Successfully reported this slideshow.
Your SlideShare is downloading. ×

Scientific commitee presentation for paper proposal prophylctic mesh placement.pptx

Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Ad
Upcoming SlideShare
Benign Breast Diseases.pptx
Benign Breast Diseases.pptx
Loading in …3
×

Check these out next

1 of 32 Ad

More Related Content

More from Pradeep Pande (20)

Recently uploaded (20)

Advertisement

Scientific commitee presentation for paper proposal prophylctic mesh placement.pptx

  1. 1. Tips on using my ppt. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. 7. See notes for bibliography.
  2. 2. Title
  3. 3. Title • Conventional versus Prophylactic Mesh placement technique of midline laparotomy: A comparative study. Dr. Kameshwar Assistant Professor -Dr. Pradeep Pande Associate Professor Deptt. Of Surgery
  4. 4. Abstract
  5. 5. Abstract Background and Objectives • The midline laparotomy is frequently used for abdominal surgeries. • Main complication is incisional hernia. • The objective of this study is to compare Mesh Placement Technique with conventional Mass closure technique in preventing the incisional hernia
  6. 6. Introduction
  7. 7. Introduction • Introduction: The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%1.
  8. 8. Introduction • Median laparotomies and incisional hernias have been subject of investigation for a long period of time already. Although a lot is known about patient related risk factors and suture materials, technical risk factors such as suture techniques have not been investigated thoroughly 2.
  9. 9. Materials and Methods
  10. 10. Materials and Methods Trial Design • This trial has been designed as a prospective, double-blind, randomized controlled trial, in which Prophylactic Mesh placementTechnique will be compared with the conventionally used large bites mass closure technique for the closure of midline laparotomy.
  11. 11. Materials and Methods • 100 consecutive patients reporting to the department of General Surgery of BRK Memorial Medical College in whom midline laparotomy is indicated will be included in this study. • These 100 patients will be randomized into two groups of 50 each.
  12. 12. Materials and Methods • Group A patients will be managed by conventional closure of the midline incision • GroupB patients will be managed by Mesh placement technique. • One year after surgery the patients will be examined for the complication of incisional hernia clinically and sonographically.
  13. 13. Results: Outcome parameters
  14. 14. Results: Outcome parameters Primary outcome • Primary outcome will be incisional hernia occurrence within one year after surgery, either clinically and/or ultrasonographically detected.
  15. 15. Results: Outcome parameters Secondary outcomes • Postoperative complications • Pain • Quality of life • Cost effectiveness
  16. 16. Conclusions:
  17. 17. Conclusions: • The trial will provide level 1b evidence to support the preference for either a Prophylactic Mesh placementTechnique or for the conventionally used large bites technique
  18. 18. Participants
  19. 19. Participants • Participants: Patients undergoing midline laparotomy in BRK Memorial Medical College Jagdalpur will be included in this study .
  20. 20. Inclusion criteria:
  21. 21. Inclusion criteria: • Patients undergoing midline laparotomy in BRK Memorial Medical College Jagdalpur .
  22. 22. Exclusion criteria
  23. 23. Exclusion criteria • None
  24. 24. Analysis
  25. 25. Analysis • Differences between randomized groups will be tested with appropriate statistical methods
  26. 26. Conclusion
  27. 27. Conclusion • This trial is a comparative studyof Conventional versus Prophylactic Mesh placement technique of midline laparotomy closure.
  28. 28. Bibliography
  29. 29. Bibliography • Muysoms FE, Detry O, Vierendeels T, Huyghe M, Miserez M, Ruppert M, Tollens T, Defraigne JO, Berrevoet
  30. 30. Get this ppt in mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
  31. 31. Get this ppt in mobile
  32. 32. Get my ppt collection • https://www.slideshare.net/drpradeeppande/ edit_my_uploads • https://www.dropbox.com/sh/x600md3cvj8 5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl =0 • https://www.facebook.com/doctorpradeeppa nde/?ref=pages_you_manage

Editor's Notes

  • drpradeeppande@gmail.com
    7697305442
  • BACKGROUND:
    The incidence of incisional hernias after abdominal aortic aneurysm repair is high. Prophylactic mesh-augmented reinforcement during laparotomy closure has been proposed in patients at high risk of incisional hernia.
    METHODS:
    A multicenter randomized trial was conducted on patients undergoing elective abdominal aortic aneurysm repair through a midline laparotomy (Clinical.Trials.gov: NCT00757133). In the study group, retromuscular mesh-augmented reinforcement was performed with a large-pore polypropylene mesh (Ultrapro, width 7.5 cm). The primary endpoint was the incidence of incisional hernias at 2-year follow-up.
    RESULTS:
    Between February 2009 and January 2013, 120 patients were recruited at 8 Belgian centers. Patients' characteristics at baseline were similar between groups. Operative and postoperative characteristics showed no difference in morbidity or mortality. The cumulative incidence of incisional hernias at 2-year follow-up after conventional closure was 28% (95% confidence interval [CI], 17%-41%) versus 0% (95% CI, 0%-6%) after mesh-augmented reinforcement (P < 0.0001; Fisher exact test). The estimated "freedom of incisional hernia" curves (Kaplan-Meier estimate) were significantly different across study arms (χ = 19.5, P < 0.0001; Mantel-Cox test). No adverse effect related to mesh-augmented reinforcement was observed, apart from an increased mean time to close the abdominal wall for mesh-augmented reinforcement compared with the control group: 46 minutes (SD, 18.6) versus 30 minutes (SD, 18.5), respectively (P < 0.001; Mann-Whitney U test).
    CONCLUSIONS:
    Prophylactic retromuscular mesh-augmented reinforcement of a midline laparotomy in patients with abdominal aortic aneurysm is safe and effectively prevents the development of incisional hernia during 2 years, with an additional mean operative time of 16 minutes.
  • BACKGROUND:
    The incidence of incisional hernias after abdominal aortic aneurysm repair is high. Prophylactic mesh-augmented reinforcement during laparotomy closure has been proposed in patients at high risk of incisional hernia.
    METHODS:
    A multicenter randomized trial was conducted on patients undergoing elective abdominal aortic aneurysm repair through a midline laparotomy (Clinical.Trials.gov: NCT00757133). In the study group, retromuscular mesh-augmented reinforcement was performed with a large-pore polypropylene mesh (Ultrapro, width 7.5 cm). The primary endpoint was the incidence of incisional hernias at 2-year follow-up.
    RESULTS:
    Between February 2009 and January 2013, 120 patients were recruited at 8 Belgian centers. Patients' characteristics at baseline were similar between groups. Operative and postoperative characteristics showed no difference in morbidity or mortality. The cumulative incidence of incisional hernias at 2-year follow-up after conventional closure was 28% (95% confidence interval [CI], 17%-41%) versus 0% (95% CI, 0%-6%) after mesh-augmented reinforcement (P < 0.0001; Fisher exact test). The estimated "freedom of incisional hernia" curves (Kaplan-Meier estimate) were significantly different across study arms (χ = 19.5, P < 0.0001; Mantel-Cox test). No adverse effect related to mesh-augmented reinforcement was observed, apart from an increased mean time to close the abdominal wall for mesh-augmented reinforcement compared with the control group: 46 minutes (SD, 18.6) versus 30 minutes (SD, 18.5), respectively (P < 0.001; Mann-Whitney U test).
    CONCLUSIONS:
    Prophylactic retromuscular mesh-augmented reinforcement of a midline laparotomy in patients with abdominal aortic aneurysm is safe and effectively prevents the development of incisional hernia during 2 years, with an additional mean operative time of 16 minutes.

×