Hernia : the journal of hernias and abdominal wall surgery
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Randomized Controlled Trial
'Dissectalgia' following TEP, a new entity: its recognition and treatment. Results of a prospective randomized controlled trial.
To find the effect of pre-peritoneal instillation of bupivacaine on 'dissectalgia' (pain over a wide area corresponding to the area of pre-peritoneal dissection) and return to work following totally extraperitoneal (TEP) repair for groin hernia in labor-active males. ⋯ Dissectalgia following TEP deserves its due recognition. Pre-peritoneal bupivacaine instillation significantly reduces its occurrence, although the time of patients' resuming their jobs remains unaffected.
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Laparoscopic repair of iatrogenic diaphragmatic hernias after sternectomy and pedicled omentoplasty.
During sternectomy and pedicled omental flap transposition for the treatment of deep sternal wound infections, an ectopic diaphragmatic aperture is created. This may be the site of an iatrogenic diaphragmatic hernia, which may result in the herniation of intra-abdominal organs, and is difficult to repair. Although this complication was described as early as 1991, no effective treatment for this condition has been described previously. ⋯ We describe a laparoscopic technique to repair this difficult diaphragmatic hernia used in four patients, with a good clinical and computed tomographic outcome at 12 months.