Oktay Yener

Self-gripping Covidien™ ProGrip™ Mesh versus Polypropylene Mesh in Open Inguinal Hernia Repair: Multicenter Short Term Results

The purpose of this study was to compare clinical outcomes following sutureless ProGrip™ mesh repair to traditional Lichtenstein repair with polypropylene mesh secured with sutures. Data were collected prospectively and were analyzed for 57 male and 3 female patients with 60 inguinal hernias. All patients included underwent open surgical repair for inguinal hernia with polypropylene mesh or ProGrip mesh. In our two centres study sixty patients were operated; 30 were treated with Lichtenstein repair with polypropylene mesh (L group) and 30 with ProGrip mesh (P group) with or without fixation. The primary parameter measured was intensity of postoperative pain using visual analogue scale (VAS); other outcomes included assessment of early and late complication. VAS was assessed in 7 days and 4 months of the postoperative period. Our results show that VAS scored at the 7th postoperative day was 1.5 for the ProGrip mesh versus 4.4 in Lichtenstein repair group. The difference between groups was statistically significant (P=0.001). Surgery duration was significantly shorter in the P group (24.9 vs. 58.3 min; P=0.001). No recurrence was observed at 3 months in both groups. The 3-months follow-up has shown that time necessary to return to daily routine activity was significantly lower in the P group during the (P=0.001). Surgery duration, early and late postoperative, pain and return to daily routine activity rates were significantly reduced with self-gripping ProGrip mesh compared to Lichtenstein repair with polypropylene mesh.

Agenesis of the gallbladder diagnosed by magnetic resonance cholangiography: report of a case and review of the literature.

Gallbladder agenesis (GA) is a rare congenital anomaly of the biliary system often associated with other congenital abnormalities. Patients become symptomatic in 23% of cases (Richards et al., 1993). GA is often misinterpreted as other diseases, therefore, leading to unnecessary surgery. Many of these patients develop a typical symptomatology of cholelithiasis that leads them to operating theatre. If an operative procedure is done, it is better to remain at the level of laparoscopy because further surgical investigation may lead to detrimental biliary tract injuries (Waisberg et al., 2002). We present a case of GA, diagnosed by magnetic resonance with cholangiopancreatography.

Giant post-traumatic cyst after motorcycle injury: a case report with review of the pathogenesis

Post-traumatic cysts of soft tissue usually occur at the junction of the subcutaneous fat and deep fascia, most often filled with serosanguinous fluid and lined with fibrous tissue. It appears as complication after severe injuries when crushing and shearing forces cause separation of the skin and subcutaneous fat from the deep fascia and muscle, creating a cavity filled with hematoma and liquefied fat. This rare condition calls Morel-Lavallee lesion, which was first described by this French physician in 1853 (Sterling et al., 1977; Tull and Borrelli, 2003). Magnetic resonance imaging is the modality of choice for detection and revealing the exact size and location of these lesions. The best method of treatment is surgical excision with complete resection.

Intestinal ischaemia associated with carcinoid tumor: a case report with review of the pathogenesis.

Carcinoid tumors are rare, slow-growing neuroendocrine neoplasms that are often indolent and may not become clinically apparent until there is a metastatic spread or evidence of carcinoid syndrome. A 44-year-old man presented to our clinic department with a history of previous left colon cancer operation, chronic crampy left lower quadrant pain, mass and severe anemia. A MR scan was obtained which demonstrated a calcified mesenteric mass 12×8×10 cm diameter with surrounding left colon mesenteric infiltration. The liver was normal. A case of ischaemic ileal necrosis is reported. It was associated with elastic vascular sclerosis produced by mesenteric metastases of an ileal carcinoid tumor. It is postulated that intestinal ischaemia may be of more importance in the production of abdominal pain by carcinoid tumors than has been generally accepted, and that it is the result of functional and structural changes in and around the mesenteric blood vessels, caused by substances secreted by the carcinoid tumor.

Intussusception Secondary to a Meckel Diverticulum in an Adolescent

Adult intussusception caused by an inverted Meckel diverticulum is rare. We report a 39-year-old Turkish man with intussusception due to Meckel diverticulitis. Ileoileal intussusception was suggested by computed tomography. Exploration revealed ileoileal intussusception with Meckel diverticulum. A diverticulectomy with small bowel resection was performed.

Difficult cases of inguinal hernia repair: 12 cases aged 65 years and over

Two hundred and forty-nine cases of inguinal hernia operated on at Medeniyet University Goztepe Training and Research Hospital from 2010 to 2012 were reviewed retrospectively. Malignancy was present as a comorbid disease in twelve patients, ten of whom were male and two female. Eleven cases were operated on electively and one case was operated on in an emergency setting. The average duration of hospital stay was 2.7 days. No mortality was recorded. Nowadays, notwithstanding the increased risk due to comorbid diseases, consensus advocates routine surgery for inguinal hernia repair in patients aged 65 years and over.

Partial caecal necrosis

Non-occlusive caecal infarction is a rare condition that has been described in association with a variety of clinical entities, generally due to a low-flow state, and has been reported to occur in association with chronic heart disease, open-heart surgery, certain drugs, and haemodialysis.We report on an 80-year-old female with known chronic heart disease and chronic renal failure presenting with right lower abdominal quadrant pain, tenderness and leukocytosis. Intraoperatively, caecal necrosis was confirmed, while the appendix and the remainder of the intestine appeared normal. Ileocaecal resection and anastomosis was performed. Histopathologic analysis demonstrated isolated transmural caecal necrosis as a consequence of nonocclusive ischaemic colitis. The patient made a complete recovery and was discharged from the hospital on the fifth postoperative day without any surgical complications.

A rare tumour of the breast: Carcinosarcoma

We present a 55-year-old female patient with a mass in her right breast characterized by rapid growth and positive axillary lymph-nodes. The frozen section showed an aggressive malignacy of carcinosarcoma also known as metaplastic carcinoma which is a very rare tumour that accounts for just 0.08–0,2% of all brest cancers. We proceeded to perform a right modified radical mastectomy. We discuss the properties of this rare tumour and therapeutic challenges.

Missed Lipoma of the Spermatic Cord

The aim of the research was to determine the incidence, significance, and anatomy of spermatic cord and round ligament lipomas. Between 2000 and 2010 we evaluated 969 consecutive patients with 1,070 indirect inguinal hernias, who underwent open repair. A total of 22 lipomas of the spermatic cord or round ligament were identified and resected in 22 patients. No neoplastic changes confirmed in histopathologic examinations of the specimens were reported. Lipomas of the cord and round ligament occur with a considerable incidence. We believe that even if there is no peritoneal sac, the herniation of extraperitoneal fat through the inguinal canal should be counted as an inguinal hernia, and it requires adequate treatment.