Comparison of Outcomes of Total Extraperitoneal Repair and Transabdominal Preperitoneal Approach in Inguinal Hernia Surgery - Journal of Academic Research in Medicine

Background and Objectives: We aimed to evaluate early postoperative radiographic changes in sagittal foot alignment following laparoscopic sleeve gastrectomy and to investigate the association between early weight loss and sagittal foot alignment parameters. Materials and Methods: This study included 72 consecutive patients who underwent primary laparoscopic sleeve gastrectomy. Standardized lateral foot radiographs were obtained preoperatively and at the fourth postoperative month. Meary’s angle, calcaneal pitch, and talar declination angle were measured on all radiographs. Demographic and clinical variables, including age, sex, height, body weight, and body mass index (BMI), were recorded. Results: Meary’s angle demonstrated a significant postoperative decrease from 15° (IQR, 8°) to 11° (IQR, 12°) (p < 0.001), indicating improvement in medial longitudinal arch alignment. In contrast, no significant postoperative changes were observed in the calcaneal pitch (p = 0.227) or talar declination angles (p = 0.751). The proportion of patients within the normal range for all measured sagittal alignment parameters increased postoperatively, without showing statistical significance. Statistical analysis revealed that all postoperative sagittal alignment parameters showed significant correlation with preoperative values. Notably, postoperative Meary’s angle demonstrated a very strong positive correlation with preoperative Meary’s angle (r = 0.80, p < 0.001), whereas no significant correlation was identified between postoperative Meary’s angle and either postoperative weight or weight/BMI loss (p > 0.05). Although BMI loss showed a significant correlation with postoperative calcaneal pitch and talar declination angles, these correlations were weak to moderate (r = −0.403, and r = −0.362, respectively). Conclusions: Early postoperative body weight/BMI loss following sleeve gastrectomy is associated with modest, parameter-specific improvements in sagittal foot alignment, primarily reflected by changes in Meary’s angle, suggesting that the medial longitudinal arch may be more responsive to early postoperative unloading than other sagittal alignment parameters. The strong association between preoperative and postoperative measurements underscores the central role of baseline alignment in determining early postoperative outcomes.

Objective: Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis and is the most commonly performed surgical procedure worldwide. It is superior to open cholecystectomy in terms of aesthetics, but the visibility of the trocar ports is a cosmetic problem due to increasing aesthetic concerns. We report the results of patients who underwent conventional four port LK with all incisions below the bikini line. Material and Method: The study included patients who underwent LK through bikini incision in our clinic between 01.11.2020 and 31.11.2021. Age, gender, comorbidities, indications for cholecystectomy, previous abdominal surgeries, anesthesia scores, and body mass index (BMI) were recorded. The procedure was not performed in patients undergoing emergency surgery for acute cholecystitis and other causes. Results: The study included 9 patients, all of whom were female. The mean age was 30 ± 7.8 years and mean BMI was 23.1 ± 4.3. Mean operative time was 33.9 ± 8.5 minutes. Open operation was not performed in any patient. The hospitalization period was one day for all patients. There were no complications in any of the patients. Eight of the nine patients (89%) expressed cosmetic satisfaction in the first month after surgery. Conclusion: The prevalence of LC leads to an increase in the number of patients expecting less scarring. Here, we propose a modified four-port laparoscopic cholecystectomy that is easy to perform, safe, requires no additional cost, and has high patient satisfaction