IntroductionThe need of this study is to assess the role of collagen III in all hernias which include primary inguinal hernias ventral and recurrent abdominal hernias.Collagen type III represents the mechanically instable, less cross-linked collagen synthesized during the early days of wound healing. Quantitative assessment of collagen III in scar tissue on transversalis fascia as tissue obtained from cases operated for various hernias and compared to that of patients operated for abdominal surgeries for indications other than hernia was compared.Materials and methodsIn this study we had a total of 90 patients, of which 45 patients underwent mesh repair for the various hernias and 45 patients who underwent laparotomies for various reasons were included as controls. Size of 1 × 1cm transversalis fascia was taken in both subjects and was sent for quantitative assessment using Immunohistochemistry test. All the above cases were randomized as per age,sex,BMI, co morbidities and materials used for repair.ResultsResults were analysed quantitatively and classified into following groups:Based on intensity of staining into Mild, Intermediate and Well stained and based on Quantity of Collagen III into Grade 0---NIL, Grade 1--1-25%, Grade 2-26-50%, Grade 3--51-75%, Grade 4--76-100% (Table 1). In the case group we had 52.4%,35.7% and 11.9% of the cases in Grade 4, Grade 3 and Grade 2 which proved that there was increased presence of Collagen 3, where as 84.4%,4.4% and 11.1% of patients in the control group were classified as Grade 1, Grade 2, Grade 0. For the quantitative study -Chi square test value −81.279 and the p value < 0.001. For the intensity of staining -Chi square test value −57.64 and p value is < 0.001.ConclusionThis study signifies that ventral, recurrent and primary inguinal hernias are not just caused because of a primary defect but an acquired disorder with respect to collagen distribution.
No abstract
Introduction: In the present era of laparoscopy and its everexpanding application to various different types of surgeries, the art of suturing and knotting still plays a pivotal role in determining the success of any surgery as in case of open surgeries. Despite the introduction of various energy sources as an alternative to suturing and knotting, the various complications associated with them and the cost limitations have to be considered. Extracorporeal and intracorporeal knotting in laparoscopic surgery can be used in various situations and though it can be technically demanding, it can be overcome with repeated practice. Here we describe a new technique of knot which is simple, easy, and a safe extracorporeal knotting technique which can be used for any continuous tubular structure up to a maximum diameter of 22 mm. This technique was introduced by Professor and Doctor Mishra who has himself worked upon it in the last 2 years after trying various other knots and modifying them to achieve better security. Technique description: Mishra's knot is a modification of the Roeder's knot or the Meltzer's knot. It's a relative simple technique where we use 3 hitches and 3 loops alternating each other. The modification aims to achieve better knot security by application of a lock after every wind. Materials and methods: A literature review was performed using PubMed, SpringerLink, HighWire Press and search engines like Google and Yahoo. The following search terms were used: Extracorporeal knot, Roeder's knot, Meltzer's knot, Mishra's knot. A total of more than 300 citations were found. Selected papers were screened for further references according to our requirements. A list of 280 surgeries where Mishra's knot was successfully used was given to us for study purpose by Professor Dr RK Mishra. Conclusion: "This is a very simple and safe technique and has been successfully followed in more than 300 cases for tying an extracorporeal knot. It's a very safe and reliable knot even for the critical structures like cystic duct, uterine artery, and various arteries and we observed it to be very secure."
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.