Background: There are controversies about the etiology and management of recurrent pilonidal sinus. The numbers of techniques are testament in treating pilonidal sinus (PNS) and no single procedure is superior in all aspects. Aim of the study: The aim of this study was to compare two operative procedures (modified Limberg flap versus Z plasty flap) in management of recurrent pilonidal sinus, regarding their complications including recurrences of the disease, morbidity, hospital stay, day off work and postoperative complications.Patients and methods: This is comparative prospective study between modified Limberg flap and Z plasty flap in treatment of recurrent pilonidal sinus. 30 patients were divided into 2 groups: Group (1) treated with modified Limberg flap and group (2) treated with Z plasty, and we followed up the patients in both groups for postoperative complications, hospital stay, day off work, recurrences, patients satisfactions. Results: Operative time, hospital stay duration, complete wound healing was longer in group (2) Z plasty group. Mobilization was early in MLF group than Z plasty group (1 day versus 2 days). Time to return to work, it was 14 (12 -16) days in MLF groups and 18 (15 -22) in Z plasty group (p < 0.001). Infection occurred only in one in MLF group (1) and 2 patients in Z plasty group (2). The mean time for complete healing of the wound after Modified Limberg flap group (1) was 16 ± 4.2 days while in Z plasty group (2) it was 22 ± 6.8 days. Satisfaction score was better in MLF group (1). Recurrence hadn't occurred in any of the patients included in this study during the follow-up period. Conclusion: Both of modified Limberg flap and Z-plasty technique are used to cause flattening of the natal cleft,

Background: Ventral hernia is one of the most common abdominal wall hernias. Several procedures have been used for hernia repair. During the last few decades, the open surgical approach has been the standard technique for hernia repair. During the past 10 years, laparoscopic repair of ventral hernia has become increasingly established in clinical practice and aimed to be an acceptable and successful technique. There are many techniques used in laparoscopic ventral hernia repair and the most commonly used is fixation of mesh without closing the defect or closing the defect before fixation of mesh. Aim of the Study: The aim of this study is to compare outcomes and results of closure versus non-closure of ventral hernia defect during laparoscopic ventral hernia repair in tow center and report our experience in laparoscopic ventral hernia repair. Patients and Methods: This is comparative prospective study between laparoscopic ventral hernia repair without closure of the defect and with closure of the defect before fixation of the mesh. 60 patients were divided into 2 groups: Group 1 treated with laparoscopic ventral hernia repair without defect closure and group 2 treated with laparoscopic ventral hernia repair with hernia defect closure, and we followed up the patients in both groups for operative outcomes and post-operative complications, hospital stay, recurrences, patients' satisfactions. Results: Operative time was longer in group 2-closure group than in group 1-non-closure group. Post operative seroma is 65% in group 1 and 16% in group 2. Recurrence occurs in one patient [3.33%] in group 2 versus 4 patients [13.33%] in group 1. Conclusion: Laparoscopic ventral hernia repair is safe and feasible, although laparoscopic ventral hernia repair without closure of the defect is easy with less operative time and does not need extra-experience in intra-corporeal suturing How to cite this paper: