Laser laparoscopic inguinal herniorraphy represents an extension of current technology. Based on the principles of preperitoneal inguinal herniorraphy, it is performed by internal incision of the peritoneum and identification of the musculofascial defect through a laparoscope. Polypropylene mesh is then passed down the laparoscope, placed into the defect to obliterate the space, and the edges of the peritoneum are then reapproximated. Results in 20 patients with an 11 month followup indicates success in nineteen exhibiting early resumption of activity (3.3 days) and minimal pain (2.1 Tylenol #3 tablets per patient). One early recurrence suggests that anatomic identification of a direct space hernia may be difficult and that routine support of this area with additional mesh may be a requirement of a complete inguinal hernia repair.
At our center, embolism was found to be the most common etiology for UEI followed by thrombosis and stenosis. Patients presented with embolism were older, were more likely to undergo thromboembolectomy, and had higher rates of hypertension and longer hospital stays.
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