Marco Paul

Polyurethane-covered dacron mesh versus polytetrafluoroethylene DualMesh for intraperitoneal hernia repair in rats.

Abstract.Purpose: Abdominal hernia repair using the intraperitoneal implantation of a prosthesis requires mesh with impervious properties, such as expanded polytetrafluoroethylene (ePTFE). A newly developed polyurethane-covered polyester mesh with impervious properties has recently been introduced as a less expensive alternative to PTFE, and we compare these materials herein. Methods: The adhesion formation and stability of intraperitoneal abdominal hernia repairs with DualMesh (macroporous ePTFE mesh with a microporous component) and PolyesterComposite (the newly developed polyurethane-covered Dacron mesh) were compared in a rat model. Forty rats were randomly divided into two groups; ten animals from each group were killed after 14 days, and the other ten after 90 days. Results: The number and intensity of adhesions were comparable in the PolyesterComposite and PTFE groups. Loose adhesions were seen in 13 animals and appeared only selectively at the fixation sutures. Both PolyesterComposite and PTFE induced the formation of a smooth neoperitoneum on the intraperitoneal surface and showed a complete ingrowing of the prosthesis in the surrounding tissue. There were no significant differences between the prostheses in terms of clinical herniation pressure and hydroxyproline concentration. Conclusions: PolyesterComposite and PTFE are both suitable prostheses for intrapertoneal implantation, but PolyesterComposite is less expensive, which is an important advantage for clinical use.

Sexual function before and after mesh repair of inguinal hernia

Abstract Aim:  Several factors having an influence on the quality of life after an inguinal hernia repair have been studied, yet little has been reported on sexual function before and after this operation.

First clinical experience with a video presentation informing patients before surgery for inguinal hernia

ZusammenfassungHintergrundPatienteninformationen und -aufklärung als wichtiger Bestandteil chirurgischer Behandlung leiden unter dem zunehmenden Zeitdruck des ärztlichen Personals.Material und MethodenAls ergänzende Informationsquelle wurde ein Video zur Leistenhernienoperation produziert, in dem anschaulich das Krankheitsbild, die Operation inkl. Aufklärung sowie alle relevanten perioperativen Aspekte erläutert und vor Originalkulisse dargestellt wurden. Im Rahmen einer prospektiv-vergleichenden Beobachtungsstudie wurde die Dauer der chirurgischen Aufklärung, die Bewertung der Aufklärungsqualität, die Patientenzufriedenheit sowie die Dauer der stationären Behandlung bzw. Arbeitsunfähigkeit bei Leistenhernienpatienten mit (n=50) bzw. ohne Video (n=50) verglichen.Ergebnisse und SchlussfolgerungZusammenfassend zeigte sich, dass in der Videogruppe nicht nur die Aufklärungszeit kürzer (p<0,05), sondern auch die Patientenbewertung zum Informationsgehalt sowie zur Gesamtzufriedenheit höher (p>0,05) waren bei vergleichbarer Dauer für die stationäre Behandlung und Arbeitsunfähigkeit. Das vorgestellte Informationsvideo ließ sich problemlos in den klinischen Alltag etablieren und führte neben einer Zeitersparnis bei der Aufklärung zu einem deutlichen Zuwachs an Informationsempfinden und Zufriedenheit beim Patienten.AbstractBackgroundAlthough it is a significant part of surgical treatment, informing patients beforehand seems to be more and more neglected, mainly due to the enormous amount of work and time pressure on surgical personnel.Material and methodsA video clip explaining groin hernia surgical repair was produced as additional information for patients. In it, visual material from actual practice describes the disease, the operation itself, all the perioperative aspects, and patients’ own experiences. In a prospective comparison study, the length of patient education, its quality, patient satisfaction, and the duration of hospitalization and time off work were compared between patients who saw the video clip (n=50) and those who did not (n=50).Results and conclusionIn summary, the time spent informing the video group was shorter (P<0.05) and their total satisfaction and evaluation of the information material were both higher (P>0.05) for comparable duration of treatment and time off work. This informative video was adopted without problems in our daily clinical life and, besides reducing the time needed to inform patients, it has significantly improved patient understanding of the operative procedure and their satisfaction with treatment.

Prevention of catheter disconnection after laparoscopic adjustable gastric banding.

In a consecutive series of 138 laparoscopic adjustable gastric bandings (LAGB) we observed disconnection of the gastric band catheter at the site of the port connector in 17 patients. During operative revision we established a new port position with a minimal distance of 10 cm between the connector and the entrance of the catheter to the abdominal cavity. Using this technique no complications and no catheter disruptions occurred during a median followup period of 25 months.