IntroductionEndoscopic hernia repair integrates the advantages of tension-free preperitoneal mesh support of the groin with the advantages of minimally invasive surgery procedures.AimTo compare outcomes between slit mesh (SM) and nonslit mesh (NSM) placement in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.Material and methodsThis is a retrospective study of 353 patients who underwent TEP inguinal hernia repair between January 2010 and December 2011. One hundred forty-nine and 154 hernias were operated on in the SM and NSM groups, respectively. Postoperative complications, recurrence, early postoperative pain, and chronic pain levels were evaluated.ResultsIn a total of 303 patients, hernia repair was performed as 395 direct and indirect hernias. Nonslit mesh was converted from TEP to transabdominal preperitoneal patch plasty (TAPP) in 4 patients in the group and 6 patients in the slit mesh group. The average operation time of the SM group was significantly higher than that of the NSM group (p < 0.001). In the evaluation of early postoperative pain, VAS levels of the NSM group were statistically significantly lower than those of the SR group in all evaluations (p = 0.001). The pain rate of the SM group after 3 months of chronic pain was significantly higher than that of the NSM group (p = 0.004). There was no difference in recurrence rate, 6th month chronic pain, wound infection or wound hematoma.ConclusionsThe use of SM and NSM in TEP operations is not different in terms of recurrence and complications. However, the use of NSM gives better results in terms of early postoperative pain and chronic pain.

Laparoscopy is safe and efficient in the management of ASI and should be more frequently considered as a therapeutic tool.

IntroductionPort site herniation is one of the serious complications of laparoscopic surgery, which decreases its benefits. Closure of a fascia defect at the port site is an important problem of laparoscopic surgery, especially in obese patients.AimTo evaluate needle grasper fascia closure.Material and methodsWe closed the port site fascia using a percutaneous organ-holding device (needle grasper) in laparoscopic cholecystectomy patients. This study included 334 patients who underwent laparoscopic cholecystectomy between January 2015 and January 2017 in our hospital. Patients were divided into 2 fascia closure groups: group 1 with a standard simple suturing technique and group 2 with a needle grasper to close the port site. Patient demographics, operative details, and postoperative outcomes were collected and evaluated.ResultsThere were 243 female and 91 male (total 334) patients with the mean age of 49.18 ±13.15 years. Only 1 patient in the BMI > 30 kg/m2 group of patients had port site hernia development with the needle grasper technique at the end of the 8-month follow-up period. The port site hernia incidence was higher in group 1 than group 2 (p < 0.001), but there was no significant difference in terms of operation duration between the two groups (p < 0.001, p = 0.709, respectively). In patients with a BMI > 30 kg/m2, both operation duration and port site hernia incidence were higher in simple suture closure than in the needle grasper technique (p < 0.001, p = 0.016, p = 0.005).ConclusionsThe needle grasper technique is easy, simple, safe, fast, and effective for fascia closure of port sites. This method can also be applied in obese patients easily, safely and in a short time.

Introduction: Covid-19 is a viral epidemic disease that causes serious health problems and death worldwide. The rapid expansion of Covid-19 infection led to the disruption of healthcare services and radical reorganisation of healthcare resources due to the healthcare workers' infection. Aim: This clinical study investigated the effects of Covid-19 infection on emergency and elective cases in our general surgery clinic. Material and methods: We retrospectively analysed the clinical data of 195 patients who underwent elective (Group Elective) and emergency (Group Emergency) surgery during the Covid-19 incubation period in the Bakırköy Dr. Sadi Konuk Training and Research Hospital between March 11 - May 18, 2020. Demographic features, symptoms, surgical diagnoses, surgical methods, complications, duration of surgery, length of hospital stay and mortality, the status of Covid-19 of all patients were recorded. Results: 195 patients, including emergency and elective surgery cases, were operated on (104 and 91, respectively). The incidence of Covid-19 infection was 5.49% in patients scheduled for elective surgery and 4.8% in patients operated urgently, and all developed in the postoperative period. Two patients with emergency surgery died of respiratory failure, their mean age was 51 years. Two of 104 emergency-operated patients were positive from Covid-19 (1.92%) at the time of admission. Eighteen medical staff and nurses got Covid-19 infections. Conclusions: Due to the rapid spread of Covid-19 infection, early precautions must be taken in surgical clinics to guarantee the safety of patients all healthcare providers, and personnel.

Introduction:The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim: To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation. Material and methods: Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra-and post-operative complications were evaluated. Results: The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients. Conclusions: The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.