Background: Inguinal hernia is one of the diseases that has haunted humanity from its very beginning to the modern times. Groin hernias are the most common conditions referred to surgeons all over the world and over five lakh hernia repairs are performed annually. The lifetime risk for men is 27.0% and for women is 3.0%. Approximately 75.0% of all abdominal wall hernias occur in the groin. Inguinal hernias are more common on the right than on the left and are seven times more likely in males than in females. Aims and Objectives: Aim and objective of the study is to compare extended total extra peritoneal (e-TEP) and total extra peritoneal (TEP) repair in terms of complications and recurrence. To evaluate ease of operability of e-TEP and TEP for inguinal hernia repair. Materials and Methods: Patients with inguinal hernia who were hospitalized to the Department of General Surgery at GSVM Medical College, Kanpur, and who were over the age of 18 years of both sexes were studied from December 2019 to October 2021 after signing a consent form. The research procedure followed was in accordance with the approved ethical standards of GSVM Medical College, Kanpur, UP, India Ethics Committee (Human). Data were analyzed and evaluated using Statistical Package for Social Sciences, version 23 (SPSS Inc., Chicago, IL). Results for continuous variables are shown as mean ± standard deviation, whereas results for categorical variables are shown as number (percentage). For comparison of nominal data, Chi-square (χ2) test was used. The level P<0.05 was considered as the cut-off value of significance. Results: Majority of the patients of Group TEP (25 patients) had complications as Conversion to trans abdominal pre-peritoneal (TAPP) 4 (16.0%) and proceed surgery without veress needle decompression 2 (8.0%). In Group eTEP (25 patients) majority of patients had complications as proceed surgery without veress needle decompression 8 (32%) followed by Seroma 2 (8.0%). No recurrences seen in either groups. Mean operative time of eTEP was less as compared to TEP. Conclusion: With TEP, complications such as SSI, hematoma, and conversion to TAPP are more common; however with eTEP, proceed surgery without veress needle decompression and seroma. Considering the average operative time of eTEP and TEP, as well as the bigger defect size that eTEP can readily handle. For new surgeons, eTEP is a more straightforward procedure. Moreover, our study findings showed that e-TEP mesh repair of inguinal hernia showed more firm and efficacious results than TEP repair. We suggest that long-term randomized control trials with enhanced sample size and reduced confounding factors are still required to establish the absolute superiority of e-TEP over TEP.
Background: About 75% of abdominal wall hernias are inguinal hernias, with a lifetime risk of 27% in men and 3% in women. Lichtenstein's hernia repair was favored and became the gold standard of open tension-free hernia repair. However, the use of synthetic prostheses can result in new clinical problems. In order to reduce the incidence of complications and postoperative dysfunction, the tissue-based groin herniorrhaphies has re-attracted the attentions in recent years. In 2001, Dr. Mohan Desarda proposed a solution which involves use of a strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal.(1) To compare the Aim: post-operative complications, short-term outcomes and recurrence rate for one year between Lichtenstein's and Desarda's technique. Materials And Methods: This is a prospective, randomised study (ODD – EVEN basis) in GSVM Medical College, LLR & Associated Hospitals, Kanpur (UP). 100 patients in two groups with 50 patients in each group: Group A (Lichtenstein's repair) and Group B (Desarda's repair). Outcomes were assessed on the basis of recurrence (with regular follow ups at one month, three months, six months and one year); Operating time; Cost of procedure in total; Post operative course (post operative pain, induration, redness of operated site, post operative wound infection rate. discharge time or hospital stay). Out of 100 patients majority of Results: patients were having right sided indirect hernia. The duration of the surgery was statistically less in Desarda group (53.68±20.21) than Lichtenstein (68.4±53.68) (p<0.05). The pain was signicantly lesser in Desarda group than Lichtenstein groups (p<0.05). The duration of hospital stay was signicantly lower in Desarda group (p<0.05). Seroma Formation was major complication in Lichtenstein group followed by Hematoma Formation, Surgical site infection and recurrence whereas in Desarda group seroma formation was found in only 2 patients and recurrence was in only 1 patient (association of complications in both groups was found to be statistically signicant (p<0.05)). The result of the Conclusion: inguinal hernia treatment with Desarda technique are comparable to results of Lichtenstein surgery. Desarda technique do not use mesh, this makes Desarda repair cost effective and easy to learn. Patients after Desarda's procedure get sooner ambulatory than Lichtenstein mesh repair.(2,3). Recurrence rate is more in Lichtenstein's group although the association was insignicant.(3,4). Hence, Desarda's no mesh repair is favorably comparable with Lichtenstein's mesh repair.
INTRODUCTION Varicose veins are a common problem that affects approximately 25% of Indian adults. The condition is most often caused by great saphenous vein (GSV) insufciency. varicose veins may be asymptomatic, common associated problems include pain, itching, night cramps, fatigue, heaviness, and in a proportion of patients, chronic venous insufciency characterized by ankle edema, eczema, hyper pigmentation, and leg ulceration. AIM AND OBJECTIVES To compare between endovenous laser therapy (EVLT) with open perforator ligation and stripping for varicose vein in term of post operative complication and recurrences of symptoms MATERIAL AND METHODS The study was conducted in the department of general surgery, LLR & Associated Hospitals, GSVM Medical College, and Kanpur from December 2019 to October 2021 on all patients of varicose vein who would be admitted in our ward. Criteria for selection of patients were based on varicose veins caused by incompetence of SFJ or SPJ with GSV or SSV as demonstrated by bidirectional continuous wave Doppler and duplex US imaging and Age at least >18 yrs. RESULT Varicose vein mostly occur due to involvement of saphenofemoral junction leading to great saphenous vein dilation. In our study maximum no. of patients were found in 35-45 age group with male prevalence(93.11%) . Most no. of patients presented with complaints of dilated veins. Right limb involvement was most prevalent (81.48%) In our study bruise ,hematoma , post op infection , post op parasthesia was less common in EVLT group than stripping and ligation ( p value- < .005). hospital stay also less in EVLT group. CONCLUSION EVLT is better than stripping and ligation in term of post procedure complication and hospital stay & time to return the routine normal activity.
Gitanjali Nain Gill, Environmental Justice in India: The National Green Tribunal (Abingdon and New York, NY: Routledge, 2017), xxv + 238 pp.
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