Intraperitoneal laparoscoic repair of inguinal hernia by plug and patch technique

Between May 1996 and May 1999, thirty patients underwent intraperitoneal laparoscopic repair of inguinal hernia by plug and patch procedure and were followed for a mean of 20 months. All patients were males with an average age of 35 years. Twenty-five [83.3%] of the patients had bilateral hernias. Preoperative recurrent cases were three [10%]. The aim of this procedure was to obliterate the inguinal canal in cases with indirect hernia by plug made of rolled mesh or by plugging the defect in the direct hernia by many layers of mesh. In all cases, a preperitoneal patch of mesh was fixed to cover the defect. This patch was covered completely by peritoneum. The mean operative time was 65 minutes for unilateral cases and 5 minutes for bilateral cases. Postoperative recurrences were reported in two of the patients; this recurrences were most probably due to incomplete fixation of mesh, too small mesh and less experience in early cases

Initial experience of laparoscopic truncal vagotomy [in El-Minia University Hospital]

This report evaluates the role, efficacy and advantages of laparoscopic truncal vagotomy as an alternative treatment for patients in whom medical treatment failed to cure their ulcers. Between June 1997 and June1999, twelve patients with chronic duodenal ulcer underwent laparoscopic truncal vagotomy. Nine patients were males and three were females with an average age of 41 years. Through four ports 10mm and one port 5mm, the operations were done and both anterior and posterior vagi were cut. The mean operative time was 85 minutes and there were no major intraoperative complications. The mean hospital stay was 3.5 days. The mean postoperative follow-up period was 6 months. Postoperative complications were minor. One patient developed gastric stasis and was treated with repeated balloon dilatation

Laparoscopic appendectomy does not change the incidence of postoperative infectious complications

It is not clear whether the laparoscopic approach does decrease the incidence of postoperative infectious complications after appendectomy. One hundred twenty nine patients were randomized, 67 with laparoscopic [LA] and 62 with open appendectomy [OA]. Patients in the OA group had a Mc Burney incision, LA was performed in the Lithotomy position. Acute appendicitis was confirmed in 85 percent of patients. The appendix was perforated in 5 patients of the LA versus 2 of the OA group. No conversion to the open procedure was necessary. The median operating time was 35 minutes in the LA group and 31 minutes in the open group [P=0.58]. The median postoperative hospital stay was shorter after Laparoscopic than after open surgery [2 days versus 5 days P= 0.026], where as the time required for return to work was not significantly different [14 versus 15 days]. There were 5 [7.4 percent] patients with superficial wound infection following LA and 6 [9.6 percent] after OA [P=0.67]. Intra-abdominal fluid collections were found in 2 [2.9 percent] patients following LA and 3 [4.8 percent] patients following OA [P =0.60]. In the LA group, 3 patients presented with intra abdominal hemorrhage and another 3 developed a paralytic ileus that was treated conservatively. Laparoscopic appendectomy is as safe as and as effective as the open procedure, however it does not decrease the rate of postoperative infectious complications