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J M Ramia

Publications and source records attributed to J M Ramia.

26 records · Page 2Linked to original sources
PubMed1998

Prosthetic repair of femoral hernia: audit of long term follow-up.

OBJECTIVE: To study the long term results of 93 femoral hernia repairs by cylindrical prothesis with a polypropylene mesh. DESIGN: Prospective open study. SETTING: District hospital, Spain. SUBJECTS: 92 patients who had 93 hernias repaired between 1989 and 1992. INTERVENTIONS: Lichtenstein repair of femoral hernias. MAIN OUTCOME MEASURES: Complications and recurrences. RESULTS: The mean follow up was 64 months (range 43-84). There was one recurrence 4 months postoperatively in a patient who had been operated on as an emergency for an incarcerated hernia, and in one patient the prosthesis had to be removed 10 days after the initial operation. This was subsequently repaired with polypropylene mesh and had not recurred at 4 years. CONCLUSION: Herniorrhaphy with cylindrical prosthesis is our preferred elective technique for repair of primary femoral hernias although other techniques are advisable for incarcerated or recurrent hernias.

Adult↗
PubMedDate not supplied

Pneumomediastinum as a complication of extraperitoneal laparoscopic inguinal hernia repair.

A 52-year-old man with left indirect groin hernia was admitted for elective inguinal repair using the totally extraperitoneal (TEP) approach. After an uneventful intubation, TEP repair of the hernia was performed with three midline trocars. Immediately after extubation, the patient noted severe chest pain. There was a decrease in PaO2 saturation, and neck subcutaneous emphysema was detected. There was no emphysema of the abdomen or of the back. A chest film and thoracic computed tomographic (CT) scan confirmed the presence of pneumomediastinum without pneumothorax. The patient was discharged without complications.

Disease-Free Survival↗
PubMedDate not supplied

Postlaparoscopic cholecystectomy bile leak secondary to an accessory duct of Luschka.

Complications produced by the sectioning of a nonvisualized duct of Luschka are uncommon during laparoscopic cholecystectomy. From 1999 through 2003, we performed 1351 laparoscopic cholecystectomies in our department and observed 2 cases (0.15%) of bile leakage due to duct of Luschka injury. Injury during laparoscopic cholecystectomy is usually produced by an excessively deep plane of dissection and by the anatomical localization of this accessory duct. Clinical symptoms are scarce after duct of Luschka injury. Numerous diagnostic methods have been used to detect these injuries. Nevertheless, careful clinical examination is still of the utmost importance. Noninvasive treatments are usually effective. In patients who present with acute abdomen, as in our cases, or who are not cured by noninvasive treatments, exploratory laparotomy is the best approach. The surgical treatment consists of a lavage of the abdominal cavity, closure of the duct of Luschka, and intraoperative cholangiography to confirm that the biliary tree is intact.

Aged↗