Adel Lasheen - Academia.edu (original) (raw)

Papers by Adel Lasheen

Research paper thumbnail of Role of Rouviere's sulcus in identification and dissection of Calot's triangle during Laparoscopic Cholecystectomy

Al-Azhar International Medical Journal

Background: One of most common surgical technique applied overall the world is laparoscopic chole... more Background: One of most common surgical technique applied overall the world is laparoscopic cholecystectomy due to the high features instead of another surgical techniques. Furthermore; it is represents as the main technique for gallstones treatment; however the incidence of bile-duct injury still higher than that of open cholecystectomy. Various surgical procedures and principles have been proposed to reduces bile duct injury. Aim of the work: To determine the frequency and the type of Rouviere's sulcus and its importance as landmark during laparoscopic cholecystectomy. Patients and methods: This prospective study included hundredpatients who had symptomatic gallstone disease and underwent laparoscopic cholecystectomy in Al Azhar Universty Hospitals and Ahmed Maher Hospital. Results: Our results revealed that, regarding the indications for cholecystectomy, the most common indication in the study participants were symptomatic gall stones in 36 (36%) of participants followed by acute cholecystitis in 29 (29%) participants and biliary pancreatitis in 16 (16%) participants. Conclusion: Rouviere's sulcus was represent in (76%) of total cases. It is an easily identifiable anatomic feature for secure laparoscopic cholecystectomy.

Research paper thumbnail of Cable Tie Seton in Surgical Treatment of High Perianal Fistula

The Egyptian Journal of Hospital Medicine

Background: Seton is any string-like material which when tied through the fistula tract causes an... more Background: Seton is any string-like material which when tied through the fistula tract causes an inflammatory reaction which stimulates fibrosis that fixes and prevents retraction of the sphincter continuity when it is divided. In this way, it maintains sphincter continuity during cutting process. Aim of work: was to evaluate the cable tie seton technique in surgical treatment of high perianal fistula, regarding the rate of fecal incontinences and recurrence. Patients and Methods: This prospective study included a total of 20 cases having single tract, high perianal fistula, primary or recurrent and who were managed by cable tie seton from October 2016 till September 2017. Patients were enrolled from General Surgery Department, Al-Hussein Hospital. Patients were instructed to follow up weekly for 10 weeks with continuous tightening of the seton. Results: All the patients were followed up for the state of incontinence for flatus, liquid and solid stool and follow up for recurrence, slippage of cable: Incontinence: There is 3 cases noticed in early 2 weeks incontinent for flatus. Incontinence for liquid stool noticed in 2 cases in early 1 week. Incontinence for solid stool not noticed in our study. In all cases, the cable tie seton was kept in its position and didn't dislodged or slipped. Conclusion: It could be concluded that cable tie seton is safe, low cost, ubiquitous, pragmatic, precise, and accost effective option for the treatment of high perianal fistula. We there for recommended it for treating fistula in ano requiring the placement of aseton. It does not carry the disadvantages of repeated anesthesia and visits to the operating theater and reduce the morbidity, inconvenience, and cost to the patient.

Research paper thumbnail of Hydrocelectomy through the inguinal approach versus scrotal approach for idiopathic hydrocele in adults

Journal of the Arab Society for Medical Research 2012, 7:68–72 Background/aim Hydrocele is a comm... more Journal of the Arab Society for Medical Research 2012, 7:68–72 Background/aim Hydrocele is a common chronic condition in men that causes physical, psychological, social, and economic distress. This study aimed to evaluate the outcome of hydrocelectomy through the inguinal approach as compared with the scrotal approach in adults. Subjects and methods This prospective study was conducted on 40 patients who presented to the El-Hussein University Hospital with idiopathic hydrocele and underwent hydrocelectomy. These patients were divided into two groups: group I (inguinal approach group) included 20 patients with a mean age of 30.75 ± 10.76 years and who underwent hydrocelectomy through the inguinal approach, group II (scrotal approach group) included 20 patients with a mean age of 29.35 ± 8.93 years and who underwent hydrocelectomy through the scrotal approach. A comparison was made between the two groups as regards the volume of the hydrocele sac, operative time, postoperative morbidi...

Research paper thumbnail of Outcome of Surgical Excision of Accessory Breast Tissue in the Axilla

al-azhar medical journal, 2021

Background: The axilla is the most common site for accessory breasts. Although they may be asympt... more Background: The axilla is the most common site for accessory breasts. Although they may be asymptomatic, axillary accessory breasts can cause cosmetic concerns, pain, or restriction in arm movements. The radiological methods used for diagnosis include ultrasonography and MRI. The main concerns about the surgical treatment of accessory breasts are leaving any breast tissue unresected and cosmetic problems resulting from a bad scar or contour deformities. Objective: To evaluate the surgical outcome after excision of prominent accessory breast in the axilla. Patients and Methods: The current study included 50 female patients, presented to Al-Azhar University Hospitals, in Cairo, for elective excision of uncomplicated axillary accessory breast, in which an axillary swelling was noticed by themselves following pregnancy and lactation, during the period from May 2019 till April 2020. Their ages ranged from ranged between 18-40 years with a mean of 28.76 ± 5.7 years. Results: The local exa...

Research paper thumbnail of Umbilical Hernia in Cirrhotic Patients : Outcome of Elective Repair

Journal of the Egyptian Society of Parasitology, 2013

Cirrhotic patients with umbilical hernia have an increased likelihood of complications following ... more Cirrhotic patients with umbilical hernia have an increased likelihood of complications following repair. The aim of this study was to assess the outcomes of elective umbilical hernia repair in cirrhotic patients. Fifty patients having uncomplicated umbilical hernia with a cirrhotic liver were studied prospectively. These patients divided into three groups' according to Child-Turcotte-Pugh (CTP) classification. After management of coagulopathy, correction of hypoalbuminaemia and electrolytes imbalance, and control of ascites, all patients underwent elective hernia repair under regional anesthesia. A comparison was made between the three groups as regard the size of the defect in the linea Alba, operative time, postoperative morbidity and mortality, length of hospital stay, time of return to daily life and postoperative changes in liver function tests (LFT S) in relation to the regional anesthesia applied. hernioplasty was done under spinal anesthesia in 13 patients (26%), under epidural anesthesia in 10 patients (20%), under intercostal nerve block in 7 patients (14%), and under local anesthesia in 20 patients (40%). There was an increased safety (less changes in LFT S) in cases done under local anesthesia and intercostal nerve block. The overall complications rate was 30%. There was an increased complications rate towards the decompensated cases. The differences in the mean length of hospital stay and mean time of return to daily life are statistically significant between the three groups. Umbilical hernia recurrence rate was 2% and no mortality was reported in the study groups.

Research paper thumbnail of Comparative Study Between Lightweight Meshes Versus Traditional Heavyweight Meshes for the Repair of Inguinal Hernia

The Egyptian Journal of Hospital Medicine, 2019

Background and aim: the ideal outcome of inguinal hernia surgery is to provide a repair that is f... more Background and aim: the ideal outcome of inguinal hernia surgery is to provide a repair that is free from recurrence, pain and infection with minimal scarring and with improvement in patient's quality of life. Aim of the work: this study aimed to compare light weight poliglecaprone (Ultrapropolypropylene/Monocryl), UltraPro™ mesh with the standard heavy weight polypropylene mesh in tension free Lichtenstein inguinal hernia repair. Patients and methods: the current study included 40 patients complained of uncomplicated inguinal hernia and they were randomized into two groups according to the type of mesh used in tension free Lichtenstein inguinal hernia repair. Group I, 20 patients received the standard polypropylene mesh. Group II, 20 patients received light weight UltraPro™ mesh, using sutures for their fixation. Results: the UltraPro™ (LWM) mesh proved to be as safe and effective as the standard (HWM) prolene mesh in repair of uncomplicated inguinal hernia. There was no difference between the two groups as regard to the technical difficulties, operative complications and surgeons were equally satisfied. There was more incidence of chronic pain with prolene mesh (25%) compared to (zero%) with UltraPro™ mesh. The mesh fixation time and the overall operative time were shorter with UltraPro™ mesh. Conclusion: the shorter operative time and the no-need to use analgesics could partially compensate the higher cost of UltraPro™ mesh in the absence of other economic factors such as the duration of patient improvement and return to work.

Research paper thumbnail of Role of Rouviere's sulcus in identification and dissection of Calot's triangle during Laparoscopic Cholecystectomy

Al-Azhar International Medical Journal

Background: One of most common surgical technique applied overall the world is laparoscopic chole... more Background: One of most common surgical technique applied overall the world is laparoscopic cholecystectomy due to the high features instead of another surgical techniques. Furthermore; it is represents as the main technique for gallstones treatment; however the incidence of bile-duct injury still higher than that of open cholecystectomy. Various surgical procedures and principles have been proposed to reduces bile duct injury. Aim of the work: To determine the frequency and the type of Rouviere's sulcus and its importance as landmark during laparoscopic cholecystectomy. Patients and methods: This prospective study included hundredpatients who had symptomatic gallstone disease and underwent laparoscopic cholecystectomy in Al Azhar Universty Hospitals and Ahmed Maher Hospital. Results: Our results revealed that, regarding the indications for cholecystectomy, the most common indication in the study participants were symptomatic gall stones in 36 (36%) of participants followed by acute cholecystitis in 29 (29%) participants and biliary pancreatitis in 16 (16%) participants. Conclusion: Rouviere's sulcus was represent in (76%) of total cases. It is an easily identifiable anatomic feature for secure laparoscopic cholecystectomy.

Research paper thumbnail of Cable Tie Seton in Surgical Treatment of High Perianal Fistula

The Egyptian Journal of Hospital Medicine

Background: Seton is any string-like material which when tied through the fistula tract causes an... more Background: Seton is any string-like material which when tied through the fistula tract causes an inflammatory reaction which stimulates fibrosis that fixes and prevents retraction of the sphincter continuity when it is divided. In this way, it maintains sphincter continuity during cutting process. Aim of work: was to evaluate the cable tie seton technique in surgical treatment of high perianal fistula, regarding the rate of fecal incontinences and recurrence. Patients and Methods: This prospective study included a total of 20 cases having single tract, high perianal fistula, primary or recurrent and who were managed by cable tie seton from October 2016 till September 2017. Patients were enrolled from General Surgery Department, Al-Hussein Hospital. Patients were instructed to follow up weekly for 10 weeks with continuous tightening of the seton. Results: All the patients were followed up for the state of incontinence for flatus, liquid and solid stool and follow up for recurrence, slippage of cable: Incontinence: There is 3 cases noticed in early 2 weeks incontinent for flatus. Incontinence for liquid stool noticed in 2 cases in early 1 week. Incontinence for solid stool not noticed in our study. In all cases, the cable tie seton was kept in its position and didn't dislodged or slipped. Conclusion: It could be concluded that cable tie seton is safe, low cost, ubiquitous, pragmatic, precise, and accost effective option for the treatment of high perianal fistula. We there for recommended it for treating fistula in ano requiring the placement of aseton. It does not carry the disadvantages of repeated anesthesia and visits to the operating theater and reduce the morbidity, inconvenience, and cost to the patient.

Research paper thumbnail of Hydrocelectomy through the inguinal approach versus scrotal approach for idiopathic hydrocele in adults

Journal of the Arab Society for Medical Research 2012, 7:68–72 Background/aim Hydrocele is a comm... more Journal of the Arab Society for Medical Research 2012, 7:68–72 Background/aim Hydrocele is a common chronic condition in men that causes physical, psychological, social, and economic distress. This study aimed to evaluate the outcome of hydrocelectomy through the inguinal approach as compared with the scrotal approach in adults. Subjects and methods This prospective study was conducted on 40 patients who presented to the El-Hussein University Hospital with idiopathic hydrocele and underwent hydrocelectomy. These patients were divided into two groups: group I (inguinal approach group) included 20 patients with a mean age of 30.75 ± 10.76 years and who underwent hydrocelectomy through the inguinal approach, group II (scrotal approach group) included 20 patients with a mean age of 29.35 ± 8.93 years and who underwent hydrocelectomy through the scrotal approach. A comparison was made between the two groups as regards the volume of the hydrocele sac, operative time, postoperative morbidi...

Research paper thumbnail of Outcome of Surgical Excision of Accessory Breast Tissue in the Axilla

al-azhar medical journal, 2021

Background: The axilla is the most common site for accessory breasts. Although they may be asympt... more Background: The axilla is the most common site for accessory breasts. Although they may be asymptomatic, axillary accessory breasts can cause cosmetic concerns, pain, or restriction in arm movements. The radiological methods used for diagnosis include ultrasonography and MRI. The main concerns about the surgical treatment of accessory breasts are leaving any breast tissue unresected and cosmetic problems resulting from a bad scar or contour deformities. Objective: To evaluate the surgical outcome after excision of prominent accessory breast in the axilla. Patients and Methods: The current study included 50 female patients, presented to Al-Azhar University Hospitals, in Cairo, for elective excision of uncomplicated axillary accessory breast, in which an axillary swelling was noticed by themselves following pregnancy and lactation, during the period from May 2019 till April 2020. Their ages ranged from ranged between 18-40 years with a mean of 28.76 ± 5.7 years. Results: The local exa...

Research paper thumbnail of Umbilical Hernia in Cirrhotic Patients : Outcome of Elective Repair

Journal of the Egyptian Society of Parasitology, 2013

Cirrhotic patients with umbilical hernia have an increased likelihood of complications following ... more Cirrhotic patients with umbilical hernia have an increased likelihood of complications following repair. The aim of this study was to assess the outcomes of elective umbilical hernia repair in cirrhotic patients. Fifty patients having uncomplicated umbilical hernia with a cirrhotic liver were studied prospectively. These patients divided into three groups' according to Child-Turcotte-Pugh (CTP) classification. After management of coagulopathy, correction of hypoalbuminaemia and electrolytes imbalance, and control of ascites, all patients underwent elective hernia repair under regional anesthesia. A comparison was made between the three groups as regard the size of the defect in the linea Alba, operative time, postoperative morbidity and mortality, length of hospital stay, time of return to daily life and postoperative changes in liver function tests (LFT S) in relation to the regional anesthesia applied. hernioplasty was done under spinal anesthesia in 13 patients (26%), under epidural anesthesia in 10 patients (20%), under intercostal nerve block in 7 patients (14%), and under local anesthesia in 20 patients (40%). There was an increased safety (less changes in LFT S) in cases done under local anesthesia and intercostal nerve block. The overall complications rate was 30%. There was an increased complications rate towards the decompensated cases. The differences in the mean length of hospital stay and mean time of return to daily life are statistically significant between the three groups. Umbilical hernia recurrence rate was 2% and no mortality was reported in the study groups.

Research paper thumbnail of Comparative Study Between Lightweight Meshes Versus Traditional Heavyweight Meshes for the Repair of Inguinal Hernia

The Egyptian Journal of Hospital Medicine, 2019

Background and aim: the ideal outcome of inguinal hernia surgery is to provide a repair that is f... more Background and aim: the ideal outcome of inguinal hernia surgery is to provide a repair that is free from recurrence, pain and infection with minimal scarring and with improvement in patient's quality of life. Aim of the work: this study aimed to compare light weight poliglecaprone (Ultrapropolypropylene/Monocryl), UltraPro™ mesh with the standard heavy weight polypropylene mesh in tension free Lichtenstein inguinal hernia repair. Patients and methods: the current study included 40 patients complained of uncomplicated inguinal hernia and they were randomized into two groups according to the type of mesh used in tension free Lichtenstein inguinal hernia repair. Group I, 20 patients received the standard polypropylene mesh. Group II, 20 patients received light weight UltraPro™ mesh, using sutures for their fixation. Results: the UltraPro™ (LWM) mesh proved to be as safe and effective as the standard (HWM) prolene mesh in repair of uncomplicated inguinal hernia. There was no difference between the two groups as regard to the technical difficulties, operative complications and surgeons were equally satisfied. There was more incidence of chronic pain with prolene mesh (25%) compared to (zero%) with UltraPro™ mesh. The mesh fixation time and the overall operative time were shorter with UltraPro™ mesh. Conclusion: the shorter operative time and the no-need to use analgesics could partially compensate the higher cost of UltraPro™ mesh in the absence of other economic factors such as the duration of patient improvement and return to work.