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J P Cossa

Publications and source records attributed to J P Cossa.

11 recordsLinked to original sources
PubMed1999

[Laparoscopic treatment of recurrent inguinal hernia after only mesh].

The recurrences of inguinal hernia after onlay mesh may cause technical difficulties for a new repair. The aim of our study was to assess intraoperative findings, feasibility and results of laparoscopic transpreperitoneal mesh onlay in this indication. Twenty-one repairs were performed. In all cases, direct, internal, inguinal recurrences were observed, associated in two cases with an external or femoral recurrence. In 16 cases, there were no adhesions in the peritoneal cavity. The were no conversions and peritonealisation was always completed. The mean length of hospitalization was 2.7 days. Our study suggests that technical errors during the first procedure, insufficient mesh or wrongly positioned are responsible for recurrence and allow reinsertion of a mesh laparoscopy via transpreperitoneal in this indication.

Adult↗
PubMed1996

[Treatment of inguinal hernia by laparoscopy. Four-year results of the transpreperitoneal approach].

The laparoscopic approach to inguinal hernia repair remains controversial. The authors report the results of 790 repairs performed during the first four years of their experience. The complication rate requiring surgical revision was 1.39%. None of these complications was related to the transpreperitoneal approach and all but one of them occurred during the first two years of the authors' experience. The recurrence rate for patients with a follow-up of more than two years was 5.01%. With experience, the size of the meshes has gradually increased. The authors' experience suggests that all types of hernia can be treated via this approach and that the recurrence rate makes this technique competitive compared to the results of other techniques reported in the literature.

Adolescent↗
PubMed1995

[Impact of celioscopic surgery in general and digestive system surgery].

A retrospective study was conducted to evaluate the impact of laparoscopic surgery on activity in general and digestive surgery. From May 1990 to December 1994, 2256 laparoscopic procedures were performed for cholecystectomy (36%), appendicectomy (20.4%) or inguinal hernia (19.8%). 23.2% of all procedures performed in 1994 were done laparoscopically. The use of laparoscopy did not, in our experience, added any new indications from 1988 to 1994. The conversion rate was 8.15%. 24% of the conversion cases could not be predicted. Mortality was 0.18% and 1.19% of the patients had to undergo a second operation due to complications of laparsocopic surgery. The impact of laparoscopic procedures, 7 years after the first laparoscopic cholecystectomy has been great. The results of this surgical technique must be evaluated to determine its medical and economic impact.

Appendectomy↗
PubMed1994

[Treatments of inguinal hernias by celioscopy. Preliminary results apropos of 162 cases].

Mesch insertion is a reliable means for repairing inguinal hernias. Results in 162 patients treated laparoscopically via an intraperitoneal approach are reviewed herein. Analgesics were not required after the first postoperative day in 71% of patients. Fourteen patients were treated on a day-care basis. There were two recurrences due to inadequate fixation of the mesch to Cooper's ligament. The two patients who developed an infection did not require removal of the patch and had a strong, completely healed wall at the follow-up evaluation after four and ten months, respectively. The number of patients and duration of follow-up are still inadequate. However, these preliminary data warrant continued use and evaluation of this technique.

Adult↗
PubMed1992

[Tubular gastrostomy using celioscopy].

Surgical feeding gastrostomy is attended by a significant morbidity and mortality. Today, the percutaneous endoscopic route is regarded as the best method, but it is not feasible in case of pharyngo-oesophageal stenosis and has its own drawbacks. A new method using laparoscopy to perform a Depage-Janeway gastrostomy is presented here. The theoretical advantages of this method are clear: the limited parietal damage should avoid cicatricial complications, and the limited ventilatory aggression should reduce the amplitude of respiratory complications. Moreover, in surgical practice this is a simple, rapid and efficient operation.

Aged↗
PubMedDate not supplied

[Value of celioscopy in the diagnosis of inguinal hernia].

OBJECTIVE: Prospectively compare laparoscopic findings with functional impairment and clinical diagnosis and classification of inguinal hernias. METHODS: Fifty eight consecutive patients (mean age 55.3 years, range 22-87) presenting with 68 symptomatic hernial orifices and undergoing laparoscopic procedures for inguinal hernia were included in the study. Type of hernia was identified according to the Nyhus classification. Clinical examination found 73 hernias and laparoscopy identified 86 hernias. RESULTS: Laparoscopic findings confirmed clinical diagnosis in 20 out of 30 type II hernias, 24 out of 37 type IIIA hernias, 2 out of 3 type IIIB hernias and 13 out of 16 type IV hernias. CONCLUSION: Laparoscopic procedures can successfully confirm or refute the clinical diagnosis of inguinal hernia, especially important when the preoperative diagnosis is doubtful. The type of hernia can be clearly identified for adaptation of therapeutic indications.

Adult↗
PubMedDate not supplied

[Benign serous cystadenoma of the pancreas. Duodenopancreatectomy and segmentary resection of the portal vein].

Although the mandatory mesenterico-portal resection in patients with cancer of the pancreas is thought to have no anticancer effect, this wide exeresis does not increase operative mortality significantly. We performed this operation for a large benign tumour englobing the portal vein. The tumour was completely removed with no major per-operative problem with haemostasis. Venous circulation was reestablished by direct suture without prosthesis. The post-operative period was uneventful and the patient was asymptomatic three years later. We emphasize the technical procedure and draw attention to this operation in non-cancer cases.

Aged↗