Volume 12, Issue 1, June 2024
Pages:
23-26
Received:
22 March 2024
Accepted:
15 May 2024
Published:
6 June 2024
Abstract: Background: abdominal surgical emergencies remain a frequent mode of admission in African public hospitals, cause of a high morbidity and mortality. This study aimed to assess the management of these diseases in a resources limited hospital. Patients and methods: this was a descriptive cross-sectional study for a period of 2 years from January 2018 to December 2021. Results: 637 patients were selected including 321 males 316 females. The age of the patients ranged from 5 to 79 years old. Abdominal pain was the main reason for consultation (90.11%), with appendicitis the dominant pathology (47.4%). All cases were managed surgically. Postoperative course was simple in 65.8% of cases, with an overall mortality of 13.3%. The average hospital stay was 9.96±6.77 days, with extremes of 3 and 54 days. Conclusion: abdominal surgical emergencies are very common in our practice with appendicitis being the dominant pathology. The mortality still remains considerable in resources limited setting.
Abstract: Background: abdominal surgical emergencies remain a frequent mode of admission in African public hospitals, cause of a high morbidity and mortality. This study aimed to assess the management of these diseases in a resources limited hospital. Patients and methods: this was a descriptive cross-sectional study for a period of 2 years from January 2018...
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Research Article
Health Disparities and Route of Repair of Fetal Myelomeningocele-Prenatal Versus Postnatal Repair
Issue:
Volume 12, Issue 1, June 2024
Pages:
27-35
Received:
29 April 2024
Accepted:
31 May 2024
Published:
14 June 2024
Abstract: Background: Spina bifida (SB) is a relatively common birth defect with the highest prevalence among Hispanics. A randomized controlled trial (MOMS) demonstrated that prenatal repair yielded improved outcomes compared to postnatal repair. However, the social determinants of health can significantly impact the overall well-being of affected individuals or their eligibility for some of these evidenced-based interventions. Methods: We conducted a retrospective observational study to describe and compare the mean Child Opportunity Index (COIs) scores among patients treated at a free-standing children’s hospital who underwent either prenatal or postnatal repair of SB from January 1st, 2012, to December 31st, 2021. We excluded patients with identifiable maternal and fetal contraindications to prenatal repair, as per the MOMS trial eligibility, apart from those pertaining to socio-economic status. RESULTS: Among a total cohort of 51 fetuses, 86% (n = 44) underwent postnatal repair for SB, while 14% (n = 7) received prenatal repair. Patients who underwent prenatal repair exhibited lower COI scores across all domains (education, health, and environment, social and economic) on national, state, and metro levels compared to the postnatal group. Our cohort showed a higher percentage of primary commercial insurance in the prenatal (fetal) surgery group (57.14%) versus the postnatal surgery group (47.73%), without attaining statistical significance (p=0.25). Conclusion: While COI scores across all domains were lower in the prenatal cohort, our data does not suggest a statistically significant difference between prenatal and postnatal surgery groups. This highlights the need for future studies with larger sample sizes to further explore and define this relationship.
Abstract: Background: Spina bifida (SB) is a relatively common birth defect with the highest prevalence among Hispanics. A randomized controlled trial (MOMS) demonstrated that prenatal repair yielded improved outcomes compared to postnatal repair. However, the social determinants of health can significantly impact the overall well-being of affected individua...
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Case Report
Gallbladder Volvulus: A Rare Case of Pre-operative Diagnostic Quandary
Issue:
Volume 12, Issue 1, June 2024
Pages:
36-42
Received:
15 May 2024
Accepted:
31 May 2024
Published:
19 June 2024
Abstract: Introduction: Gallbladder volvulus (GBV) is a rare but critical condition characterized by torsion of the gallbladder on its mesentery. Prompt surgical intervention is crucial in preventing complications and improving patient outcomes. Despite advancements in imaging techniques, diagnosing GBV remains challenging due to its nonspecific clinical presentation and low preoperative detection rates. Case Details: This paper presents the case of a 79-year-old female presenting with symptoms suggestive of acute appendicitis and urinary tract infection. Imaging, including Computed Tomography (CT), ultrasound, (US) and magnetic resonance cholangiopancreatography (MRCP), were indicative of acute acalculous cholecystitis. Intraoperatively, a necrotic gangrenous gallbladder was encountered, resulting from GBV. Discussion: GBV poses diagnostic difficulties due to its variable presentation and low preoperative detection rates. Misdiagnoses poses significant risk of mismanagement, especially in the elderly and high risk populations, where non-operative management is attempted (antibiotics, percutaneous cholecystostomy, etc.) leading to increased morbidity and mortality. Therefore, high index of suspicion and correlation with imaging findings are crucial for accurate diagnosis. While various imaging modalities can assist in diagnosis, interpretation may be challenging, as demonstrated in this case. Surgical intervention, preferably through laparoscopy, is the cornerstone of treatment and offers favorable outcomes when performed promptly. Conclusion: In conclusion, GBV is a rare but potentially life-threatening condition that necessitates early recognition and surgical intervention. Despite challenges in diagnosis, a comprehensive clinical and radiological approach is crucial for timely management and optimal patient outcomes. Further research and awareness are warranted to enhance early diagnosis of this uncommon entity.
Abstract: Introduction: Gallbladder volvulus (GBV) is a rare but critical condition characterized by torsion of the gallbladder on its mesentery. Prompt surgical intervention is crucial in preventing complications and improving patient outcomes. Despite advancements in imaging techniques, diagnosing GBV remains challenging due to its nonspecific clinical pre...
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