Tension-free open hernia repair using an innovative self-gripping semi-resorbable mesh.

BACKGROUND: Lichtenstein tension-free mesh repair is the most commonly used technique for the open treatment of inguinal hernia. Mesh fixation and the potential risk of associated pain are always a surgical concern. The aim of this study was to report the initial clinical experience using an innovative, partly resorbable mesh with self-gripping properties. METHODS: Fifty-two patients (70 hernias) underwent open Lichtenstein hernia repair with Parietene Progrip (Sofradim Production, Trévoux, France-Group Covidien). Patient pain as measured by a visual analogue scale (VAS) was the primary study endpoint. Clinical evaluation, with careful attention to the identification of hernia recurrence, was performed at 1 month and 1 year. The evaluation of fixation precision, quality of fixation and ease of use was assessed by the primary surgeon. RESULTS: The mean patient pain was 1.3 (+/-1.4) at discharge, 0.1 (+/-0.4) at 1 month and 0.0 (+/-0.1) (one patient with VAS 1/10) at 1 year, respectively. The mean operative time was 19 +/- 4 min. There was one minor cutaneous infection and no documented recurrence. The quality of the gripping effect was rated very good in 51 (98.1%) of the cases performed. CONCLUSION: The use of a novel low-density, macroporous mesh with semi-resorbable self-fixing properties during tension-free repair may be a satisfactory solution to the clinical problems of pain and recurrence following inguinal herniorrhaphy.

[Preliminary results of the evaluation of the Endopatch E-F in digestive surgery]. / Résultats préliminaires de l'évaluation de l'Endopatch E-F en chirurgie digestive.

Endopatch E-F is a new product elaborated with natural human and animal proteins. Its synthesis originates in a covalent link between elastin and fibrin monomers. Numerous experimental studies carried out in animal have previously shown its ability to reinforce healing process of digestive wall. The results reported herein have been obtained in very selected patients in whom a digestive anastomosis had to be done in spite of unfavorable circumstances, such as intra-abdominal infection, radiated bowel or ascitis. From October 1990 to October 1992, 21 digestive anastomosis have been performed in 18 patients. All were reinforced by Endopatch E-F. Two deaths have been observed (mortality: 11.1%), which do not look like a consequence of the use of the product (One myocardial infarction and one cirrhotic failure). There were 2 post-operative fistulas (9.5% of the whole anastomosis). No patients had any reaction of intolerance. These preliminary results confirm experimental data, and suggest that Endopatch EF can be used in order to reinforce digestive sutures when performed under unfavorable circumstances.

[Statistical analysis of results of operative treatment of 223 cases of left colon cancer (author's transl)]. / Réflexions statistiques sur une série de 223 interventions pour cancer du côlon gauche.

Statistical analysis of results of 223 operations for left colon cancer over a period of ten years is presented. The patients (age, condition), and the clinical expression (urgent or cold surgery) are discussed. The authors then give the lesions a sort of identity card of macroscopic findings (topography, local extension, invasion of glands, metastatic spread) to enable interpretation of the long-term survival results as a function of each parameter. Their conclusions are that, apart from left hemicolectomy conducted for oncological reasons or for safety of technique, no element demonstrates the superiority of standard left hemicolectomy over segmentary colectomy. They also adopt the principle of a proximal colostomy in certain cases that are difficult to treat, this procedure being for them a definite factor of security, but also a risk factor. An urgent bypass operation is conducted except when the lesion requires excision. If conditions are suitable for immediate re-establishment of continuity, which rarely happens, they carry out a systematic protective subjacent colostomy.

[Foetal pancreas implants in an insulin-dependent patient. Technique and clinical results (author's transl)]. / Implantation de pancréas foetaux chez un diabétique insulino-dépendant. Modalité technique et résultat clinique.

Fragments of foetal pancreatic buds taken before the 10th week of gestation, stored at - 196 degrees C and cultivated on artificial media were implanted in an adult, insulin-dependent diabetic patient. Following a 2 weeks latent period, the clinical symptoms of diabetes regressed within 2 months, although all insulin treatment had been withdrawn. These results have now been maintained for 11 months, but major overloads in carbohydrates are imperfectly controlled.