Incisional hernia is a common postoperative complication following open abdominal surgery with incidence varying between 3% and 20%.1 Approximately half of all incisional hernias are diagnosed within 1 year following surgery. In the United Kingdom alone, about 10,000 incisional hernia repairs are performed annually. Incisional hernia repairs are generally elective with emergency repair due to incarceration or strangulation constituting about 15% of repairs.1 Incisional hernia repair is not a low-risk operation and generally has relatively poor results due to chronic postoperative pain and high recurrence rates.2−3 Little has been published on patients' awareness of incisional hernia following open abdominal surgery. Moreover, there are very few publications on indications for incisional hernia repair and on the natural course of such hernias. The literature suggests that symptoms and complaints usually presented by patients include pain, discomfort, cosmetic complaints, skin problems, incarceration, strangulation, functional disability, and pulmonary dysfunction.4−6 The aim of this study was to investigate whether patients were aware that they had a hernia. In addition, we sought to determine symptoms for those who knew that they had an incisional hernia.
There are several techniques and variations described for tying a Surgeon's knot, all with the intention of getting a secured and square knot. A new, safe, quick and scientific approach to making a Surgeon's knot is presented here. Three basic techniques have been described in the literature for tying a Surgeon's knot: using the instrument, one-handed technique and two-handed technique. A two-handed technique for putting the initial double throw in a Surgeon's knot is described here. The number of throws can be increased as the situation demands. The basic idea is similar to the knotting steps described using an instrument, usually the needle holder. Two fingers of one hand are used in a similar fashion as the tip of needle holder in making the knot. This technique is simple, rapid and secure in making the initial double throw, and the subsequent knotting can be done as described in the literature. The advantage of this technique is that the number of throws can be increased using the same steps. This method is simpler and less time consuming compared to the existing methods.
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