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  1. Lai JH, Loo GH, Shuhaili MAB, Ritza Kosai N
    Int J Surg Case Rep, 2019;60:276-280.
    PMID: 31261047 DOI: 10.1016/j.ijscr.2019.06.045
    INTRODUCTION: Primary fascial closure can be a challenging step during a laparoscopic intraperitoneal onlay mesh (IPOM) repair for a ventral hernia.

    CASE PRESENTATION: We present here a novel technique of using intravenous (IV) cannula as an alternative to suture passer for fascial closure during laparoscopic IPOM repair for a 59-year-old patient with an incisional ventral hernia. The placement of non-absorbable sutures for fascial closure was done with the help of a 14 gauge IV cannula instead of a transfascial suture passer. The rest of the procedural steps were the same as a standard laparoscopic IPOM repair. The patient's post-operative recovery was uneventful.

    DISCUSSION: Primary fascial closure during a laparoscopic IPOM hernia repair can be done either by intracorporeal or extracorporeal techniques, using interrupted or continuous sutures. We propose a novel alternative to suture passer in primary fascial closure. IV cannulas are widely available in hospital settings. The advantage of using an IV cannula instead of a suture passer is that they are widely available. Its single-use also eliminates the risk of transmissible diseases, and as it has a smaller diameter than suture passer, it requires a lower insertion force for successful placement.

    CONCLUSION: An IV cannula may be used as a more economical alternative to a transfascial suture passer. This technique is easily reproducible and does not violate the principles of primary fascial defect closure in laparoscopic ventral hernia repair.

    Matched MeSH terms: Incisional Hernia
  2. Kong CY, Lai LL, Khoo AYY, Rahman NA, Chin KF
    BMC Surg, 2016 Feb 11;16:8.
    PMID: 26864939 DOI: 10.1186/s12893-016-0123-8
    BACKGROUND: Polypropylene meshes are widely used in hernia repairs. Hernia meshes have been developed incorporating coatings of active agents. One commercially available mesh has a fish oil coating which is promoted as having anti-inflammatory properties. We report a case, a symptomatic foreign body granuloma reaction associated with a fish oil coated polypropylene mesh, which required eventual mesh explantation.

    CASE PRESENTATION: A 61-year old lady with previous peptic ulcer disease underwent a laparoscopic intraperitoneal placement of mesh for incisional hernia utilising a fish oil coated polypropylene mesh. The patient presented 3 months after the procedure complaining of dyspepsia and pain at the operative site. There was no discharge. The patient was managed conservatively. She presented 10 months post-operatively with progressively worsening symptoms and a hard palpable mass in the epigastrium. Abdominal laparoscopy revealed dense adhesive disease around the mesh with exudates. Adhesiolysis, mesh explantation and a partial gastrectomy was performed. Histopathological examination revealed a foreign body granuloma formation to the mesh.

    CONCLUSION: In-vivo studies looking at intraperitoneal mesh placement with fish oil coatings including data on surgical outcomes such as fistula and adhesive characteristics are scarce in the literature. Further monitoring and studies are required to investigate the safety and efficacy profile of this mesh type in in-vivo models.

    Matched MeSH terms: Incisional Hernia/etiology; Incisional Hernia/surgery*
  3. Kumarappan, A.l., Norly, S., Samuel Tay, Vicknesh, C.
    MyJurnal
    Anticipation of complications is of paramount importance for a surgeon. Incisional hernia is a well-known
    complication for abdominal surgeries. Risk factors such as increasing age, obesity, male gender are well
    known. Intestinal obstruction, strangulation and perforation are imminent complications of this type of
    hernia if they become incarcerated. Common contents of a ventral incisional hernia are small bowel, large
    bowel and omentum. Even though Meckel’s diverticulum is a common gastrointestinal anomaly, it is rarely
    found to be the content of a hernial sac. A hernia sac containing Meckel’s diverticulum is also known as
    Littre’s hernia. Only a few cases have been reported in the literature. Thus here we present a case of
    perforated Meckel’s diverticulum that was entrapped in the ventral incisional hernia.
    Matched MeSH terms: Incisional Hernia
  4. Leow VM, Faizah MS, Mohd Sharifudin S, Letchumanan VP, Yang KF, Manisekar KS
    Med J Malaysia, 2014 Jun;69(3):129-32.
    PMID: 25326354 MyJurnal
    OBJECTIVE: Conventional laparoscopic cholecystectomy (LC) involves the use of four ports, but the number of ports has gradually been reduced to one for cosmetic reasons. however, single-incision LC is technically demanding, and there is a substantial learning curve associated with its successful application. The aim of this clinical study was to evaluate the safety and feasibility of a less demanding alternative LC technique with a faster learning curve.

    METHODS: This prospective descriptive study was performed from September 2009 to February 2011 at Sultanah Bahiyah hospital in Kedah, Malaysia. A total of 58 patients underwent two-incision threeport laparoscopic cholecystectomy (TILC), which was performed by the senior consultant hepato-pancreato-biliary surgeon and two hepato-pancreato-biliary trainees. Study end points included operative time, postoperative pain, length of hospital stay and early postoperative complications. The follow-up period was 4 weeks.

    RESULTS: The overall operative time taken was 44 ± 18 minutes. none of the patients had major complication or incisional hernia postoperatively. All but one of the patients were discharged within 24 h. nonsteroidal anti-inflammatory drugs were the main postoperative analgesic used.

    CONCLUSION: TILC is feasible and safe cholecystectomy technique.
    Matched MeSH terms: Incisional Hernia
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