ABSTRACT
Hernias are abnormal protrusions of a viscus [or part of it] through a normal or abnormal opening in a cavity [usually the abdomen]. They are most commonly seen in the groin; a minority are para-umbilical or incisional. In the groin, inguinal hernias are more common than femoral hernias. Inguinal hernias occur in about 15% of the adult population, and inguinal hernia repair is one of the most commonly performed surgical procedures in the world. Although open, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons, produces excellent results comparable to those of open repair. We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1985, through June 15, 2017
ABSTRACT
The spleen is one of the most frequently injured intraperitoneal organs, and management of splenic injuries may require splenectomy. Traditionally, surgical removal of the spleen was done by an open approach using either an upper midline or left subcostal incision. Open splenectomy is performed in two major clinical scenarios: trauma and hematologic disease. With the advent of minimally invasive techniques, laparoscopic splenectomy has become a standard procedure for elective removal of the spleen for most indications. Nowadays laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen. However, some contraindications still apply. The evolution of the technology has allowed though, cases which were considered to be absolute contraindications for performing a minimal invasive procedure to be treated with modified laparoscopic approaches. Moreover, the introduction of advanced laparoscopic tools for ligation resulted in less intraoperative complications. Today, laparoscopic splenectomy is considered safe, with better outcomes in comparison to open splenectomy, and the increased experience of surgeons allows operative times comparable to those of an open splenectomy. In this review we discussed the indications and the contraindications of laparoscopic splenectomy. Furthermore, we analyze the surgical techniques