Surgical endoscopy
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Effective surgical therapy for ventral and incisional hernias is problematic. Recurrence rates following primary repair range as high as 25-49%, and breakdown following conventional treatment of recurrent hernias can exceed 50%. As an alternative, laparoscopic techniques offer the potential benefits of decreased pain and a shorter hospital stay. This study evaluates the efficacy of the laparoscopic approach for ventral herniorrhaphy. ⋯ The laparoscopic approach to the repair of both primary and recurrent ventral hernias offers a low conversion rate, a short hospital stay, and few complications. At 23 months of follow-up, the recurrence rate has been 3%. Laparoscopic repair should be considered a viable option for any ventral hernia.
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Penetrating injury with retained foreign body is a common problem. Location of the foreign body and surgical excision may be difficult. Ultrasound can be a sensitive and cost-effective tool in both the detection and surgical removal of retained foreign bodies in soft tissue. We report a case in which ultrasound-guided needle localization was used for removal of a wooden foreign body
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In hernia patients, the preoperative diagnosis of strangulation is difficult. In this prospective study, we investigated the usefulness of an exploratory laparoscopy to evaluate the viability of a viscus incarcerated in a groin hernia. ⋯ At laparoscopy, the judgment of the viability of the contents of the hernia is similar to that at laparotomy. The early use of laparoscopy can prevent many unnecessary laparotomies.