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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have developed fetal lamb models of congenital cardiothoracic lesions that have been allowed to progress through birth for physiological study. Simulated lesions, simulated repairs, actual lesions, and actual repairs have been performed in this model. Sixty-two fetal lambs comprised the study group, including 48 in which models were created and 14 controls. Models included pulmonary stenosis, aortic stenosis, and diaphragmatic hernia. Gestational age ranged from 90 to 120 days (0.6 of normal gestation). In each pregnant ewe, laparotomy and hysterotomy were performed under general anesthesia, with care taken to avoid placental vessels. The foreleg was exposed, the appropriate anterior chest wall was isolated, and a thoracotomy was done. Thoracic or cardiac procedures then were performed under controlled transplacental anesthesia and perfusion. Following completion of the procedure, the fetal thoracotomy was closed, sterile antibiotic solution was placed in the amniotic sac, and the hysterotomy and laparotomy were closed. Subsequently the fetus either was allowed to progress to birth and infant study or underwent subsequent intrauterine repair and then was allowed to progress to birth and neonatal study. This fetal lamb model provides reproducible anatomical and pathophysiological lesions to facilitate the development of techniques for repair of such lesions in early infancy. Further, it offers the potential for developing methods of intrauterine cardiothoracic surgical repair.
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PMID:Intrauterine cardiothoracic surgery: the fetal lamb model. 689 Mar 30

Attention is drawn to the fact that epidural anaesthesia is the most advisable technique in the treatment of intervertebral disk hernia by chemonucleolysis. The advantages of local as opposed to general anaesthesia are described.
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PMID:[Segmental epidural analgesia in chemonucleolysis]. 703 39

In a five year period, 62 patients aged 70 to 91 years underwent operative inguinal hernial repair. Other significant ailments were present in 46 of the 51 men and six of the 11 women. Postoperatively, complications occurred in 16 patients, four of whom died. In 44 patients with reducible hernia undergoing elective repair, there were no deaths and complications occurred in eight, while, in contrast, of the 18 with incarcerated or strangulated hernia, complications occurred in ten, and four died. The differences statistically significant. Local anesthesia was associated with the lowest complication rate. All cardiovascular complications and all deaths occurred in those receiving either general or spinal anesthesia. Inguinal herniorrhaphy can be safely performed in geriatric patients. Because of high morbidity and mortality associated with incarceration, elective repair of inguinal hernia under local anesthesia should be done whenever possible.
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PMID:Inguinal and femoral hernia repair in geriatric patients. 707 6

The Authors operated on a series of 173 patients with direct, indirect or relapsing hernia and crural hernia by Mc Vay's surgical procedure, of which they outlined the salient aspects. The study led to some statistical considerations with regard to the rate and time of appearance of the various types of subject hernia in the two sexes and also evidenced two cases of post-operative complication very probably due to the technique used. The follow-up evidenced only one case of relapse. Despite the small number of cases and the restricted nature of the follow-up, which varied from two years to six months, the Authors consider that Mc Vay's plastic surgery constitutes a highly reliable technique for treatment of both primitive and relapsing hernias. Particular practical interest attaches to the observation that 90% of patients were operated under epidural anaesthesia, which, given parity of results from the surgical standpoint, involves a considerably lower anaesthesiological risk than other types of anaesthesia.
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PMID:[Surgical treatment of inguinal hernias, using the McVay technic]. 708 24

Endorphin levels in human cerebrospinal fluid (CSF) have been determined by using the electrically stimulated mouse vas deferens bioassay. Endorphins were extracted by adsorption to a synthetic resin of Amberlite XAD-2 eluted with methanol, and dried under a nitrogen atmosphere. Three different groups of patients have been studied: a) control subjects without a history of pain (n = 25), b) patients with acute postoperative pain after high abdominal and thoracic surgery (n = 8) and c) patients with chronic pain due to discal hernia (n = 14). The endorphin levels (expressed as equivalents of Met-E) obtained from the control group were 4.36 +/- 0.7 pmol/ml. In the postoperative group an endorphin decrease of 0.42 +/- 0.07 pmol/ml, was found while in the chronic pain group the levels obtained were 1.39 +/- 0.2 pml/ml. Thus a significantly low level of CSF endorphins was observed in both the postoperative and the chronic pain group as compared with the controls (p less than 0.01). These results suggest a correlation between pain levels and endorphin concentration in CSF. However in the acute postoperative pain group other factors such as depletion of endorphins by drugs used for anesthesia or due to surgical stress cannot be excluded.
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PMID:[Measurement of endorphins in human cerebrospinal fluid. Comparative study of various groups of patients]. 715 54

A patient with an unsuspected phaeochromocytoma presented with transient hypertension during anaesthesia for an elective hernia repair, and developed severe post-operative hypotension. The management of this acute crisis, appropriate preoperative preparation and the subsequent successful removal of the tumour is described. Awareness of this unusual presentation may help the attending physician to save such a patient.
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PMID:Unsuspected phaeochromocytoma presenting during surgery. 728 89

The clinical examination, anaesthesia and surgery in a gelding with an incarcerated scrotal hernia are described. The results of examination of the blood at regular intervals are shown in a table. Surgery was performed without enterectomy. The postoperation course was uneventful. It is concluded that the possibility of scrotal hernia should be borne in mind, even in geldings with colic. The incarcerated portion of the small intestine is usually found to be the jejuno-ileal junction. The anaesthesiological and surgical features of equine scrotal hernia are discussed.
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PMID:[Incarcerated scrotal hernia in a gelding (author's transl)]. 737 67

The degree of anxiety of 26 male and female patients undergoing hernia repair while receiving lumbar extradural anaesthesia was measured using the galvanic skin response. The single, most anxiety-provoking feature during the surgical procedures proved to be verbal interactions directly concerned with the patient's well-being. The psychological implications of this feature are discussed.
Anaesthesia 1980 Aug
PMID:Emotional reactions during lumbar extradural anaesthesia. 744 23

The authors report their experience of a new surgical technique for inguinal hernia repair. This operation first introduced by Lichtenstein is accurately described by the authors. This kind of hernia repair was introduced in our operative unit because we think that the first cause of recurrence is the approximation of normally unopposed tissue under tension. This concept permits hernia repair without any suture line tension. For this principle the authors have been employing for one year the tension-free herniolplasty technique that was described by Lichtenstein. The authors consider a preliminary report of 144 cases in view of the long term follow-up; however, the results to date have been extremely satisfying: no infection has happened, no painful drugs was used, local anesthesia was usually employed, thus allowing intraoperative testing; early recovery. Finally, the technique is simple, rapid, relatively less painful, safe and effective.
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PMID:[Free tension in inguinal hernioplasty]. 747 69

All standard methods of hernia repair involve suturing together tissues which are not normally in apposition. This violates the basic surgical principle that tissue must never be approximated under tension and thus accounts for an unacceptable number of failures. A total reinforcement of the inguinal floor with a sheet of suitable biomaterial and the employment of a "tension-free" technique is a more effective approach. Since June 1984, 4,000 primary inguinal hernias have been repaired on an outpatient basis and under local anesthesia at the Lichtenstein Hernia Institute by the open "tension-free" technique using Marlex mesh. The patients were followed from 1 to 11 years by physician examination. The follow-up rate was 87%. There were four recurrences. The causes of recurrence and how to avoid them are herein discussed. Three of the recurrences occurred at the pubic tubercle and were caused by placing the mesh in juxtaposition to the tubercle. This error has since been corrected by overlapping the mesh at the pubic bone. One recurrence was caused by a disruption of the lower edge of the mesh from the shelving margin of Poupart's ligament. The error here was the utilization of a patch that was too narrow and therefore under tension. It became apparent that a wider patch, fixed in place with an appropriate degree of laxity, was required.
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PMID:The Lichtenstein open "tension-free" mesh repair of inguinal hernias. 754 74


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