Faculty of Medicine

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Author: search.filters.author.Risto SimeonovSubject: search.filters.subject.inguinal hernia

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    FIRST EXPERIENCES WITH LAPAROSCOPIC HERNIOPLASTY IN THE TREATMENT OF INDIRECT INGUINAL HERNIAS IN FEMALE CHILDREN
    (2018)
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    Risto Simeonov
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    Introduction: Inguinal hernia is one of the most performed operations in pediatric surgery, and it is the most common reason for consulting a pediatric surgeon. The incidence of indirect inguinal hernia in children is 0.8-4.4%. There are more operative methods of open surgical and minimally invasive laparoscopic techniques. Aim: The aim of this study is to identify the descriptive characteristics of the initial cases of applying a laparoscopic hernia repair technique for the treatment of female children diagnosed with congenital indirect inguinal hernia. Materials and method: This is a descriptive study with collected clinical data from the University Clinic of Pediatric Surgery in Skopje. The sample, collected in the period 2015-16, covers a total of ten girls aged 0-14 years, who were clinically diagnosed with indirect inguinal hernia.The patients underwent PIRS(percutaneous internal ring suturing) techique.Results: The average age of the patients was 68,3 ± 34,2 months with a minimum of 24 and maximum of 168 months. According to the location of the inguinal hernia, in 7 (70%) patients it was right-sided, in 2 (20%) it was left-sided, and in 1 (10%) it was bilateral. During the laparoscopic exploration of the inguinal hernia repair there was an incidental finding of two contralateral occult inguinal hernias that were sutured with the same technique in a single act. In 50% of the patients the intervention lasted less than 25 (23-31) minutes. The length of the hospital stay was 10,8 ± 3,1 hours. The shortest hospital stay was 8 hours and the longest 16 hours. Fifty percent of the children took up a sitting position in bed in less than 4 hours. The average time for taking up a sitting position was 4,1 ± 0,9 hours with a minimum of 3 and maximum of 6 hours. Post-operative analgesia single dose was given to only 2 (20%) of the children. The length of the surgical scar in 50% of the children is less than 2mm. During the 6 month post-operative follow-up period, there were no recurrent findings of hernia in any of the cases. Conclusion:The laparoscopic technique of percutaneous closure of the internal inguinal ring in the treatment of inguinal hernia in female children is a minimally invasive procedure with preferable advantages in terms of reduced post-operative pain, reduced hospital stay, rapid return to normal activities as well as an excellent cosmetic effect.
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    Topical treatment of minor facial burns in pediatric patients
    (2017)
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    Risto Simeonov
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    Vladimir Chadikovski
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    Introduction Inguinal hernias have been treated traditionally with conventional methods, but the trends have changed with the introduction of minimal access surgery.The study aims to compare the open technique versus laparoscopic assisted technique of percutaneous closure of the internal inguinal(PIRS).Materials and methods: The study is done at the University Clinic for Pediatric Surgery in Skopje in the period 2016/17. There are analyzed 30 female children aged 1-14 years with clinically diagnosed indirect inguinal hernia.Results: The average duration of the intervention in the experimental or control group was 25,1 ± 6,1 v.s 44,8 ± 6,3 minutes. The length of hospital stay in the two groups is consequently 10,7 ± 2,1 v.s 25,2 ± 3,3 hours. The shortest stay was 8 v.s 24 hours and the longest 17 v.s 26 hours. All children in the experimental group took up a normal position in bed for less than 3 hours compared to the control group in which it accounted for 5 hours. The average length of the mark is 1,9 ± 0,9mm in the test and 24,8 ± 17,4mm in the control group. Analgesia because of pain is given in 3 (20%) children in the test group and on 7 (46,6%) in control group. Easy impressive scar have 8 (53,3%) patients in the control group and no patient in the experimental group. The mark does not disturb the aesthetics in 9(60%) of patients in the experimental group and in 2 (13,3%) in the control group. Conclusion: Laparoscopic assisted technique of percutaneous closure of the internal inguinal ring is minimally invasive method and is totally safe for the treatment of inguinal hernias in children with special advantage for females.