Hernia Repair - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

HERNIA REPAIR A 3-IN-1 MEDICAL REFERENCE Medical Dictionary Bibliography & Annotated Research Guide TO I NTERNET

R EFERENCES

ERNIA EPAIR A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Hernia Repair: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00538-7 1. Hernia Repair-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on hernia repair. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON HERNIA REPAIR ........................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Hernia Repair................................................................................ 4 E-Journals: PubMed Central ......................................................................................................... 8 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND HERNIA REPAIR .............................................................................. 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Hernia Repair .............................................................................. 53 Federal Resources on Nutrition ................................................................................................... 54 Additional Web Resources ........................................................................................................... 54 CHAPTER 3. ALTERNATIVE MEDICINE AND HERNIA REPAIR ........................................................ 57 Overview...................................................................................................................................... 57 National Center for Complementary and Alternative Medicine.................................................. 57 Additional Web Resources ........................................................................................................... 60 General References ....................................................................................................................... 61 CHAPTER 4. PATENTS ON HERNIA REPAIR ..................................................................................... 63 Overview...................................................................................................................................... 63 Patents on Hernia Repair............................................................................................................. 63 Patent Applications on Hernia Repair......................................................................................... 76 Keeping Current .......................................................................................................................... 88 CHAPTER 5. BOOKS ON HERNIA REPAIR ........................................................................................ 89 Overview...................................................................................................................................... 89 Book Summaries: Federal Agencies.............................................................................................. 89 Chapters on Hernia Repair .......................................................................................................... 92 CHAPTER 6. MULTIMEDIA ON HERNIA REPAIR.............................................................................. 95 Overview...................................................................................................................................... 95 Video Recordings ......................................................................................................................... 95 CHAPTER 7. PERIODICALS AND NEWS ON HERNIA REPAIR........................................................... 97 Overview...................................................................................................................................... 97 News Services and Press Releases................................................................................................ 97 Academic Periodicals covering Hernia Repair............................................................................. 99 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 103 Overview.................................................................................................................................... 103 NIH Guidelines.......................................................................................................................... 103 NIH Databases........................................................................................................................... 105 Other Commercial Databases..................................................................................................... 107 APPENDIX B. PATIENT RESOURCES ............................................................................................... 109 Overview.................................................................................................................................... 109 Patient Guideline Sources.......................................................................................................... 109 Finding Associations.................................................................................................................. 111 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 115 Overview.................................................................................................................................... 115 Preparation................................................................................................................................. 115 Finding a Local Medical Library................................................................................................ 115 Medical Libraries in the U.S. and Canada ................................................................................. 115 ONLINE GLOSSARIES................................................................................................................ 121 Online Dictionary Directories ................................................................................................... 122

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HERNIA REPAIR DICTIONARY............................................................................................... 123 INDEX .............................................................................................................................................. 155

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with hernia repair is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about hernia repair, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to hernia repair, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on hernia repair. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to hernia repair, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on hernia repair. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON HERNIA REPAIR Overview In this chapter, we will show you how to locate peer-reviewed references and studies on hernia repair.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and hernia repair, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “hernia repair” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Short, Practical Guide to Hernias Source: Harvard Health. p. 6 January 2002. Contact: Harvard Health. P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. Website: www.health.harvard.edu/newsletters/subinfo.html. Summary: Abdominal hernia is the more accurate term for what most people simply call a hernia: contents of the abdomen push through a weak area in the abdominal wall. Those contents can include segments of the large and small intestine, the ovaries, and the bladder. This brief newsletter article familiarizes readers with abdominal hernias and hernia repair. The article covers a definition of terms, causes and prevention, symptoms, non-surgical options, and surgery. One illustration depicts the typical abdominal hernia before and after surgical repair.

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Current Status of Incidental Surgery Source: Diseases of the Colon and Rectum. 38(4): 435-441. April 1995. Summary: Incidental surgery is a common occurrence in abdominal operations that results from unexpected findings or as a matter of surgical efficiency. In this article, the author reviews recent publications on the safety and efficacy of secondary procedures. Procedures discussed include cholecystectomy, incidental appendectomy, appendiceal masses, Meckel's diverticulectomy, splenectomy, oophorectomy, hernia repair, and omentectomy. The author suggests factors that must be included in a decision to perform incidental surgery: age and general health of the patient, prognosis, setting of the original operation (emergency versus nonemergency), and risk of disease when incidental surgery is performed prophylactically. 29 references. (AA-M).

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Management of Giant Paraesophageal Hernia Source: Diseases of the Esophagus. 10(1): 47-50. January 1997. Summary: This article reports on a retrospective study in which the records of 51 patients operated on for giant paraesophageal hiatal hernia were reviewed. The authors compare the transthoracic and transabdominal approaches and assess the value of a concomitant fundoplication. Operative repair was performed using open transthoracic, transabdominal, and thoracoabdominal approaches. Laparoscopic techniques were used in one patient. Fundoplication was performed in 45 patients. There was no operative mortality, but early postoperative complications occurred in 29 percent of patients. The presence of commonly associated symptoms was used to derive preoperative and postoperative symptom scores. Followup was available in 48 patients. Excellent results were reported in 69 percent of patients and 17 percent had good results. The symptom score improved significantly regardless of the operative approach selected or whether a fundoplication was performed. The authors conclude that outcome after paraesophageal hiatal hernia repair is satisfactory in most patients, irrespective of the route chosen or techniques used for repair. 3 tables. 17 references. (AA).

Federally Funded Research on Hernia Repair The U.S. Government supports a variety of research studies relating to hernia repair. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to hernia repair. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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animals or simulated models to explore hernia repair. The following is typical of the type of information found when searching the CRISP database for hernia repair: •

Project Title: A NEW ABSORBABLE MESH FOR HERNIA REPAIR Principal Investigator & Institution: Martin, David P.; Tepha, Inc. Cambridge, Ma 02139 Timing: Fiscal Year 2004; Project Start 05-AUG-2004; Project End 31-JAN-2005 Summary: (provided by applicant): The objective of this research is to determine the feasibility of developing a new absorbable mesh with prolonged strength retention for hernia repair. The product is expected to find application where current synthetic nonabsorbable meshes provide poor outcomes, such as implantation in contaminated surgical fields, or in pediatric patients where they can hinder growth. It is also hoped that the product will lead to less occurrence of complications such as fistula formation, pain, and restriction of physical capabilities that can follow hernia repair procedures. The total number of patients that could benefit from this new mesh is large if it proves to be superior to existing options. Approximately, 1.5 million inguinal hernia repair procedures and 200,000 ventral hernia procedures are performed each year. The research approach will employ a new absorbable biomaterial, know as poly-4hydroxybutyrate (also known as PHA4400), that has been shown to have prolonged strength retention in vivo compared to existing absorbable suture biomaterials. The specific aims of the project are to: (1) produce a melt extrudable grade of PHA4400; (2) extrude monofilament fiber of PHA4400 suitable for knitting into a hernia mesh; (3) prepare a monofilament knitted mesh of PHA4400 with a tensile strength comparable to commercial synthetic (polypropylene) hernia meshes; and (4) demonstrate that the in vivo mechanical stability of a hernia repair with a PHA4400 mesh at 3 months is greater than with an existing absorbable mesh (Vicryl TM) of comparable weight and density, make a preliminary comparison with the performance of a non-absorbable polypropylene mesh, and perform a morphological and histological study on samples from the implantation study to assess tissue reaction. In addition to developing a product that could improve surgical outcomes of hernia repair procedures, the research will also help to introduce a new absorbable medical biomaterial into the medical community that could find other uses, for example, in controlled release, tissue engineering, and other devices. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BEHAVIORAL EFFECT OF OBSTRUCTIVE SLEEP APNEA IN CHILDREN Principal Investigator & Institution: Chervin, Ronald D.; Associate Professor and Director; Neurology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-AUG-1999; Project End 31-JUL-2005 Summary: Adenotonsillectomy (AT) remains one of the most common surgical procedures performed in children, but indications for AT have changed in recent years. Surgeons now perform AT in many instances for suspected obstructive sleep-disordered breathing (SDB), and sometimes for daytime behaviors that may be a consequence of SDB, especially inattention and hyperactivity. However, whether SDB causes these and other disruptive behaviors, the precise nature of these behaviors, and what types or levels of SDB may be of concern are not well known. Without such knowledge, pediatricians and otolaryngologists do not often make use of objective preoperative testing that could help to assess for SDB or abnormal behavior. The main goals of the

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research described in this proposal are to (1) better define whether inattention and hyperactivity are frequent among children who undergo AT, (2) identify measures and levels of SDB that are indicative of these behaviors, (3) test whether improvement in SDB after AT is associated with improvement in behavior, and (4) investigate the hypothesis that SDB is a cause of inattention, hyperactivity, and related behaviors in some children. Subjects will be 5 through 12 year-old children recruited after they have been scheduled by their physicians for AT (n = 200) or hernia repair (n = 75 controls). A battery of well-validated behavioral assessment tools, cognitive tests, and structured psychiatric interviews will be used before surgery to define what behaviors are more prominent in the children scheduled for AT rather than hernia repair. All children will undergo preoperative polysomnography which will include, for the first time in such a series, equipment that can detect subtle forms of SDB which may be particularly prevalent in children. Results will allow determination of what polysomnographic findings are associated with well-defined adverse behavioral outcomes. Finally, preoperative and postoperative testing in these subjects will provide a controlled nonrandomized trial of AT for SDB, demonstrate whether SDB-associated abnormal behaviors improve after AT, and provide strong evidence for whether SDB is a cause of these behaviors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEW BIOMATERIALS TO MINIMIZE SCAR TISSUE FORMATION Principal Investigator & Institution: Sanders, Joan E.; Associate Professor; Bioengineering; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 15-MAR-2000; Project End 28-FEB-2004 Summary: (verbatim from the proposal): Fibrous encapsulation is an important limitation of current biomaterials intended for integration with soft collagenous tissues (e.g. abdominal wall repair, hernia repair, skin replacement from burn or ulceration, intestinal ulcer repair). A fibrous capsule can wall off the device, produce scar tissue that can adhere to underlying structures, and isolate the material from mechanical or chemical integration. However, preliminary implantation data suggest that if polymer fibers that make up the implant are very small, on the order of collagen fiber dimensions in the soft tissues (0.5-3.0 mm diameter), then fibrous encapsulation is minimized or eliminated. This feature, if validated in a systematic scientific manner, could be utilized in fibro-porous biomaterial design to create more effective devices. A systematic evaluation of a design feature's influence on bio-response (e.g. fiber diameter effect on healing) will be most useful to the biomaterials design community if it is simultaneously compared with a characteristic that has been well-studied. Biomaterial surface chemistry is the feature of interest selected for comparison here. The purpose of this research is to systematically evaluate the influence of material architecture and surface chemistry on in vivo response to fibro-porous materials. The specific aspect of surface chemistry to be evaluated is surface (ionic) electrical charge. The research proceeds in two stages: analysis on single fibers, and analysis on multi-fiber (fibro-porous) meshes. This twostage approach helps to isolate effects of the different features of interest. Because no traditional biomaterials fabrication method exists for making very small diameter fibers, a technology used mainly in non-biomedical industries called electrospinning is pursued and applied. An in vivo model is used to evaluate fibrous capsule thickness as well as foreign body giant cell density and macrophase cell density in tissue adjacent to the micro-fibers. These are key indicators of implant integration or activation of the foreign body reaction. The significance of this research is to apply an innovative material and fabrication method to assess the influence of specific biomaterial

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architectural and chemical features of a biomaterial to the tissue response. The approach could lead to a new materials fabrication technology to treat a number of soft-tissue complication in which scar tissue formation is an important clinical problem. The health relatedness of this project is to improve the health and function of persons with soft tissue defects, particularly abdominal wall perforation, intestinal ulceration, abdominal herniation, burns and skin ulceration, i.e. soft-tissue complications that require surgical repair through use of a biomaterial. The new materials will prevent scar tissue formation and reduce the occurrence of secondary complications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROSPECTIVE CLINICAL STUDIES IN NEONATAL SURGERY Principal Investigator & Institution: Blakely, Martin Lee.; Surgery; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 01-MAY-2001; Project End 30-APR-2006 Summary: (Adapted from applicant's description): The purpose of the career development activities described in this proposal is for Dr. Martin Blakely, a pediatric surgeon, to acquire the knowledge and skills required to conduct patient-oriented research of the highest quality. The candidate has a proven history of commitment to research during his surgical training. The institutional environment at UT Houston offers extensive resources available to the candidate, e.g. the Clinical Research Curriculum and Mentorship Program funded by an NIH K30 award and directed by the candidate's mentor. The career development plan includes formal mentorship, extensive coursework leading to a Master's of Science degree in clinical research, and participation in the NICHD Neonatal Research Network. Jon Tyson, M.D., M.P.H., is a renowned neonatologist and epidemiologist with extensive experience in clinical research study design and will serve as Dr. Blakely's primary mentor. Dr. Tyson also directs the Center for Population Health and Evidence-Based Medicine whose faculty members are available to the candidate. Kevin Lally, M.D., is a pediatric surgeon with experience in multi-center studies in this field and is the candidate's second mentor. Dr. Lally has established collaborative relationships with pediatric surgeons throughout the US that will facilitate the studies proposed by Dr. Blakely. There are four phases of the research plan. Initially, a series of systematic reviews of therapy for extremely low birthweight (ELBW) infants with necrotizing enterocolitis (NEC) will be completed and published in the Cochrane Library. Secondly, a multi- center prospective observational study documenting center variability and patient outcome after surgery for NEC in ELBW infants will be performed. The proposal for this study is under review by the NICHD Neonatal Research Network, of which Dr. Tyson is a principal investigator. A primary purpose of this study is to document the need for and to help design a randomized clinical trial described below. The third phase consists of completing an on-going randomized clinical trial comparing early versus late inguinal hernia repair in premature infants. And lastly, based on the results of the observational NEC study, it is anticipated that a randomized trial will be designed near the end of the award period to compare simple peritoneal drainage versus formal laparotomy in infants with NEC, which is a very controversial question in neonatal surgery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TIMING OF ELECTIVE HERNIA REPAIR IN PREMATURE INFANTS Principal Investigator & Institution: Lally, Kevin P.; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225

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Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “hernia repair” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for hernia repair in the PubMed Central database: •

Iatrogenic proximal urethral obstruction after inadvertent prostatectomy during bilateral perineal herniorrhaphy in a dog. by Sereda C, Fowler D, Shmon C.; 2002 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=339238

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Surgical physiology of inguinal hernia repair - a study of 200 cases. by Desarda MP.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=155644

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with hernia repair, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “hernia repair” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for hernia repair (hyperlinks lead to article summaries):

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A minimally invasive approach for treating postoperative seromas after incisional hernia repair. Author(s): Lehr SC, Schuricht AL. Source: Jsls. 2001 July-September; 5(3): 267-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11548834

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A multicentric comparison of transabdominal versus totally extraperitoneal laparoscopic hernia repair using PARIETEX meshes. Author(s): Lepere M, Benchetrit S, Debaert M, Detruit B, Dufilho A, Gaujoux D, Lagoutte J, Saint Leon LM, Pavis d'Escurac X, Rico E, Sorrentino J, Therin M. Source: Jsls. 2000 April-June; 4(2): 147-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10917122

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A prospective randomized study of Lichtenstein open tension-free versus laparoscopic totally extraperitoneal techniques for inguinal hernia repair. Author(s): Gokalp A, Inal M, Maralcan G, Baskonus I. Source: Acta Chir Belg. 2003 October; 103(5): 502-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14653037

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A prospective trial of primary inguinal hernia repair by surgical trainees. Author(s): Miedema BW, Ibrahim SM, Davis BD, Koivunen DG. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2004 February; 8(1): 28-32. Epub 2003 August 01. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12898290

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A randomized controlled trial of laparoscopic extraperitoneal hernia repair as a day surgical procedure. Author(s): Bessell JR, Baxter P, Riddell P, Watkin S, Maddern GJ. Source: Surgical Endoscopy. 1996 May; 10(5): 495-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8658325

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A retrospective study on the efficacy of short-term perioperative prophylaxis in abdominal surgery for hernia repair in 1,254 patients. Author(s): Gervino L, Cangioni G, Renzi F. Source: J Chemother. 2000 September; 12 Suppl 3: 34-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11432681

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A university experience using mesh in inguinal hernia repair. Author(s): Goldstein HS. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 December; 5(4): 182-5; Discussion 186-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12003045

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Abdominal wall hernia repair in patients with chronic renal failure and a dialysis catheter. Author(s): Guzman-Valdivia G, Zaga I. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 March; 5(1): 9-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11387729

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Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair. Author(s): Buinewicz B, Rosen B. Source: Annals of Plastic Surgery. 2004 February; 52(2): 188-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14745271

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Adhesion formation after laparoscopic ventral incisional hernia repair with polypropylene mesh: a study using abdominal ultrasound. Author(s): Bingener J, Kazantsev GB, Chopra S, Schwesinger WH. Source: Jsls. 2004 April-June; 8(2): 127-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15119656

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An audit of open and laparoscopic inguinal hernia repair. Author(s): Eno LM, Spigelman AD. Source: Journal of Quality in Clinical Practice. 2000 June-September; 20(2-3): 56-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11057983

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An audit of the early outcomes of ambulatory inguinal hernia repair at a surgical daycare centre. Author(s): Lau H, Lee F. Source: Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi / Hong Kong Academy of Medicine. 2000 June; 6(2): 218-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10895147

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An unusual case of gastric volvulus after laparoscopic paraesophageal hernia repair. Author(s): Sato K, Filipi CJ, Shiino Y, Mittal SK, Zacher K, Gardner GC, Awad ZT. Source: Surgical Endoscopy. 2001 July; 15(7): 757. Epub 2001 May 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11591985

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An unusual presentation of metastatic gastric cancer found during inguinal hernia repair: case report and review of the literature. Author(s): Oruc MT, Kulah B, Saylam B, Moran M, Albayrak L, Coskun F. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2002 July; 6(2): 8890. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12152647

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Analgesia-sedation for day-case inguinal hernia repair. A review of patient acceptance and morbidity. Author(s): McFarlane ME. Source: The West Indian Medical Journal. 2000 June; 49(2): 158-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10948857

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Antibiotic prophylaxis for hernia repair. Author(s): Sanchez-Manuel FJ, Seco-Gil JL. Source: Cochrane Database Syst Rev. 2003; (2): Cd003769. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12804490

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Antibiotic prophylaxis in clean surgery: breast surgery and hernia repair. Author(s): D'Amico DF, Parimbelli P, Ruffolo C. Source: J Chemother. 2001 November; 13 Spec No 1(1): 108-11. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11936352

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Antibiotic prophylaxis in incisional hernia repair using a prosthesis. Author(s): Rios A, Rodriguez JM, Munitiz V, Alcaraz P, Perez Flores D, Parrilla P. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 September; 5(3): 148-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11759801

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Assessing the costs and consequences of laparoscopic vs. open methods of groin hernia repair: a systematic review. Author(s): Vale L, Ludbrook A, Grant A. Source: Surgical Endoscopy. 2003 June; 17(6): 844-9. Epub 2003 March 14. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12632125

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Back to work more quickly after an inguinal hernia repair. Author(s): Ambach R, Weiss W, Sexton JL, Russo A. Source: Military Medicine. 2000 October; 165(10): 747-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11050871

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Best practice in groin hernia repair. Author(s): Macintyre IM. Source: The British Journal of Surgery. 2003 February; 90(2): 131-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12555287

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Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. Author(s): Katz EE, Patel RV, Sokoloff MH, Vargish T, Brendler CB. Source: The Journal of Urology. 2002 February; 167(2 Pt 1): 637-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11792935

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Bilateral paravertebral somatic nerve block for ventral hernia repair. Author(s): Naja Z, Ziade MF, Lonnqvist PA. Source: European Journal of Anaesthesiology. 2002 March; 19(3): 197-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12071240

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Blunt preperitoneal finger dissection during extraperitoneal laparoscopic inguinal hernia repair: an effective alternative to instrumental techniques. Author(s): Posta CG. Source: J Laparoendosc Surg. 1996 February; 6(1): 47-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8919177

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Bowel obstruction in the postoperative period of laparoscopic inguinal hernia repair (TAPP): review of the literature. Author(s): Cueto J, Vazquez JA, Solis MA, Valdez G, Valencia S, Weber A. Source: Jsls. 1998 July-September; 2(3): 277-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9876754

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Can laparoscopic hernia repair alter function and volume of testis? Randomized clinical trial. Author(s): Akbulut G, Serteser M, Yucel A, Degirmenci B, Yilmaz S, Polat C, San O, Dilek ON. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2003 December; 13(6): 377-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14712099

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Central mesh recurrence after incisional hernia repair with Marlex--are the meshes strong enough? Author(s): Langer C, Neufang T, Kley C, Liersch T, Becker H. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 September; 5(3): 164-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11759806

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Choice of anesthesia and risk of reoperation for recurrence in groin hernia repair. Author(s): Nordin P, Haapaniemi S, van der Linden W, Nilsson E. Source: Annals of Surgery. 2004 July; 240(1): 187-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15213635

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Chronic pain and quality of life following open inguinal hernia repair. Author(s): Silen W. Source: The British Journal of Surgery. 2002 January; 89(1): 123. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11851681

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Chronic pain and quality of life following open inguinal hernia repair. Author(s): Poobalan AS, Bruce J, King PM, Chambers WA, Krukowski ZH, Smith WC. Source: The British Journal of Surgery. 2001 August; 88(8): 1122-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11488800

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Churchill's inguinal hernia repair. Author(s): Connolly JE. Source: Journal of the American College of Surgeons. 2004 January; 198(1): 175-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14698330

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Clinical usefulness, safety, and plasma concentration of ropivacaine 0.5% for inguinal hernia repair in regional anesthesia. Author(s): Wulf H, Behnke H, Vogel I, Schroder J. Source: Regional Anesthesia and Pain Medicine. 2001 July-August; 26(4): 348-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11464355

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Combined transurethral prostatectomy and mesh-based tension-free inguinal hernia repair. Author(s): Gonzalez-Ojeda A, Anaya-Prado R, Fuentes-Orozco C, Portilla-de-Buen E, Mucino-Hernandez MI, Medina-Meza CO. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 September; 7(3): 141-5. Epub 2003 April 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712366

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Commentary: laparoscopic indirect hernia repair--the ring closure method. Author(s): Richards WO. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2001 October; 11(5): 303-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11642667

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Common iliac artery pseudoaneurysm following inguinal hernia repair--a case report and literature review. Author(s): Teodorescu VJ, Reiter BP. Source: Vascular Surgery. 2001 May-June; 35(3): 239-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452352

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Comparison between modern mesh and conventional non-mesh methods of inguinal hernia repair. Author(s): Pavlidis TE, Atmatzidis KS, Lazaridis CN, Papaziogas BT, Makris JG, Papaziogas TB. Source: Minerva Chir. 2002 February; 57(1): 7-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11832851

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Comparison of spinal vs general anesthesia via laryngeal mask airway in inguinal hernia repair. Author(s): Burney RE, Prabhu MA, Greenfield ML, Shanks A, O'Reilly M. Source: Archives of Surgery (Chicago, Ill. : 1960). 2004 February; 139(2): 183-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14769578

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Concurrent radical retropubic prostatectomy and inguinal hernia repair through a modified Pfannenstiel incision. Author(s): Manoharan M, Gomez P, Soloway MS. Source: Bju International. 2004 June; 93(9): 1203-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15180605

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Congenital diaphragmatic hernia repair on extracorporeal life support: a decade of lessons learned. Author(s): Austin MT, Lovvorn HN 3rd, Feurer ID, Pietsch J, Earl TM, Bartilson R, Neblett WW 3rd, Pietsch JB. Source: The American Surgeon. 2004 May; 70(5): 389-95; Discussion 395. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15156945

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Cost analysis of incisional hernia repair by suture or mesh. Author(s): Israelsson LA, Jonsson L, Wimo A. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 September; 7(3): 114-7. Epub 2003 February 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12942344

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Cost-effective, reliable laparoscopic hernia repair: a report on 500 consecutive repairs. Author(s): Fazzio FJ Jr. Source: Surgical Endoscopy. 2002 June; 16(6): 931-5. Epub 2002 February 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12163957

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Cost-utility analysis of open versus laparoscopic groin hernia repair: results from a multicentre randomized clinical trial (Br J Surg 2001; 88: 653-61). Author(s): O'Boyle CJ, Royston CM, Sedman PC. Source: The British Journal of Surgery. 2001 November; 88(11): 1543-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11683761

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Current laparoscopic inguinal hernia repair. Author(s): Roth JS, Johnson J, Hazey J, Pofahl W. Source: Current Surgery. 2004 January-February; 61(1): 53-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14972172

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Current status of laparoscopic ventral hernia repair. Author(s): Thoman DS, Phillips EH. Source: Surgical Endoscopy. 2002 June; 16(6): 939-42. Epub 2002 February 27. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12163959

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Cytokine modifications after tension-free hernioplasty or open conventional inguinal hernia repair. Author(s): Di Vita G, Milano S, Patti R, Raimondo D, Di Bella G, D'Agostino P, Leo P, Cillari E. Source: American Journal of Surgery. 2001 June; 181(6): 487-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11513771

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Danish nationwide cohort study of postoperative death in patients with liver cirrhosis undergoing hernia repair. Author(s): Hansen JB, Thulstrup AM, Vilstup H, Sorensen HT. Source: The British Journal of Surgery. 2002 June; 89(6): 805-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12027997

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Day case inguinal hernia repair under local anaesthetic. Author(s): Baskerville PA, Jarrett PE. Source: Annals of the Royal College of Surgeons of England. 1983 July; 65(4): 224-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6870127

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Day-care hernia repair using spinal anaesthesia. Author(s): Johnson PM. Source: Trop Doct. 1974 January; 4(1): 39. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4821281

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Day-case laparoscopic hernia repair in a single unit. Author(s): McCloud JM, Evans DS. Source: Surgical Endoscopy. 2003 March; 17(3): 491-3. Epub 2002 November 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12415338

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Day-case laparoscopic hernia repair. Author(s): Evans DS, Ghanesh P, Khan IM. Source: The British Journal of Surgery. 1996 October; 83(10): 1361-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8944451

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Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome. Author(s): Petersen S, Henke G, Freitag M, Faulhaber A, Ludwig K. Source: The European Journal of Surgery = Acta Chirurgica. 2001 June; 167(6): 453-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11471671

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Delayed onset femoral nerve block following an inguinal field block for hernia repair. Author(s): Kluger MT. Source: Anaesthesia and Intensive Care. 1998 October; 26(5): 592-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9807623

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Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Author(s): Rutkow IM. Source: The Surgical Clinics of North America. 2003 October; 83(5): 1045-51, V-Vi. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533902

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Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Author(s): Rutkow IM, Robbins AW. Source: The Surgical Clinics of North America. 1993 June; 73(3): 413-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8497793

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Dexon versus conventional sutures in hernia repair. Author(s): Baltazar N, Johnston DW. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1976 July; 19(4): 341-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=949645

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Different methods of hernia repair. Author(s): Rutledge RH. Source: Annals of Surgery. 1997 February; 225(2): 239-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9065304

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Difficult hernia repair in the elderly. A particular case. Author(s): Campanelli G, Senni-Buratti M, Ruca A, Nicolosi FM, Contessini-Avesani E. Source: Minerva Chir. 2003 August; 58(4): 601-3, 604-6. English, Italian. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14603176

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Disability and chronic pain after open mesh and laparoscopic inguinal hernia repair. Author(s): Bozuk M, Schuster R, Stewart D, Hicks K, Greaney G, Waxman K. Source: The American Surgeon. 2003 October; 69(10): 839-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570359

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Do ex-premature infants need mechanical ventilation for inguinal hernia repair? Author(s): Bouchut JC, Claris O. Source: British Journal of Anaesthesia. 2002 February; 88(2): 301-2; Author Reply 302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11878667

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Does V-A ECMO increase the likelihood of chylothorax after congenital diaphragmatic hernia repair? Author(s): Hanekamp MN, Tjin A Djie GC, van Hoek-Ottenkamp WG, Hazebroek FW, Tibboel D, Postema RR. Source: Journal of Pediatric Surgery. 2003 June; 38(6): 971-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12778405

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Don't expect a consensus on hernia repair. Author(s): Mathias JM. Source: Or Manager. 1995 November; 11(11): 1, 6-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10172505

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Double-straight device and laparoscopic incisional ventral hernia repair. Author(s): Critchlow JT. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2000 December; 10(6): 423. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147925

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Dysphagia complicating hiatal hernia repair. Author(s): Henderson RD. Source: The Journal of Thoracic and Cardiovascular Surgery. 1984 December; 88(6): 9228. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6503320

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Early results of inguinal hernia repair by the 'mesh plug' technique--first 200 cases. Author(s): Fasih T, Mahapatra TK, Waddington RT. Source: Annals of the Royal College of Surgeons of England. 2000 November; 82(6): 396400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11103156

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Effect of hiatus hernia repair and truncal vagotomy on human lower esophageal sphincter pressures. Author(s): Balison JR, Woodward ER. Source: Annals of Surgery. 1973 May; 177(5): 554-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4704040

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Effect of ilioinguinal and iliohypogastric nerve block and wound infiltration with 0.5% bupivacaine on postoperative pain after hernia repair. Author(s): Harrison CA, Morris S, Harvey JS. Source: British Journal of Anaesthesia. 1994 June; 72(6): 691-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8024918

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Effect of paraesophageal hernia repair on pulmonary function. Author(s): Low DE, Simchuk EJ. Source: The Annals of Thoracic Surgery. 2002 August; 74(2): 333-7; Discussion 337. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12173809

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Effect of single-dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh: the randomized, double-blind, prospective trial. Author(s): Yerdel MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, Kuterdem E. Source: Annals of Surgery. 2001 January; 233(1): 26-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11141221

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Effects of training and supervision on recurrence rate after inguinal hernia repair. Author(s): Robson AJ, Wallace CG, Sharma AK, Nixon SJ, Paterson-Brown S. Source: The British Journal of Surgery. 2004 June; 91(6): 774-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15164450

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Efficacy and safety of caudal injection of levobupivacaine, 0.25%, in children under 2 years of age undergoing inguinal hernia repair, circumcision or orchidopexy. Author(s): Taylor R, Eyres R, Chalkiadis GA, Austin S. Source: Paediatric Anaesthesia. 2003 February; 13(2): 114-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12562483

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Elective neurectomy during open, "tension free" inguinal hernia repair. Author(s): Tsakayannis DE, Kiriakopoulos AC, Linos DA. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2004 February; 8(1): 67-9. Epub 2003 October 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14586777

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Emergency replacement for damaged balloon dissector for laparoscopic extraperitoneal inguinal hernia repair. Author(s): Pekmezci S, Saribeyoglu K. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2001 August; 11(4): 289-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11525379

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Endoscopic assessment of hiatal hernia repair. Author(s): Johnson DA, Younes Z, Hogan WJ. Source: Gastrointestinal Endoscopy. 2000 November; 52(5): 650-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11060191

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Endoscopic inguinal hernia repair in comparison with Shouldice and Lichtenstein repair. A systematic review of randomized trials. Author(s): Schmedt CG, Leibl BJ, Bittner R. Source: Digestive Surgery. 2002; 19(6): 511-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12499747

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Endoscopic totally preperitoneal ventral hernia repair. Author(s): Miserez M, Penninckx F. Source: Surgical Endoscopy. 2002 August; 16(8): 1207-13. Epub 2002 April 09. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12189482

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Evaluation of routine barium enema and proctosigmoidoscopy before hernia repair. Author(s): Patton JJ, Benfield JR. Source: Rev Surg. 1970 March-April; 27(2): 145. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5446538

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Evaluation of staples and prostheses for use in laparoscopic inguinal hernia repair. Author(s): Powell JJ, Murray GD, O'Dwyer PJ. Source: J Laparoendosc Surg. 1994 April; 4(2): 109-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8043917

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Evolution of hernia repair: a salute to Professor Piero Pietri. Author(s): Nyhus LM. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 December; 5(4): 196-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12003048

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Experience with the preperitoneal 'plug and patch' inguinal hernia repair. Author(s): Ramanand B, Fayaz M, Patil P. Source: The British Journal of Surgery. 2000 April; 87(4): 517. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10809565

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Experience--the key factor in successful laparoscopic total extraperitoneal and transabdominal preperitoneal hernia repair. Author(s): Bobrzynski A, Budzynski A, Biesiada Z, Kowalczyk M, Lubikowski J, Sienko J. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 June; 5(2): 803. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11505653

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Exploiting vs avoiding the preperitoneal space in inguinal hernia repair. Author(s): Amid PK. Source: Archives of Surgery (Chicago, Ill. : 1960). 2004 February; 139(2): 130. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14769567

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Extraperitoneal endoscopic groin hernia repair under epidural anesthesia. Author(s): Chowbey PK, Sood J, Vashistha A, Sharma A, Khullar R, Soni V, Baijal M. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2003 June; 13(3): 185-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12819503

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Extraperitoneal laparoscopic hernia repair with local anesthesia. Author(s): Edelman DS, Misiakos EP, Moses K. Source: Surgical Endoscopy. 2001 September; 15(9): 976-80. Epub 2001 June 12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11443449

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Factors associated with early discharge after inguinal hernia repair in 500 consecutive unselected patients. French Associations for Surgical Research. Author(s): Millat B, Fingerhut A, Gignoux M, Hay JM. Source: The British Journal of Surgery. 1993 September; 80(9): 1158-60. Erratum In: Br J Surg 1993 November; 80(11): 1491. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8402121

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Feasibility of local infiltration anaesthesia for recurrent groin hernia repair. Author(s): Callesen T, Bech K, Kehlet H. Source: The European Journal of Surgery = Acta Chirurgica. 2001 November; 167(11): 851-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11848240

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Femoral hernia repair with mesh-plug in children. Author(s): Ceran C, Koyluoglu G, Sonmez K. Source: Journal of Pediatric Surgery. 2002 October; 37(10): 1456-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12378453

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Femoral hernia repair. Author(s): Hachisuka T. Source: The Surgical Clinics of North America. 2003 October; 83(5): 1189-205. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533910

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Femoral nerve block after inguinal hernia repair. Author(s): Collier CB. Source: Anaesthesia. 1989 February; 44(2): 169. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2539027

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Femoral nerve injury following inguinal hernia repair. Author(s): van Hoff J, Shaywitz BA, Seashore JH, Collins WF. Source: Pediatric Neurology. 1985 May-June; 1(3): 195-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3880405

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Fertility of men following inguinal hernia repair. Author(s): Yavetz H, Harash B, Yogev L, Homonnai ZT, Paz G. Source: Andrologia. 1991 November-December; 23(6): 443-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1814243

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First laparoscopic hernia repair onboard an aircraft carrier at sea. Author(s): Cubano MA, Luther JH, Antosek LE. Source: Military Medicine. 1997 March; 162(3): 219-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9121672

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Five-year experience with the "four-before" laparoscopic ventral hernia repair. Author(s): Reitter DR, Paulsen JK, Debord JR, Estes NC. Source: The American Surgeon. 2000 May; 66(5): 465-8; Discussion 468-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10824747

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Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Author(s): Wright D, Paterson C, Scott N, Hair A, O'Dwyer PJ. Source: Annals of Surgery. 2002 March; 235(3): 333-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11882754

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Focal testicular infarction from laparoscopic inguinal hernia repair. Author(s): Mincheff T, Bannister B, Zubel P. Source: Jsls. 2002 July-September; 6(3): 211-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12166758

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Follow-up after inguinal hernia repair. Questionnaire compared with physical examination: a prospective study in 299 patients. Author(s): Vos PM, Simons MP, Luitse JS, van Geldere D, Koelemaij MJ, Obertop H. Source: The European Journal of Surgery = Acta Chirurgica. 1998 July; 164(7): 533-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9696976

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From androlog. Potential for vasal occlusion among men after hernia repair using mesh. Author(s): Meacham RB. Source: Journal of Andrology. 2002 November-December; 23(6): 759-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12399520

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From Bassini to tension-free mesh hernia repair. Review of 1409 consecutive cases. Author(s): Rulli F, Percudani M, Muzi M, Tucci G, Sianesi M. Source: G Chir. 1998 June-July; 19(6-7): 285-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9707835

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Functional and morphological evaluation of a low-weight, monofilament polypropylene mesh for hernia repair. Author(s): Klinge U, Junge K, Stumpf M, AP AP, Klosterhalfen B. Source: Journal of Biomedical Materials Research. 2002; 63(2): 129-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11870645

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Functional impairment and complaints following incisional hernia repair with different polypropylene meshes. Author(s): Welty G, Klinge U, Klosterhalfen B, Kasperk R, Schumpelick V. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 September; 5(3): 142-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11759800

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Gas extravasation complicating laparoscopic extraperitoneal inguinal hernia repair. Author(s): Hagopian EJ, Steichen FM, Lee KF, Earle DB. Source: Surgical Endoscopy. 2001 March; 15(3): 324. Epub 2001 February 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344443

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Gastric acid secretion (GAS) and hiatal hernia. II. Relationship between GAS and clinical results after hernia repair. Author(s): Gatzinsky P, Granerus G, Sandberg N. Source: Acta Chir Scand. 1980; 146(8): 591-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7223299

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Gastroplasty and Belsey hiatus hernia repair. An operation for the management of peptic stricture with acquired short esophagus. Author(s): Pearson FG, Langer B, Henderson RD. Source: The Journal of Thoracic and Cardiovascular Surgery. 1971 January; 61(1): 50-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5540462

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General anesthesia with isoflurane for diaphragmatic hernia repair during ECMO. Author(s): Atkinson JB, Hamid R, Steward DJ. Source: Asaio Journal (American Society for Artificial Internal Organs : 1992). 1994 October-December; 40(4): 986-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7858337

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Giant prosthetic reinforcement of the visceral sac. The Stoppa groin hernia repair. Author(s): Wantz GE. Source: The Surgical Clinics of North America. 1998 December; 78(6): 1075-87. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9927985

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Groin hernia repair in Scotland. Author(s): Hair A, Duffy K, McLean J, Taylor S, Smith H, Walker A, MacIntyre IM, O'Dwyer PJ. Source: The British Journal of Surgery. 2000 December; 87(12): 1722-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11122192

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Groin hernia repair incidental to colon surgery. Author(s): Block IR, Estrin J, Fries CC. Source: Diseases of the Colon and Rectum. 1966 March-April; 9(2): 116-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5325426

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Groin Laparoscopy: a new technique for contralateral groin evaluation in pediatric inguinal hernia repair. Author(s): Colodny AH. Source: Journal of the American College of Surgeons. 1996 April; 182(4): 378. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8605564

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Groin laparoscopy: a new technique for contralateral groin evaluation in pediatric inguinal hernia repair. Author(s): Groner JI, Marlow J, Teich S. Source: Journal of the American College of Surgeons. 1995 August; 181(2): 168-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7627391

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Groin pain after hernia repair. Author(s): Condon RE. Source: Annals of Surgery. 2001 January; 233(1): 8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11141217

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Guide to hernia repair. Strain of thought. Author(s): Bryan J. Source: Health Serv J. 1999 January 28; 109(5639): Suppl 12-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10345645

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Guidelines for inguinal hernia repair in everyday practice. Author(s): Metzger J, Lutz N, Laidlaw I. Source: Annals of the Royal College of Surgeons of England. 2001 May; 83(3): 209-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11432143

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Have outcomes of incisional hernia repair improved with time? A population-based analysis. Author(s): Flum DR, Horvath K, Koepsell T. Source: Annals of Surgery. 2003 January; 237(1): 129-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12496540

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Hernia repair during endoscopic (laparoscopic) radical prostatectomy. Author(s): Stolzenburg JU, Rabenalt R, Dietel A, Do M, Pfeiffer H, Schwalbe S, Dorschner W. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2003 February; 13(1): 27-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676018

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Hernia repair during endoscopic extraperitoneal lymph node dissection. Author(s): Ferzli GS, Usal H, Hayek NE, Zeitlin S, Hurwitz JB, Albert P. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 1997 June; 7(3): 163-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9448127

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Hernia repair in elderly patients. Author(s): Gianetta E, de Cian F, Cuneo S, Friedman D, Vitale B, Marinari G, Baschieri G, Camerini G. Source: The British Journal of Surgery. 1997 July; 84(7): 983-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9240142

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Hernia repair mesh-associated Mycobacterium goodii infection. Author(s): Sohail MR, Smilack JD. Source: Journal of Clinical Microbiology. 2004 June; 42(6): 2858-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15184492

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Hernia repair without disability. Author(s): Raffman RA. Source: J Med Soc N J. 1972 August; 64(8): 651-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4504948

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Hernia repair. Author(s): Kingsnorth AN. Source: Lancet. 1994 June 11; 343(8911): 1500-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7911197

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Hernia repair. Author(s): Wright D, O'Dwyer PJ, Baxter J. Source: Lancet. 1994 May 7; 343(8906): 1164. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7910256

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Hernia repair. Author(s): Darzi A, Bouchier-Hayes D, Menzies-Gow N, Nduka CC. Source: Lancet. 1994 May 7; 343(8906): 1164. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7910255

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Hernia repair. Author(s): Notaras MJ. Source: Lancet. 1994 May 7; 343(8906): 1163-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7910254

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Hernia repair. Clinical indicators. Author(s): Clarke AD, Howat JM. Source: Annals of the Royal College of Surgeons of England. 1999 November; 81(6): 4345. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10655899

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Herniography and ultrasonography. A prospective study comparing the effectiveness of laparoscopic hernia repair with extraperitoneal balloon dissection. Author(s): Dilek ON, Bozkurt M, Arslan H, Kisli E, Poyraz N, Berberoglu M. Source: Surgical Endoscopy. 1997 January; 11(1): 29-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8994984

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Hernioplasty and simultaneous laparoscopic cholecystectomy: a prospective randomized study of open tension-free versus laparoscopic inguinal hernia repair. Author(s): Sarli L, Villa F, Marchesi F. Source: Surgery. 2001 May; 129(5): 530-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11331444

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Hiatal hernia repair by posterior gastropexy. Author(s): Marshall RD, Gay GP. Source: The Australian and New Zealand Journal of Surgery. 1975 November; 45(4): 37680. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1061558

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Hiatal hernia repair. Author(s): Mokka RE, Laitinen S, Punto L, Kairaluoma MI, Pokela R, Karkola P, Huttunen R, Larmi TK. Source: Ann Chir Gynaecol. 1976; 65(6): 369-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1020901

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Hiatus hernia repair. Clinical and radiological results of a new combined thoracoabdominal technique. Author(s): Kennedy MC, Sutherland HD. Source: The Medical Journal of Australia. 1974 March 16; 1(11): 386-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4829550

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High recurrence rate 12 years after primary inguinal hernia repair. Author(s): Melis P, van der Drift DG, Sybrandy R, Go PM. Source: The European Journal of Surgery = Acta Chirurgica. 2000 April; 166(4): 313-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10817329

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High-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair: a clinical and pharmacokinetic evaluation. Author(s): Pettersson N, Emanuelsson BM, Reventlid H, Hahn RG. Source: Regional Anesthesia and Pain Medicine. 1998 March-April; 23(2): 189-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9570609

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Historical aspects of laparoscopic hernia repair. Author(s): Ger R. Source: Semin Laparosc Surg. 1998 December; 5(4): 212-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9854127

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Historical evolution of inguinal hernia repair. Author(s): Sachs M, Damm M, Encke A. Source: World Journal of Surgery. 1997 February; 21(2): 218-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8995083

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Ilioinguinal and iliohypogastric nerve block revisited: single shot versus double shot technique for hernia repair in children. Author(s): Lim SL, Ng Sb A, Tan GM. Source: Paediatric Anaesthesia. 2002 March; 12(3): 255-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11903940

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Impact of randomized trials regarding endoscopic inguinal hernia repair in The Netherlands. Author(s): Voyles CR. Source: Surgical Endoscopy. 2002 March; 16(3): 547. Epub 2001 November 16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11928053

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Improved long-lasting postoperative analgesia, recovery function and patient satisfaction after inguinal hernia repair with inguinal field block compared with general anesthesia. Author(s): Aasbo V, Thuen A, Raeder J. Source: Acta Anaesthesiologica Scandinavica. 2002 July; 46(6): 674-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12059890

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Incisional hernia repair after orthotopic liver transplantation: a technique employing an inlay/onlay polypropylene mesh. Author(s): Muller V, Lehner M, Klein P, Hohenberger W, Ott R. Source: Langenbeck's Archives of Surgery / Deutsche Gesellschaft Fur Chirurgie. 2003 July; 388(3): 167-73. Epub 2003 June 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12811565

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Incisional hernia repair. Author(s): Millikan KW. Source: The Surgical Clinics of North America. 2003 October; 83(5): 1223-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533912

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Incisional hernia repair: tensiometry for the selection of the appropriate procedure. Author(s): Reingruber B, Kastl S, Stremmel C, Klein PD. Source: The European Journal of Surgery = Acta Chirurgica. 2001 December; 167(12): 903-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11841080

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Incisional self-administration of bupivacaine or ropivacaine provides effective analgesia after inguinal hernia repair. Author(s): Vintar N, Pozlep G, Rawal N, Godec M, Rakovec S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 May; 49(5): 481-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11983663

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Influence of suture material and surgical technique on risk of reoperation after nonmesh open hernia repair (Br J Surg 2003; 90: 1004-1008). Author(s): Amalesh T. Source: The British Journal of Surgery. 2004 February; 91(2): 253. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14760680

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Influence of suture material and surgical technique on risk of reoperation after nonmesh open hernia repair. Author(s): Nordin P, Haapaniemi S, Kald A, Nilsson E. Source: The British Journal of Surgery. 2003 August; 90(8): 1004-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12905556

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Inguinal hernia repair in a premature infant. Author(s): Miserez M. Source: Journal of Pediatric Surgery. 2004 February; 39(2): 252. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14966762

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Inguinal hernia repair with beta glucan-coated mesh: prospective multicenter study (115 cases)--preliminary results. Author(s): Barrat C, Seriser F, Arnoud R, Trouette P, Champault G. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2004 February; 8(1): 33-8. Epub 2003 September 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13680304

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Inguinal hernia repair. Author(s): Macintyre IMC. Source: Journal of the Royal College of Surgeons of Edinburgh. 2001 December; 46(6): 349-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11768576

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Inguinal hernia repair: anaesthesia, pain and convalescence. Author(s): Callesen T. Source: Dan Med Bull. 2003 August; 50(3): 203-18. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13677240

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Inguinal hernia repair: where to next? Author(s): Zib M, Gani J. Source: Anz Journal of Surgery. 2002 August; 72(8): 573-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12190732

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Inguinal hernia repair: where to next? Author(s): Amid PK. Source: Anz Journal of Surgery. 2003 May; 73(5): 352; Author Reply 352-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12752296

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Inguinal hernia: obligatory indication for elective surgery? A prospective assessment of quality of life before and after plug and patch inguinal hernia repair. Author(s): Zieren J, Kupper F, Paul M, Neuss H, Muller JM. Source: Langenbeck's Archives of Surgery / Deutsche Gesellschaft Fur Chirurgie. 2003 February; 387(11-12): 417-20. Epub 2003 January 11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12607122

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Inguinal hernioplasty: the gold standard of hernia repair. Author(s): Forte A, D'Urso A, Palumbo P, Lo Storto G, Gallinaro LS, Bezzi M, Beltrami V. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 March; 7(1): 35-8. Epub 2002 December 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12612796

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Intestinal obstruction after totally extraperitoneal laparoscopic inguinal hernia repair. Author(s): Rink J, Ali A. Source: Jsls. 2004 January-March; 8(1): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14974673

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Intraperitoneal underlay ventral hernia repair utilizing bilayer expanded polytetrafluoroethylene and polypropylene mesh. Author(s): Millikan KW, Baptista M, Amin B, Deziel DJ, Doolas A. Source: The American Surgeon. 2003 April; 69(4): 287-91; Discussion 291-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12716085

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Is parastomal hernia repair with polypropylene mesh safe? Author(s): Steele SR, Lee P, Martin MJ, Mullenix PS, Sullivan ES. Source: American Journal of Surgery. 2003 May; 185(5): 436-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12727563

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Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial. Author(s): Andersson B, Hallen M, Leveau P, Bergenfelz A, Westerdahl J. Source: Surgery. 2003 May; 133(5): 464-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12773973

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Laparoscopic incisional hernia repair in liver transplant and other immunosuppressed patients. Author(s): Andreoni KA, Lightfoot H Jr, Gerber DA, Johnson MW, Fair JH. Source: American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2002 April; 2(4): 349-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12118857

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Laparoscopic incisional hernia repair: a technical advance. Author(s): Chu UB, Adrales GL, Schwartz RW, Park AE. Source: Current Surgery. 2003 May-June; 60(3): 287-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14972258

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Laparoscopic paracecal hernia repair. Author(s): Omori H, Asahi H, Inoue Y, Irinoda T, Saito K. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2003 February; 13(1): 55-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676024

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Laparoscopic paraesophageal hernia repair, a challenging operation: medium-term outcome of 116 patients. Author(s): Diaz S, Brunt LM, Klingensmith ME, Frisella PM, Soper NJ. Source: Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. 2003 January; 7(1): 59-66; Discussion 66-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12559186

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Laparoscopic parastomal hernia repair. Author(s): Gould JC, Ellison EC. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2003 February; 13(1): 51-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12598761

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Laparoscopic parastomal hernia repair. Author(s): Deol ZK, Shayani V. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 February; 138(2): 203-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12578421

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Laparoscopic techniques versus open techniques for inguinal hernia repair. Author(s): McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Source: Cochrane Database Syst Rev. 2003; (1): Cd001785. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12535413

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Laparoscopic ventral and incisional hernia repair: an 11-year experience. Author(s): Franklin ME Jr, Gonzalez JJ Jr, Glass JL, Manjarrez A. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2004 February; 8(1): 23-7. Epub 2003 September 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14505237

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Laparoscopic ventral hernia repair with extraperitoneal mesh: surgical technique and early results. Author(s): Chowbey PK, Sharma A, Khullar R, Soni V, Baijal M. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2003 April; 13(2): 101-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12709615

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Laparoscopic ventral hernia repair. Author(s): Miedema BW. Source: Surgical Endoscopy. 2003 October; 17(10): 1684; Author Reply 1685. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14702978

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Laparoscopic ventral hernia repair: an initial institutional experience. Author(s): Varghese TK, Denham DW, Dawes LG, Murayama KM, Prystowsky JB, Joehl RJ. Source: The Journal of Surgical Research. 2002 June 15; 105(2): 115-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12121696

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Laparoscopic versus open umbilical hernia repair. Author(s): Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ. Source: Jsls. 2003 October-December; 7(4): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14626398

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Laparoscopy for hemoperitoneum after traditional inguinal hernia repair. Author(s): Yamada T, Kasamatsu H, Fujita S, Mori H. Source: Jsls. 2002 July-September; 6(3): 221-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12166761

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Late complication of open inguinal hernia repair: small bowel obstruction caused by intraperitoneal mesh migration. Author(s): Ferrone R, Scarone PC, Natalini G. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 September; 7(3): 161-2. Epub 2003 April 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712367

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Lateral cutaneous nerve of the thigh pain in association with inguinal hernia repair. Author(s): Davies RG, Arthurs G. Source: Anaesthesia. 2003 May; 58(5): 489-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694017

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Learning curve for laparoscopic ventral hernia repair. Author(s): Bencini L, Sanchez LJ. Source: American Journal of Surgery. 2004 March; 187(3): 378-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15006566

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Local injection for the treatment of suture site pain after laparoscopic ventral hernia repair. Author(s): Carbonell AM, Harold KL, Mahmutovic AJ, Hassan R, Matthews BD, Kercher KW, Sing RF, Heniford BT. Source: The American Surgeon. 2003 August; 69(8): 688-91; Discussion 691-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12953827

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Local or general anesthesia for open hernia repair: a randomized trial. Author(s): O'Dwyer PJ, Serpell MG, Millar K, Paterson C, Young D, Hair A, Courtney CA, Horgan P, Kumar S, Walker A, Ford I. Source: Annals of Surgery. 2003 April; 237(4): 574-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12677155

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Local, regional, or general anaesthesia in groin hernia repair: multicentre randomised trial. Author(s): Nordin P, Zetterstrom H, Gunnarsson U, Nilsson E. Source: Lancet. 2003 September 13; 362(9387): 853-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13678971

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Male genital tract injuries after contemporary inguinal hernia repair. Author(s): Ridgway PF, Shah J, Darzi AW. Source: Bju International. 2002 August; 90(3): 272-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12133064

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Management of chronic postoperative pain following incisional hernia repair with Composix mesh: a report of two cases. Author(s): LeBlanc KA, Whitaker JM. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2002 December; 6(4): 194-7. Epub 2002 September 11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12424601

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Medium-term follow-up confirms the safety and durability of laparoscopic ventral hernia repair with PTFE. Author(s): Eid GM, Prince JM, Mattar SG, Hamad G, Ikrammudin S, Schauer PR. Source: Surgery. 2003 October; 134(4): 599-603; Discussion 603-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14605620

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Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials and laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Author(s): Aldridge AJ, Nehra D. Source: The British Journal of Surgery. 2001 March; 88(3): 471. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11269270

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Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials and laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Author(s): Wijesuriya LI. Source: The British Journal of Surgery. 2001 March; 88(3): 471. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11269269

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Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials and laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Author(s): Slater GH, Hopkins G, Bailey M. Source: The British Journal of Surgery. 2001 March; 88(3): 470-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11260123

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Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Author(s): Collaboration EH. Source: The British Journal of Surgery. 2000 July; 87(7): 854-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10931018

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Mesh prosthesis versus triangular flap from the anterior sheath of the abdominal rectus muscle in primary inguinal hernia repair. Author(s): Guzman-Valdivia Gomez G. Source: Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research. 2003 January-February; 16(1): 45-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12554339

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Meta-analysis of laparoscopic inguinal hernia repair favors open hernia repair with preperitoneal mesh prosthesis. Author(s): Slim K. Source: American Journal of Surgery. 2003 April; 185(4): 395; Author Reply 395. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12657399

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Meta-analysis of laparoscopic inguinal hernia trials favors open hernia repair with preperitoneal mesh prosthesis. Author(s): Voyles CR, Hamilton BJ, Johnson WD, Kano N. Source: American Journal of Surgery. 2002 July; 184(1): 6-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12135710

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Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair (Br J Surg 2003; 90: 1479-1492). Author(s): Kehlet H, Kingsnorth A. Source: The British Journal of Surgery. 2004 April; 91(4): 509. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15048759

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Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair (Br J Surg 2004; 91: 253. Author(s): Das D. Source: The British Journal of Surgery. 2004 May; 91(5): 647. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15122626

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Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Author(s): Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR. Source: The British Journal of Surgery. 2003 December; 90(12): 1479-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14648725

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Metabolic responses after laparoscopic or open hernia repair. Author(s): Schrenk P, Bettelheim P, Woisetschlager R, Rieger R, Wayand WU. Source: Surgical Endoscopy. 1996 June; 10(6): 628-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8662400

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Migrating mesh plug: complication of a well-established hernia repair technique. Author(s): Moorman ML, Price PD. Source: The American Surgeon. 2004 April; 70(4): 298-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15098779

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Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases. Author(s): Koehler RH, Begos D, Berger D, Carey S, LeBlanc K, Park A, Ramshaw B, Smoot R, Voeller G. Source: Jsls. 2003 October-December; 7(4): 335-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14626400

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Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases. Author(s): Koehler RH, Begos D, Berger D, Carey S, LeBlanc K, Park A, Ramshaw B, Smoot R, Voeller G. Source: Zentralblatt Fur Chirurgie. 2003 August; 128(8): 625-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12931256

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Minimally invasive approaches to inguinal hernia repair. Author(s): Safadi BY, Duh QY. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2001 December; 11(6): 361-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11814126

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Minimally invasive preperitoneal inguinal hernia repair with epidural anaesthesia. Author(s): Salihoglu Z, Demiroluk S, Yavuz N. Source: Anaesthesia and Intensive Care. 2002 December; 30(6): 813-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12500526

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Modifications to Rives technique for midline incisional hernia repair. Author(s): Martin-Duce A, Noguerales F, Villeta R, Hernandez P, Lozano O, Keller J, Granell J. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 June; 5(2): 702. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11505651

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Needlescopic inguinal hernia repair in children. Author(s): Shalaby R, Desoky A. Source: Pediatric Surgery International. 2002 March; 18(2-3): 153-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11956783

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Nerve injury during laparoscopic inguinal hernia repair. Author(s): Kraus MA. Source: Surgical Laparoscopy & Endoscopy. 1993 August; 3(4): 342-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8269257

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Nerve irritation after laparoscopic hernia repair. Author(s): Stark E, Oestreich K, Wendl K, Rumstadt B, Hagmuller E. Source: Surgical Endoscopy. 1999 September; 13(9): 878-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10449843

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Neuralgia after inguinal hernia repair. Author(s): Bower S, Moore BB, Weiss SM. Source: The American Surgeon. 1996 August; 62(8): 664-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8712565

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New developments in hernia repair. Author(s): Voeller GR. Source: Surg Technol Int. 2003; 11: 111-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12931291

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New method for paracolostomy hernia repair? Author(s): Stelzner S, Hellmich G, Ludwig K. Source: Diseases of the Colon and Rectum. 1999 June; 42(6): 823. Erratum In: Dis Colon Rectum 1999 July; 42(7): 880. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10378610

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New method of femoral hernia repair using a silastic stud. Author(s): Know AJ, Caldwell KP. Source: British Medical Journal. 1971 March 13; 1(749): 604-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5548304

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New method of inguinal hernia repair: a new solution. Author(s): Losanoff JE, Jones JW, Richman BW. Source: Anz Journal of Surgery. 2001 November; 71(11): 680-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11736834

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New method of inguinal hernia repair: a new solution. Author(s): Desarda MP. Source: Anz Journal of Surgery. 2001 April; 71(4): 241-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11355734

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New surgical procedure for sliding inguinal hernia repair in female infants and girls. Author(s): Kaneko K, Ando H, Tsuda M. Source: Journal of the American College of Surgeons. 2002 April; 194(4): 544-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11949760

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New techniques in hernia repair. Author(s): Bendavid R. Source: World Journal of Surgery. 1989 September-October; 13(5): 522-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2815797

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New trends: preperitoneal laparoscopic inguinal hernia repair. Author(s): Ammar G, Abdelnour A, Souraty P. Source: J Med Liban. 1996; 44(3): 138-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9260401

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Nissen fundoplication for hiatus hernia repair. Author(s): Simmons S, Given B. Source: Aorn Journal. 1981 July; 34(1): 35-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6167202

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Nissen hiatal hernia repair: problems of recurrence and continued symptoms. Author(s): Henderson RD. Source: The Annals of Thoracic Surgery. 1979 December; 28(6): 587-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=518187

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Nursing care study. Prostatectomy and hernia repair: an old soldier 'relieved' in time. Author(s): Small K. Source: Nurs Mirror. 1979 June 21; 148(25): 30-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=88046

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Obesity is a risk factor for recurrence after incisional hernia repair. Author(s): Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2004 February; 8(1): 42-6. Epub 2003 September 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13680307

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Obstructing internal hernia complicating totally extraperitoneal inguinal hernia repair. Author(s): Lodha K, Deans A, Bhattacharya P, Underwood JW. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 1998 June; 8(3): 167-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9681431

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Obturator hernia repair--a new technique. Author(s): Maharaj D, Maharaj S, Young L, Ramdass MJ, Naraynsingh V. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2002 March; 6(1): 45-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12090583

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Open mesh-plug technique in inguinal hernia repair--short-term results. Author(s): Seleem MI. Source: S Afr J Surg. 2003 May; 41(2): 44-7; Discussion 47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12889242

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Open vs laparoscopic hernia repair. Analysis of costs, charges, and outcomes. Author(s): Schurz JW, Arregui ME, Hammond JC. Source: Surgical Endoscopy. 1995 December; 9(12): 1311-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8629218

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Operating and anaesthetic time required for inguinal hernia repair in the neonate. Author(s): Burge DM. Source: Pediatric Surgery International. 2003 November; 19(9-10): 646-8. Epub 2003 October 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14579072

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Operative complications of hernia repair in childhood. Author(s): Tiryaki T, Baskin D, Bulut M. Source: Pediatric Surgery International. 1998 March; 13(2-3): 160-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9563033

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Operative techniques in inguinal hernia repair associated with patients returning to work. Author(s): Himal HS. Source: Surgery. 2002 June; 131(6): 694; Author Reply 694-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12075190

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Optimal mesh size for endoscopic inguinal hernia repair: a study in a porcine model. Author(s): Knook MT, van Rosmalen AC, Yoder BE, Kleinrensink GJ, Snijders CJ, Looman CW, van Steensel CJ. Source: Surgical Endoscopy. 2001 December; 15(12): 1471-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11965468

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Optimal timing of elective indirect inguinal hernia repair in healthy children: clinical considerations for improved outcome. Author(s): Stephens BJ, Rice WT, Koucky CJ, Gruenberg JC. Source: World Journal of Surgery. 1992 September-October; 16(5): 952-6; Discussion 957. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1462636

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Osteomyelitis of the symphysis pubis after inguinal hernia repair. Author(s): Baxandall RC, Curtis MJ, Cahill CJ. Source: Annals of the Royal College of Surgeons of England. 1996 January; 78(1): 65-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8659980

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Other methods of laparoendoscopic hernia repair: mini-hernia--inguinal hernia repair through a 2-cm incision. Author(s): Nduka C, Darzi A. Source: Semin Laparosc Surg. 1998 December; 5(4): 248-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9854134

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Outcome of inguinal hernia repair total extraperitoneal laparoscopic hernia repair versus open tension free repair (Lichtenstein technique). Author(s): Subwongcharoen S. Source: J Med Assoc Thai. 2002 October; 85(10): 1100-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12501902

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Outcome of laparoscopic transabdominal preperitoneal inguinal hernia repair. Author(s): Toouli J, Baldini E, Casaccia M, Gugenheim J, Migliori G, Mouiel J. Source: Surgical Laparoscopy & Endoscopy. 1998 June; 8(3): 223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9649049

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Outcome of laparoscopic ventral hernia repair in correlation with obesity, type of hernia, and hernia size. Author(s): Raftopoulos I, Vanuno D, Khorsand J, Ninos J, Kouraklis G, Lasky P. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2002 December; 12(6): 425-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12590723

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Outpatient hernia repair. The Shouldice technique. Author(s): Long TD, Sandler J. Source: Aorn Journal. 1990 October; 52(4): 801, 804-11, 814-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2241129

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Overnight hernia repair: updated considerations. Author(s): Gilbert AI. Source: Southern Medical Journal. 1987 February; 80(2): 191-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3810215

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Overview of nonrandomized studies of laparoscopic hernia repair. Author(s): Horgan PG. Source: Semin Laparosc Surg. 1998 December; 5(4): 233-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9854131

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Overview of randomized trials in laparoscopic inguinal hernia repair. Author(s): Go PM. Source: Semin Laparosc Surg. 1998 December; 5(4): 238-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9854132

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Overview of randomized trials of inguinal hernia repair-a European Union concerted action. Report of first collaborators' meeting, Nieuwegein, the Netherlands, October 16-17, 1998. EU Hernia Trialists Collaboration. Author(s): Webb K. Source: Surgical Endoscopy. 1999 October; 13(10): 1030-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10526042

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Paraesophageal hernia repair and deep vein thrombosis. Author(s): Tang SJ, Tran T, Memmesheimer C, Pandol S, Aranda R, Pisegna JR, Jensen DM. Source: Journal of Clinical Gastroenterology. 2002 February; 34(2): 187-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11782617

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Paravertebral block anesthesia for inguinal hernia repair. Author(s): Weltz CR, Klein SM, Arbo JE, Greengrass RA. Source: World Journal of Surgery. 2003 April; 27(4): 425-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12658486

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Paravertebral blockade vs general anesthesia or spinal anesthesia for inguinal hernia repair. Author(s): Naja MZ, el Hassan MJ, Oweidat M, Zbibo R, Ziade MF, Lonnqvist PA. Source: Middle East J Anesthesiol. 2001 June; 16(2): 201-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11565433

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Paravesical abscess as an unusual late complication of inguinal hernia repair in children. Author(s): Imamoglu M, Cay A, Sarihan H, Ahmetoglu A, Ozdemir O. Source: The Journal of Urology. 2004 March; 171(3): 1268-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14767328

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Planned totally extraperitoneal laparoscopic Spigelian hernia repair. Author(s): Tarnoff M, Rosen M, Brody F. Source: Surgical Endoscopy. 2002 February; 16(2): 359. Epub 2001 December 10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11967699

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Postoperative analgesia is not different after local vs systemic administration of meloxicam in patients undergoing inguinal hernia repair. Author(s): Romsing J, Mysager S, Vilmann P, Sonne J, Larsen NE, stergaard D. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2001 November; 48(10): 978-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11698316

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Postoperative convalescence after inguinal hernia surgery: prospective randomized multicenter study of laparoscopic versus shouldice inguinal hernia repair in 1042 patients. Author(s): Berndsen F, Arvidsson D, Enander LK, Leijonmarck CE, Wingren U, Rudberg C, Smedberg S, Wickbom G, Montgomery A. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2002 July; 6(2): 5661. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12152639

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Postoperative necrotizing enterocolitis following incarcerated inguinal hernia repair: report of a case. Author(s): Turkyilmaz Z, Sonmez K, Numanoglu V, Kale N, Basaklar AC. Source: Surgery Today. 2001; 31(6): 550-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11428613

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Preperitoneal inguinal hernia repair during pelvic surgery. Author(s): Medica M, Germinale F, Giglio M, Campodonico F, Raggio M, Carmignani G. Source: Arch Esp Urol. 2002 March; 55(2): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12014057

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Pre-vascular hernia: a rare cause of chronic obscure groin pain after inguinal hernia repair. Author(s): Aldridge AJ, Packham IM, Nash AG. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2001 March; 5(1): 53-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11387726

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Previous appendicitis may affect peritoneal overlap of the mesh in laparoscopic inguinal hernia repair. Author(s): Vecchio R, Di Martino M, Lipari G, Sambataro L. Source: Surgical Endoscopy. 2002 February; 16(2): 359. Epub 2001 November 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11967702

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Prolene Hernia System compared with Lichtenstein patch: a randomised double blind study of short-term and medium-term outcomes in primary inguinal hernia repair. Author(s): Kingsnorth AN, Wright D, Porter CS, Robertson G. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2002 September; 6(3): 113-9. Epub 2002 July 31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12209299

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Prospective randomized trial of polypropylene mesh compared with nylon darn in inguinal hernia repair. Author(s): Koukourou A, Lyon W, Rice J, Wattchow DA. Source: The British Journal of Surgery. 2001 July; 88(7): 931-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11442522

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Prospective randomized trial of pre-emptive analgesics following ambulatory inguinal hernia repair: intravenous ketorolac versus diclofenac suppository. Author(s): Lau H, Wong C, Goh LC, Patil NG, Lee F. Source: Anz Journal of Surgery. 2002 October; 72(10): 704-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12534378

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Prosthetic implants for hernia repair. Author(s): Schumpelick V, Klinge U. Source: The British Journal of Surgery. 2003 December; 90(12): 1457-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14648721

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Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT. Author(s): Parra JA, Revuelta S, Gallego T, Bueno J, Berrio JI, Farinas MC. Source: The British Journal of Radiology. 2004 March; 77(915): 261-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15020373

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Quality of life in patients undergoing inguinal hernia repair. Author(s): Lawrence K, McWhinnie D, Jenkinson C, Coulter A. Source: Annals of the Royal College of Surgeons of England. 1997 January; 79(1): 40-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9038494

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Quality of result in hernia repair--review of 166 consecutive groin hernia operations. Author(s): O'Donovan P, Brady MP, O'Donnell J, Kirwan WO. Source: Ir Med J. 1983 June; 76(6): 283-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6874311

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Quantification of pain and satisfaction following laparoscopic and open hernia repair. Author(s): Fujita F, Lahmann B, Otsuka K, Lyass S, Hiatt JR, Phillips EH. Source: Archives of Surgery (Chicago, Ill. : 1960). 2004 June; 139(6): 596-600; Discussion 600-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15197084

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Radiologic investigation after laparoscopic inguinal hernia repair. Author(s): Larmark M, Ekberg O, Montgomery A. Source: European Radiology. 2003 December; 13(12): 2615-9. Epub 2003 May 21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12759773

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Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Author(s): Post S, Weiss B, Willer M, Neufang T, Lorenz D. Source: The British Journal of Surgery. 2004 January; 91(1): 44-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14716792

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Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Author(s): Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Source: Surgical Endoscopy. 2003 June; 17(6): 850-6. Epub 2003 March 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12658428

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Randomized controlled trial of preservation or elective division of ilioinguinal nerve on open inguinal hernia repair with polypropylene mesh. Author(s): Picchio M, Palimento D, Attanasio U, Matarazzo PF, Bambini C, Caliendo A. Source: Archives of Surgery (Chicago, Ill. : 1960). 2004 July; 139(7): 755-8; Discussion 759. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15249409

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Randomized trial of Lichtenstein versus Shouldice hernia repair in general surgical practice. Author(s): Nordin P, Bartelmess P, Jansson C, Svensson C, Edlund G. Source: The British Journal of Surgery. 2002 January; 89(1): 45-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11851662

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Re: Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatecomy. Author(s): Liedberg F. Source: The Journal of Urology. 2002 August; 168(2): 661; Author Reply 661-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12131339

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Re: Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. Author(s): Kennedy-Smith A. Source: The Journal of Urology. 2003 April; 169(4): 1475-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12641083

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Re: Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. Author(s): Foley CL, Kirby RS. Source: The Journal of Urology. 2003 April; 169(4): 1475. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12629393

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Recurrence and pain three years after groin hernia repair. Validation of postal questionnaire and selective physical examination as a method of follow-up. Author(s): Haapaniemi S, Nilsson E. Source: The European Journal of Surgery = Acta Chirurgica. 2002; 168(1): 22-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12022367

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Reduced acute phase response after laparoscopic total extraperitoneal bilateral hernia repair compared to open repair with the Stoppa procedure. Author(s): Suter M, Martinet O, Spertini F. Source: Surgical Endoscopy. 2002 August; 16(8): 1214-9. Epub 2002 April 09. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12189483

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Safety of daycare hernia repair in Jos, Nigeria. Author(s): Ramyil VM, Iya D, Ogbonna BC, Dakum NK. Source: East Afr Med J. 2000 June; 77(6): 326-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12858934

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Scar endometriosis developing after an umbilical hernia repair with mesh. Author(s): Majeski J, Craggie J. Source: Southern Medical Journal. 2004 May; 97(5): 532-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15180034

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Sigmoidocolocystoplasty for augmentation of iatrogenic small capacity bladder caused by direct injury to the bladder during inguinal hernia repair: long-term follow-up. Author(s): Miyano G, Yamataka A, Okada Y, Shimotakahara A, Kaneko K, Lane GJ, Yamashiro Y, Miyano T. Source: Pediatric Surgery International. 2004 January; 20(1): 61-4. Epub 2004 February 01. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14758496

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Simplified technique for incisional hernia repair with mesh prosthesis. Author(s): Guzman-Valdivia G, Medina O, Martinez A. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 December; 7(4): 206-9. Epub 2003 September 16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13680302

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Sudden death following a ventral hernia repair. Author(s): Gonzalez D, Lesho E. Source: Lancet. 2003 February 1; 361(9355): 391. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12573377

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Surgical outcome and hospital cost analyses of laparoscopic and open tension-free hernia repair. Author(s): Papachristou EA, Mitselou MF, Finokaliotis ND. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2002 July; 6(2): 6872. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12152642

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Surgical physiology of inguinal hernia repair--a study of 200 cases. Author(s): Desarda MP. Source: Bmc Surgery [electronic Resource]. 2003 April 16; 3(1): 2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12697071

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Surgical site infection after groin hernia repair (Br J Surg 2004; 91: 105-111). Author(s): Kumar S, Foo Wong P, Melling A, Leaper DJ. Source: The British Journal of Surgery. 2004 May; 91(5): 647. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15122625

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Surgical site infection after groin hernia repair (Br J Surg 2004; 91: 105-111). Author(s): Gaunt A, McKain ES, Feroz A, Stephenson BM. Source: The British Journal of Surgery. 2004 April; 91(4): 509. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15048760

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Surgical site infection after groin hernia repair. Author(s): Taylor EW, Duffy K, Lee K, Hill R, Noone A, Macintyre I, King PM, O'Dwyer PJ. Source: The British Journal of Surgery. 2004 January; 91(1): 105-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14716803

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Tension-free inguinal hernia repair: the design of a trial to compare open and laparoscopic surgical techniques. Author(s): Neumayer L, Jonasson O, Fitzgibbons R, Henderson W, Gibbs J, Carrico CJ, Itani K, Kim L, Pappas T, Reda D, Dunlop D, McCarthy M, Hynes D, Giobbie-Hurder A, London MJ, Hatton-Ward S. Source: Journal of the American College of Surgeons. 2003 May; 196(5): 743-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12742208

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Testicular pain after inguinal hernia repair: an approach to resection of the genital branch of genitofemoral nerve. Author(s): Ducic I, Dellon AL. Source: Journal of the American College of Surgeons. 2004 February; 198(2): 181-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14759772

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The effects of different hernia repair methods on postoperative pain medication and CRP levels. Author(s): Vatansev C, Belviranli M, Aksoy F, Tuncer S, Sahin M, Karahan O. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2002 August; 12(4): 243-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12193818

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The effects of the critical pathway for inguinal hernia repair. Author(s): Joh HJ, Moon IS, Park HR, Kim NC, Yang S. Source: Yonsei Medical Journal. 2003 February; 44(1): 81-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12619179

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The history of open inguinal hernia repair. Author(s): Johnson J, Roth JS, Hazey JW, Pofahl WE. Source: Current Surgery. 2004 January-February; 61(1): 49-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14972171

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The preperitoneal tissue dilemma in totally extraperitoneal (TEP) laparoscopic hernia repair: an anatomo-surgical study. Author(s): Lange JF, Rooijens PP, Koppert S, Kleinrensink GJ. Source: Surgical Endoscopy. 2002 June; 16(6): 927-30. Epub 2002 February 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12163956

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The role of antibiotic prophylaxis on wound infection after mesh hernia repair under local anesthesia on an ambulatory basis. Author(s): Celdran A, Frieyro O, de la Pinta JC, Souto JL, Esteban J, Rubio JM, Senaris JF. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2004 February; 8(1): 20-2. Epub 2003 September 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14505238

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The Stoppa procedure in inguinal hernia repair: to drain or not to drain. Author(s): Rodrigues AJ Jr, Jin HY, Utiyama EM, Rodrigues CJ. Source: Revista Do Hospital Das Clinicas. 2003 March-April; 58(2): 97-102. Epub 2003 June 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12845362

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The use of prosthetics in hernia repair. Author(s): Anwar S. Source: Hosp Med. 2003 January; 64(1): 34-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12572333

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Thromboprophylaxis can be omitted in selected patients undergoing varicose vein surgery and hernia repair. Author(s): Enoch S, Woon E, Blair SD. Source: The British Journal of Surgery. 2003 July; 90(7): 818-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854106

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Ultrasonographic characteristics of different methods of inguinal hernia repair. Author(s): Kovachev LS. Source: Surgery Today. 1995; 25(7): 612-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7549273

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Ultrasound-based volumetric evaluation of fluid retention after inguinal hernia repair. Author(s): Peiper C, Ponschek N, Truong S, Schumpelick V. Source: Surgical Endoscopy. 2000 July; 14(7): 666-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10948306

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Umbilical and epigastric hernia repair. Author(s): Muschaweck U. Source: The Surgical Clinics of North America. 2003 October; 83(5): 1207-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533911

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Update of hernia repair-1998. Author(s): Patton ML. Source: Jsls. 1999 January-March; 3(1): 88B. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10323180

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Update: what is left for laparoscopic hernia repair? Author(s): Bittner R, Leibl B, Kraft K, Schwarz J, Schmedt CG. Source: Digestive Surgery. 1998; 15(2): 167-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9845581

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Uraemia after laparoscopic bilateral hernia repair. Author(s): Doehn C, Fornara P, Miglietti G, Jocham D. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1998 May; 13(5): 1265-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9623566

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Use of a Foley catheter to dissect the preperitoneal space for extraperitoneal endoscopic hernia repair. Author(s): Wishart GC, Wright D, O'Dwyer PJ. Source: J Laparoendosc Surg. 1995 February; 5(1): 27-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7766925

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Use of a new type of PTFE mesh in laparoscopic incisional hernia repair: the continuing evolution of technique and surgical expertise. Author(s): Verbo A, Petito L, Pedretti G, Lurati M, D'Alba P, Coco C. Source: Int Surg. 2004 January-March; 89(1): 27-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15085994

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Use of spinal or continuous caudal anesthesia for inguinal hernia repair in premature infants: are there advantages? Author(s): Broadman LM. Source: Reg Anesth. 1996 November-December; 21(6 Suppl): 108-13. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8956434

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Use of the prolene hernia system for inguinal hernia repair: retrospective, comparative time analysis versus other inguinal hernia repair systems. Author(s): Murphy JW. Source: The American Surgeon. 2001 October; 67(10): 919-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11603544

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Vaginal hysterectomy after previous ventral scar hernia repair. Author(s): Sheth SS, Ghoshal AA. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 July; 22(4): 430-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521472

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Variations in the inferior pelvic pathway of the lateral femoral cutaneous nerve: implications for laparoscopic hernia repair. Author(s): Dibenedetto LM, Lei Q, Gilroy AM, Hermey DC, Marks SC Jr, Page DW. Source: Clinical Anatomy (New York, N.Y.). 1996; 9(4): 232-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8793216

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Various materials used for hernia repair. Author(s): McNelly CJ. Source: American Journal of Surgery. 1990 November; 160(5): 540-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2240394

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Vasopressin and haemostatic responses to inguinal hernia repair under local anaesthesia. Author(s): Grant PJ, Hampton KK, Primrose J, Davies JA, Prentice CR. Source: Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis. 1991 October; 2(5): 647-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1782335

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Ventilatory capacity after three methods of anaesthesia for inguinal hernia repair: a randomized controlled trial. Author(s): Godfrey PJ, Greenan J, Ranasinghe DD, Shabestary SM, Pollock AV. Source: The British Journal of Surgery. 1981 August; 68(8): 587-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7023596

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Ventral hernia repair by the laparoscopic approach. Author(s): Larson GM. Source: The Surgical Clinics of North America. 2000 August; 80(4): 1329-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10987039

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Ventral hernia repair with simultaneous panniculectomy. Author(s): Hughes KC, Weider L, Fischer J, Hopkins J, Antonetti A, Manders EK, Dunn E. Source: The American Surgeon. 1996 August; 62(8): 678-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8712568

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Ventral hernia repair: a study of current practice. Author(s): Courtney CA, Lee AC, Wilson C, O'Dwyer PJ. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 March; 7(1): 44-6. Epub 2003 January 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12612798

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Video-assisted Spigelian hernia repair. Author(s): Fisher BL. Source: Surgical Laparoscopy & Endoscopy. 1994 June; 4(3): 238-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8044371

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Weight gain: a possible factor in deciding timing for inguinal hernia repair in premature infants. Author(s): Desch LW, DeJonge MH. Source: Clinical Pediatrics. 1996 May; 35(5): 251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8804543

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When to return to work following a routine inguinal hernia repair: are doctors giving the correct advice? Author(s): Baker DM, Rider MA, Fawcett AN. Source: Journal of the Royal College of Surgeons of Edinburgh. 1994 February; 39(1): 313. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7515427

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When to use mesh in inguinal hernia repair. Author(s): Chang EG. Source: Military Medicine. 1991 July; 156(7): 364-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1922850

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Which inguinal hernia repair? Author(s): Kirk RM. Source: British Medical Journal (Clinical Research Ed.). 1983 July 2; 287(6384): 4-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6407687

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Winston S Churchill's (1874-1965) inguinal hernia repair by Thomas P Dunhill (18761957). Author(s): Schein M, Rogers P. Source: Journal of the American College of Surgeons. 2003 August; 197(2): 313-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12892817

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Wrapping the visceral sac into a bilateral mesh prosthesis in groin hernia repair. Author(s): Stoppa RE. Source: Hernia : the Journal of Hernias and Abdominal Wall Surgery. 2003 March; 7(1): 2-12. Epub 2003 January 31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12612790

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CHAPTER 2. NUTRITION AND HERNIA REPAIR Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and hernia repair.

Finding Nutrition Studies on Hernia Repair The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “hernia repair” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “hernia repair” (or a synonym): •

Colonic parastomal hernia repair by translocation without formal laparotomy. Author(s): Unitat de Cirurgia Digestiva, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Spain. Source: Botet, X Boldo, E Llaurado, J M Br-J-Surg. 1996 July; 83(7): 981 0007-1323

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Inguinal herniorrhaphy under local anesthesia: a study of intraoperative tolerance. Author(s): Division of Surgery, Instituto Nacional de la Nutricion, Tlalpan, Mexico. Source: Prado, E Herrera, M F Letayf, V Am-Surg. 1994 August; 60(8): 617-9 0003-1348

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Regional anaesthesia for hernia repair in children: local vs caudal anaesthesia. Author(s): Department of Anaesthesia, Children's Hospital of Eastern Ontario, Ottawa, Canada. Source: Splinter, W M Bass, J Komocar, L Can-J-Anaesth. 1995 March; 42(3): 197-200 0832-610X

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

Nutrition

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND HERNIA REPAIR Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to hernia repair. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to hernia repair and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “hernia repair” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to hernia repair: •

A comparison of intra-operative or postoperative exposure to music--a controlled trial of the effects on postoperative pain. Author(s): Nilsson U, Rawal N, Unosson M. Source: Anaesthesia. 2003 July; 58(7): 699-703. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886915

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Acupuncture anaesthesia in inguinal hernia repair. Author(s): Chu DW, Lee DT, Chan TT, Chow TL, Que MB, Kwok SP. Source: Anz Journal of Surgery. 2003 March; 73(3): 125-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12608974

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Allergic contact dermatitis from myrrh, a topical herbal medicine used to promote healing.

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Author(s): Al-Suwaidan SN, Gad el Rab MO, Al-Fakhiry S, Al Hoqail IA, Al-Maziad A, Sherif AB. Source: Contact Dermatitis. 1998 September; 39(3): 137. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9771992 •

Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery; a randomized controlled trial. Author(s): Nilsson U, Rawal N, Enqvist B, Unosson M. Source: Acta Anaesthesiologica Scandinavica. 2003 March; 47(3): 278-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648193

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Changes in adipose tissue composition in malnourished patients before and after liver transplantation: a carbon-13 magnetic resonance spectroscopy and gas-liquid chromatography study. Author(s): Thomas EL, Taylor-Robinson SD, Barnard ML, Frost G, Sargentoni J, Davidson BR, Cunnane SC, Bell JD. Source: Hepatology (Baltimore, Md.). 1997 January; 25(1): 178-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8985287

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Changes in muscle strength and pain in response to surgical repair of posterior abdominal wall disruption followed by rehabilitation. Author(s): Hemingway AE, Herrington L, Blower AL. Source: British Journal of Sports Medicine. 2003 February; 37(1): 54-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12547744

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Electrostimulation of healing abdominal incisional hernias by low frequency, bipolar, symmetrical rectangular pulses. An experimental study. Author(s): Franke A, Reding R, Tessmann D. Source: Acta Chir Scand. 1990 October; 156(10): 701-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2148248

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Evacuation proctography (defecography): an aid to the investigation of pelvic floor disorders. Author(s): Kelvin FM, Maglinte DD, Benson JT. Source: Obstetrics and Gynecology. 1994 February; 83(2): 307-14. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8290201

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Fish oil interaction with warfarin. Author(s): Buckley MS, Goff AD, Knapp WE. Source: The Annals of Pharmacotherapy. 2004 January; 38(1): 50-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14742793

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Impact of Oregon's priority list on Medicaid beneficiaries. Author(s): Mitchell JB, Bentley F. Source: Medical Care Research and Review : Mcrr. 2000 June; 57(2): 216-34; Discussion 235-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10868074

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Improved seminal characteristics in infertile men after a conservative treatment regimen based on the avoidance of testicular hyperthermia. Author(s): Lynch R, Lewis-Jones DI, Machin DG, Desmond AD. Source: Fertility and Sterility. 1986 September; 46(3): 476-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3743798

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Improvement of laryngopharyngeal reflux symptoms after laparoscopic Hill repair. Author(s): Wright RC, Rhodes KP. Source: American Journal of Surgery. 2003 May; 185(5): 455-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12727567

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Intraoperative therapeutic suggestions in day-case surgery: are there benefits for postoperative outcome? Author(s): Lebovits AH, Twersky R, McEwan B. Source: British Journal of Anaesthesia. 1999 June; 82(6): 861-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10562780

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Mortality with extracorporeal membrane oxygenation following repair of congenital diaphragmatic hernia in 93 infants. Author(s): Langham MR Jr, Krummel TM, Bartlett RH, Drucker DE, Tracy TF Jr, Toomasian JM, Greenfield LJ, Salzberg AM. Source: Journal of Pediatric Surgery. 1987 December; 22(12): 1150-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3440902

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Restoration of abdominal wall integrity as a salvage procedure in difficult recurrent abdominal wall hernias using a method of wide myofascial release. Author(s): Levine JP, Karp NS. Source: Plastic and Reconstructive Surgery. 2001 March; 107(3): 707-16; Discussion 717-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11304595

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Sauna-bathing with sutures. A prospective and randomised study. Author(s): Papp AA, Alhava EM. Source: Scand J Surg. 2003; 92(2): 175-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12841561

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Surgical intervention for the repair of exomphalos. Author(s): Yeo H.

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Source: Prof Nurse. 1996 January; 11(4): 226-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8552699 •

Surgical treatment for chronic pelvic pain. Author(s): Carter JE. Source: Jsls. 1998 April-June; 2(2): 129-39. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9876726

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TENS after hernia repair. Author(s): Smedley F, Taube M. Source: The British Journal of Surgery. 1986 December; 73(12): 1046. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3491653

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Transcutaneous electrical nerve stimulation for pain relief following inguinal hernia repair: a controlled trial. Author(s): Smedley F, Taube M, Wastell C. Source: European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes. 1988; 20(4): 233-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3262516

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Ventral/incisional abdominal herniorrhaphy by fascial partition/release. Author(s): Thomas WO 3rd, Parry SW, Rodning CB. Source: Plastic and Reconstructive Surgery. 1993 May; 91(6): 1080-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8479974

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON HERNIA REPAIR Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “hernia repair” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hernia repair, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Hernia Repair By performing a patent search focusing on hernia repair, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on hernia repair: •

Apparatus and method for dissecting tissue layers Inventor(s): Echeverry; Jan M. (San Jose, CA), Howell; Thomas A. (Palo Alto, CA), Jervis; James E. (Atherton, CA), Kayan; Helmut (Redwood City, CA), Kieturakis; Maciej J. (San Carlos, CA), Mollenauer; Kenneth H. (Los Gatos, CA), Robinson; Janine C. (Half Moon Bay, CA) Assignee(s): General Surgical Innovations, Inc. (Norwalk, CT) Patent Number: 6,540,764 Date filed: January 6, 1999 Abstract: An expansible tunneling apparatus and assosiated methods for creating an anatomic working space for a surgical procedure such as a hernia repair. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated through a balloon inflation lumen to cause the balloon to dissect tissue and create an operating space. The operating space may then be insulated with gas to form a working space for repairing a hernia. Excerpt(s): This invention relates generally to an apparatus and method for developing an anatomic space for laparoscopic procedures, and more specifically, to an apparatus and method that provides for laparoscopic visualization both during tunneling dissection to the desired anatomic space as well as during subsequent tissue dissection during balloon inflation once the desired potential space has been identified. In the past, in developing spaces and potential spaces within a body, blunt dissectors or soft-tipped dissectors have been utilized to create a dissected space which is parallel to the plane in which the dissectors are introduced into the body tissue. This often may be in an undesired plane, which can lead to bleeding which may obscure the field and make it difficult to identify the body structures. In utilizing such apparatus and methods, attempts have been made to develop anatomic spaces in the anterior, posterior or lateral to the peritoneum. The same is true for pleural spaces and other anatomic spaces. Procedures that have been performed in such spaces include varicocele dissection, lymph node dissection, sympathectomy and hernia repair. In the past, the inguinal hernia repair has principally been accomplished by the use of an open procedure which involves an incision in the groin to expose the defect in the inguinal floor, removal of the hernial sac and subsequent suturing the ligaments and fascias together to reinforce the weakness in the abdominal wall. Recently, laparoscopic hernia repairs have been attempted by inserting laparoscopic instruments into the abdominal cavity through the peritoneum and then placing a mesh patch over the hernia defect. Hernia repair using this procedure has a number of disadvantages, principally because the mesh used for the hernia repair is in direct contact with the structures in the abdominal cavity, as for example the intestines, there is a tendency for adhesions to form between these

Patents 65

structures. Such adhesions are known to be responsible for certain occasionally serious complications. Such a procedure is also undesirable because typically the patch is stapled to the peritoneum, which is a very thin unstable layer covering the inner abdomen. Thus, the stapled patch can tear away from the peritoneum or shift its position. Other laparoscopic approaches involve cutting away the peritoneum and stapling it closed. This is time consuming, however, and involves the risk that important anatomic structures may be inadvertently cut. In addition, such a procedure is undesirable because it requires the use of a general anesthesia. There is therefore a need for a new and improved apparatus and method for developing an anatomic space and particularly for accomplishing hernia repair by laparoscopy. In general, it is an object of the present invention to provide an apparatus and method for developing an anatomic space. Web site: http://www.delphion.com/details?pn=US06540764__ •

Apparatus and method for laparoscope hernia repair Inventor(s): Eberbach; Mark A. (Tampa, FL) Assignee(s): Cook Incorporated (Bloomington, IN) Patent Number: 5,366,460 Date filed: August 24, 1992 Abstract: Apparatus and method for laparoscopic hernia repair including the use of an introducer sheath housed around an inner tubular plunger. The plunger houses an elongated ribbon formed into a loop, the loop being formed by a bipartite distal end of the ribbon. A patch with a passageway is attached to the loop with each of the two ends of the bipartite distal end of the ribbon being introducible into one end of the passageway for opening the patch into a planar configuration once it is pushed out of the sheath by the plunger. Excerpt(s): This invention relates to medical apparatus and methods, and, more particularly, to the repair of hernias with a laparoscopic approach and associated delivery and expansion systems. A hernia is one of the most common ailments of mankind. Approximately five percent of the adult male population is affected. Basically, a hernia is a weakness or hole in the abdominal wall through which abdominal contents such as bowels may protrude. Inguinal or groin hernias normally occur at one or more of three locations. The first location is in the weakened wall or inguinal floor of the abdomen in Hesselbach's triangle. This type of hernia is called a direct hernia. An indirect hernia occurs at the internal ring adjacent to the vas deferens as it exits the abdomen to become part of the spermatic cord. The third is a femoral hernia that occurs adjacent and medial to the femoral blood vessels. All hernias represent a potentially lifethreatening condition and once diagnosed they should be repaired unless there is some contraindication. Web site: http://www.delphion.com/details?pn=US05366460__

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Coil fastener applier Inventor(s): Allen; William J. (Stratford, CT), Bachman; Alan B. (Hamden, CT), Bryan; Deborah M. (Norwalk, CT), DeFonzo; Stephen A. (Bridgeport, CT), Holsten; Henry E. (Wolcott, CT), Markus; Richard L. (Milford, CT), Savage; Robert C. (Stratford, CT), Stein; Jeffrey A. (Woodbridge, CT) Assignee(s): United States Surgical Corporation (Norwalk, CT) Patent Number: 5,830,221 Date filed: September 20, 1996 Abstract: There is provided a surgical coil fastener applier for use in applying helical coil fasteners in surgical procedures, such as hernia repair, to affix surgical mesh to tissue. The coil fastener applier includes a housing having a handle extending therefrom and a trigger pivotally mounted on the housing. An elongated tubular portion extends from the housing and includes a drive rod rotatably supported therein and slidably supporting a plurality of coil fasteners thereon. A drive assembly is provided within the housing to rotate the drive rod and coil fasteners. The drive assembly includes an antireverse mechanism to allow rotation of the drive rod in only one direction. An actuation assembly is provided within the housing to convert the motion of the trigger into rotary motion for supply to the drive assembly. The drive assembly includes structure to limit the amount of rotary motion supplied to the drive assembly. The drive assembly further includes a ratchet and pawl mechanism to prevent a partial cycling of the coil fastener applier. Also provided are various coil fasteners for use with the coil fastener applier. Excerpt(s): Various surgical procedures require instruments capable of applying fasteners to tissue to form tissue connections or to secure objects to tissue. For example, during hernia repair it is often desirable to fasten a mesh to body tissue. In certain hernias, such as direct or indirect inguinal hernias, a part of the intestine protrudes through a defect in the support abdominal wall to form a hernial sac. The defect may be repaired using an open surgery procedure in which a relatively large incision is made and the hernia is closed off outside the abdominal wall by suturing. The mesh is attached with sutures over the opening to provide reinforcement. Currently endoscopic techniques for hernia repair utilize fasteners, such as, surgical staples or clips, to secure the mesh to the tissue to provide reinforcement to the repair and structure for encouraging tissue ingrowth. The staples or clips need to be compressed against the tissue and mesh to secure the two together. One other type of fastener suited for use in affixing mesh to tissue, during procedures such as hernia repair, is a coil fastener having a helically coiled body portion terminating in a tissue penetrating tip. An example of this type of fastener is disclosed in U.S. Pat. No. 5,258,000. Web site: http://www.delphion.com/details?pn=US05830221__

•

Device and method for laparoscopic inguinal hernia repair Inventor(s): Benchetrit; Salomon (276 rue Andre Philip 69003, Lyon, FR) Assignee(s): none reported Patent Number: 5,681,342 Date filed: August 17, 1995 Abstract: A laparoscopic surgical separating device (1) for creating a preperitoneal workspace, for use in preperitoneal laparoscopic inguinal hernia repair, comprising a

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relatively rigid longitudinal element (2), a longitudinal axis (5), an interior wall (6) defining a throughbore (7), an inflatable element (8) fixedly attached to a point (9) along the length of an outer wall (10) of element (2), fluid insufflation member (11), connected to inflatable element (8), and to throughbore (7), and sealing member (12) capable of preventing fluid from escaping from element (2), wherein inflatable element (8) is of generally asymmetrical shape, having, on one side of the axis (5), a relatively large portion (13) of inflatable material, and on the other side of the axis (5) in the same plane, a relatively small portion (15) of inflatable material, the portions (13, 15) corresponding to the space available in the body after insertion and inflation of the device (1) via an incision (16) made at the antero-superior iliac crest (17). Excerpt(s): The present invention concerns a device used in laparoscopic surgery, in particular, laparoscopic inguinal hernia repair surgery, and a method of carrying out such surgical repair. Laparoscopic or keyhole surgical interventions have recently taken on increasing importance as surgeons have realized the benefits, both in terms of cost and patient comfort, of minimal invasive surgical techniques. Accordingly, there has been a constant development in the techniques used in this type of surgery and the equipment necessary to successfully carry out such operations. In the particular field of hernia repair, the application of preperitoneal laparoscopic techniques has enabled surgeons to obviate many of the dangers of traditional open bowel surgery, and even intraperitoneal laparoscopy, since the technique does not involve the risk of the surgeon damaging a sensitive organ with one of the inserted instruments. The basis for this technique lies in separating two layers of tissue, namely the peritoneum from the overlying abdominal wall, and creating a sufficiently large working preperitoneal space therebetween to enable the surgeon to carry out the hernia repair. Web site: http://www.delphion.com/details?pn=US05681342__ •

Endoscopic hernia repair clip and method Inventor(s): Hutchinson, Jr.; William B. (1301 20th St., Ste. 376, Santa Monica, CA 90404) Assignee(s): none reported Patent Number: 5,425,740 Date filed: May 17, 1994 Abstract: A clip unit for hernia repair surgery has first and second arms joined at a hinge joint. A latch or hook locks the arms together after they are closed. A mesh material extends around the outside edges of the clip. In use, the clip is placed over a portion of the elevated peritoneum and then closed and locked. The mesh is fixed to the surrounding peritoneum. The clip and surgical method expedites hernia repair surgery and reduces trauma and medical costs. Excerpt(s): The present invention relates to a method and clip for performing hernia repair. Over 500,000 hernia operations are performed each year in the United States. These surgeries make up about 15% of all general surgical procedures. It can be estimated that one out of twenty men, will at some point develop a hernia, and that about 1.5% of the general population (men and women) will develop this condition. Hernia surgery is accordingly widely needed, notwithstanding its costs, discomfort, risks, etc. Many methods have been proposed in hernia surgery. Most require approximation of the tissues under tension to close the hernial defect. Unfortunately, these methods may cause increased post-operative pain and a predisposition to hernia recurrence. Tension-free repair procedures of the hernial defect using synthetic

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materials such as polypropylene mesh, Dacron or polytetrafluroethylene, have more recently been employed. The hernial defect is closed with the mesh which is anchored in position with staples or sutures to the surrounding facial margin. However, properly placing and anchoring the mesh can be a technically challenging procedure for the surgeon, and requires considerable expertise and time. Accordingly, there remains a need for a simpler and more easily performed hernia repair operation. Web site: http://www.delphion.com/details?pn=US05425740__ •

Endoscopic stapler and hernia repair mechanism Inventor(s): Coletti; Paul A. (Somerset, NJ), MacLees; John (Goshen, OH), Moore; Michael (Cincinnati, OH), Rothfuss; Robert G. (Bellevue, KY), Schulze; Dale R. (Lebanon, OH) Assignee(s): Ethicon, Inc. (Somerville, NJ) Patent Number: 5,174,487 Date filed: April 4, 1991 Abstract: A unique hernia repair stapler is described which allows the forming of staples to attach prosthetics to tissue, or to approximate herniated tissue. The staple is useful in endoscopic operations and may be rotatable or stationary. The stapler has a unique forming and ejecting mechanism; as well, there is the availability of a loading mechanism useful for both cartridges and magazines of staples. An improved staple shape allows for better staple alignment, especially in a multiple load device. Excerpt(s): Generally, this invention relates to repair mechanisms to be used endoscopically. More specifically, this invention relates to repair mechanisms which allow for the repair of hernias. Most specifically, this invention relates to a hernia repair mechanism which describes a unique stapling mechanism for endoscopically fastening a prosthetic patch over a hernia, as well as a unique loading and alignment system for use with this repair mechanism, as well as the application of metallic staples for the endoscopic approximation of herniated tissue. With the proliferation of endoscopic surgery, it has been realized that there are many procedures typically performed in open surgery which are now capable of being performed endoscopically. A trocar, which is a pointed piercing device, is sent into the body with a cannula placed around the trocar. After the trocar accomplishes piercing of the abdominal walls, it is removed and the cannula remains in the body. Through this cannula, endoscopic procedures are possible. Generally, these endoscopic procedures take place under insufflation. Some of the more typical procedures have been gall bladder removal, tissue repair and sterilization procedures such as occluding of the Fallopian tubes. Surgeons realize that it may be possible to perform additional procedures endoscopically, once the proper materials and mechanisms become available for performing these procedures. One of the more basic, and quite logical extensions of current endoscopic procedures has been focused on repair of hernias. It is realized that to have the capability of performing hernia repair endoscopically will serve the medical community in many ways. Specifically, it is realized that endoscopic hernia repair will allow the patient to recuperate more rapidly, and without the more than likely extensive physical therapy currently practiced as a result of such "simple" procedures. Web site: http://www.delphion.com/details?pn=US05174487__

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Hernia repair prosthesis and methods for making same Inventor(s): Lindh; David (Somersworth, NH), Rousseau; Robert A. (Ottsville, PA) Assignee(s): Ethicon, Inc. (Somerville, NJ) Patent Number: 6,712,859 Date filed: June 28, 2001 Abstract: A hernia repair prosthesis with an occlusive member for inserting into and/or backing the herniated tissue. The occlusive member is convertible from a first configuration with a first axial length and first major radial extent to a second configuration with a second axial length and a second major radial extent. The second axial length is less than the first axial length and the second major radial extent is larger than the first major radial extent. The occlusive member has a pair of subsections, each having an apex, lands and pleats and each flaring outwardly therefrom towards a terminal end. The apexes are disposed at opposite ends of the occlusive member with the terminal ends overlapping. The pair of subsections are conjoined proximate the overlapping terminal ends. The terminal end of one or both of the subsections may be in the form of a conic flange mimicking the lands and pleats of the other subsection providing automatic alignment and nesting to aid in the attachment of the two subsections. In accordance with methods for forming the subsections, a surgical fabric is thermoset on a male die and may be stretched or heat shrunk to aid in conforming the surgical fabric to the contours of the male die. The subsections may be joined by ultrasound. Excerpt(s): The present invention relates to an implantable hernia repair prosthesis for reinforcing and repairing damaged tissue or muscle walls and methods for making same. Various prosthetic mesh materials have been proposed to reinforce the abdominal wall and to close abdominal wall defects utilizing different repair prostheses and methods of installation. The methods of executing a surgical repair can be segregated into two main approaches. The repair can be made exclusively from the anterior side (closest to the surgeon) of the defect by dissecting the sac free of the fascia and pressing it back into the pre-peritoneal space and providing permanent closure of the defect. The closure can be provided through the application of space filling prostheses and overlay patches (tension-free techniques) or can be accomplished through the use of sutures (tension techniques). An example of a tension free anterior repair is to fold a sheet of surgical mesh fabric into a multi-layer cone configuration and then to insert the mesh plug into a hernia defect to occlude the void. Such a multi-layer prosthesis is inherently stiff, may not fully conform to variations in the contour of the defect, and is subject to shrinkage that potentially could lead to recurrent herniation. The stiff, multi-layered mesh plug also may be susceptible to kinking and buckling during placement. Web site: http://www.delphion.com/details?pn=US06712859__

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Manometric pressure sensing and liquid evacuating device for intraoperative hiatal hernia repair Inventor(s): Hill; Lucius D. (522 McGilvra Blvd. E., Seattle, WA 98102) Assignee(s): none reported Patent Number: 4,030,481 Date filed: October 29, 1975

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Abstract: A device for making intraoperative pressure studies after repair but while the stomach is being evacuated. The device includes a nasal gastric suction tube having a perforated end region with a closed tip and having secured thereto a pressure-sensing tube with a closed end and which is provided with a pressure-sensing opening a known distance up from the closed tip of the nasal gastric tube. Excerpt(s): This invention pertains to medical instruments, and more particularly, to a pressure-sensing device suitable for use during hiatal hernia repair. Hiatal hernia repair is needed in a large number of patients suffering from esophagitis. A hiatal hernia is defined as an enlarged opening at the point where the esophagus goes through the diaphragm. A relatively small hernia will permit the lowest part of the esophagus to slide upward into the chest while a larger hernia will let part of the stomach slide upward. In both cases the sphincter muscle has stretched and lost its capability of holding the stomach's acidic contents from refluxing or flowing back up into the esophagus. A present repair technique for hiatal hernia is described in Hospital Practice, April 1972, Volume 7, No. 4 at pages 116-124 and in Time Magazine, Mar. 28, 1969 as well as in additional other articles in medical journals. The present preferred procedure is to stitch a part of the stomach to form an internal flap that prevents reflux. Ligaments and other tissues are attached where the esophagus joins the stomach (gastroesophageal junction) so that the junction is anchored permanently below the diaphragm. In addition, the sphincter muscle is tightened around the junction to prevent refluxing of the acidic contents of the stomach. Web site: http://www.delphion.com/details?pn=US04030481__ •

Method and apparatus for hernia repair Inventor(s): Campos; Luis I. (Allentown, PA) Assignee(s): Sipes; Earl K. (Allentown, PA) Patent Number: 5,290,217 Date filed: October 10, 1991 Abstract: Surgical repairs such as hernia repairs are made via laparoscopic techniques, by attaching a panel or patch of substantially continuous prosthetic material, dimensioned for introduction into a patient via a laparoscopic instrument. The panel is preferably expanded polytetrafluoroethylene (PTFE), provided with a plurality of holes at a peripheral edge for engagement via a surgical clip applicator. The applicator can be used readily to spread the patch over the site of the repair, and to receive the surgical clips which attach the patch to ligamentous structures of the patient. Examples of application of the patch to inguinal hernia repair and diaphragmatic hernia repair are disclosed. Excerpt(s): This invention relates to repair of hernias and similar defects in the tissues of humans and animals, and in particular to a laparoscopic hernia repair method and a synthetic patch used therefor. The patch is manipulated in the body cavity of the patient and is attached to connective tissues, by engaging the patch at a plurality of peripheral punch holes preliminarily formed in the patch. A hernia is a weakening of the musculofascial tissues defining the structural wall of a body cavity such as the abdomen, resulting in a gap through which tissues can protrude. Typically a sac is formed confining the tissues at the musculofascial defect, which sac protrudes from the plane of the tissue wall. There is a possibility of constriction of the neck of the sac, and life-threatening infection if untreated. A weakening or separation of the musculofascial

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tissues due to any cause can develop into a hernia. For example scarring from a previous incision or other trauma of the abdominal wall can develop into a hernia, or a hernia can form at the site of a passage through the musculofascial tissue, the passage becoming enlarged, for example, due to pressure of the viscera during muscular exertion. There are various forms of hernias, the inguinal hernia being a common example wherein the abdominal viscera and peritoneal sac protrude through the floor of the inguinal cavity at the point where the musculofascial tissue is relatively weakened due to the passage of the spermatic duct (in males) or the femoral blood vessels and the round ligament (in females). Another common site of a hernia is the passage of the umbilical cord. Hernias can also develop in the diaphragm, and elsewhere. In general similar problems occur wherever visceral tissues are abutted against a confining wall of tissue which, when weakened for whatever reason, permits the tissues to protrude through the confining wall, where the tissues become subject to constriction and infection or exert potentially dangerous pressure on tissues beyond the wall. Web site: http://www.delphion.com/details?pn=US05290217__ •

Method for use in laparoscopic hernia repair Inventor(s): Wilk; Peter J. (185 W. End Ave., New York, NY 10023) Assignee(s): none reported Patent Number: 5,269,753 Date filed: July 14, 1992 Abstract: A method for use in laparoscopic hernia repair comprises the steps of inserting a distal end of a laparoscope through a patient's abdominal muscles to a point outside of the parietal peritoneum, and inserting through the abdominal muscles a distal end of an elongate instrument provided at that distal end with a balloon in a collapsed configuration, the balloon being transparent to optical radiation. Upon disposition of the balloon between the abdominal muscles and the peritoneum, the balloon is inflated and the instrument is subsequently manipulated from outside the patient to push the inflated balloon against connective tissues between the abdominal muscles and the peritoneum to shift the tissues to form a pre-peritoneal space. During the manipulation of the instrument with the balloon, the laparoscope is to view, through and around the inflated balloon, the connective tissues and other organic structures. Excerpt(s): This invention relates to a method for use in laparoscopic hernia repair. A hernia results when a person's abdominal wall is torn to form an opening. A portion of the person's internal body organs, including a portion of the peritoneal lining, is then displaced through the opening and into the inguinal tissues. Pain is generated upon the pinching of the displaced internal body organ or organs by the opening in the abdominal wall. Although some progress has been made in simplifying hernial repair operations, for example, through the use of laparoscopic means, there is yet opportunity for improvement. Laparoscopic repair of hernias conventionally involves the insertion of a laparoscope through a trocar sleeve or laparoscopic cannula which itself traverses abdominal muscles of the patient. The laparoscope is manipulated from outside the patient to push and displace connective tissue to thereby form a pre-peritoneal space which may be enlarged and maintained in an enlarged configuration by inflation with carbon dioxide gas. Web site: http://www.delphion.com/details?pn=US05269753__

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Method of repairing inguinal hernias Inventor(s): Nicolo; Enrico (Clairton, PA) Assignee(s): Davol Inc. (Cranston, RI) Patent Number: 6,652,595 Date filed: January 9, 1998 Abstract: A universal, surgical prosthesis for hernia repair is provided in the form of a foldable sheet. The prosthesis includes a barrier layer formed of a material adapted to prevent biological adherence thereto, such as polytetrafluoroethylene, and a second surface layer formed of a material adapted to promote biological tissue adherence thereto, such as polypropylene. The second surface may be formed of a series of spaced projections. The prosthesis is adapted to be manipulated into an operative position to exhibit an appropriate exterior when in the operative position. In this manner, the universal, surgical prosthesis can be utilized for a wide range of surgical procedures. Excerpt(s): The present invention relates to a mesh prosthesis. In particular, the present invention relates to a universal, surgical mesh prosthesis for hernia repair. Surgical mesh prostheses of various different types have long been known and have long been used for hernia repair. The general surgical technique for hernia repair is to utilize a surgical mesh prosthesis, also called a hernia patch, over the hernia defect. The hernia patch has sufficient strength to resist the tendency of the hernia sack to protrude. The hernia patch is placed over the hernia defect and sutured to the surrounding tissue. This technique avoids undesirable, additional tension on the musculofascial tissue and minimizes the reoccurrence of a hernia. Examples of hernia patches for hernia repairs can be found in U.S. Pat. Nos. 5,368,602; 5,356,432; 5,326,355; 5,292,328; 5,290,217; 5,254,133; and 5,147,374. Endoscopic and laparoscopic surgical techniques have been developed for repairing hernias with a hernia patch. Examples of these techniques can be found in U.S. Pat. Nos. 4,769,038; 5,379,754; and 5,370,650. Web site: http://www.delphion.com/details?pn=US06652595__

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Method using approximating apparatus for hernia repair Inventor(s): Ciccolella; Michael (Lake Carmel, NY), Cuny; Douglas J. (Bethel, CT), Tovey; H. Jonathan (Milford, CT) Assignee(s): United States Surgical Corporation (Norwalk, CT) Patent Number: 5,379,754 Date filed: July 30, 1992 Abstract: A method for using an endoscopic apparatus for measuring the size of a hernia defect comprising a handle which is pivotally attached to a measuring rod. The hernia defect is measured by a plurality of calibrations positioned along the measuring rod. The measuring rod includes a blunt tip at its distal end and further is adaptable for 180' positioning relative to the handle. Excerpt(s): The present invention relates generally to a measuring apparatus for surgical instrumentation and more particularly to an apparatus which effects measurement of a hernia defect to ascertain the corresponding necessary size of the repair material. Hernias may be divided into three general classes--direct hernia, indirect hernia and femoral hernia. Direct or indirect hernias are usually characterized by a part of the intestine protruding through a defect n the supporting abdominal wall to form a hernia

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sac. This sac requires surgical repair which traditionally involved invasive repair and include a large incision. In order to reach the herniated portions, several layers of the abdominal wall must be separated. During the hernia repair procedure, to hernia is closed outside the abdominal wall in a manner which resembles the tying of a sack at the neck. A surgical mesh is usually then attached by sutures directly over the weakened abdominal wall opening to provide a reinforcement to the opening. The above described traditional hernia repair amounts to a major invasive surgical procedure which frequently causes excessive trauma to the patient and results in an extended post-operative recuperative period. The need for cutting through the numerous tissue layers in order to access the herniated area also frequently causes severe trauma to the patient. Further, numerous complications related directly or indirectly to the surgery and including bleeding, infection, testicular atrophy, organ damage, nerve damage, blood vessel damage, etc., often enough result from repair performed by the traditional approach. Web site: http://www.delphion.com/details?pn=US05379754__ •

Patch for endoscopic repair of hernias Inventor(s): Brown; Roderick B. (1920 N. Lakeshore Dr., Glenwood, MN 56334) Assignee(s): none reported Patent Number: 5,824,082 Date filed: July 14, 1997 Abstract: A prosthesis for use in hernia repair surgery having a preformed prosthetic fabric supported along its periphery by shape memory alloy wire having a transformation temperature corresponding to normal body temperature allowing the prosthesis to be tightly rolled into a cylindrical configuration for delivery through a laparoscopic instrument and which deploys to a predetermined shape as it warms up to body temperature. Excerpt(s): This invention relates to apparatus to be used in hernia repair surgery, and more particularly to a prosthetic hernia repair patch that can be rolled into a tube for laparoscopic delivery through a trocar and which deploys to a generally planar form when ejected from the trocar into the abdominal cavity. Since 1991, I have performed numerous laparoscopic hernia repair procedures on inguinal, ventral, incisional and umbilical hernias with a great deal of success in terms of patient satisfaction. When compared to open surgery, those having the laparoscopic procedure experience significantly less pain and more rapid return to normal activity. In carrying out those procedures, I initially used a prosthetic patch made at the time of surgery from a sterile, woven, polypropylene mesh material that I folded in half to create a double layer and then cut to size, typically a 6 cm by 9 cm rectangle. Sutures were used to join the four corners of the rectangle and two additional sutures were positioned approximately midway along the unfolded edge. A slit was then created between these two additional sutures which was designed to accommodate the inferior epigastric vessels. Following dissection of the hernia sac away from the ipsilateral testicle and cord structures, the creation of a peritoneal incision and the subsequent dissection of the peritoneal flap and hernia sac away from the hernia defect and surrounding fascia and cord structures, the patch was rolled into a tube and inserted into a trocar sleeve that was then introduced through a larger diameter trocar, and delivered into the peritoneal cavity. A laparoscopic forceps was then used to unfurl the patch and place it anterior to the hernia defect and around the inferior epigastric vessels with the mesh covering both the direct

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and indirect hernia spaces. The mesh patch would then be held in place by stapling or suturing it to underlying fascia. Subsequently, the peritoneum was closed over the patch so that the entire piece of mesh was covered thereby. Web site: http://www.delphion.com/details?pn=US05824082__ •

Prosthesis for hernia repair and soft tissue reconstruction Inventor(s): Eldridge; Stephen N. (Cranston, RI), Robbins; Alan W. (Freehold, NJ), Rutkow; Ira M. (Marlboro, NJ), Shriner; Kelly M. (Barrington, RI) Assignee(s): C.R. Bard, Inc. () Patent Number: 5,716,408 Date filed: May 31, 1996 Abstract: An implantable prosthesis for repairing or reconstructing a tissue or muscle wall defect including an outer plug and at least two inner filler plugs positioned within the outer plug that stiffen, and impart bulk to, the outer plug when the implant is inserted into the narrow confines of the tissue or muscle wall defect. Excerpt(s): The present invention relates to an improved prosthesis for hernia repair and soft tissue reconstruction. The present invention is an enhancement of the PerFix.RTM. plug, particularly indicated for use in the repair of large tissue ruptures. The present invention is a biologically compatible, implantable prosthesis for use in the repair of groinal hernia defects and in other soft tissue reconstruction. The repair and reconstructive device includes an outer plug, preferably formed of a single layer of tissue infiltratable fabric, which is compressible into a slender shape which fits within an opening in a tissue or muscle wall defect. The surface of the outer plug may be pleated to facilitate conformance of the plug to irregularities in the shape of the rupture. An inner filler body, consisting of at least two plugs also preferably formed of single layers of a tissue infiltratable fabric, is positioned within the outer plug and imparts bulk to, and stiffens, the implant when it is compressed within the defect. Use of the inner filler plugs avoids the need to stiffen the single layer outer plug itself, reducing the likelihood that the prosthesis will kink or buckle when fitted in an irregularly shaped opening. Web site: http://www.delphion.com/details?pn=US05716408__

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Prosthetic mesh patch for hernia repair Inventor(s): Fernandez; Alfredo (16145 Carden Dr., Odessa, FL 33556) Assignee(s): none reported Patent Number: 5,147,374 Date filed: December 5, 1991 Abstract: A patch is made from a rolled up first flat sheet of polypropylene or polytetrafluroethylene surgical mesh. One end of the rolled up mesh has multiple slits to provide multiple flared out flaps stitched to a second flat sheet of surgical mesh. The patch is compressed into a longitudinal cylindrical structure and is inserted through a trocar into an opening of a hernia. The rolled up first flat sheet is inserted through the opening and the flaps and second flat sheet are stapled to the patient's tissue adjacent the opening.

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Excerpt(s): This invention relates to laparoscopic hernia repair. More particularly, it refers to the use of a flared mesh patch to repair an inguinal hernia during laparoscopic procedures. The traditional inguinal approach to hernia repair results in recurrence ranging from seven to twenty-one percent for primary repair and up to eighteen percent after repair of recurrent hernias. In addition, recovery periods associated with herniorrhaphy can be lengthy and painful, sometimes lasting from three to six weeks. See the Journal of Laparoendoscopic Surgery, Volume 1, No. 5, p. 269, 1991, Mary Ann Liebert, Inc., publishers. In seeking to improve on these results and reduce recovery periods associated with herniorrhaphy, surgeons have been carrying out laparoscopic hernia repair employing laser surgery techniques. See the Journal of Laparoendoscopic Surgery, Vol. 1, No. 1, 1990, pages 41-45; and Contemporary Surgery, October 1991, Vol. 39, No. 14, pages 15-19. While it appears that laparoscopic hernia repair techniques have been successful, the insertion of polypropylene mesh into the opening in the inguinal region causing the hernia has sometimes resulted in bulging of the inguinal region. This could be caused by movement of the rolled up surgical mesh inserted into the hernia opening. A more perfect prosthetic mesh patch that can be delivered to the hernia site by laparoscopic techniques is needed to reduce side effects and recurrences from laparoscopic hernia repair surgery. Web site: http://www.delphion.com/details?pn=US05147374__ •

Surgical mesh fabric Inventor(s): Herzog; Fred D. (Westford, MA), Titone; Milo A. (Wilmington, DE) Assignee(s): C. R. Bard, Inc. (Murray Hill, NJ) Patent Number: 5,569,273 Date filed: July 13, 1995 Abstract: A dual bar warp knit, hexagonal mesh fabric for use in hernia repair and to mend other muscle and tissue wall defects, produced according to a back bar pattern chain of 2/0 2/4 2/0 4/6 4/6 and a front bar pattern chain of 4/6 4/2 4/6 2/0 2/4 2/0. Excerpt(s): The present invention relates to a surgical mesh fabric and, more particularly, to a surgical mesh fabric for use in laparoscopic procedures. Various prosthetic repair materials have been proposed to reinforce the abdominal wall and to close abdominal wall defects. Marlex mesh, a single bar warp knit, dual course Atlas polypropylene monofilament knit, is exemplary of an implant material that has been successfully used in hernia repair. Traditionally, prosthetic repair materials are placed in an open procedure where a two inch or longer incision is made through the abdominal wall, layers of healthy tissue are retracted to expose the void and then the rupture is filled or covered with the implantable fabric. Recently, prosthetic surgical fabrics have been implanted laparoscopically which is a surgical procedure employing slender tubes (cannulas) that extend through narrow punctures in the abdominal wall. Because the abdominal cavity remains closed, the surgeon employs an illuminating optical instrument through one of the cannula to visualize the surgical site on a television monitor. Surgical instruments are manipulated by the surgeon through other cannula in the abdominal wall, as the location of the instruments are observed on the monitor, to place the prosthetic repair material over or in the defect. Web site: http://www.delphion.com/details?pn=US05569273__

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Three-dimensional culture of pancreatic parenchymal cells cultured living stromal tissue prepared in vitro Inventor(s): Naughton; Brian A. (El Cajon, CA), Naughton; Gail K. (Del Mar, CA) Assignee(s): Advanced Tissue Sciences, Inc. (La Jolla, CA) Patent Number: 6,022,743 Date filed: March 8, 1999 Abstract: A stromal cell-based three-dimensional cell culture system is prepared which can be used to culture a variety of different cells and tissues in vitro for prolonged periods of time. The stromal cells and connective tissue proteins naturally secreted by the stromal cells attach to and substantially envelope a framework composed of a biocompatible non-living material formed into a three-dimensional structure having interstitial spaces bridged by the stromal cells. The living stromal tissue so formed provides the support, growth factors, and regulatory factors necessary to sustain longterm active proliferation of cells in culture and/or cultures implanted in vivo. When grown in this three-dimensional system, the proliferating cells mature and segregate properly to form components of adult tissues analogous to counterparts in vivo, which can be utilized in the body as a corrective tissue. For example, and not by way of limitation, the three-dimensional cultures can be used to form tubular tissue structures, like those of the gastrointestinal and genitourinary tracts, as well as blood vessels; tissues for hernia repair and/or tendons and ligaments; etc. Excerpt(s): The present invention relates to a stromal cell-based three-dimensional cell and tissue culture system and its use to form corrective structures that can be implanted and utilized in vivo. This culture system can be used for the long term proliferation of cells and tissues in vitro in an environment that more closely approximates that found in vivo. The culture system described herein provides for proliferation and appropriate cell maturation to form structures analogous to tissue counterparts in vivo. In particular, the invention relates to the use of the fibroblast-based three-dimensional cell culture system to construct complex structures such as, but not limited to, tubular sections of gastrointestinal and genitourinary tracts, blood vessels, tissues for hernia repair, tendons and ligaments. The three-dimensional cultures can be implanted in vivo to correct defects in the body. Cell culture systems have been used to study cells, expand cell populations for additional study, and in the production of recombinant gene products. However, cell culture systems have not been utilized for the repair of defects or abnormal tissues in the body. The majority of vertebrate cell cultures in vitro are grown as monolayers on an artificial substrate bathed in nutrient medium. The nature of the substrate on which the monolayers grow may be solid, such as plastic, or semisolid gels, such as collagen or agar. Disposable plastics have become the preferred substrate used in modern-day tissue or cell culture. Web site: http://www.delphion.com/details?pn=US06022743__

Patent Applications on Hernia Repair As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take 9

This has been a common practice outside the United States prior to December 2000.

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several years.) The following patent applications have been filed since December 2000 relating to hernia repair: •

Absorbable mesh device Inventor(s): Rousseau, Robert A.; (Ottsville, PA) Correspondence: Ralph W. Selitto, JR.; P.O. Box 1477; Edison; NJ; 08818-1477; US Patent Application Number: 20030078602 Date filed: October 19, 2001 Abstract: A hernia repair device, which is implantable in a patient's body, includes first and second layers cooperating with one another so as to form an implantable patch for repairing a hernia defect. The first layer is made from a textile material which is absorbable in a patient's body, while the second layer is made from a non-absorbable textile material. When the patch is implanted in a patient's body, the non-absorbable second layer remains permanently implanted, while the absorbable first layer is dissolved. Excerpt(s): The present invention relates to a hernia repair device and, more specifically, to a hernia patch used to repair damaged tissue or muscle walls. Mesh-type patches have been used to repair hernia defects (e.g., openings or holes formed in a wall of an organ, through which interior organs tend to protrude). Typically, these patches are permanently implanted in a patient's body and may hence cause postoperative discomfort to the patient. U.S. Pat. No. 6,224,616 B1 discloses a mesh-type patch for repairing an abdominal wall hernia. More particularly, the patch is formed by top and bottom layers made from an inert mesh material. An implantable loop is positioned between the top and bottom layers to keep the patch expanded under tension in a planar configuration. In order to repair a hernia defect, the entire patch is implanted permanently in a patient's body. Because the total mass or weight of the implanted patch is relatively large and because the patch is rigid, it tends to be noncompliant with respect to the natural anatomy of the patient and increases the risk of seroma formation and/or recurrence. Moreover, the permanent tension induced by the implantable loop may cause additional discomfort to the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Apparatus and method for developing an anatomic space for laparoscopic hernia repair and patch for use therewith Inventor(s): Kayan, Helmut L.; (Redwood City, CA), Kieturakis, Maciej J.; (San Carlos, CA), Mollenauer, Kenneth H.; (Santa Clara, CA), Monfort, Michelle Y.; (Los Gatos, CA) Correspondence: Lawrence Cruz; Tyco Healthcare Group LP; 150 Glover Avenue; Norwalk; CT; 06856; US Patent Application Number: 20020111652 Date filed: April 5, 2002 Abstract: An apparatus for creating an anatomic space in tissue in a body comprises an introducer and a sheath. The tubular sheath may surround the introducer, and may have a weakened region along its longitudinal axis. A handle may be provided on the sheath. The handle may be adapted to be pulled proximally to separate the weakened region and allow the sheath to be removed from the introducer. The sheath may be secured to the introducer via detents or latches on the handle.

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Excerpt(s): This application is a continuation of U.S. application Ser. No. 08/861,913, which is a continuation of U.S. application Ser. No. 08/483,293, filed on Jun. 7, 1995, now abandoned, which is a divisional of U.S. application Ser. No. 08/124,283, filed on Sep. 20, 1993, now U.S. Pat. No. 5,836,961, which is a continuation-in-part of U.S. application Ser. No. 07/893,988, filed on Jun. 2, 1992, now U.S. Pat. No. 6,312,442. The disclosure of each of these prior applications is hereby incorporated by reference in their entirety. This invention relates to an apparatus and method for developing an anatomic space for laparoscopic hernia repair and a patch for use therewith. In the past, in developing spaces and potential spaces within a body, blunt dissectors or soft-tipped dissectors have been utilized to create a dissected space which is parallel to the plane in which the dissectors are introduced into the body tissue. This often may be in an undesired plane, which can lead to bleeding which may obscure the field of view and make it difficult to identify the body structures. In utilizing such apparatus and methods, attempts have been made to develop anatomic spaces in the anterior, posterior, or lateral to the peritoneum. The same is true for pleural spaces and other anatomic spaces. Procedures that have been performed in such spaces include varicocele dissection, lymph node dissection, sympathectomy, and hernia repair. In the past, the inguinal hernia repair has principally been accomplished by the use of an open procedure which involves an incision in the groin to expose the defect in the inguinal floor, remove the hernial sac, and subsequently suture the ligaments and fascias together to reinforce the weakness in the abdominal wall. Recently, laparoscopic hernia repairs have been attempted by inserting laparoscopic instruments into the abdominal cavity through the peritoneum and then placing a mesh to cover the hernia defect. Hernia repair using this procedure has a number of disadvantages, principally because the mesh used for hernia repair is in direct contact with the structures in the abdominal cavity, as for example the intestines, so that there is a tendency for adhesions to form in between these structures. Such adhesions are known to be responsible for certain occasionally serious complications. Such a procedure is also undesirable because typically the patch is stapled into the peritoneum, which is a very thin unstable layer covering the inner abdomen. Thus, the stapled patch can tear away from the peritoneum or shift its position. Other laparoscopic approaches involve cutting away the peritoneum and stapling it closed. This is time consuming, however, and involves the risk that important anatomic structures may be inadvertently cut. In addition, such a procedure is undesirable because it requires the use of a general anesthesia. There is therefore a need for a new and improved apparatus and method for developing an anatomic space and particularly for accomplishing hernia repair by laparoscopy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Apparatus and methods for developing an anatomic space for laparoscopic hernia repair and patch for use therewith Inventor(s): Kieturakis, Maciej J.; (San Carlos, CA), Mollenauer, Kenneth H.; (Santa Clara, CA), Monfort, Michelle Y.; (Los Gatos, CA) Correspondence: Lyon & Lyon Llp; 633 West Fifth Street; Suite 4700; Los Angeles; CA; 90071; US Patent Application Number: 20010053919 Date filed: August 17, 2001 Abstract: Laparoscopic apparatus and method for insertion into a space or potential space in a body comprising an introducer device having a tubular member with a bore

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extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon. Excerpt(s): This invention relates to an apparatus and method for developing an anatomic space for laparoscopic hernia repair and a patch for use therewith. In the past, in developing spaces and potential spaces within a body, blunt dissectors or soft-tipped dissectors have been utilized to create a dissected space which is parallel to the plane in which the dissectors are introduced into the body tissue. This often may be in an undesired plane, which can lead to bleeding which may obscure the field and make it difficult to identify the body structures. In utilizing such apparatus and methods, attempts have been made to develop anatomic spaces in the anterior, posterior or lateral to the peritoneum. The same is true for plural spaces and other anatomic spaces. Procedures that have been performed in such spaces include varocele dissection, lymph node dissection, sympathectomy and hernia repair. In the past, the inguinal hernia repair has principally been accomplished by the use of an open procedure which involves an incision in the groin to expose the defect in the inguinal floor, remove the hernial sac and subsequently suture the ligaments and fascias together to reinforce the weakness in the abdominal wall. Recently, laparoscopic hernia repairs have been attempted by inserting laparoscopic instruments into the abdominal cavity through the peritoneum and then placing a mesh to cover the hernia defect. Hernia repair using this procedure has a number of disadvantages, principally because the mesh used for hernia repair is in direct contact with the structures in the abdominal cavity, as for example the intestines, so that there is a tendency for adhesions to form in between these structures. Such adhesions are known to be responsible for certain occasionally serious complications. Such a procedure is also undesirable because typically the patch is stapled into the peritoneum, which is a very thin unstable layer covering the inner abdomen. Thus, the stapled patch can tear away from the peritoneum or shift its position. Other laparoscopic approaches involve cutting away the peritoneum and stapling it closed. This is time consuming and involves the risk of inadvertent cutting of important anatomic structures. In addition, such a procedure is undesirable because it requires the use of a general anesthesia. There is therefore a need for a new and improved apparatus and method for developing an anatomic space and particularly for accomplishing hernia repair by laparoscopy. In general, it is an object of the present invention to provide an apparatus and method for developing an anatomic space. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Balloon device for use in surgery and method of use Inventor(s): Jervis, James E.; (San Mateo, CA) Correspondence: United States Surgical, A Division OF; Tyco Healthcare Group LP; 150 Glover Avenue; Norwalk; CT; 06856; US Patent Application Number: 20020032456 Date filed: September 4, 2001 Abstract: A balloon device useful for dissecting tissue or retracting tissue for the purpose of providing space for laproscopic surgery comprising a balloon having at least two protuberances in its distal region. The present device is particularly useful in bladder neck suspension and hernia repair procedures. Excerpt(s): This is a continuation of application Ser. No. 08/570,766, filed Dec. 12, 1995, the disclosure of which is incorporated herein by reference, which is a continuation-inpart of application Ser. No. 08/403,012, filed on Mar. 10, 1995, which is a continuationin-part of application Ser. No. 08/388,233, filed Feb. 13, 1995, which is a continuation-inpart of application Ser. No. 08/267,488, filed Jun. 29, 1994, which is a continuation-inpart of application Ser. No. 08/124,283, filed Sep. 20, 1993, which is a continuation-inpart of application Ser. No. 08/073,737, filed Jun. 8, 1993, which is a division of application Ser. No. 07/893,988, filed Jun. 2, 1992. My application Ser. No. 08/717,794, filed Sep. 20, 1996 discloses a device of the type disclosed and claimed herein. The disclosure of each of these prior applications is hereby incorporated by reference in its entirety. The present invention constitutes specially shaped balloon dissection or retraction devices and their use. The invention relates generally to an apparatus and method for developing an anatomic space for laproscopic procedures and, more specifically, to an apparatus and method particularly suitable for surgical procedures in which there is a need to dissect around an obstruction or around an area which it would be undesirable to dissect. The present invention provides a device which can be used to dissect around a hernia and in bladder neck suspension procedures, also known as urethropoxy, in which avoidance of the pubic symphysis is desirable. The present invention comprises a balloon suitable for tissue dissection or tissue retraction which has at least two protuberances (which may be referred to as "legs", "arms", "horns" or other descriptive term) at its distal region and its method of use. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Coil fastener applier and removal method Inventor(s): Holsten, Henry E.; (Wolcott, CT), Markus, Richard L.; (Milford, CT), Savage, Robert C.; (Stratford, CT) Correspondence: Paul R. Audet, ESQ.; United States Surgical; Division OF Tyco Healthcare Group LP; 150 Glover Avenue; Norwalk; CT; 06856; US Patent Application Number: 20030009441 Date filed: April 15, 2002 Abstract: There is provided a surgical coil fastener applier for use in applying helical coil fasteners in surgical procedures, such as hernia repair, to affix surgical mesh to tissue. The coil fastener applier includes a housing having a handle extending therefrom and a trigger pivotally mounted on the housing. An elongated tubular portion extends from the housing and includes a drive rod rotatably supported therein and slidably

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supporting a plurality of coil fasteners thereon. A drive assembly is provided within the housing to rotate the drive rod and coil fasteners. The drive assembly includes an antireverse mechanism to allow rotation of the drive rod in only one direction. An actuation assembly is provided within the housing to convert the motion of the trigger into rotary motion for supply to the drive assembly. The drive assembly includes structure to limit the amount of rotary motion supplied to the drive assembly. The drive assembly further includes a ratchet and pawl mechanism to prevent a partial cycling of the coil fastener applier. Also provided are various coil fasteners for use with the coil fastener applier. The surgical coil fastener applier is configured and dimensioned to remove a coil fastener from tissue or drive a fastener previously applied to tissue further into the tissue. A lockout mechanism is provided to immobilize the drive rod relative to the elongated tubular portion. Excerpt(s): This application is a continuation-in-part of U.S. application Ser. No. 08/717,492, filed Sep. 20, 1996, entitled Coil Fastener Applier, the disclosure of which is incorporated by reference herein. Various surgical procedures require instruments capable of applying fasteners to tissue to form tissue connections or to secure objects to tissue. For example, during hernia repair it is often desirable to fasten a mesh to body tissue. In certain hernias, such as direct or indirect inguinal hernias, a part of the intestine protrudes through a defect in the support abdominal wall to form a hernial sac. The defect may be repaired using an open surgery procedure in which a relatively large incision is made and the hernia is closed off outside the abdominal wall by suturing. The mesh is attached with sutures over the opening to provide reinforcement. Currently endoscopic techniques for hernia repair utilize fasteners, such as, surgical staples or clips, to secure the mesh to the tissue to provide reinforcement to the repair and structure for encouraging tissue ingrowth. The staples or clips need to be compressed against the tissue and mesh to secure the two together. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Helical fastener and applicator for surgical procedures Inventor(s): Jervis, James E.; (Atherton, CA) Correspondence: Chief Patent Counsel; United States Surgical; Division OF Tyco Healthcare Group LP; 150 Glover Avenue; Norwalk; CT; 06856; US Patent Application Number: 20020058967 Date filed: October 25, 2001 Abstract: A device and method for deploying helical fasteners which may be used to attach a prosthesis to tissue, e.g., to attach a mesh patch in a hernia repair procedure. A helical coil fastener which is inhibited from undesirable migration after installation is also provided. Excerpt(s): The present invention relates to surgical fasteners. In particular, the invention relates to helical fasteners and a means for containing and applying a plurality of them in the course of laparoscopic surgery. The time consuming processing of traditional suturing necessitated the development of surgical fasteners. By shortening the time of the suturing process, surgical fasteners reduce blood loss and trauma to the patient. For open surgery, there has been a substantial amount of activity in developing staples and staple applicators to be used to secure tissue elements, e.g., in wound closure. Staples have also found use in attaching prostheses, e.g., the mesh patches used to repair hernias. The use of staples has now become widespread, but with the advent of

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minimally invasive, or laparoscopic, surgery, the amount of room available for fastening devices to operate in has decreased substantially. In addition, in some instances, e.g., laparoscopic hernia repair, the surgeon has access to only one side of the tissue to which the mesh patch is to be secured. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hernia repair device Inventor(s): Rousseau, Robert A.; (Ottsville, PA) Correspondence: Allen N. Friedman, ESQ.; C/o Mccarter & English, Llp; Four Gateway Center; 100 Mulberry Street; Newark; NJ; 07102; US Patent Application Number: 20030181988 Date filed: March 22, 2002 Abstract: An implantable prosthetic device adapted for use in repairing a hernia defect includes at least one body made from a biocompatible textile material. The body is provided with a first section and a second section inverted into the first section such that the second section is radially surrounded by the first section. The second section is movably connected to the first section such that the body is expandable or collapsible in a radial direction so as to conform to the size and shape of a hernia defect. Excerpt(s): The present invention relates to a hernia repair device and, more particularly, to a hernia repair device adapted to be implanted in a patient. Various prosthetic mesh devices have been proposed for use in repairing hernia defects (e.g., an opening in or the thinning of the tranversalis fascia through which the abdominal viscera can extrude). Some of these mesh devices are adapted for anterior-side hernia repair (i.e., repairing a hernia defect from an anterior side of the fascia proximate to the surgeon). For instance, a hernia defect can be repaired exclusively from the anterior side of the fascia by dissecting the sac from the surrounding structures, inverting the sac into an abdominal cavity and then closing the defect with the use of an overlay patch or with the use of a space-filling prosthesis having an overlay patch. One type of prosthesis adapted for anterior-side hernia repair is made from a sheet of surgical mesh fabric folded into a multi-layered cone. In order to repair a hernia defect, the prosthesis is inserted into the defect to occlude the void. Because the prosthesis is stiff, it does not readily conform to the contour of the defect, forming gaps between the prosthesis and the interior wall of the defect and hence potentially causing recurrent herniation. The stiff, multi-layered prosthesis is also susceptible to kinking and buckling during its placement into the defect. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Hernia repair mesh prosthesis, and method of using same Inventor(s): Tyagi, Narendra S.; (Bloomfield Hills, MI) Correspondence: Carrier Blackman And Associates; 24101 Novi Road; Suite 100; Novi; MI; 48375 Patent Application Number: 20020042658 Date filed: October 9, 2001

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Abstract: A hernia repair prosthetic element includes: a central portion which covers a hernia opening within a patient; plural support portions integrally connected about a periphery of the central portion for securing the central portion in covering relation to the hernia opening; the prosthetic element, including the central and support portions, being a substantially planar member formed of flexible mesh material; the support portions being foldable relative to the central portion so that the prosthetic element can be selectively manipulated between folded and unfolded shapes; the support portions being adapted to securely engage various components of the patient's body surrounding the hernia opening; and openings are formed through the central portion for passage of fluid therethrough. The prosthetic element has only two basic shapes, one for use in relation to all groin hernias and one for use in relation to all abdominal hernias. The flexible mesh material may be of propylene or other suitable materials, the central portion has an enhanced strength, such as being formed of two layers of the mesh material, and the central portion may be stretchable to absorb greater forces imposed thereon. Excerpt(s): The present invention relates to novel hernia repair mesh prostheses, and to methods of using same to repair hernias. More particularly, the present invention relates to such prostheses which drastically reduce hernia recurrences and which are relatively simple to construct and install, and to methods of using same. Hernias are common medical problems involving a protrusion of an organ or body part through a rupture in connective tissue or through a wall of a cavity in which is normally enclosed. Some known types of hernias are in the groin area, including direct, indirect and femoral hernias, and others are in the abdominal wall. Medical devices and procedures for repairing hernias are widely known, and have been reported well over one hundred years ago, and treatment of hernias has gone through incremental improvements over time, including the early work of A. P. Cooper, The Anatomy And Surgical Treatment Of Abdominal Hernia In Two Parts, London, Longman, Rees, Orme, Brown and Green 1827, the landmark advancement known as the Lichtenstein repair (I L Lichenstein, A G Schulman, P K Amid, M M Montilor, The Tension Free Hernioplasty, AnJ Surgery, 1989; 157:188-193, the placement of a truss-like mechanical support in the preperitoneal space utilizing the principals of Pascal's Law, R E Stoppa, J L Rives, C R Warlaumont, et al., The Use Of Dacron In The Repair Of Hernias Of The Groin, Surg. Clin. North Am, 1984; 64:269-285, and placement of mesh posterior to the muscles and investing fascia of the abdominal wall such that the kinetic force of abdominal pressure is used in a reverse role--instead of causing a hernia, the force is used to support the repair, L M Nyhus, R E Condon, H N Harkins, Clinical Experience With Preperitoneal Hernial Repair For All Types Of Hernias Of The Groin, Am J Surg, 1960; 100:234-244. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hernia repair prosthesis Inventor(s): Rousseau, Robert A.; (Ottsville, PA) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20020147457 Date filed: May 31, 2002 Abstract: The present invention is directed to prostheses containing a radiallyexpandable member for placement within and occlusion of a hernia opening, which

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member is made from a biocompatible, flexible, porous textile suitable for reinforcing tissue. Excerpt(s): The present invention relates to an implantable hernia repair prosthesis and a method for reinforcing and repairing damaged tissue or muscle walls. Various prosthetic mesh materials have been proposed to reinforce the abdominal wall and to close abdominal wall defects utilizing different repair prostheses and methods of installation. The methods of executing a surgical repair can be segregated into two main approaches. The repair can be made exclusively from the anterior side (closest to the surgeon) of the defect by dissecting the sac free of the fascia and pressing it back into the pre-peritoneal space and providing permanent closure of the defect. The closure can be provided through the application of space filling prostheses and overlay patches (tension-free techniques) or can be accomplished through the use of sutures (tension techniques). An example of a tension free anterior repair is to fold a sheet of surgical mesh fabric into a multi-layer cone configuration and then to insert the mesh plug into a hernia defect to occlude the void. Such a multi-layer prosthesis is inherently stiff and may not fully conform to variations in the contour of the defect, leaving gaps between the implant and the abdominal wall that potentially could lead to recurrent herniation. The stiff, multi-layered mesh plug also may be susceptible to kinking and buckling during placement. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hiatal hernia repair patch and method for using the same Inventor(s): Rehil, Om P.; (Marion, IN) Correspondence: Richard C. Litman; Litman Law Offices, LTD.; P.O. Box 15035; Arlington; VA; 22215; US Patent Application Number: 20010049539 Date filed: January 3, 2001 Abstract: This invention relates to a surgical prosthesis and method of use. The hiatal hernia repair patch is a ring with an integral mesh attached to and surrounding the ring. The ring and the mesh have a slit therein extending radially so that the ring may be placed about the esophagus. The ring may be hollow or solid and is flexible so that it may be inserted through a small incision or a laparoscopic port into the abdominal cavity. The patch, including the ring and mesh, is made as a one-piece unit and is made from polypropylene or other biocompatible material. In use, the ring is placed around the esophagus, between the stomach and the diaphragm. Next, the mesh is stapled or sutured to the undersurface of the diaphragm, bridging the hiatal hernia defect. Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application Ser. No. 60/179,149, filed Jan. 31, 2000. The present invention relates to a method, and a prothesis, for use in maintaining the intra-abdominal reduction of a sliding esophageal hiatal hernia. In humans, there is no anatomical valve, or discrete sphincter at the esophago-gastric (EG) junction. When anatomy in the area is normal, esophageal peristalsis pushes food through the EG junction. The stomach fills, like a sack, pulling the EG junction tighter. Normal, intact esophageal hiatal muscles prevent reflux. However, a gaping hiatal muscle sling creates a large defect around the esophagus, thereby interfering with the EG junction mechanism. This may lead to a hiatal hernia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and device for use in minimally invasive approximation of muscle and other tissue Inventor(s): de la Pena, Jose; (Lomas Virreyes, MX), de la Torre, Roger; (Wentzville, MO), Drews, Michael; (Sacramento, CA), Hermann, George D.; (Portola Valley, CA), Howell, Thomas; (Palo Alto, CA), Khouri, Roger; (Key Biscayne, FL), Willis, David; (Palo Alto, CA) Correspondence: Cameron A. King; Morrison & Foerster Llp; 425 Market Street; San Francisco; CA; 94105; US Patent Application Number: 20020065534 Date filed: October 2, 2001 Abstract: Tissue approximation devices for the minimally invasive approximation of muscle or fascia, such as approximation of the rectus muscles in the abdomen (abdominoplasty), or hernia repair and other such applications using minimally invasive methods to access and perform the procedures thereby reducing or eliminating visible scars. Excerpt(s): The present invention relates generally to medical apparatus and methods and more particularly to devices and methods for the minimally invasive approximation of muscle, fascia or other tissue such as approximation of the rectus muscles in the abdomen (abdominoplasty), hernia repair, closing fascial defects and other such applications where fascia or other tissue structures need approximating, that provide patient benefit using minimally invasive techniques that, among other benefits, reduce or eliminate visible scars. In the case of diastasis of the rectus muscle and ventral hernias, separation of muscles and fascia from each other can occur over time due to stretching or weakening of tissue, resulting in protrusion at the region of separation of otherwise contained material, e.g. Fat, tissue, or intestine. For example, during pregnancy or over time with weight gain, the rectus abdominals muscles, (the large muscles that run longitudinally along the abdomen from the torso to the groin of a human being), can diverge from each other, resulting in a flabby appearance or in some cases protrusion of accumulated fat or other structures through the separated region. Many people desire to undergo surgical repair of the separated muscles either to repair the herniation of material, or in less extreme cases, purely for cosmetic reasons, sometimes in conjunction with liposuction or removal of excess skin and fatty tissue. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Pocketed hernia repair Inventor(s): Rousseau, Robert A.; (Ottsville, PA) Correspondence: Ralph W. Selitto, JR.; P.O. Box 1477; Edison; NJ; 08818-1477; US Patent Application Number: 20020133236 Date filed: March 19, 2001 Abstract: A device for surgically repairing and reinforcing a hernia includes a hernia prosthesis having a substantially planar base portion and an overlay portion, each formed from a biocompatible material. The overlay portion is peripherally attached to the base portion to define a pocket to receive a surgical instrument or a surgeon's finger for placing the prosthesis within the human body. The pocket may be formed with

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releasable stitching to enable it to be flattened or removed after placement and may contain a resilient member that urges the prosthesis into a flat configuration. Excerpt(s): The present invention relates to a hernia repair prosthesis, and more particularly to a substantially planar surgical mesh prosthesis for bridging a hernia. Surgically implantable mesh patches for the repair of inguinal and other abdominal wall hernias are commonly used and provide tension free repairs by bridging the hernia defect. Patches of this type constitute a structural support which decreases recurrence rates and because they do not require the displacement of tissues to cover the hernia, decrease postoperative discomfort. Frequently, prostheses of this type are sutured in place, i.e., proximate to the periphery of the patch. An alternative to suturing the prosthesis is to insert it into the properitoneal space. U.S. Pat. No. 5,916,225 to Kugel discloses a hernia prosthesis having a resilient ring made of synthetic material, such as nylon, polypropylene or polyester enclosed within a pocket formed by opposing planar segments of surgical mesh that are attached together to encapsulate the ring. A slit is provided in one of the planar segments to permit the surgeon to insert a finger therein in order to push the prosthesis through an incision in the abdominal wall into the properitoneal space and across the hernia. The resilient ring urges the pocket into a deployed planar configuration, i.e., to straighten the wrinkling and folding of the pocket that occurs in the course of its placement. The disadvantages associated with the device disclosed in U.S. Pat. No. 5,916,225 are that each layer of mesh is stiff and dense, such that the combination of two layers and the resilient ring constitutes a rigid, high mass prosthesis which tends to cause discomfort and resists conformance to the patient's anatomy. It is therefore an object of the present invention to provide a hernia repair prosthesis for use in a surgical hernia repair as generally described in U.S. Pat. No. 5,916,225 but that has lower mass, and greater flexibility. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Prosthetic mesh anchor device Inventor(s): Xavier, Alfredo F.; (Mattapoisett, MA) Correspondence: Chester E. Flavin; Ross, Ross & Flavin; Suite 207; 120 Maple Street; Springfield; MA; 01103; US Patent Application Number: 20040092970 Date filed: October 18, 2002 Abstract: A percutaneous mesh anchoring and placement device for use in groin hernia repair wherein trocars are positioned along a patient's abdominal midline and extend into an insufflated pre-peritoneal space, the device being introduced into the preperitoneal space through a selected one of the trocars and comprising a tubular sleeve which encases a spirally-wound roll of prosthetic mesh having an anchor captured therein, the anchor having a string attached thereto which extends outwardly through provided orifices in the prosthetic mesh and sleeve whereby the string may be grasped by the surgeon to position and hold the device firmly against the posterior abdominal wall, the sleeve being separable from the mesh and removable from the pre-peritoneal space through a selected one of the trocars, the orifice in the mesh being of suitable size as to permit the passage of a selected one of the trocars therethrough, whereby the prosthetic mesh may be partially unfurled and an edge stapled to the abdominal wall, the anchor being separable from the mesh and removable from the pre-peritoneal space through a selected one of the trocars, whereby the prosthetic mesh may be fully unfurled and its' remaining edges stapled to the abdominal wall to repair the hernia.

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Excerpt(s): The invention relates to the laparoscopic repair of groin hernias. Laparoscopic repair of groin hernias, including inguinal and femoral hernias, using prosthetic mesh is gaining increasing popularity among surgeons. It offers comparable results to conventional open repair, with significantly less pain and disability. Despite its solid anatomical and physiological principles, as well as excellent patient acceptance, it still offers significant technical challenges to the average surgeon. Specifically, proper anatomical placement of the mesh, sufficient coverage of all anatomically weak areas, and the avoidance of wrinkles or folds, constitute the most crucial determinants for a successful procedure, leading to decreased post-operative pain and reduced recurrence rate. These important features are among the objects of this invention. To the best of our knowledge, there is currently no system devised to secure mesh placement for laparoscopic groin hernia repair using a percutaneous anchoring device. The current standard technique uses a rectangular mesh usually rolled into a cylinder, introduced through a trocar and dropped into the pre-peritoneal space. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

PROSTHETIC REPAIR FABRIC Inventor(s): Darois, Roger E.; (Foster, RI), Eldridge, Stephen N.; (Exeter, RI), Lee, Michael J.; (Barrington, RI) Correspondence: Wolf Greenfield & Sacks, PC; Federal Reserve Plaza; 600 Atlantic Avenue; Boston; MA; 02210-2211; US Patent Application Number: 20030212460 Date filed: May 10, 2002 Abstract: An implantable prosthesis is provided for repairing or augmenting anatomical weaknesses or defects, and is particularly suitable for the repair of soft tissue and muscle wall openings. The prosthesis is configured to promote enhanced tissue ingrowth thereto, while limiting the incidence of post-operative adhesions between the fabric and tissue or organs. The prosthesis may include a layer of fabric that is constructed and arranged to allow tissue ingrowth and is susceptible to the formation of adhesions for tissue and organs. One or more barriers may be provided on selected portions of the fabric to inhibit the formation of adhesions with tissues and organs. The prosthesis may have an opening that is adapted to receive the esophagus or other tubelike structure, or other projection, that passes through an opening in or projects from a tissue, muscle or organ wall requiring repair and/or augmentation. The prosthesis may be configured for use in hiatal hernia repair and/or treatment of GERD. A method is also provided for the treatment of GERD. Excerpt(s): The present invention relates to an implantable prosthesis, and more particularly to a prosthetic repair fabric for use in soft tissue repair and reconstruction. Gastroesophageal reflux disease ("GERD") and hiatal hernia commonly occur together. A hiatal hernia occurs when a natural opening, or "hiatus," in the diaphragm through which the esophagus extends, becomes enlarged, allowing the stomach to pass through the hiatus into the thoracic cavity. GERD indicates a backflow of acid from the stomach into the esophagus. Although GERD may be an independent affliction, GERD is often a symptom of, or a co-affliction with, a hiatal hernia. Representative surgical treatments for GERD and/or hiatal hernia may include one or more of the following: a fundoplication, more specifically an open or laparoscopic Nissen fundoplication, where part of the fundus of the stomach is wrapped around the lower end of the esophagus to recreate or augment the lower esophageal sphincter (LES); a cruroplasty, which involves

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tightening the crura of the diaphragm around the esophagus; and an endoscopic gastroplication where pleats are formed within the esophagus at or near the LES, reducing the size of the internal diameter of the lower esophagus. It has been known to use a prosthetic repair fabric in the surgical treatment of GERD and/or hiatal hernia. Typically, a sheet of surgical mesh fabric, such as BARD MESH, commercially available in rectangular stock sheets, is custom fashioned by a surgeon into a shape suitable for a particular patient's hiatal repair, such as a rectangular or oval shape. The surgeon forms a keyhole opening in the patch by cutting a slit from one edge of the implant and then forming an opening at the end of the slit that is large enough to receive the esophagus. The adjacent flaps of mesh formed by the slit running through the edge, known as "tails" or "fins", may be stitched together after the esophagus has been positioned in the keyhole opening, recreating a hiatal ring about the esophagus to help prevent the stomach from reentering the thoracic cavity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with hernia repair, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “hernia repair” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on hernia repair. You can also use this procedure to view pending patent applications concerning hernia repair. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON HERNIA REPAIR Overview This chapter provides bibliographic book references relating to hernia repair. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on hernia repair include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “hernia repair” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on hernia repair: •

Mayo Clinic Gastrointestinal Surgery Source: St. Louis, MO: Elsevier Science. 2004. 1020 p. Contact: Available from Elsevier Science. Customer Service Department, 11830 Westline Industrial Drive, St. Louis, MO 63146 (800) 545-2522. Fax (800) 535-9935. Email: [email protected]. Website: www.elsevierhealth.com. PRICE: $195.00. ISBN: 721692877. Summary: This book focuses on the major diseases treated by gastrointestinal surgeons, from the esophagus to the anal canal. The presentation has a definite clinical orientation and a major emphasis on practical applications as they are applied at the Mayo Clinic. Sections on etiology, pathophysiology, pathology, and diagnosis are also included by are purposely not the emphasis of the chapters. The book offers 49 chapters: the experience of being a Mayo Clinic surgeon; gastroesophageal reflux disease (GERD) and esophageal hiatal hernia; achalasia and other esophageal motility disorders; epiphrenic

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esophageal diverticula; cancer of the esophagus; gastric adenocarcinoma, primary gastric lymphoma; peptic ulcer; disorders of gastrointestinal motility and emptying after gastric operations; morbid obesity; hepatocellular carcinoma and intrahepatic cholangiocarcinoma; hepatic metastases from extrahepatic cancers; benign tumors and cysts of the liver; liver diseases necessitating liver transplantation; biliary stone disease; benign biliary strictures; cancer of the gallbladder; pancreatic and periampullary carcinoma; islet cell tumors; acute and chronic pancreatitis; pancreas transplantation after complications of diabetes mellitus; cystic tumors of the pancreas; thrombocytopenia and other hematologic disorders; malignant tumors of the small intestine; villous tumors of the duodenum; small intestinal diverticula; Crohn's disease; small bowel obstruction; acute mesenteric ischemia; acute mesenteric venous thrombosis; chronic mesenteric ischemia; visceral artery aneurysms; colonic motor disorders (constipation); diverticular disease of the colon; colon cancer; ischemic colitis; appendicitis; chronic ulcerative colitis; colonic volvulus; familial adenomatous polyposis; cancer of the rectum; common anorectal problems; rectal prolapse and solitary rectal ulcer syndrome; abdominal trauma; unclosable abdomen and the dehisced wound; ventral and incisional hernias; open repair of inguinal hernia; endoscopic inguinal hernia repair; and common pediatric gastrointestinal disorders. Each chapter is illustrated with line drawings, black and white photographs, and some color plates. References are provided with each chapter and a detailed subject index concludes the text. •

Guide to Laparoscopic Surgery Source: Malden, MA: Blackwell Science, Inc. 1998. 169 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail: [email protected]. Website: www.blackwell-science.com. PRICE: $54.95. ISBN: 086542649X. Summary: This book reviews the important aspects of laparoscopy that every surgeon needs to know. The authors address the needs of trainees in all surgical disciplines, as well as the concerns of qualified surgeons, urologists, and gynecologists. The emphasis is on procedures and practical approaches; four sections are included. In the introduction, the authors review the advantages and disadvantages of laparoscopy, risk factors, combined laparoscopy and open surgery, physiological changes during laparoscopy, anesthesia during the procedures, and postoperative management. The second section on equipment, instruments, basic techniques, problems and solutions includes: imaging and viewing, sterilization and maintenance of optics and the camera, creation of the pneumoperitoneum access, gasless laparoscopy, Veress needle procedures, primary cannula insertion, open cannulation (Hasson's technique), secondary cannula, extraperitoneal laparoscopy, instruments for dissection, diathermy and electrocautery, hemostasis, laser, ultrasound, high velocity water jet, ligation and suturing, and specimen extraction. The section on setting up in the operating theater covers hand instruments, equipment, patient position and preparation, and setting up for the procedure. The final section on laparoscopic procedures themselves, covers diagnostic laparoscopy, laparoscopic ultrasonography, adhesiolysis, cholecystectomy (gallbladder removal), management of common bile duct stones, appendectomy, laparoscopic Nissen's fundoplication, gastroenterostomy, truncal vagotomy, laparoscopy for perforated duodenal ulcer, splenectomy, laparoscopy for undescended testicles, varicocele, laparoscopic simple nephrectomy (kidney removal), and inguinal

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hernia repair. The book is illustrated with numerous line drawings of the equipment and procedures being discussed. A subject index concludes the book. •

Inguinal Hernia: Advances or Controversies? Source: New York, NY: Radcliffe Medical Press. 1994. 524 p. Contact: Available from Radcliffe Medical Press. Scoville, Patterson Inc., 141 Fifth Avenue, Suite 8N, New York, NY 10010. PRICE: $99.50 (as of 1995). ISBN: 1857750462. Summary: This comprehensive medical text explains the various types of hernia repairs (classical, contemporary, and laparoscopic) and analyzes in detail the newer laparoscopic approaches. Complications, recurrences, technical, and cost considerations are covered in the text, which includes divergent professional viewpoints. Eighty-six chapters, authored by specialists in the field, cover history, embryology and anatomy; the biology of hernia formation; diagnosis, classification, and anesthesia; biomaterials in hernia repairs; the economics of hernia repair; complications and controversies in open hernia repair; techniques of laparoscopic hernia repairs; and complications, recurrences, and technical considerations in laparoscopic hernia repair. The last 36 chapters present selected studies on hernia repair. Each chapter includes numerous black and white photographs, figures, and references. A subject index concludes the volume.

•

Nyhus and Condon's Hernia, Fifth Edition Source: Philadelphia, PA: Lippincott Williams and Wilkins. 2002. 650 p. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2365. PRICE: $179.00 plus shipping and handling. ISBN: 0781719623. Summary: This lengthy textbook offers a comprehensive look at the surgical management of hernias. The authors stress that there are four general changes in the area of hernia surgery that have affected the way surgeons practice their craft: the widespread acceptance of the 'tension-free' principle, the routine use of prosthetic materials, the realization that the preperitoneal space can be used for hernia repair, and therapeutic laparoscopy. The text offers 50 chapters in eight sections: etiology, history and anatomy of hernias; conventional groin hernia repairs; laparoscopic and endoscopic groin hernia repairs; complications of groin hernia; ventral incisional hernias; pediatric hernias; diaphragmatic hernias; and miscellaneous considerations in hernia repair. Each chapter includes extensive references and black and white photographs, drawings, and charts. A subject index concludes the volume.

•

Surgical Laparoscopy Source: St. Louis, MO: Quality Medical Publishing, Inc. 1991. 359 p. Contact: Available from Quality Medical Publishing, Inc. 2086 Craigshire Drive, St. Louis, MO 63146. (314) 878-7808. PRICE: $110, shipping and handling free with prepaid orders. ISBN: 094221921X. Summary: This textbook is a guide to the burgeoning field of surgical laparoscopy. It is intended to introduce surgeons to the principles of laparoscopic surgery and to familiarize those already performing laparoscopic cholecystectomy with the newer procedures and instruments that have been developed. Seventeen chapters cover topics including the history of laparoscopy, laparoscopic equipment and instrumentation, practical anesthesia, open laparoscopy, and clinical applications, including those for

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preoperative diagnosis and staging for gastrointestinal cancers, for gallstone disease, cholecystectomy, cholangiography and management of choledocholithiasis, appendectomy, pelvic lymphadenectomy, truncal and selective vagotomy, inguinal hernia repair, and intestinal surgery. Two final chapters cover the complications of laparoscopic general surgery and training and credentialing for laparoscopic surgery. One appendix provides a partial listing of manufacturers of surgical laparoscopy equipment. A detailed subject index concludes the volume.

Chapters on Hernia Repair In order to find chapters that specifically relate to hernia repair, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and hernia repair using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “hernia repair” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on hernia repair: •

Unique Features of Groin Hernia Repair in Infants and Children Source: in Fitzgibbons, R.J.; Greenberg, A.G., eds. Nyhus and Condon's Hernia. Philadelphia, PA: Lippincott Williams and Wilkins. 2002. p.435-451. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 223-2300. Fax (301) 223-2365. PRICE: $179.00 plus shipping and handling. ISBN: 0781719623. Summary: Although the surgical techniques in the repair of inguinal hernia in adults and children share common features, there are unique aspects to the childhood hernia that merit specific consideration. These relate to the pathophysiologic processes leading to the manifestation of a hernia, the differential diagnosis to be considered, and the potential for incarceration and strangulation. This chapter on unique features of groin hernia repair in infants and children is from a lengthy textbook on the surgical management of hernias. The authors present the current concepts of the embryology of childhood hernia, tools for clinical diagnosis, and techniques for operative management, as well as a discussion of the age-specific anesthetic risks and options for postoperative pain control. 9 figures. 48 references.

•

Endoscopic Inguinal Hernia Repair Source: in Kelly, K.A.; Sarr, M.G.; Hinder, R.A., eds. Mayo Clinic Gastrointestinal Surgery. St. Louis, MO: Elsevier Science. 2004. p. 691-697. Contact: Available from Elsevier Science. Customer Service Department, 11830 Westline Industrial Drive, St. Louis, MO 63146 (800) 545-2522. Fax (800) 535-9935. Email: [email protected]. Website: www.elsevierhealth.com. PRICE: $195.00. ISBN: 721692877. Summary: This chapter on endoscopic inguinal hernia repair is from a book that focuses on the major diseases treated by gastrointestinal surgeons, from the esophagus to the anal canal. The text has a clinical orientation and a major emphasis on practical applications as they are applied at the Mayo Clinic. The authors of this chapter note that

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even tough various operative techniques are useful for repair of hernias, the endoscopic approaches totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP), have definite advantages in selected patients. Topics include physiology, diagnosis and imaging, indications for operation, the operative techniques of TEP and TAPP, anticipated surgical outcome, and long-term follow-up. The chapter is illustrated with line drawings. 7 figures. 14 references. •

Laparoscopic Herniorrhaphy Source: in Hernia. 4th ed. Philadelphia, PA: Lippincott-Raven Publishers. 1995. p. 253268. Contact: Available from Lippincott-Raven Publishers. 1185 Avenue of the Americas, New York, NY 10036. (212) 930-9500. Fax (212) 869-3495. PRICE: $149 (as of 1995). ISBN: 0397512864. Summary: This chapter on laparoscopic herniorrhaphy is from a medical textbook on the diagnosis and treatment of hernia. Topics include the history of laparoscopic herniorrhaphy; materials used for hernia repair; intraperitoneal landmarks of the anatomy of the inguinal canal; operative exposures for laparoscopic herniorrhaphy, including intraperitoneal inlay prosthesis, transabdominal preperitoneal prosthetic repair, and the preperitoneal approach; complications of laparoscopic herniorrhaphy; and cost factors. The chapter concludes with eight pages of comments on specific aspects covered within the text, each with its own references. 6 figures. 5 tables. 63 references.

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CHAPTER 6. MULTIMEDIA ON HERNIA REPAIR Overview In this chapter, we show you how to keep current on multimedia sources of information on hernia repair. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on hernia repair is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “hernia repair” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “hernia repair” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on hernia repair: •

Laparoscopic Herniorrhaphy: Hernia Repair by Laparoscopy Source: Camp Hill, PA: Chek-Med Systems, Inc. 1994. (videocassette). Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011. (800) 451-5797 or (717) 761-1170. Fax (717) 761-0216. PRICE: $120.00 each; $215.00 for two in series of 3; $295.00 for whole series. Summary: This patient education videotape provides a brief overview of the use of laparoscopy for the correction of hernias. The videotape features a general introduction to the procedure of laparoscopy, noting that it usually results in less patient discomfort, a quicker recovery time, and lower cost. The program shows a series of patients expressing their concerns and the results they obtained with laparoscopy. The program then defines hernia and discusses why it occurs, the types of hernias, typical symptoms, and diagnostic considerations. After mention of the standard 'open' surgery previously used for hernia repair, the program covers the advantages, risk factors and patient selection issues of laparoscopy herniorrhaphy (hernia removal). The program then uses

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graphics to show how the actual laparoscopic procedure is conducted. The program concludes by showing one patient's postoperative recovery period. The program features Dr. Paul Kunkel. •

Inguinal Anatomy for Laparoscopic Hernia Repair Source: St. Louis, MO: Quality Medical Publishing, Inc. 1994. Contact: Available from Quality Medical Publishing, Inc. 11970 Borman Drive, Suite 222, St. Louis, MO 63146. (800) 348-7808 or, in Missouri, (314) 878-7808. Fax (314) 878-9937. PRICE: $59 for 1/2 in NTSC; $84 for PAL, SECAM, and 3/4 in formats. Summary: This videotape program is from a series of instructional videotapes designed to take viewers into the operating room for a firsthand look at laparoscopic procedures. This program focuses on documenting the anatomy of the inguinal region for laparoscopic hernia repair. A cadaver demonstration and live laparoscopic footage are used to define this anatomical region for safer hernia repairs. (AA-M).

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CHAPTER 7. PERIODICALS AND NEWS ON HERNIA REPAIR Overview In this chapter, we suggest a number of news sources and present various periodicals that cover hernia repair.

News Services and Press Releases One of the simplest ways of tracking press releases on hernia repair is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “hernia repair” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to hernia repair. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “hernia repair” (or synonyms). The following was recently listed in this archive for hernia repair: •

Laparoscopic hernia repair decreases long-term complication rate Source: Reuters Medical News Date: May 09, 2003

•

Laparoscopic groin hernia repair sometimes, but not always, cost effective Source: Reuters Industry Breifing Date: June 22, 2001

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•

Ampicillin/sulbactam reduces hernia repair wound infection rate Source: Reuters Industry Breifing Date: February 14, 2001

•

Prosthetic mesh used in hernia repair can be site of infection Source: Reuters Medical News Date: May 30, 2000

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Laparoscopic Hernia Repair Shown Superior To Open Repair Source: Reuters Medical News Date: May 29, 1997

•

Laparoscopic Hernia Repair Benefits Source: Reuters Health eLine Date: May 28, 1997 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “hernia repair” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “hernia repair” (or synonyms). If you know the name of a company that is relevant to hernia repair, you can go to any stock trading Web site (such as http://www.etrade.com/) and

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search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “hernia repair” (or synonyms).

Academic Periodicals covering Hernia Repair Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to hernia repair. In addition to these sources, you can search for articles covering hernia repair that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

10

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

11

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “hernia repair” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 5686 124 740 16 29 6595

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “hernia repair” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

14

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

18 Adapted 19

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on hernia repair can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to hernia repair. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to hernia repair. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “hernia repair”:

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Birth Defects http://www.nlm.nih.gov/medlineplus/birthdefects.html Gastroesophageal Reflux/Hiatal Hernia http://www.nlm.nih.gov/medlineplus/gastroesophagealrefluxhiatalhernia.html Male Genital Disorders http://www.nlm.nih.gov/medlineplus/malegenitaldisorders.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on hernia repair. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Same Day Surgery: Hernia Repair Source: Waco, TX: Health Edco. 1991. 2 p. Contact: Available from Health Edco. P.O. Box 21207, Waco, TX 76702-1207. (800) 2993366, ext. 295. Fax (817) 751-0221. PRICE: $2.00 each for 1-99 copies, $0.43 each for 100199 copies. Summary: This brochure describes hernia conditions that can be corrected by same day surgery. The symptoms of a hernia are usually a bulge under the skin and pain when lifting, coughing, or straining in some way. A hernia happens when a torn or weakened wall, usually in the abdominal cavity, lets the inner structure, such as a loop of intestine, slip through into a hernial sac. This causes pain, and can be quite serious if not taken care of promptly; the hernia can become strangulated and gangrenous. In hernia repair, the doctor returns the contents of the hernial sac to the body cavity, and repairs the torn or weakened wall. The brochure outlines recommended preoperative care strategies, what to expect the day of the surgery, the types of surgical techniques used to treat each hernia condition, and postoperative healing at home. The tissues surrounding the incision may be tender and discolored, which is normal. However, the patient should contact the doctor if there is bleeding from the incision site, a fever of 101 degrees or higher, severe pain, or inability to urinate. Full color line drawings illustrate a common hernia and the surgery used to treat it. 4 figures.

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When You Need an Operation: About Hernia Repair Source: Chicago, IL: American College of Surgeons. 1994. 4 p. Contact: Available from American College of Surgeons. 55 East Erie Street, Chicago, IL 60611. (312) 664-4050 PRICE: $14 for 50 copies, $27 for 100 copies. Summary: This brochure provides information for patients scheduled to undergo hernia repair or herniorrhaphy. Written in a question and answer format, the brochure explains why the procedure may be recommended; how hernias develop; symptoms of hernias and the types of activity associate with the appearance of an inguinal hernia; preparing for the operation; outpatient surgery; the types of surgical procedures, including the conventional method, the tension-free mesh technique, and laparoscopic techniques; recovery from the operation; and possible complications. The brochure concludes with a description of the specialized training required for surgeons and for certification as a Fellow of the American College of Surgeons. 1 figure. The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to hernia repair. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to hernia repair. By consulting all of associations listed

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in this chapter, you will have nearly exhausted all sources for patient associations concerned with hernia repair. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about hernia repair. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “hernia repair” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “hernia repair”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “hernia repair” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “hernia repair” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

21

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

22

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on hernia repair: •

Basic Guidelines for Hernia Repair Hernia repair Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002940.htm

•

Signs & Symptoms for Hernia Repair Hernia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003100.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm

•

Background Topics for Hernia Repair Scrotum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002296.htm Wound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000043.htm

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Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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HERNIA REPAIR DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in

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determining protein conformation. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Appendectomy: An operation to remove the appendix. [NIH]

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Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Approximate: Approximal [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium enema: A procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Stricture: A narrowing of the biliary tract from scar tissue. The scar tissue may result from injury, disease, pancreatitis, infection, or gallstones. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of

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tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Broad Ligament: A broad fold of peritoneum that extends from the side of the uterus to the wall of the pelvis. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bupivacaine: A widely used local anesthetic agent. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Cadaver: A dead body, usually a human body. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for

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example, age, gender, ethnic origin). [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cholangiography: Radiographic examination of the bile ducts. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Choledocholithiasis: Gallstones in the bile ducts. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circumcision: Excision of the prepuce or part of it. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names.

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Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]

Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast Media: Substances used in radiography that allow visualization of certain tissues.

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[NIH]

Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Convalescence: The period of recovery following an illness. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Credentialing: The recognition of professional or technical competence through registration, certification, licensure, admission to association membership, the award of a diploma or degree, etc. [NIH] Culture Media: Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as agar or gelatin. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cystic Duct: The tube that carries bile from the gallbladder into the common bile duct and the small intestine. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Defecography: Radiographic examination of the process of defecation after the instillation of a contrast media into the rectum. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH]

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Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH]

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Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Emulsions: Colloids of two immiscible liquids where either phase may be either fatty or aqueous; lipid-in-water emulsions are usually liquid, like milk or lotion and water-in-lipid emulsions tend to be creams. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Motility Disorders: Disorders affecting the motor function of the upper or lower esophageal sphincters, the esophageal body, or a combination of these parts. The

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failure of the sphincters to maintain a tonic pressure may result in the impeding of the passage of food, regurgitation of food, or reflux of gastric acid into the esophagus. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Evacuation: An emptying, as of the bowels. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracorporeal: Situated or occurring outside the body. [EU] Extracorporeal Membrane Oxygenation: Application of a life support system that circulates the blood through an oxygenating system, which may consist of a pump, a membrane oxygenator, and a heat exchanger. Examples of its use are to assist victims of smoke inhalation injury, respiratory failure, and cardiac failure. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Nerve: A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH]

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Flatus: Gas passed through the rectum. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gangrenous: A circumscribed, deep-seated, suppurative inflammation of the subcutaneous tissue of the eyelid discharging pus from several points. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastroenterostomy: Surgical construction of a channel between the stomach and intestines. [NIH]

Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genital: Pertaining to the genitalia. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH]

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Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemoperitoneum: Hemorrhage into the peritoneal cavity. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Herniated: Protrusion of a degenerated or fragmented intervertebral disc into the intervertebral foramen compressing the nerve root. [NIH] Herniorrhaphy: An operation to repair a hernia. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormones: Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various endocrine glands and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. [NIH]

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Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hysterectomy: Excision of the uterus. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs. [NIH] Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incarceration: Abnormal retention or confinement of a body part; specifically : a constriction of the neck of a hernial sac so that the hernial contents become irreducible. [EU] Incidental: 1. Small and relatively unimportant, minor; 2. Accompanying, but not a major part of something; 3. (To something) Liable to occur because of something or in connection with something (said of risks, responsibilities, .) [EU] Incision: A cut made in the body during surgery. [NIH] Incisional: The removal of a sample of tissue for examination under a microscope. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH]

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Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inguinal Hernia: A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Instillation: . [EU] Insufflation: The act of blowing a powder, vapor, or gas into any body cavity for experimental, diagnostic, or therapeutic purposes. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intrahepatic: Within the liver. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intravenous: IV. Into a vein. [NIH] Intussusception: A rare disorder. A part of the intestines folds into another part of the intestines, causing blockage. Most common in infants. Can be treated with an operation. [NIH]

Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

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Ipsilateral: Having to do with the same side of the body. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic Colitis: Decreased blood flow to the colon. Causes fever, pain, and bloody diarrhea. [NIH] Islet: Cell producing insulin in pancreas. [NIH] Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketorolac: A drug that belongs to a family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in cancer prevention. [NIH] Keyhole: A carrier molecule. [NIH] Kinetic: Pertaining to or producing motion. [EU] Kink: Deviation from the normal long axis, as in a fractured bone healed out of line. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Laparotomy: A surgical incision made in the wall of the abdomen. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lesion: An area of abnormal tissue change. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or

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animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenectomy: A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. Also called lymph node dissection. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH]

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Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution.

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[NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Necrotizing Enterocolitis: A condition in which part of the tissue in the intestines is destroyed. Occurs mainly in under-weight newborn babies. A temporary ileostomy may be necessary. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatologist: Doctor who specializes in treating the diseases and disorders of newborn babies. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Oophorectomy: Surgery to remove one or both ovaries. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and

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secrete some of the female sex hormones. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreas Transplant: A surgical procedure that involves replacing the pancreas of a person who has diabetes with a healthy pancreas that can make insulin. The healthy pancreas comes from a donor who has just died or from a living relative. A person can donate half a pancreas and still live normally. [NIH] Pancreas Transplantation: The transference of a pancreas from one human or animal to another. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of

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proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth

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day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polyethylene Glycols: Alpha-Hydro-omega-hydroxypoly(oxy-1,2-ethanediyls). Additional polymers of ethylene oxide and water and their ethers. They vary in consistency from liquid to solid, depending on the molecular weight, indicated by a number following the name. Used as surfactants in industry, including foods, cosmetics and pharmaceutics; in biomedicine, as dispersing agents, solvents, ointment and suppository bases, vehicles, tablet excipients. Some specific groups are lauromagrogols, nonoxynols, octoxynols and poloxamers. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polytetrafluoroethylene: Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may

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be infused without repeated needle sticks. Also called a port. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [NIH] Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Preoperative: Preceding an operation. [EU] Prepuce: A covering fold of skin; often used alone to designate the preputium penis. [EU] Proctosigmoidoscopy: An examination of the rectum and the lower part of the colon using a thin, lighted tube called a sigmoidoscope. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH]

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Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Punctures: Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively.

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At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectal Prolapse: Protrusion of the rectal mucous membrane through the anus. There are various degrees: incomplete with no displacement of the anal sphincter muscle; complete with displacement of the anal sphincter muscle; complete with no displacement of the anal sphincter muscle but with herniation of the bowel; and internal complete with rectosigmoid or upper rectum intussusception into the lower rectum. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Reoperation: A repeat operation for the same condition in the same patient. It includes reoperation for reexamination, reoperation for disease progression or recurrence, or reoperation following operative failure. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic

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nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retraction: 1. The act of drawing back; the condition of being drawn back. 2. Distal movement of teeth, usually accomplished with an orthodontic appliance. [EU] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retropubic prostatectomy: Surgery to remove the prostate through an incision made in the abdominal wall. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Round Ligament: A fibromuscular band that attaches to the uterus and then passes along the broad ligament, out through the inguinal ring, and into the labium majus. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seminal vesicles: Glands that help produce semen. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoidoscope: A thin, lighted tube used to view the inside of the colon. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the

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large intestine. [NIH] Smoke Inhalation Injury: Pulmonary injury following the breathing in of toxic smoke from burning materials such as plastics, synthetics, building materials, etc. This injury is the most frequent cause of death in burn patients. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Security: Government sponsored social insurance programs. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solitary Rectal Ulcer: A rare type of ulcer in the rectum. May develop because of straining to have a bowel movement. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spermatic: A cord-like structure formed by the vas deferens and the blood vessels, nerves and lymphatics of the testis. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH]

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Splenectomy: An operation to remove the spleen. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Stenosis: Narrowing or stricture of a duct or canal. [EU] Sterile: Unable to produce children. [NIH] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strangulation: Extreme compression or constriction of the trachea or of any part. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. [NIH] Suppository: A medicated mass adapted for introduction into the rectal, vaginal, or urethral orifice of the body, suppository bases are solid at room temperature but melt or dissolve at body temperature. Commonly used bases are cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, polyethylene glycols of various molecular weights, and fatty acid esters of polyethylene glycol. [EU] Suppurative: Consisting of, containing, associated with, or identified by the formation of

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pus. [NIH] Surgical Mesh: Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathectomy: The removal or interruption of some part of the sympathetic nervous system for therapeutic or research purposes. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Testicle: The male gonad where, in adult life, spermatozoa develop; the testis. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make

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permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Truncal: The bilateral dissection of the abdominal branches of the vagus nerve. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10

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megahertz. [NIH] Umbilical Arteries: Either of a pair of arteries originating from the internal iliac artery and passing through the umbilical cord to carry blood from the fetus to the placenta. [NIH] Umbilical Cord: The flexible structure, giving passage to the umbilical arteries and vein, which connects the embryo or fetus to the placenta. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethral Obstruction: Obstruction anywhere along the urethra. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Varicocele: A complex of dilated veins which surround the testicle, usually on the left side. [NIH]

Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vas Deferens: The excretory duct of the testes that carries spermatozoa. It rises from the scrotum and joins the seminal vesicles to form the ejaculatory duct. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Venter: Belly. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the

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alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villous: Of a surface, covered with villi. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Void: To urinate, empty the bladder. [NIH] Volvulus: A twisting of the stomach or large intestine. May be caused by the stomach being in the wrong position, a foreign substance, or abnormal joining of one part of the stomach or intestine to another. Volvulus can lead to blockage, perforation, peritonitis, and poor blood flow. [NIH] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

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INDEX A Abdominal Pain, 123, 142, 151 Abscess, 41, 123 Adenocarcinoma, 90, 123, 134 Adhesions, 35, 64, 78, 79, 87, 123 Adipose Tissue, 58, 123 Adverse Effect, 123, 147 Agar, 76, 123, 129, 135 Airway, 14, 123 Algorithms, 123, 126 Alkaline, 123, 125 Alpha Particles, 123, 145 Alternative medicine, 98, 123 Amino acid, 123, 132, 135, 141, 143, 144, 145, 149, 151, 152 Amino Acid Sequence, 123, 132 Ampicillin, 18, 98, 124 Ampulla, 124, 131 Anaesthesia, 15, 16, 17, 18, 20, 21, 27, 28, 29, 32, 35, 41, 49, 54, 57, 59, 124, 135 Anaesthetic, 15, 38, 124 Anal, 89, 92, 124, 146 Analgesic, 124, 129, 130 Analogous, 76, 124, 151 Anatomical, 84, 87, 96, 124, 135 Anesthesia, 12, 13, 14, 20, 23, 26, 27, 32, 40, 41, 47, 48, 54, 65, 78, 79, 90, 91, 123, 124 Ankle, 124, 152 Anorectal, 90, 124 Antibacterial, 124, 148, 149 Antibiotic, 11, 47, 124, 126, 141, 148, 149 Antibiotic Prophylaxis, 47, 124 Antibody, 124, 127, 135, 136 Antigen, 124, 128, 135, 136 Anti-inflammatory, 124, 129, 130, 137 Anti-Inflammatory Agents, 124, 137 Antipyretic, 124, 129 Anus, 124, 125, 126, 127, 131, 142, 146 Aorta, 124, 135 Appendectomy, 4, 90, 92, 124 Appendicitis, 42, 90, 125 Approximate, 68, 125 Arteries, 124, 125, 126, 129, 135, 139, 152 Arterioles, 125, 126, 139 Artery, 90, 125, 126, 129, 131, 145 Articular, 125, 137 Asymptomatic, 125, 141 Atrophy, 73, 125

Autodigestion, 125, 141 Autosuggestion, 125, 135 B Bacteria, 124, 125, 131, 132, 133, 139, 148, 151 Barium, 19, 125 Barium enema, 19, 125 Benign, 90, 125 Benign tumor, 90, 125 Beta-Lactamases, 125, 149 Bilateral, 8, 12, 44, 48, 51, 125, 151 Bile, 125, 127, 129, 133, 137 Bile Acids, 125, 133 Bile duct, 125, 127 Biliary, 90, 125, 127, 141 Biliary Stricture, 90, 125 Biliary Tract, 125, 141 Biological therapy, 125, 134 Biopsy, 125, 142 Biotechnology, 8, 98, 105, 126 Bladder, 3, 45, 68, 80, 126, 133, 136, 144, 147, 152, 153 Blood Platelets, 126, 150 Blood pressure, 126, 139, 148 Blood vessel, 65, 71, 73, 76, 126, 137, 138, 139, 145, 148, 150, 152 Body Fluids, 126, 130, 148 Bone Marrow, 126, 138, 149 Bowel, 12, 32, 67, 90, 124, 126, 131, 136, 137, 142, 146, 148, 149, 151 Bowel Movement, 126, 148, 149 Broad Ligament, 126, 147 Broad-spectrum, 124, 126 Bupivacaine, 18, 28, 126 Burns, 7, 126 Burns, Electric, 126 C Cadaver, 96, 126 Cannula, 68, 71, 75, 90, 126 Capsules, 126, 132, 133 Carbon Dioxide, 71, 126, 142, 146 Carcinoma, 90, 126 Cardiac, 126, 132, 140 Case report, 10, 13, 126 Catheter, 10, 48, 127 Caudal, 18, 48, 54, 127, 144

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Cell, 6, 76, 90, 125, 126, 127, 128, 129, 132, 134, 136, 137, 138, 140, 142, 143, 146, 149, 150 Cell Division, 125, 127, 134, 143 Cell Survival, 127, 134 Cholangiography, 92, 127 Cholecystectomy, 4, 26, 90, 91, 127 Choledocholithiasis, 92, 127 Chronic, 10, 13, 17, 33, 42, 60, 90, 127, 131, 132, 136, 141, 149, 151, 152 Chronic renal, 10, 127, 152 Circumcision, 18, 127 Clinical trial, 4, 7, 105, 127, 129, 130, 139, 141, 145, 146 Cloning, 126, 127 Colitis, 127 Collagen, 6, 76, 123, 127, 133, 144 Colon, 4, 23, 36, 90, 125, 127, 137, 144, 147, 151 Common Bile Duct, 90, 127, 129 Complement, 127, 128 Complementary and alternative medicine, 57, 61, 128 Complementary medicine, 57, 128 Computational Biology, 105, 128 Concomitant, 4, 128 Cone, 69, 82, 84, 128 Connective Tissue, 70, 71, 76, 83, 126, 127, 128, 129, 133, 138, 149 Connective Tissue Cells, 128 Consciousness, 124, 128 Constipation, 90, 128, 142 Constriction, 70, 128, 135, 137, 149 Contact dermatitis, 57, 128 Contraindications, ii, 128 Contralateral, 23, 24, 128 Contrast Media, 128, 129 Controlled study, 43, 129 Convalescence, 29, 41, 129 Coronary, 129, 139 Coronary Thrombosis, 129, 139 Cranial, 129, 152 Credentialing, 92, 129 Culture Media, 123, 129 Curative, 129, 150 Cutaneous, 32, 49, 128, 129 Cystic Duct, 127, 129 D Defecation, 129 Defecography, 58, 129 Density, 5, 6, 129, 140, 143, 148 Dermatitis, 58, 129

Dermis, 10, 129, 150 Diabetes Mellitus, 90, 129, 134, 136 Diagnostic Imaging, 129, 145 Diagnostic procedure, 63, 98, 129 Diaphragm, 70, 71, 84, 87, 129, 134, 143 Diarrhea, 129, 137 Diathermy, 90, 129 Diclofenac, 42, 129, 130 Diclofenac Sodium, 129, 130 Diffusion, 130, 135, 136 Digestion, 125, 126, 130, 136, 137, 141, 149 Digestive tract, 130, 147 Direct, iii, 45, 64, 65, 66, 72, 73, 78, 79, 81, 83, 130, 144, 146 Discrete, 84, 130 Disposition, 71, 130 Dissection, 12, 24, 26, 64, 73, 78, 79, 80, 90, 130, 138, 151 Distal, 64, 65, 71, 72, 79, 80, 130, 133, 147 Diverticula, 90, 130 Diverticulum, 130 Dorsal, 130, 144 Double-blind, 18, 130 Drive, ii, vi, 53, 66, 80, 89, 91, 92, 96, 130 Drug Interactions, 130 Drug Tolerance, 130, 150 Duct, 71, 124, 126, 127, 130, 132, 149, 150, 152 Duodenal Ulcer, 90, 130 Duodenum, 90, 125, 130, 131, 141, 149 E Edema, 128, 130, 152 Efficacy, 4, 9, 18, 130 Elastin, 127, 130 Elective, 18, 29, 39, 43, 131 Electrons, 131, 138, 145 Elementary Particles, 131, 138, 140, 145 Embolus, 131, 135 Embryo, 131, 135, 152 Embryology, 91, 92, 131 Emulsions, 123, 131 Endoscope, 131 Endoscopic, 19, 20, 24, 27, 39, 48, 66, 67, 68, 72, 73, 81, 88, 90, 91, 92, 131 End-stage renal, 127, 131 Enema, 131 Environmental Health, 104, 106, 131 Enzyme, 131, 141, 149, 153 Epidermis, 129, 131 Epidural, 20, 35, 131 Epigastric, 48, 73, 131, 141 Epithelial, 123, 131

157

Erythema, 128, 131 Esophageal, 84, 89, 131, 133 Esophageal Motility Disorders, 89, 131 Esophagitis, 70, 132, 133 Esophagus, 4, 23, 70, 84, 87, 89, 92, 130, 131, 132, 133, 134, 138, 141, 142, 146, 149 Evacuation, 58, 128, 132, 137 Exocrine, 132, 141 Exon, 16, 132 Extracellular, 128, 132, 148 Extracellular Matrix, 128, 132 Extracorporeal, 14, 59, 132 Extracorporeal Membrane Oxygenation, 59, 132 Extraction, 90, 132 Extravasation, 22, 132 Extremity, 79, 132 F Facial, 68, 132 Family Planning, 105, 132 Fat, 85, 123, 126, 131, 132, 148 Feces, 128, 132, 149 Femoral, 16, 21, 36, 49, 65, 71, 72, 83, 87, 132 Femoral Nerve, 16, 132 Femur, 132 Fetus, 132, 142, 152 Filler, 74, 132 Fistula, 5, 132 Flatus, 133 Fold, 69, 84, 126, 133, 139, 144 Foramen, 133, 134, 142 Fundus, 87, 133 G Gallbladder, 90, 123, 125, 127, 129, 133 Gangrenous, 110, 133 Gas, 22, 58, 64, 71, 126, 130, 133, 136, 146, 149, 153 Gastric, 10, 23, 70, 84, 90, 125, 132, 133, 134, 141 Gastric Acid, 132, 133 Gastric Juices, 133, 141 Gastroenterostomy, 90, 133 Gastroesophageal Reflux, 89, 110, 133 Gastroesophageal Reflux Disease, 89, 133 Gastrointestinal, 19, 30, 76, 89, 92, 125, 133, 149 Gastrointestinal tract, 125, 133 Gelatin, 129, 133, 149 Gels, 76, 133 Gene, 76, 126, 133 Genital, 33, 46, 110, 133

Germ Cells, 133, 140, 148, 150 Gland, 133, 138, 140, 141, 144, 147, 149, 150 Glucose, 129, 133, 134, 136 Glucose Intolerance, 129, 134 Gonad, 134, 150 Governing Board, 134, 144 Grade, 5, 134 Grafting, 134, 135 Growth factors, 76, 134 H Hair follicles, 129, 134 Heartburn, 134 Hemoperitoneum, 32, 134 Hemostasis, 90, 134 Hepatic, 90, 127, 134, 137 Hepatocellular, 90, 134 Hepatocellular carcinoma, 90, 134 Heredity, 133, 134 Herniated, 68, 69, 73, 134 Herniorrhaphy, 8, 54, 60, 75, 93, 95, 111, 134 Hiatal Hernia, 4, 17, 19, 23, 37, 69, 70, 84, 87, 89, 110, 134 Hormonal, 125, 134 Hormones, 133, 134, 141, 150 Hydroxylysine, 127, 135 Hydroxyproline, 123, 127, 135 Hyperthermia, 59, 129, 135 Hysterectomy, 49, 135 I Iatrogenic, 8, 45, 135 Ileostomy, 135, 140 Iliac Artery, 13, 135, 152 Immunodiffusion, 123, 135 Immunoelectrophoresis, 123, 135 Impairment, 22, 135 Implantation, 5, 6, 135 In vitro, 76, 135, 150 In vivo, 5, 6, 76, 135 Incarceration, 92, 135 Incidental, 4, 23, 135 Incision, 14, 39, 64, 66, 67, 71, 73, 75, 78, 79, 81, 84, 86, 110, 135, 136, 137, 144, 145, 147 Incompetence, 133, 135 Induction, 129, 135 Infarction, 22, 129, 135, 139 Infection, 16, 25, 45, 46, 70, 73, 98, 125, 136, 138, 141, 149 Infiltration, 18, 20, 26, 136

158

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Inflammation, 124, 125, 127, 128, 129, 132, 133, 136, 141, 142, 143, 151, 152 Inguinal Hernia, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17, 18, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 57, 60, 64, 66, 67, 70, 71, 72, 75, 78, 79, 81, 90, 91, 92, 111, 136 Inhalation, 136, 137 Inlay, 27, 93, 136 Innervation, 132, 136 Instillation, 129, 136 Insufflation, 67, 68, 136 Insulin, 136, 137, 141 Interstitial, 76, 136 Intervertebral, 134, 136 Intestinal, 6, 29, 90, 92, 136 Intestine, 66, 72, 81, 85, 110, 126, 136, 137, 142, 153 Intracellular, 136 Intrahepatic, 90, 136 Intraperitoneal, 29, 32, 67, 93, 136 Intravenous, 42, 136 Intussusception, 136, 146 Invasive, 9, 35, 67, 73, 82, 85, 136, 138 Ipsilateral, 73, 137 Ischemia, 90, 125, 137 Ischemic Colitis, 90, 137 Islet, 90, 137 Isoflurane, 23, 137 K Kb, 104, 137 Ketorolac, 42, 137 Keyhole, 67, 88, 137 Kinetic, 83, 137 Kink, 74, 137 L Laparoscopy, 12, 17, 19, 20, 23, 24, 30, 31, 32, 36, 39, 46, 50, 65, 67, 78, 79, 90, 91, 95, 137 Laparotomy, 7, 54, 137 Large Intestine, 130, 136, 137, 146, 148, 153 Laryngeal, 14, 137 Larynx, 137, 151, 152 Laser Surgery, 75, 137 Latent, 137, 144 Laxative, 123, 137 Lesion, 137, 151 Ligaments, 64, 70, 76, 78, 79, 129, 137 Ligation, 90, 137 Lip, 64, 137

Liver, 15, 27, 30, 58, 90, 123, 125, 132, 133, 134, 136, 137 Liver Cirrhosis, 15, 137 Liver Transplantation, 27, 58, 90, 137 Localized, 123, 136, 138, 143, 151 Loop, 65, 77, 110, 134, 135, 138 Lower Esophageal Sphincter, 18, 87, 131, 133, 138 Lumbar, 132, 138 Lymph, 24, 64, 78, 79, 138, 140 Lymph node, 24, 64, 78, 79, 138, 140 Lymphadenectomy, 92, 138 Lymphatic, 136, 138, 143, 148 Lymphatic system, 138, 148 Lymphocytes, 124, 138, 148 Lymphoid, 138 Lymphoma, 90, 138 M Magnetic Resonance Imaging, 138 Magnetic Resonance Spectroscopy, 58, 138 Malignant, 90, 123, 138 Malignant tumor, 90, 138 Malnutrition, 125, 138 Mechanical ventilation, 17, 138 Medial, 65, 138 Medical Records, 139, 147 MEDLINE, 105, 139 Membrane, 128, 132, 137, 139, 141, 142, 143, 146 Memory, 73, 139 Mental, iv, 4, 104, 106, 130, 135, 139, 145, 152 Mesenteric, 90, 139 Mesentery, 139, 142 Metastasis, 139 Metastatic, 10, 139 MI, 13, 26, 34, 38, 82, 122, 139 Microcirculation, 137, 139 Microorganism, 139, 153 Migration, 32, 81, 139 Modification, 123, 139, 145 Molecular, 105, 107, 126, 128, 139, 143, 149, 151 Molecule, 124, 128, 137, 139, 146 Monitor, 75, 139 Morphological, 5, 22, 131, 139 Motility, 90, 139 Mucosa, 139, 149 Mucus, 139, 151 Multicenter study, 28, 41, 139 Myocardium, 139, 140

159

N Necrosis, 135, 139, 140 Necrotizing Enterocolitis, 7, 41, 140 Neonatal, 7, 140 Neonatologist, 7, 140 Neoplastic, 138, 140 Nephrectomy, 90, 140 Nerve, 12, 18, 21, 27, 32, 36, 43, 46, 49, 60, 73, 124, 132, 134, 136, 140, 147, 149, 152 Nervous System, 140, 149, 150 Neutrons, 123, 140, 145 Nuclei, 123, 131, 138, 140, 145 O Observational study, 7, 140 Oophorectomy, 4, 140 Opacity, 129, 140 Organ Culture, 140, 150 Outpatient, 40, 111, 140 Ovaries, 3, 140 Ovary, 134, 140, 149 Oxygenator, 132, 141 P Palliative, 141, 150 Pancreas, 90, 123, 136, 137, 141 Pancreas Transplant, 90, 141 Pancreas Transplantation, 90, 141 Pancreatic, 76, 90, 133, 141 Pancreatic Juice, 133, 141 Pancreatitis, 90, 125, 141 Parietal, 71, 141, 142, 143 Parietal Lobe, 141 Patch, 20, 29, 42, 64, 65, 68, 70, 72, 73, 74, 75, 77, 78, 79, 81, 82, 84, 86, 88, 141 Pathophysiology, 89, 141 Patient Education, 95, 110, 116, 118, 122, 141 Patient Satisfaction, 27, 73, 141 Patient Selection, 95, 141 Pelvic, 41, 49, 58, 60, 92, 141, 144 Pelvis, 123, 126, 135, 138, 140, 141, 152 Penicillin, 124, 141 Pepsin, 141 Peptic, 23, 90, 141 Peptic Ulcer, 90, 141 Peptide, 123, 141, 143, 145 Perception, 128, 142 Percutaneous, 12, 17, 19, 20, 30, 31, 46, 86, 87, 142 Perforation, 7, 133, 142, 153 Perineal, 8, 142, 145 Perineum, 142 Perioperative, 9, 142

Peristalsis, 84, 142 Peritoneal, 7, 42, 69, 71, 73, 84, 86, 87, 134, 136, 142 Peritoneal Cavity, 73, 134, 136, 142 Peritoneum, 64, 67, 71, 74, 78, 79, 126, 139, 142 Peritonitis, 142, 153 Pharmacokinetic, 26, 142 Pharmacologic, 124, 142, 151 Pharynx, 133, 142, 152 Phospholipids, 132, 142 Physical Examination, 22, 44, 142 Physical Therapy, 68, 142 Physiology, 8, 45, 93, 142, 152 Placenta, 142, 152 Plants, 126, 133, 143, 151 Plasma, 13, 133, 134, 143 Platinum, 138, 143 Pleated, 74, 143 Pleura, 143 Pleural, 64, 78, 143 Plexus, 132, 143 Pneumonia, 128, 143 Polyethylene, 143, 149 Polyethylene Glycols, 143, 149 Polymers, 143, 145, 150 Polypeptide, 123, 127, 143 Polyposis, 90, 143 Polytetrafluoroethylene, 29, 70, 72, 143 Port, 84, 143 Port-a-cath, 143 Posterior, 26, 58, 64, 78, 79, 83, 86, 124, 130, 141, 144 Postoperative, 4, 6, 9, 12, 15, 18, 27, 33, 41, 46, 57, 59, 77, 86, 90, 92, 96, 110, 144 Postoperative Complications, 4, 144 Practice Guidelines, 106, 144 Predictive factor, 16, 144 Predisposition, 67, 144 Preoperative, 4, 5, 92, 110, 144 Prepuce, 127, 144 Proctosigmoidoscopy, 19, 144 Progression, 144, 146 Progressive, 127, 130, 140, 144 Projection, 87, 144 Proline, 127, 135, 144 Prophylaxis, 9, 11, 144 Prospective study, 22, 26, 144 Prostate, 144, 145, 147, 151 Prostatectomy, 8, 13, 37, 144, 145 Prosthesis, 11, 16, 34, 45, 51, 69, 72, 73, 74, 81, 82, 83, 84, 85, 86, 87, 93, 144

160

Hernia Repair

Protein S, 126, 144 Proteins, 76, 123, 124, 127, 135, 139, 141, 142, 143, 145 Protons, 123, 138, 145 Psychiatric, 6, 145 Psychiatry, 145, 153 Public Policy, 105, 145 Publishing, 8, 91, 96, 145 Pulmonary, 18, 126, 145, 148, 152 Pulse, 139, 145 Punctures, 75, 145 Q Quality of Life, 13, 29, 145 R Race, 139, 145 Radiation, 71, 131, 135, 145, 153 Radical prostatectomy, 24, 145 Radio Waves, 129, 145 Radioactive, 135, 145 Radiological, 26, 142, 145 Radiology, 42, 43, 145 Randomized clinical trial, 7, 12, 14, 34, 43, 145 Randomized Controlled Trials, 33, 34, 146 Receptor, 124, 128, 146 Recombinant, 76, 146 Rectal, 90, 146, 149 Rectal Prolapse, 90, 146 Rectum, 4, 23, 36, 90, 124, 125, 126, 127, 129, 130, 133, 137, 144, 146, 148 Recurrence, 12, 18, 26, 37, 44, 67, 75, 77, 86, 87, 146 Refer, 1, 127, 140, 146, 151 Reflux, 59, 70, 84, 87, 132, 133, 146 Regimen, 59, 130, 146 Regurgitation, 132, 133, 134, 146 Remission, 146 Reoperation, 12, 28, 146 Resection, 46, 146, 151 Respiration, 126, 139, 146 Respirator, 138, 146 Respiratory failure, 132, 146 Retina, 146, 147 Retinal, 128, 147 Retraction, 80, 147 Retropubic, 12, 14, 44, 144, 145, 147 Retropubic prostatectomy, 12, 14, 44, 145, 147 Retrospective, 4, 9, 49, 147 Retrospective study, 4, 9, 147 Risk factor, 37, 90, 95, 144, 147 Rod, 66, 72, 80, 147

Round Ligament, 71, 147 S Screening, 127, 147 Scrotum, 121, 147, 152 Sebaceous, 129, 147 Sebaceous gland, 129, 147 Secretion, 23, 139, 147 Seminal vesicles, 147, 152 Sensibility, 124, 147 Shock, 147, 151 Side effect, 75, 123, 125, 137, 147, 151 Sigmoidoscope, 144, 147 Small intestine, 3, 90, 129, 130, 136, 147, 153 Smoke Inhalation Injury, 132, 148 Social Environment, 145, 148 Social Security, 146, 148 Sodium, 129, 130, 148, 150 Soft tissue, 6, 74, 87, 126, 148 Solitary Rectal Ulcer, 90, 148 Soma, 148 Somatic, 12, 148, 152 Sound wave, 129, 148 Specialist, 112, 148 Species, 139, 145, 148, 151 Spectrum, 145, 148, 149 Spermatic, 65, 71, 148 Spermatozoa, 148, 150, 152 Sphincter, 70, 84, 137, 146, 148 Spinal cord, 131, 132, 140, 148, 150 Spleen, 138, 148, 149 Splenectomy, 4, 90, 149 Staging, 92, 149 Stenosis, 149 Sterile, 73, 149 Sterilization, 68, 90, 149 Stimulus, 130, 136, 149 Stomach, 70, 84, 87, 123, 125, 130, 131, 132, 133, 134, 138, 141, 142, 146, 147, 148, 149, 153 Stool, 127, 137, 149 Strangulation, 92, 149 Stress, 91, 144, 149 Stricture, 23, 149 Stromal, 76, 149 Stromal Cells, 76, 149 Subacute, 136, 149 Subclinical, 136, 149 Subcutaneous, 130, 133, 149 Substance P, 147, 149 Substrate, 76, 149 Suction, 70, 149

161

Sulbactam, 18, 98, 149 Suppository, 42, 143, 149 Suppurative, 133, 149 Surgical Mesh, 66, 69, 72, 73, 74, 75, 80, 82, 84, 86, 88, 150 Sweat, 129, 150 Sweat Glands, 129, 150 Sympathectomy, 64, 78, 79, 150 Sympathetic Nervous System, 150 Symphysis, 39, 80, 144, 150 Symptomatic, 141, 150 Systemic, 41, 124, 126, 136, 150 T Testicle, 73, 134, 150, 152 Testicular, 22, 46, 59, 73, 150 Testis, 12, 148, 150 Therapeutics, 150 Thigh, 32, 132, 134, 150 Thoracic, 17, 18, 23, 37, 87, 129, 143, 150 Thorax, 123, 138, 150, 152 Thrombocytopenia, 90, 150 Thrombosis, 40, 49, 144, 150 Thrombus, 129, 135, 150, 152 Tissue Culture, 76, 150 Tolerance, 54, 134, 150 Tone, 90, 150, 151 Tonic, 132, 151 Tonus, 150, 151 Topical, 57, 151 Torsion, 135, 151 Toxic, iv, 148, 151 Toxicity, 130, 151 Toxicology, 106, 151 Toxin, 150, 151 Trachea, 137, 142, 149, 151 Transfection, 126, 151 Translocation, 54, 151 Transplantation, 30, 48, 127, 151 Transurethral, 13, 144, 151 Transurethral resection, 144, 151 Transurethral Resection of Prostate, 144, 151 Trauma, 67, 71, 73, 81, 90, 132, 140, 141, 151, 153 Truncal, 18, 90, 92, 151 Tryptophan, 127, 151

U Ulcer, 6, 130, 148, 151, 152 Ulceration, 6, 141, 151 Ulcerative colitis, 90, 151 Ultrasonography, 26, 90, 151 Umbilical Arteries, 152 Umbilical Cord, 71, 152 Uraemia, 48, 141, 152 Urethra, 144, 151, 152 Urethral Obstruction, 8, 152 Urinary, 144, 147, 152 Urinate, 110, 152, 153 Urine, 126, 152 Uterus, 126, 133, 135, 140, 147, 152 V Vaginal, 49, 149, 152 Vagotomy, 18, 90, 92, 152 Vagus Nerve, 151, 152 Varicocele, 64, 78, 90, 152 Varicose, 47, 152 Varicose vein, 47, 152 Vas Deferens, 65, 148, 152 Vascular, 13, 42, 129, 135, 136, 137, 139, 142, 150, 152 Vasculitis, 141, 152 Vein, 40, 136, 152 Venous, 90, 144, 152 Venous Thrombosis, 90, 152 Venter, 152, 153 Ventilation, 152 Ventral, 5, 10, 12, 15, 17, 19, 21, 29, 31, 32, 33, 35, 39, 42, 45, 49, 50, 60, 73, 85, 90, 91, 153 Venules, 126, 139, 153 Veterinary Medicine, 105, 153 Villi, 153 Villous, 90, 153 Viscera, 71, 82, 139, 148, 153 Visceral, 23, 51, 71, 90, 142, 152, 153 Vitro, 76, 153 Vivo, 5, 6, 76, 153 Void, 69, 75, 82, 84, 153 Volvulus, 10, 90, 153 W Wound Infection, 18, 47, 98, 153 X X-ray, 125, 145, 153

162

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163

164

Hernia Repair