Laparoscopic ventral hernia repair (LVHR) is a widely practiced treatment for primary (PH) and incisional (IH) hernias, with acceptable outcomes. Prevention of recurrence is crucial and still highly ...debated. Purpose of this study was to evaluate predictive factors of recurrence following LVHR with intraperitoneal onlay mesh with a single type of mesh for both PH and IH. A retrospective, multicentre study of data collected from patients who underwent LVHR for PH and IH with an intraperitoneal monofilament polypropylene mesh from January 2014 to December 2018 at 8 referral centers was conducted, and statistical analysis for risk factors of recurrence and post-operative outcomes was performed. A total of 1018 patients were collected, with 665 cases of IH (65.3%) and 353 of PH (34.7%). IH patients were older (p < 0.001), less frequently obese (p = 0.031), at higher ASA class (p < 0.001) and presented more frequently with large, swiss cheese type and border site defects (p < 0.001), compared to PH patients. Operative time and hospital stay were longer for IH (p < 0.001), but intraoperative and early post-operative complications and reinterventions were comparable. IH group presented at major risk of recurrence than PH (6.7% vs 0.9%, p < 0.001) and application of absorbable tacks resulted a significative predictive factor for recurrence increasing the risk by 2.94 (95% CI 1.18-7.31). LVHR with a light-weight polypropylene mesh has low intra- and post-operative complications and is appropriate for both IH and PH. Non absorbable tacks and mixed fixation system seem to be preferable to absorbable tacks alone.
Laparoscopic cholecystectomy is the first-choice treatment for symptomatic cholelithiasis. Though generally safe, this procedure is not without complications, with bleeding the most frequent cause of ...conversion to open cholecystectomy. Oxidized regenerated cellulose (ORC) added to conventional hemostatic strategies, is widely used to control bleeding during surgery despite limited evidence supporting its use. This retrospective study analyzed patients undergoing laparoscopic cholecystectomy in an Italian center over a 16-month period, between October 2014 and February 2016, who experienced uncontrollable bleeding despite the use of conventional hemostatic strategies, requiring the addition of ORC gauze (Emosist
).
Of the 530 patients who underwent laparoscopic cholecystectomy, 24 (4.5%) had uncontrollable bleeding from the liver bed. Of these, 62.5% had acute cholecystitis and 33.3% chronic cholecystitis; 1 patient was diagnosed with gallbladder carcinoma, postoperatively. Most patients had comorbidities, 16.7% had liver cirrhosis, and 37.5% used oral anticoagulants. The application of ORC rapidly controlled bleeding in all patients. Patients were discharged after a mean duration of 2.2 days. ORC was easy to use and well tolerated. Bleeding complications remain a relevant issue in laparoscopic cholecystectomy. ORC was able to promptly stop bleeding not adequately controlled by conventional methods and appears, therefore, to be a useful hemostat.
Groin hernias are a common condition that can be treated with various surgical techniques, including open surgery and laparoscopic approaches. Laparoscopic surgery has several advantages but its use ...is limited due to the complexity of the posterior inguinal region and the need for advanced laparoscopic skills. This paper presents a standardized and systematic approach to trans-abdominal pre-peritoneal (TAPP) groin hernioplasty, which is useful for training young surgeons.
The paper provides a detailed, step-by-step description of the TAPP based on evidence from literature, anatomical knowledge, and the authors' experience spanning over 30 years. The sample includes 487 hernia repair procedures, with 319 surgeries performed by experienced surgeons and 168 surgeries performed by young surgeons in training. The authors performed a descriptive analysis of their data to provide an overview of the volume of laparoscopic hernioplasty performed.
The analysis of the data shows a low complication rate of 0.41% (2/487) and a low recurrence rate of 0.41% (2/487). The median duration of the surgery was 55 min, while the median operation time for surgeons in training was 93 min, specifically 83 min for unilateral hernia and 115 min for bilateral hernia.
The TAPP procedure appears, to date, comparable to the open inguinal approach in terms of recurrence, postoperative pain and speed of postoperative recovery. In this paper, the authors challenge the belief that TAPP is not suitable for surgeons in training. They advocate for a training pathway that involves gradually building surgical skills and expertise. This approach requires approximately 100 procedures to achieve proficiency.
Topical hemostatic agents in surgical practice Emilia, Masci; Luca, Santoleri; Francesca, Belloni ...
Transfusion and apheresis science,
12/2011, Letnik:
45, Številka:
3
Journal Article
Recenzirano
Abstract Hemostasis is of critical importance in achieving a positive outcome in any surgical intervention. Different hemostatic methods can be employed and topical hemostatic agents are used in a ...wide variety of surgical settings. Procoagulation agents have different hemostatic properties and the choice of a specific one is determined by the type of surgical procedure and bleeding. Hemostatic treatments include fibrin sealants, microfibrillar collagen, gelatin hemostatic agents, oxidized regenerated cellulose and cyanoacrylates adhesives. Surgeons should be familiar with topical hemostatics to ensure an appropriate use. Our purpose is to illustrate the currently available agents, their mechanism of action and their effective applications, in order to ensure an optimal use in operating room.
It La digital library “Ti Racconto la Storia : Voci dalla Shoah” (sito web: http://www.shoah.acs.beniculturali.it/) è il risultato di un progetto durato diversi anni, nato con l’obiettivo di ...preservare e diffondere un considerevole patrimonio documentario audiovisivo che il Ministero per i Beni e le Attività Culturali ha ricevuto in copia dalla Survivors of the Shoah Visual History Foundation nell’ambito di un accordo di collaborazione. La trasformazione di un sistema software proprietario per l’indicizzazione dei contenuti e l’archiviazione digitale in un sistema di digital library più attuale, basato sulle tecnologie più recenti, ha consentito di definire un modello per il recupero, la preservazione e la diffusione di risorse digitali adatto ad essere impiegato in qualsiasi ambito della storia orale. En The digital library “Ti Racconto la Storia : Voci dalla Shoah” (website: http://www.shoah.acs.beniculturali.it/) is the result of a project carried out for several years, aimed at the preservation and diffusion to the broad public of a huge audio-visual documentary heritage that the Italian Ministry for Cultural Heritage and Activities received in copy from the Survivors of the Shoah Visual History Foundation, in the context of a collaboration agreement. The transformation of a pre-existing proprietary software for the indexing and storage of digital resources into a modern Digital Library system, based on the most recent technologies, permitted to define a generic model for the recovery, preservation and dissemination of digital resources, that can be re-used for similar projects in the field of oral history.
In Naples by 1764, the year in which Sir William Hamilton arrived in the city and in which Winckelmann asserted that the so-called ‘Etruscan’ vases should be attributed to the ancient Greeks, the ...collecting of figured vases was already a well-established practice. This paper examines the process that led to the codification of this new typology of antiquarian collecting during the first half of the eighteenth century. The analysis of this phenomenon takes into account three key components and their mutual interaction: the tradition of antiquarian studies, the antiquarian market and original eighteenth-century Neapolitan vase collections that are here reconstructed on the basis of archival documents.
In Naples by 1764, the year in which Sir William Hamilton arrived in the city and in which Winckelmann asserted that the so-called 'Etruscan' vases should be attributed to the ancient Greeks, the ...collecting of figured vases was already a well-established practice. This paper examines the process that led to the codification of this new typology of antiquarian collecting during the first half of the eighteenth century. The analysis of this phenomenon takes into account three key components and their mutual interaction: the tradition of antiquarian studies, the antiquarian market and original eighteenth-century Neapolitan vase collections that are here reconstructed on the basis of archival documents. (Author abstract)
It La digital library “Ti Racconto la Storia : Voci dalla Shoah” (sito web: http://www.shoah.acs.beniculturali.it/) è il risultato di un progetto durato diversi anni, nato con l’obiettivo di ...preservare e diffondere un considerevole patrimonio documentario audiovisivo che il Ministero per i Beni e le Attività Culturali ha ricevuto in copia dalla Survivors of the Shoah Visual History Foundation nell’ambito di un accordo di collaborazione. La trasformazione di un sistema software proprietario per l’indicizzazione dei contenuti e l’archiviazione digitale in un sistema di digital library più attuale, basato sulle tecnologie più recenti, ha consentito di definire un modello per il recupero, la preservazione e la diffusione di risorse digitali adatto ad essere impiegato in qualsiasi ambito della storia orale. En The digital library “Ti Racconto la Storia : Voci dalla Shoah” (website: http://www.shoah.acs.beniculturali.it/) is the result of a project carried out for several years, aimed at the preservation and diffusion to the broad public of a huge audio-visual documentary heritage that the Italian Ministry for Cultural Heritage and Activities received in copy from the Survivors of the Shoah Visual History Foundation, in the context of a collaboration agreement. The transformation of a pre-existing proprietary software for the indexing and storage of digital resources into a modern Digital Library system, based on the most recent technologies, permitted to define a generic model for the recovery, preservation and dissemination of digital resources, that can be re-used for similar projects in the field of oral history.
CARARE is a best practice network funded by the EU ICT Policy Support Programme. It is aimed at establishing a best practice network of heritage agencies, archaeological organisations and research ...institutions to establish an aggregation service for Europeana for archaeological and architectural digital content, including images, texts and 3D objects. CARARE is particularly focused on recommendations for metadata schemas dedicated to archaeological and architectural heritage and on solutions for the publication of 3D and Virtual Reality content. This paper describes the recommendations which have been made by the project for publishing 3D objects online in easily accessible formats such as 3D PDF with the metadata necessary for discovery in Europeana. It is illustrated by the contribution of the Scuola Normale Superiore and its work in preparing 3D representations of Pompeii monuments for publication through Europeana.
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