Objective: Totally extraperitoneal (TEP) surgeries were considered contraindicated in patients who underwent lower abdominal surgery until recently. However, in recent surgeries, it has been reported that they can be performed safely in those cases. Our aim in this study is to investigate the effectiveness of laparoscopic hernia repair methods in patients who have and have not had lower abdominal surgery before. Patients and Method: This study was a prospective observational study between May 2018 and May 2023. Two hundred eighty-eight patients were included in the study. The operation was started with the TEP technique in all patients. Patients, classified in two groups who had not previously undergone abdominal surgery (n = 216) (Group I) and who had surgery (n = 72) (Group II). Demographic characteristics of patients, intraoperative and postoperative complications were determined. In addition to descriptive statistical methods (mean, standard deviation), Shapiro-Wilk normality test, independent t test, and chi-square test were used to evaluate the data. Logistic regression analysis was performed to determine the factors affecting the presence of Previous Surgery and Peritoneal Tear. Results were evaluated at the significance level of P < .05. Results: Two hundred fifty-nine patients were operated with TEP method. TEP method was converted to transabdominal preperitoneal (TAPP) in 9 patients from Group I and 20 patients from Group II. Intraoperative and postoperative complications were recorded. Conclusion: With increasing experience in laparoscopic hernia surgery, it is now possible to perform hernia surgeries with preperitoneal (TEP) and abdominal approaches (TAPP) in patients who have previously undergone lower abdominal surgery.

Objective: Laparoscopic Total Extraperitoneal (TEP) hernia repair is frequently performed around the world. Ourgoal here was to evaluate preoperative radiologic findings, intraoperative and postoperative conditions of cases, together with their demographic characteristics, in unilateral, bilateral primary and recurrent cases undergoing hernia operation. Methods: Between 2011 and 2021, 512 patients were operated for hernia with laparoscopic TEP method. Age, gender, BMI, hernia type, radiologic or peroperative type of hernia, defect size measured during surgery, hernia side, content of hernia, postoperative complications(seroma) of these patients were evaluated retrospectively. Additionally to the expressive statistical procedures (mean, standard deviation) in interpriting and calculating the input, the allocations of the variables were analyzed by the Shapiro-Wilk normality test. Also the independent t test, chisquare test, and logistic regression analysis used. The outcome spicked up were analyzed with p

Purpose Diverting ileostomies are routinely created during low rectal cancer surgery, yet 15–30% remain permanent. Understanding predictors of non-reversal is essential for informed patient counseling. This study investigated factors preventing ileostomy closure following colorectal surgery, primarily for rectal malignancy. Methods This retrospective cohort study analyzed prospectively collected data from patients undergoing diverting ileostomy creation (January 2015–December 2020). Exclusions included early postoperative mortality (within 30 days), follow-up less than 6 months, or missing primary outcome data. Demographics, surgical details, and reversal outcomes were analyzed. Multivariable logistic regression identified independent predictors of non-reversal. Results Of 508 patients, 456 met inclusion criteria (mean age 58.9 ± 13.2 years, 63.8% male). Malignancy accounted for 96.7% of cases, with low anterior resection performed in 83.8%. Ileostomy closure was achieved in 364 patients (79.8%) at a median of 6 months (mean 7.4 ± 5.3). The non-reversal rate was 20.2% (92 patients). Main reasons included mortality (35.8%), metastatic disease (23.9%), and anastomotic complications (22.8%). Multivariable analysis identified ASA score 3–4 (OR 2.68, 95% CI 1.58–4.54, p < 0.001) and malignant pathology (OR 5.12, 95% CI 1.23–21.3, p = 0.025) as independent predictors of non-reversal. Age showed statistical but limited clinical significance. Conclusion One in five patients with diverting ileostomies will not undergo reversal. High ASA scores, malignant disease, mortality, metastatic progression, and anastomotic complications are primary barriers. These findings emphasize the need for realistic preoperative counseling regarding permanent stoma risk.

Background: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors for incisional hernia were evaluated with surgical outcomes. Results: 76 patients were included. Mean age was 46 ± 8.1 years. Bulging (81.5%), pain or discomfort (57.8%) and distention (31.5%) were the most common symptoms. We combined ultrasonography (90.7%) with contrasted tomography (71%) or magnetic resonance imaging (30%) for surgical planning. Risk factors were found as multiple previous CSs, local wound complications such as seroma, hematoma or abscess, body mass index >25, smoking, pregnancy-induced diabetes mellitus, emergency CS, and inadequate surgical technique (each, p < 0.05). In open technique (51.3%), fascia was closed by polydioxanone suture, with onlay mesh fixation. In laparoscopic hernioplasty (48.6%), tacker was used for mesh reinforcement. There was no bowel injury. Early complications were seroma and infection (p < 0.01 and p < 0.05, respectively). Most significant late complication was recurrence (7.8%). Conclusions: Clinicians should be ready to encounter more reproductive aged women with incisional hernia, since worldwide CS rate continues to rise. Awareness of risk factors, imaging methods, surgical options and outcomes are of great importance.

Purpose: Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD.Methods: A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6.Results: The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively).Conclusion: This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference.Trial registration: ClinicalTrials.gov identifier: NCT05429060