• כרטיס רופא והטבות
  • אתרי הר"י
  • צרו קשר
  • פעולות מהירות
  • עברית (HE)
  • מה תרצו למצוא?

        תוצאת חיפוש

        יולי 2001

        דן גרינברג ויוחנן פייזר
        עמ'

        Costs and Benefits of Laparoscopic Inguinal Hernia Repair- Is there an Economic Justification?

         

        Dan Greenberg1, Jochanan G. Peiser2

         

        1Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion, 2Operatory Room Directorate and Division of Surgery, Medical Center, Soroka University, Israel

         

        Background: With the recent accelerated development of laparoscopic surgery, it has been applied in all fields of surgery. The main issue today is not the technical ability of performing laparoscopic procedures but rather their justification while considering the disease and cost-benefit aspects.

        Objectives: The present study surveys the experience accumulated in recent years concerning the economical aspects of laparoscopic inguinal hernia repair. Issues like length of the surgical procedure, cost, typical complications and recuperation time are being addressed.

        Methods: We reviewed controlled clinical trials that compare laparoscopic and open repair of inguinal hernia. Trials that included at least 100 patients and were published in peer-reviewed journals since 1996 were included. Various operative techniques were compared using clinical and economical parameters.

        Results: Most studies examined the issues from an institutional or health care system viewpoint and not from a comprehensive societal perspective. Therefore, indirect costs were seldom included. Operative times were longer and direct costs were significantly higher in the laparoscopic approach as compared to conventional open surgery. However, recovery time and return to work were found to occur earlier in patients who underwent laparoscopic surgery.

        Conclusions: A shorter recovery time and shorter off-work period after laparoscopic hernia repair could compensate for the increased hospital expenditures. However, this contribution has not yet been completely established and needs further validation by supplementary studies. Other aspects that will have to be evaluated include quality of life and patient satisfaction.

        מרץ 1999

        יואב מינץ, דוד גויטיין ומיכאל מוג'ה-סולם
        עמ'

        Tension-Free "Plug and Patch" Inguinal Hernia Repair

         

        Y. Mintz, D. Goitein, M. Muggia-Sullam

         

        Dept. of General Surgery, Hadassah-Hebrew University Hospital, Jerusalem

         

        Inguinal hernias are common and have highly variable clinical presentations, ranging from the asymptomatic to surgical emergencies when incarcerated, sometimes necessitating bowel resection. Several techniques have been described for repair of inguinal hernias based on the unique anatomic structure of the inguinal region. In 1989 Lichtenstein and co-workers described a "tension free" repair based on using a synthetic mesh patch to reinforce the inguinal canal floor and as a plug to prevent recurrence through the internal inguinal ring. This technique has been used in many centers worldwide with good rates of success.

        פברואר 1999

        שלמה קייזר, איליה קריסטלני, מרינה אליס ואילן חרוזי
        עמ'

        Laparoscopic Repair of Inguinal Hernia Experience in 54 Consecutive Cases

         

        S. Kyzer, I. Kristalni, M. Alis, I. Charuzi

         

        Surgical Dept. B, Wolfson Medcial Center, Holon

         

        We describe our experience in 54 consecutive patients who underwent laparoscopic repair of 86 inguinal hernias. Laparoscopic repair of inguinal hernia is technically feasible, does not prolong the length of the procedure nor of hospitalization and is not accompanied by increased morbidity. Although there is not yet general agreement, in our experience and that of others, it appears that laparoscopic repair will be the preferred approach to the treatment of inguinal hernia.

        ינואר 1999

        אדוארד רמדאן, דן צרור, רומן בליאבסקי וזאב דרזניק
        עמ'

        Tension-Free Repair of Inguinal Hernia with Properitoneal Mesh

         

        Eduard Ramadan, Dan Seror, Roman Belavsky, Zeev Dreznik

         

        Dept. of Surgery A, Rabin Medical Center, Golda Campus (Hasharon Hospital) Petah Tikvah, and Sackler School of Medicine, Tel Aviv University

         

        The results of properitoneal mesh repair of inguinal hernia were evaluated in 38 of 43 consecutive patients operated by Stoppa's technique. In 33 patients the hernia was bilateral and in 10 unilateral; in 20 it was recurrent. In 33/43 patients the mesh was fixed either by sutures or metal clips. The overall recurrence rate after 22 (14-36) months of follow-up, was 10.5%. This result was composed of a 3.0% recurrence rate in the fixated-mesh group, and 30.0% among those with non-fixated mesh.

        The outcome following the Stoppa method for tension-free properitoneal mesh repair of inguinal hernia, compares favorably with those of other methods, provided proper attention is paid to adequate mesh placement and fixation. Further prospective studies are needed to define the role and indications for this technique in the laparoscopic era.

        דצמבר 1997

        הרברט פרוינד, דן צרור, דני אימרל ועודד זמיר
        עמ'

        Preliminary Experience with Laparoscopic Repair of Inguinal Hernias

         

        Herbert R. Freund, Dan Seror, Dan Eimerl, Oded Zamir

         

        Surgery and Anesthesiology Depts., Hadassah-University Hospital, Mount Scopus, Jerusalem

         

        During 1992-1996 we performed 163 laparoscopic hernia repairs in 100 men and 2 women. The mean age was 50.6; and in 61 the operation was bilateral. 66 were by transabdominal preperitoneal approach and 36 btotal extra-peritoneal approach. There were only a few minor complications and total recurrence rate was only 4.3%, partly attributable to our learning curve. Laparoscopic inguinal herniorrhaphy reduces postoperative incisional and muscular pain and causes less disruption in the postoperative period than open repair. Return to normal activity and work is faster for laparoscopic than for open repair, but operating room costs are higher (time and equipment). However, economic advantages for the national economy should be considered.

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303