Comparison between Lichtenstein and Prolene Hernia System (PHS) in Anterior Tension-Free, Inguinal & Femoral Hernioplasty

PURPOSE: The aim of this study was to see if there are any differences in the post-surgical outcomes between 2 tension-free hernioplasty methods. METHODS: We selected those patients with unilateral, bilateral inguinal hernias and femoral hernias who had undergone Lichtenstein n=224) and PHS (n=62) mesh hernioplasty at the Pundang Jaesang Hospital, Department of Surgery, between January 2000 and February 2004, and compared the post-surgical results of each method. The factors analyzed for this comparative study included the patient's age, gender, operation time, length of hospital stay, use of analgesics, cost and recurrences. RESULTS: The results from the statistic showed significant differences between the 2 methods with respect to postoperative pain, cost, duration of hospital stay and recurrences. CONCLUSION: The PHS hernioplasty is a superior method to that of Lichtenstein's herni-oplasty in terms of hospital stay, operation time, postoperative pain & recurrences.

Experience with a Retroperitoneoscopic Adrenalectomy: A report of 16 cases

BACKGROUND: The laparoscopic adrenalectomy has become the standard procedure of adrenal surgery owing to its advantage of minimally invasive surgery and to rapid developments in the laparoscopic technique and apparatus. A posterior retroperitoneoscopic adrenalectomy is a new alternative to both the conventional open approach and a transperitoneal laparoscopic adrenalectomy. This technique is known to be technically difficult and is less frequently done than a transperitoneal laparoscopic adrenalectomy. However, recently, a number of acceptable results have been reported for this procedure. GOAL: We report our experience with and the results from 16 cases involving a retroperitoneoscopic adrenalectomy and evaluate the advantages and disadvantages of this technique. MATERIALS AND METHOD: Between November 1996 and November 1997, a total of 16 retroperitoneoscopic adrenalectomies were performed. All 16 cases had unilateral adrenal tumors(size 1.5-6 cm): 8 Conn adenomas, 4 Cushing adenomas, 2 neurogenic tumors, 1 nonfunctioning adenoma, and 1 vascular cyst. The operations were carried out in the prone position in all cases. Three trochars were inserted below the lower posterior costal margin. The balloon dilatation technique with a surgical globe was used to induce pneumoretroperitoneum in the first 10 cases but in the last 6 cases, the cavity was made only by blunt dissection with the scope and laparoscopic dissector. RESULTS: Fourteen adrenalectomies were completed endoscopically. One was converted to an open posterior approach due to severe skin emphysema and the other case was converted to an open anterior approach due to technical difficulty. The average operating time of the completed endoscopic adrenalectomies was 183 minutes (85-315 minutes) and the average time of the last 8 cases was 148 minutes. There was no operative morbidity or mortality. Immediate mobilization and food uptake was possible on the day of the operation in all cases. Postoperative analgesic injection was needed only one time on the day of the operation in 12 cases and was not needed in 2 cases. The average hospital stay was 4 days after the surgery.