الفهرس 
Anatomy of the anterior abdominal wallOnly 14 pages are availabe for public view
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Abstract
The nonincisional ventral hernia is the second most common of abdominal hernia after inguinal hernia; it represents about 10% of abdominal hernia. Tension-free hernioplasty using a variety of techniques and synthetic meshes has become a widely accepted method of management, and has been found to reduce the incidence of recurrence. However, surgeons and patients are currently concentrating on other postoperative measures of the quality of hernia repair. However, in an attempt to reduce chronic pain induced by sutures, several methods of mesh fixation have been developed over time, including absorbable sutures, self-adhering meshes and glue fixation. Cyanoacrylate glue is synthetic cyanoacrylate-based compounds similar to ‘Superglue’. It is biological glue whose mechanism of action is based on reproducing the final steps in the coagulation cascade. The medical applications of butyl cyanoacrylate include its use as an adhesive for lacerations of the skin, and in the treatment of bleeding from vascular structures. This prospective clinical study was carried out on 25 patients with ventral hernia at the Surgical Oncology Unit, General Surgery Department, Tanta University Hospital, during the period from August 2017 to end of July 2018 to evaluate the feasibility, efficacy of cyanoacrylate glue in mesh fixation in ventral hernia repair as regard the postoperative pain, the operative time, complications and hospital stay. Every patient was subjected to full history taking, Clinical examination, laboratory investigations and pelvi-abdominal ultrasound. The ampoule of cyanoacrylate glue (Histoacryl® - B. Braun ) was stored at temperature less than 220 and it was opened from its tip, applied on the edges of mesh first then on its centre of mesh. The patients’ age ranged from 30 to 45 years with a mean of 34.50 ± 4.07 years. In our study, 13 out of 20 patients (65%) were females while 7 out of 20 patients (35%) of patients were males. There was a strong relation between the number of pregnancies, obesity and the incidence of ventral hernia. The time of mesh fixation ranged from 2 to 10 minutes with a mean of 3.95 ± 2.04 minutes and median 3.0 minutes. The post operative pain was evaluated in 1st month and at 6 months by visual analogue score, 8 out of 20 patients (40%) had mild pain and 2 out of 20 patients (10%) had moderate pain. Shrinkage of the mesh reported in 2 out of 20 patients (10%) and 5 out of 20 patients (25%) developed seroma over the mesh that resolved on conservative treatment. No recurrence of the hernia during the follow up period by clinical examination and by abdominal ultrasound. In the present study one out of 20 patients (5%) developed wound infection which was treated conservatively with antibiotic and daily dressing and improved with the treatment. the time of removal of the drain ranged from 3 days to 10 days with a mean of 7 ± 2.4.