POSTER ABSTRACTS <strong>SAGES</strong> <strong>2005</strong> P310–Flexible Diagnostic & Therapeutic Endoscopy ENDOSCOPIC REMOVAL OF SIGMOID COLON FOREIGN BODY: WHAT TO DO WITH A TRAPPED BREAD BAG CLIP?, K J Wirsing MD, D E Scheeres, M.D., FACS, Grand Rapids General Surgery Residency Program, Grand Rapids, MI Introduction: Ingestion of plastic bread bag clips is a rare but potentially life threatening cause of bowel obstruction or perforation. At least 25 cases of ingestion of this foreign body have been reported in the medical literature. We present a patient who presented with rectal pain and bleeding after she unknowingly swallowed a plastic bread bag clip, and review the literature on this topic as well as the relevant anatomy. Case: A 59 year-old female presented with intermittent hematochezia. Colonoscopy revealed a foreign body 35 cm from the anal verge, which was identified as a plastic bread bag clip. Its two teeth had encircled a haustral fold and eroded through its base, creating a colo-colonic fistula which trapped the clip in the colonic mucosa. Attempts to forcibly remove the bag clip using a polypectomy snare, endoscopic scissors, and toothed forceps failed. Following a mechanical and antibiotic bowel prep, a flexible sigmoidoscopy was performed. An endoscopic sphincterotomy catheter was passed under the haustal fold through the fistula, and the opening was enlarged by cutting the haustral band with the wire directed towards the colonic lumen. After this, the tip of a snare device was used to incise the top of the haustrum in a longitudinal fashion to reduce the size of the fold trapping the bread bag clip. The clip was then grasped with rat-tooth forceps and manipulated until it disengaged from the haustrum. The foreign body was removed with no radiographic evidence of bowel perforation and an uneventful observation overnight in the hospital. Conclusion: Bread bag clips that become entrapped on mucosal surfaces can be difficult to remove. Use of an endoscopic sphincterotomy catheter and a polypectomy snare to cut the mucosal fold has not been described in the literature, and is a safe method to remove this foreign body from the colon. P311–Hernia Surgery COMPARATIVE STUDY OF INCIDENCE OF WOUND INFEC- TION, PAIN AND QUALITY OF LIFE IN PATIENTS UNDERGO- ING INGUINAL HERNIA MESH REPAIR BY LAPAROSCOPY AND OPEN METHOD, Sandeep Aggarwal MD, Arvind Kumar MD,Madhusudan MD,Rajinder Parshad MD,Sandeep Guleria MD,Hemraj Pal* MD, Department of Surgical Disciplines and Psychiatry* All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India ABSTRACT TITLE: Comparative Study of incidence of wound infection, pain and quality of life in patients undergoing inguinal hernia mesh repair by laparoscopy and open method BACKGROUND Laparoscopic surgery for inguinal hernia is gaining increasing popularity, both among the patients as well as surgeons. The main reported benefits of the laparoscopic approach to unilateral inguinal hernia repair are decreased postoperative pain and decreased wound infection rate. In recent years, the outcomes of different health care interventions have been assessed in terms of quality of life. Therefore we did a prospective non-randomized study to compare the incidence of wound infection, pain and quality of life in patients undergoing inguinal hernia repair by laparoscopic and open methods. Methods Between January 2002 and November 2003, 90 patients above 15 years of age with a clinical diagnosis of uncomplicated unilateral inguinal hernia were assigned to open method of hernia repair by Lichtenstein technique (Group A, n=60) and laparoscopic hernia repair (Group B, n=30). RESULTS There was no significant difference in wound infection rate between the two groups. The pain scores were higher in the open group in the early postoperative period. At the end of three months following surgery, the pain scores were similar in the two groups. However, there was no difference in the quality of life in the two groups at any time in the postoperative period ( at the end of one week, 1 month and 3 months). CONCLUSIONS Laparoscopic repair of unilateral inguinal hernia offers no advantage over open repair in terms of improved quality of life. However the pain scores are lower in the early postoperative period in the laparoscopy group allowing early mobilisation and possible early return to work. P312–Hernia Surgery MINILAPAROSCOPIC INGUINAL HERNIA REPAIR, Ferdinando Agresta (1) MD, Emanuele Santoro (2) MD,Luigi Francesco Ciardo (1) MD,Giacco Mulieri (2) MD,Natalino Bedin (1) MD,Massimo Mulieri (2) MD, (1) Dept. of General Surgery, Civil Hospital, Vittorio Veneto (TV); (2) Dept. of General Surgery ?Nuovo Regina Margherita? Hospital, Rome - Italy. INTRODUCTION: Laparoscopy has recently been characterised by an increasing development of smaller laparoscopes, trocars and operative instruments, thus in order to minimise more nerve and muscle damage and to optimise aesthetical results. As a consequence minilaparoscopy has been gradually employed in the treatment of several pathologies. Minilaparoscopic surgery has recently commenced in the treatment of inguinal hernias, similar to its ?major sister? laparoscopy. The indications for latter are well defined (bilateral or recurrent hernias or patients desiring or requiring a fast recovery to resume normal activities), however not completely clear is the feasibility of the minilaparoscopic technique. The aim of this study is to evaluate retrospectively the last three years of patients who underwent minilaparoscopic transabdominal inguinal hernia repair (miniTAPP) at Our Institutions. Materials and Methods: Between February 2000 and December 2003 a total of 303 patients (mean age 45 years) underwent a miniTAPP procedure. Amongst them, 213 (70.2%) were operated on for a bilateral diseases and 90 (28.7%) for a monolateral defect, with a total of 516 hernia defects repaired. Results: No conversion to laparoscopy or anterior open approach was registered. Major complications were nil whilst minor occurance ranged as high as 0.3%. Hospital stay was the same as a laparoscopic approach with a faster recovery to a normal activity and less analgesic requirement CONCLUSIONS: On the basis of our initial experience minilaparoscopic preperitoneal transabdominal hernioplasty is feasible, effective and easy to perform (without any increase in technique difficulties) in experienced hands. MiniTAPP provides positive and comparable results concerning the operative time, the post op. morbidity and hospitalisation as the classical LAP. Sparing patients a wider skin incision in the trocars site might reduce postoperative pain, increase prompt recovery of gastrointestinal functions, shorten hospitalisation, help contain health-care costs and increases cosmesis. This approach appears to play a crucial role in the laparoscopic approach of all kind of hernias in patients not previously having had abdominal surgery. P313–Hernia Surgery LAPAROSCOPIC VS. OPEN INCISIONAL HERNIA REPAIR: A COMPARATIVE STUDY., C G Andrew MD, L S Feldman MD,W Hanna,S Bergman MD,M Vassiliou MD,S Demyttenaere MD,D Stanbridge RN,G M Fried MD, Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, Canada. Introduction: Laparoscopic incisional hernia repair (LIHR) has been shown to be safe and feasible. However, comparative studies have had conflicting results. Our goal was to compare short-term outcomes and recurrence rates after laparoscopic vs. open incisional hernia repair (OIHR). Methods: Charts were reviewed of all patients who had elective mesh repair of incisional hernia at a single institution over a two year period. Patients were contacted by telephone and subsequently examined in clinic. Using an intention-to-treat analysis, LIHR (n=42) and OIHR (n=97) data were compared using Student?s T, Chi Square, and rank sum tests. Results: Both groups were similar with respect to age, gender and ASA. There were more morbidly obese patients in the 208 http://www.sages.org/
POSTER ABSTRACTS LIHR group (27.5% vs. 10.3%, p=0.01) and more patients with previous incisional hernia repair (48.8% vs. 27.8%, p=0.01). Mean operative time was greater in the LIHR group (129+/-19 minutes vs.105+/-12 minutes, p=0.04); however, median hospital stay was shorter (1.0, range 0.5-24 days vs. 3.0, range 0.5- 53 days, p0.05, histiocyte p>0.05, gaint cell p>0.05, p>0.05, vascular proliferation p>0.05, fibroblast proliferation p>0.05, collagen p>0.05). There was a significant difference between 3 groups regarding to adhesion formation (X2: 7,287, SD:2, p:0,026). The difference was coming from the PM group. PM group was significantly adhesive than the other groups. There wasn?t a significant difference between SM and PM+IC groups (p>0.05). There was a significant difference between these 3 groups regarding to dissection difficulty (X2:13,322 SD:2, p:0,001). The significant difference occurred due to the PM group. There wasn?t a significant difference between SM and PM+IC groups (p>0.05). Conclusion: SM and PM+YC adhesion barrier can be safely used in incisional hernia repair to prevent intraabdominal adhesions. As a surgical technique the SM application is much easier than PM+IC, however; PM+IC application is much cheaper than the SM application. http://www.sages.org/ <strong>SAGES</strong> <strong>2005</strong> 209
- Page 1 and 2:
ABSTRACTS Thursday, April 14, 2005
- Page 3 and 4:
ABSTRACTS Thursday, April 14, 2005
- Page 5 and 6:
ABSTRACTS Thursday, April 14, 2005
- Page 7 and 8:
ABSTRACTS Thursday, April 14, 2005
- Page 9 and 10:
ABSTRACTS Thursday, April 14, 2005
- Page 11 and 12:
ABSTRACTS Thursday, April 14, 2005
- Page 13 and 14:
ABSTRACTS Thursday, April 14, 2005
- Page 15 and 16:
ABSTRACTS Thursday, April 14, 2005
- Page 17 and 18:
ABSTRACTS Friday, April 15, 2005 en
- Page 19 and 20:
ABSTRACTS Friday, April 15, 2005 an
- Page 21 and 22:
ABSTRACTS Friday, April 15, 2005 to
- Page 23 and 24:
ABSTRACTS Friday, April 15, 2005 to
- Page 25 and 26:
ABSTRACTS Friday, April 15, 2005 in
- Page 27 and 28:
ABSTRACTS Friday, April 15, 2005 co
- Page 29 and 30:
ABSTRACTS Friday, April 15, 2005 Co
- Page 31 and 32:
POSTER ABSTRACTS Posters of Distinc
- Page 33 and 34:
POSTER ABSTRACTS P076 MURPHY, JASON
- Page 35 and 36:
POSTER ABSTRACTS P152 CHOKKI, ADEL
- Page 37 and 38:
POSTER ABSTRACTS P235 YASUI, M “L
- Page 39 and 40:
POSTER ABSTRACTS P312 AGRESTA, FERD
- Page 41 and 42:
POSTER ABSTRACTS FUNDOPLICATION TO
- Page 43 and 44:
POSTER ABSTRACTS In two groups of 5
- Page 45 and 46:
POSTER ABSTRACTS Carvalho PhD, Debo
- Page 47 and 48:
POSTER ABSTRACTS tive procedures on
- Page 49 and 50:
POSTER ABSTRACTS invasive procedure
- Page 51 and 52:
POSTER ABSTRACTS allows identificat
- Page 53 and 54:
POSTER ABSTRACTS Laparoscopic gastr
- Page 55 and 56:
POSTER ABSTRACTS Results: A total o
- Page 57 and 58:
POSTER ABSTRACTS P054-Bariatric Sur
- Page 59 and 60:
POSTER ABSTRACTS laparoscopic Gastr
- Page 61 and 62:
POSTER ABSTRACTS P070-Bariatric Sur
- Page 63 and 64:
POSTER ABSTRACTS becomes increasing
- Page 65 and 66:
POSTER ABSTRACTS MD,Ajay K Chopra M
- Page 67 and 68:
POSTER ABSTRACTS to have a fewer co
- Page 69 and 70:
POSTER ABSTRACTS RESULTS: The mean
- Page 71 and 72:
POSTER ABSTRACTS surgeons working i
- Page 73 and 74:
POSTER ABSTRACTS One patient had un
- Page 75 and 76: POSTER ABSTRACTS operative time, na
- Page 77 and 78: POSTER ABSTRACTS divided to two maj
- Page 79 and 80: POSTER ABSTRACTS tomies during this
- Page 81 and 82: POSTER ABSTRACTS tumor. Discussion:
- Page 83 and 84: POSTER ABSTRACTS to avoid dissemina
- Page 85 and 86: POSTER ABSTRACTS sure of a gastric
- Page 87 and 88: POSTER ABSTRACTS subjects had used
- Page 89 and 90: POSTER ABSTRACTS (CS2) tasks, and 5
- Page 91 and 92: POSTER ABSTRACTS P180-Education/Out
- Page 93 and 94: POSTER ABSTRACTS laparoscopic equip
- Page 95 and 96: POSTER ABSTRACTS defined borders, a
- Page 97 and 98: POSTER ABSTRACTS B1.1?}0.3days, p =
- Page 99 and 100: POSTER ABSTRACTS P210-Hepatobiliary
- Page 101 and 102: POSTER ABSTRACTS P218-Basic Science
- Page 103 and 104: POSTER ABSTRACTS P225-Complications
- Page 105 and 106: POSTER ABSTRACTS perforated. Result
- Page 107 and 108: POSTER ABSTRACTS J Lomax MD,Christi
- Page 109 and 110: POSTER ABSTRACTS METHODS: A databas
- Page 111 and 112: POSTER ABSTRACTS 3=severe). A total
- Page 113 and 114: POSTER ABSTRACTS silluminated the a
- Page 115 and 116: POSTER ABSTRACTS Introduction Radic
- Page 117 and 118: POSTER ABSTRACTS and GERD symptom s
- Page 119 and 120: POSTER ABSTRACTS performed followed
- Page 121 and 122: POSTER ABSTRACTS this practice by t
- Page 123 and 124: POSTER ABSTRACTS Esophageal aperist
- Page 125: POSTER ABSTRACTS were rejected for
- Page 129 and 130: POSTER ABSTRACTS adhesion between p
- Page 131 and 132: POSTER ABSTRACTS P328-Hernia Surger
- Page 133 and 134: POSTER ABSTRACTS urement tools. Rat
- Page 135 and 136: POSTER ABSTRACTS CONCLUSION: The su
- Page 137 and 138: POSTER ABSTRACTS Results: 7 perfora
- Page 139 and 140: POSTER ABSTRACTS MS,Susan Hallbeck
- Page 141 and 142: POSTER ABSTRACTS All complications
- Page 143 and 144: POSTER ABSTRACTS In the past we foc
- Page 145 and 146: POSTER ABSTRACTS Materials and Meth
- Page 147 and 148: POSTER ABSTRACTS total traveling di
- Page 149 and 150: POSTER ABSTRACTS Patients in both g
- Page 151 and 152: POSTER ABSTRACTS P406-Solid Organ R
- Page 153 and 154: POSTER ABSTRACTS stay period was 1.
- Page 155 and 156: EMERGING TECHNOLOGY LUNCH ORAL ABST
- Page 157 and 158: EMERGING TECHNOLOGY LUNCH ORAL ABST
- Page 159 and 160: EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 161 and 162: EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 163 and 164: EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 165 and 166: EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 167 and 168: EMERGING TECHNOLOGY LUNCH POSTER AB