The debate of what is the best technique continues today. The aim of this study was to describe the technique and surgical outcomes including morbidity and recurrence after TAPP. Material and Methods: Retrospective cohort study. Data was obtained from the database of patients who underwent laparoscopic inguinal hernia repair with TAPP at Hospital Clínico Universidad Católica de Chile from October 2008 to December 2012. The follow-up was performed with postoperative controls and telephone calls, specifically asking for recurrence and pain. results: Two-hundred and seventy-one TAPP procedures in 197 patients with inguinal hernia were included in the study. Twenty two patients had complications (11.2%), 18 of which corresponded to Clavien type I. Median follow-up was 18 months (12-28), including 94% patients of this series. There were five recurrences, corresponding to 1.85% patients. conclusions: In this study the outcomes of TAPP for inguinal hernia repair were similar to the outcomes reported in the current literature.
Laparoscopic treatment of adhesive small bowel obstruction Background: Treatment options for adhesive small bowel obstruction (ASBO) involve conservative and surgical management, traditionally through open adhesiolysis. Laparoscopic approach has been performed in recent years; however, limited data exist on its safety and results vary considerably. Our aim is to report our experience of laparoscopic treatment for ASBO. Methods: Retrospective study including patients admitted with the diagnosis of adhesive small bowel obstruction and that were submitted to laparoscopic exploration, between June 2003 and April 2013. We analyzed demographic, surgical variables and outcomes in terms of conversion rate, operative time, re-feeding time and length of stay. Non-parametric tests were used for statistical analysis. Results: Series of 38 patients submitted to laparoscopic exploration, mean age: 51 ± 16 years, 47% male. 53% had prior intra-abdominal surgeries. Laparoscopic resolution of bowel obstruction was possible in 31 patients (82%), with 7 conversions to open surgery. Median operative time was 60 (25-180) minutes, median re-feeding time was 24 (24-192) hours and median length of stay was 4 (2-52) days. Two patients required re-intervention during their hospital stay, one due to persistent bowel obstruction and one due to ischemic colitis. There were no other complications or mortality. Conclusions: Laparoscopy in adhesive small bowel obstruction was a feasible approach in this series, with good results when laparoscopic resolution is achieved. Patients with no prior surgeries seem to be good candidates for this approach.
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