Browsing by Autor "Mario Alberto Latiff"

Now showing 1 - 2 of 2

How I do It: Knot Placement Technique for Self-Gripping Mesh in Totally Extraperitoneal (TEP) Inguinal Hernia Repair
(Research Square (United States), 2022) Ricardo Nassar; Felipe Girón; Ricardo E. Núñez-Rocha; Carlos Eduardo Rey Cháves; Lina Rodríguez; Agustín Pérez; Mario Alberto Latiff; Juan David Hernández
Abstract Background Surgical Inguinal hernia repair techniques are constantly evolving. Mesh fixation and placement remain cornerstones of the procedures. The use of self-gripping mesh has shown a significant reduction in postoperative pain and complications. However, technical difficulties arise, and multiple deployment methods have been described, with no consensus. Therefore, in this study, we present a novel preparation, deployment, and placement technique for self-gripping mesh during laparoscopic inguinal hernia repair, with its consequent outcomes and follow-up. Methods The self-gripping mesh is folded in half, non-absorbable sutures are placed in each distal portion and in the middle of the mesh, making sure the knot lies in the non-adherent surface. Corners are rounded. Mesh is rolled using the “tobacco technique”. The mesh is then placed with the laparoscopic grasper inside the preperitoneal cavity and is unrolled from medial to lateral. Results 142 patients underwent totally extraperitoneal (TEP) inguinal hernia repair. Self-gripping mesh (ProgripTM) was used in all cases. 48.6% had bilateral defects. 33 patients underwent additional procedures. Mean time for mesh deployment was 180 seconds. Mean in-hospital stay was 1.6 days. No conversion was necessary. 88.9%, 86% and 36.7% of patients completed one year, 2 years, and 5 years of follow-up respectively. Chronic pain was present in two patients. Conclusion We introduce a new technique for self-gripping mesh preparation, deployment and placement for inguinal hernia repair using the TEP approach. Our technique seems to have satisfactory results regarding long-term follow-up complications.
Mortality Related Factors in Penetrating Abdominal Trauma
(Research Square (United States), 2023) Andrés Felipe Bernal; Mario Alberto Latiff; Ricardo E. Núñez-Rocha; Lina Rodríguez; Andres Mauricio Garcia Sierra; Carlos Eduardo Rey Cháves; Raquel Tabares; Kelly Alvarado; David Espitia; Danny Conde
Abstract Background: Penetrating abdominal trauma is a frequent cause of death in Latinamerica with high rates of morbidity and mortality. A wide variety of therapeutic appraches have been proposed for the manegement of this pathology. In this study, we aimed to analyze the factors related to mortality and to describe outcomes of patients in penetrating abdominal trauma. Methods: Retrospective review of a prospectively collected database was performed. All patients with penetrating abdominal, or thoracoabdominal injury that required urgent laparotomy or laparoscopic exploration between 2018-2020 in our institution were included. Results: A total of 231 patients were included. Male patients were 92.21% and the median age was 28 IQR (22-37). 56.2% patients were ASA I, 19.9% ASA II, 4.7% ASA III, 7.3% ASA IV and 11.6% unknown. 77.5% patients had sstab wounds as penetrating abdmonal trauma etiology and 22.1% by gunshots. 76.2% of the wounds were made in the thoracoabdominal area, 73.8% were abdominal injuries and 24.2% were thoracic. 77.9% of patients presented a PATI score under 25 points. Comorbidities, gunshot wounds, ASA, need of blood product transfusion, number of pRBC needed, surgical approach and organ injury had a statistically significant association ( p<0.05 ) with total mortality and mortalifty after 48 hours. There was also a statistically significant association between comorbidities (OR 407.405 [1.4-118534.05 95% IC]), ASA III (OR 0.004 [0-0.644 95% IC]), and blood product transfusion (OR 0 [0-0.877 95% IC]) with overall mortality. Conclusion: PATI scale appear to be a feasible tool to predict worst outcomes in abdominal penetrating trauma patients. Residents as first surgeons showed no evidence of a higher complications rate.