6. Conclusion SPA represents an expeditious selleckchem and reliable technique for appendicitis in pediatric populations. In our opinion, SPA is a safe and cost-effective technique. The main negative features of conventional LA, that are longer operative time and operating room cost compared to OA [24], seem to be not attributable to SPA. Additional randomized trials are needed to verify this hypothesis. In our unit, SPA is the standard procedure for appendectomy in children.
Inguinal hernia repair is one of the most frequently performed operations in general surgery. With the introduction of laparoscopy in hernia surgery in 1990s, laparoscopic posterior repair (transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP)) has gained increasing popularity and emerged as the procedure of choice over open conventional techniques due to its well-established advantages such as lower rates of postoperative pain, rapid return to normal activities, and a lower incidence of infections.

The major concern after inguinal hernia repair is recurrence. Recurrence rate after laparoscopic repair is comparable to that of open conventional techniques; however, such recurrences do occur after a laparoscopic repair with a reported rate of up to 5% [1, 2]. It is recommended that anterior mesh repair be performed for a recurrent hernia after previous posterior repair due to the increased risk of complications associated with the repeated posterior repair [3].

However, repeated laparoscopic treatment of hernia recurrences after previous posterior repair has become a relatively new concept and data on an increasing number of reported series has shown promising results with this approach in terms of safety, feasibility, and reliability [4�C11]. We performed the first laparoscopic inguinal hernia repair in 1993 and since then we have widely employed this approach in the treatment of both primary and recurrent inguinal hernias. The purpose of this study was to examine a series of relaparoscopic surgeries for recurrences after previous laparoscopic inguinal hernia repair, present technical experiences, and the clinical outcomes in this subset of patients. 2. Patients and Methods Between March 2005 and September 2012, five patients underwent relaparoscopic repair (TAPP or TEP) for a recurrence after previous laparoscopic inguinal hernia repair at Istanbul University Cerrahpasa Medical School and Acibadem Kozyatagi Hospitals.

The medical records of these patients were prospectively entered to a database and the data were retrospectively reviewed. All the patients had been initially treated in outside medical centers and then referred to us for a definitive treatment for recurrences. All the recurrences were detected by both physical examination and ultrasonography. Written informed Carfilzomib consent was taken from each patient after the patients were informed of the details of the relaparoscopic procedure.