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Biomedical subjects

S D Berliner

Publications and source records attributed to S D Berliner.

17 recordsLinked to original sources
PubMed1993

Clinical experience with an inlay expanded polytetrafluoroethylene soft tissue patch as an adjunct in inguinal hernia repair.

Fifteen percent of 2,331 inguinal hernias required a biomaterial to effect a tension-free repair. Using the anterior approach, a graft placed deep to the posterior wall fulfills all the requirements of a sound operation. The procedure is normally performed using local anesthesia in an ambulatory facility. Three hundred fifty inguinal hernias were repaired using an expanded polytetrafluoroethylene soft tissue inlay patch. Ninety-one percent of the patients had personal follow-up examination with a mean follow-up period of 41.8 months. There were four recurrences.

Adult↗
PubMed1992

The Henry operation for incarcerated and strangulated femoral hernias.

Selection of a subinguinal, inguinal, or preperitoneal approach permits the surgeon flexibility in managing femoral hernias. A 20-year experience is reviewed, with 44 incarcerated or strangulated femoral hernias corrected using the preperitoneal Henry operation. It is an effective and safe method of repair. Examination of the contralateral side revealed an unsuspected femoral hernia in seven (16%) of the cases.

Aged↗
PubMed1990

When is surgery necessary for a groin hernia?

Hernias are one of the most common causes of symptoms in the groin. Surgery is needed for all femoral and indirect inguinal hernias to prevent incarceration and strangulation. Asymptomatic direct hernias can be observed if they are not enlarging. Atypical symptoms in a patient with a hernia must be evaluated to exclude other disease. Fortunately, most groin hernias can be repaired electively.

Adult↗
PubMed1990

The femoral cone and its clinical implications.

The transversus abdominis aponeurosis and its investing sheath of transversalis fascia are the first line of defense against groin herniation. If transversus abdominis fibers insert on the superior pubic ramus as a narrow band, a cone shaped defect will result. With an increase in intra-abdominal pressure, preperitoneal fat, with or without a peritoneal sac, can enter this femoral cone. It is an asymptomatic internal hernia that will be detected only if the preperitoneal space is explored during inguinal herniorrhaphy. This is stage I in the development of a femoral hernia. Should the contents within the femoral cone protrude through its narrow distal orifice, a stage II external hernia results. Incarceration or strangulation may then occur. Herniation into and through the femoral cone was encountered in 159 instances while repairing 3,609 hernias of the groin in adults. Sixty-seven external (stage II) hernias were diagnosed preoperatively. Sixteen per cent were irreducible, 18 per cent were incarcerated and 3 per cent were strangulated. During inguinal herniorrhaphy, an unsuspected stage II femoral hernia was found in 12 instances, and a stage I precursor was present in 80. Flexibility in management is important. The choice of the low, inguinal or preperitoneal approach is determined by the mode of presentation of the hernia.

Adult↗
PubMed1984

An approach to groin hernia.

Fascia and aponeuroses are dynamic, metabolically active structures characterized by an ongoing balance of collagen synthesis and enzymatic lysis. Basic concepts concerning the pathogenesis and repair of groin hernias revolve about this essential point.

Abdominal Muscles↗
PubMed1983

Adult inguinal hernia: pathophysiology and repair.

An anatomic and physiologic rationale is presented for the correction of inguinal hernias utilizing a simplified anterior approach, which opens and overlaps the transversalis-transversus abdominis posterior wall. The absence of tension is vital. It permits an uninterrupted repair of the direct and indirect components without additional reinforcement. A prospective randomized study is currently in progress comparing this two-layer technique to the author's three-layer modified Shouldice operation. Three-hundred and twenty-six repairs have been followed for at least 20 months with a mean follow-up time of 29 months. There have been two recurrences in each group. A better evaluation will be available when 1000 operations have been collected with a mean follow-up time of 46 months.

Adolescent↗
PubMed1979

Telescoping anastomosis of the colon: a comparative study.

The incidence of large-intestinal anastomotic leaks remains unacceptably high. For this reason, we studied the resistance to dehiscence of a telescoping type of anastomosis and compared it with the conventional one-layer, two-layer, and stapled anastomoses in a canine model. These experiments demonstrated that the telescoping anastomosis provided a more resistant suture line during the early postoperative phase and did not cause encroachment of the lumen by the diaphragm, which was consistently produced when an inverting suture line was used. Three days postoperatively the mean bursting pressures of the one-layer, two-layer, and stapled anastomoses were 31 +/- 12, 120 +/- 46, and 52 +/- 21 mm Hg, respectively. The telescoping anastomosis had a mean bursting pressure of 210 +/- 44 mm Hg, which was significantly (P less than 0.01) higher than those of all the other anastomoses tested. However, seven and 14 days after operation, there was no statistically significant difference among the bursting pressures of the various anastomoses. When the different types of anastomoses were examined histologically, it was found that there was considerably more suture-line inflammation, edema, micro-abscess formation, mucosal ulceration and pericolic inflammation of the fat in the one-layer, two-layer, and stapled anastomoses than in the telescoping anastomosis.

Animals↗