Primary perineal hernia: a case report.

INTRODUCTION: We present the case of a female patient with anterior primary perineal hernia. CASE REPORT: Our 63-year-old obese patient presented with recurrent “inguinal hernia“ at the Hernia Centre of Liberec. However, she was diagnosed with perineal hernia and was indicated for hernioplasty. Combined abdominal and perineal approach was used. One year has elapsed from the surgery and the patient shows no signs of recurrence. CONCLUSION: Primary perineal hernia is a challenge for every herniologist. We managed the case using a combined approach with the use of two meshes.

[Czech bariatry in 2010]. / Ceská bariatrie v roce 2010.

INTRODUCTION: It is only during the past two decades, when obesity has become to be considered a pandemic disorder. However, in 1953 Varco performed jejunoileal bypass as the world's first bariatric surgical procedure. 30 years later, Pesková performed the first bariatric surgery--a gastroplasty--in Czechoslovakia. From 1984 she started to perform fixed gastric bandages, through laparotomic app- roach at that time. The first laparoscopic fixed bandage in Czechoslovakia was performed in 1993. Over the years, the number of surgical procedures to treat morbid obesity, as well as the number of bariatric surgeons, continued to increase. In 2004, Czech Bariatric Section of the Czech Surgical Society and the Czech Society of Obesitology of the Czech Medical Association of J. E. Purkyne, were established. MATERIAL AND METHODS: 170 bariatric surgeries were performed in the Czech Republic in 1999. The majority of procedures included fixed gastric bandage, rarely, adjustable bandage was performed. At that time, bariatric procedures were performed at five sites only. However, over the past 10 years, bariatric surgery has largely developed in the Czech Republic. The exact number of bariatric procedures completed per year was unknown, therefore, 21 surgical clinics, at which bariatric procedures are performed, were contacted from January to June 2010. Heads of the clinics were asked to provide basic data on surgical treatment of obesity. The aim of the study was to analyze the situation in bariatric surgery in the Czech Republic at the end of 2009. A total of 18 clinics (85.8%) joined the study and provided their own statistical data. 14 of them perform over 20 bariatric procedures a year. RESULTS: The analysis data showed that, in 2009, a total of 1558 bariatric procedures were completed at 18 surgical clinics and approximately 1600 procedures were performed in the whole Czech Republic. However, out of the total, over 230 patients were foreigners. In 99% of bariatric procedures in morbid obese subjects, laparoscopic approach was used. CONCLUSION: Over the ten year period, the number of clinics performing over 20 bariatric procedures a year increased from five to 14 clinics and the number of bariatric procedures increased from 170 to 1600 procedures a year. It is 900% increase, compared to the year 1999! Nevertheless, compared to other countries, e.g. Austria, the number of bariatric procedures does not correspond with prevalence rates of obesity in the Czech Republic.

[Laparoscopic appendectomy at the Department of Surgery in Jablonec nad Nisou]. / Laparoskopické apendektomie na chirurgickém oddelení v Jablonci nad Nisou.

The paper deals with experience regarding laparoscopic appendectomy at the Department of Surgery in Jablonec nad Nisou. Between May, 1992 and Jan. 1, 1994 the authors performed 82 operations. They are listed in a table according to pathological findings and the number of complications according to a described classification. In the author's opinion the advantage of the new method is, as compared with the classical open one, a shorter time of hospitalization and a substantially shorter period of convalescence.