In gastrointestinal and endoscopic surgery, the progress in devices and techniques over the last two decades has been unprecedented. However, ensuring the safety of new techniques has its challenges. The US FDA regulates diagnostics, drugs and devices-it does not regulate new procedures. Guidelines have been given for various newer laparoscopic procedures, to ensure the safety of patients as compared to conventional options. Laparoscopic Ventral Hernia Repair: Guidelines Laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. The guideline has been divided into following topics: Laparoscopic vs. Open Repair Preoperative Considerations Operative Technique Postoperative Management: Avoiding and Treating Problems I. Laparoscopic vs. Open Repair Laparoscopic ventral hernia repair, compared to open repair, has a lower rate of wound infections. Recurrence rates and postoperative pain are similar between the…
Introduction The symptom of abdominal pain in childhood is very common. More than one-third of elementary and middle school children complain of weekly abdominal pain. Children with recurrent abdominal pain (RAP) and their families often suffer with this frustrating situation. However, the majority of children with RAP (almost 90%) do not have a serious disease.1Campo JV. Functional Recurrent Abdominal Pain in Children and Adolescents. International Foundation for Functional Gastrointestinal Disorders (IFFGD). Recurrent abdominal pain was first described in 19582Plunkett A, Beattie RM. J R Soc Med 2005; 98:101-6. , and is considered as a symptom and not a diagnosis. The seminal work of Apley and Naish, who studied 1000 school children in Bristol, England, used a pragmatic definition of recurrent abdominal pain as, '3 episodes over 3 months, severe enough to affect daily activity'.3Bremner AR, Sandhu BK. Indian Pediatr 2009;46: 375-9. Prevalence In Apley's original study, the prevalence of recurrent abdominal…
