Perianal problems in patients with ulcerative colitis.
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Abscess↗
Biomedical subjects
Ismail Hamzaoglu
Publications and source records attributed to Ismail Hamzaoglu.
Spiral tacks may contribute to intra-abdominal adhesion formation.
PURPOSE: With the inception of laparoscopic ventral hernia repair came a novel device not used in conventional hernia repair; the spiral tack. We conducted an experimental study on pigs to determine whether spiral tacks contribute to adhesion formation. METHODS: Using a standard laparoscopic technique in pigs, pieces of polypropylene mesh were fixed to the fascia on the upper abdominal wall, with polypropylene sutures on a randomly chosen side (side 1), and with 5-mm spiral tacks on the opposite side (side 2). The extent, type, and tenacity of the adhesions were assessed on postoperative days (PODs) 30 and 90. RESULTS: The mesh fixed to the abdominal wall with spiral tacks tended to increase the extent, type, and tenacity of adhesions more than the mesh fixed with polypropylene sutures (P < 0.05). CONCLUSIONS: Spiral tacks contributed to the formation of adhesions more than polypropylene mesh did. Although this was a small-scale animal study, our findings suggest that the effect of spiral tacks used in laparoscopic ventral hernia repair should be assessed and the consequences monitored more closely.
Abdomen↗
Is umbilical flora responsible for wound infection after laparoscopic surgery?
To our knowledge, the association of umbilical flora and infections has not been studied yet. The aim of this study was to identify the causative agents for trocar site infections and to highlight whether there is association between umbilical flora and trocar site infections. One hundred consecutive patients who had undergone laparoscopic surgery were studied. Microbiological samples were taken from the umbilicus before (group 1) and after (group 2) antisepsis with povidone-iodine. Microbiological assessment was done for wounds suspected to be infected, and the wounds with positive cultures were classified as group 3. The incidence of wound infection was 8%. One hundred percent of the infections were associated with the extraction trocar. Eighty-nine percent of all of the infections occurred after laparoscopic cholecystectomy, whereas 11% occurred after laparoscopic appendectomy. The micro-organisms in group 3 did not belong to the skin flora, unlike the micro-organisms in groups 1 and 2, but hospital-acquired pathogens were responsible for the infections. The umbilical flora and the bile are not the source of the surgical site infections after laparoscopic surgery in our study despite the considerations in the literature.
Adult↗
Enteroclysis-guided laparoscopic adhesiolysis in recurrent adhesive small bowel obstructions.
The aim of this study was to point out the efficiency of enteroclysis assay in localization of intraabdominal adhesions that impede small bowel transit in patients with recurrent adhesive small bowel obstruction who underwent laparoscopic partial adhesiolysis. Between January 1998 and June 2001, 15 selected patients with recurrent adhesive small bowel obstructions were treated successfully by medical means and evaluated with enteroclysis to define the pathologic adhesive site that impeded bowel transit. If the results of enteroclysis were indicative, they underwent laparoscopic partial adhesiolysis. The mean duration of the laparoscopic procedure was 99 minutes. In one patient conversion to laparotomy occurred because of excessive adhesions, and in another patient a small bowel injury occurred and enterorrhaphy was performed laparoscopically. Mean postoperative hospital stay was 4 days. During a mean follow-up of 17.2 months (range, 6-39), there was no delayed morbidity or recurrence. Identification of the small bowel site of recurrent obstruction with enteroclysis permits limited laparoscopic adhesiolysis. This approach may be a rational alternative to not only open procedures but also complete laparoscopic adhesiolysis without enteroclysis.
Adult↗