This is a 45 years old female with history of hysterectomy in the past who presented with lower abdominal pain, abdominal distension and obstipation and found to have complete small bowel obstruction on her CT scan. She underwent a diagnostic laparoscopy which showed strangulated loop of ileum in an internal hernia created by a very tight adhesion between right side of pelvic wall and sigmoid colon.
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This is a 45 years old female with five years history of episodic upper abdominal pain whose ultrasound showed gallstones with thickened gallbladder wall , consistent with chronic cholecystitis. Initial inspection with laparoscopic technique showed chronic cholecystitis with significant thick, firm adhesion and scar tissue around the gallbladder
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This is a 48 years old female with history of chronic back pain on multiple pain medications, including aspirin who came into the emergency room with sudden onset of severe upper abdominal pain and found to have significant tenderness on her physical examination. Her abdominal CT scan showed free intraabdominal air and fluid, consistent with perforated viscus.
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This is a 52 years old female who presented to the emergency room with two days history of severe left lower quadrant abdominal pain, nausea, vomiting, and fever. She was found to have severe tenderness and guarding in the left lower quadrant and her abdominal CT scan showed severe sigmoid diverticulitis with micro-perforation and significant peri-colonic inflammatory changes.
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This is a 61 years old male with history of multiple abdominal surgeries for placement of the gastrostomy and jejunostomy feeding tubes in the past. He recently required another feeding tube due to recurrent inability to tolerate the oral diet and significant malnutrition.
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Abdominal wall hernia is a common surgical problem. Hernia is a defect in the abdominal wall. Therefore, the content of the abdominal cavity could potentially protrude through this defect causing an abdominal wall bulge with on and off pain and discomfort especially during activity and straining. The hernias could be congenital or acquired and could get larger and more symptomatic by time.
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Gallbladder disease is a common problem in the world and at times it is underdiagnosed or even undertreated. The gallbladder is a small structure underneath of the liver and is connected to the liver via a common channel, called common bile duct. It is responsible to store a small portion of the bile that is produced by the liver.
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Gallbladder disease is a common problem in the United States and approximately 10-15 percent of the adult population have gallstones. Gallstones are more common in women, older patients, and certain ethnic groups, and are associated with multiple pregnancies, obesity, and rapid weight loss.
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Performing any abdominal surgery has the risk of developing abdominal wall hernia, called incisional hernia. The incisional hernia has many underlying reasons and could be associated with many factors, including technical issues, post-operative wound infection, obesity, Smoking, lung disease associated with cough, steroid usage, and age.
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This question is a very controversial topic in general surgery and coming up with one right answer for all situations is impossible and incorrect. Therefore, let`s evaluate different scenarios and situations. One major rule is, that in the presence of infection whether in the area of the hernia or in the remote location, repairing of the hernia with permanent mesh is not advised.
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For a long time, repairing the ventral hernia and diastasis recti required open surgical intervention with large mid-line abdominal incision, creation of large skin flap to approximate the mid-line muscle structures and reinforce the closure with mesh. That was associated with severe post-operative pain, long recovery, large mid-line scar and more potential for wound complications.
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This is a 65 year old male with history of a bulge in the left groin with on and off pain and discomfort during straining and heavy activity. Patient underwent a robotic assisted repair of inguinal hernia with placement of 3 D mesh. Patient was taken to the operating room and underwent a general anesthesia and placed in the lithotomy position.
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