INTRODUCTION: One of the most important goals in abdominal surgery is to reduce as much as possible the postoperative pain and increasing patients comfort. We aimed to assess the analgesic efficacy of the transversus abdominis plane block (TAP) in patients with non-perforated acute appendicitis undergoing laparoscopic appendectomy (LA).
METHODS: Seventy patients who underwent LA were divided retrospectively into two groups; the LA group (control group: n=39) and the LA group with TAP-block (treatment group; n=31). The present study was planned retrospectively but the data was collected prospectively. Groups were compared regarding age, gender, perioperative symptoms and signs, such as physical operation time, postoperative pain score (visual analogue scale = VAS), hospitalization period stay time, postoperative complications, and return to normal daily activity.
RESULTS: The mean VAS score in LA+TAP-block group was 3.1±2.1; 3.3±2.1; 3.9±2.3; 4.2±2.6 and 4.3±3 on the 0th; 2th; 6th; 16th and 24th hours and 4±1.5; 4.7±2.2; 6±2; 6.2±2 and 5.9±2 on the 0th; 2th; 6th; 16th and 24th hours in only LA group, respectively. Postoperative abdominal pain was significantly less in LA+TAP-block group than the LA group at 2th (p=0.01), 6th (p<0.01), 16th (p<0.001) and 24th (p=0.01) hours. Although, statistically not significant, TAP-block was associated with more quickly to return to normal daily activities.
DISCUSSION AND CONCLUSION: USG-guided TAP block can improve significantly postoperative abdominal pain during the first 24 hours in laparoscopic appendectomy performed patients.

INTRODUCTION: The present study is a description of the learning curve experienced and the process implemented to incorporate the increasingly common laparoendoscopic technique of totally extraperitoneal (TEP) inguinal hernia repair at our clinic.
METHODS: Patients with a primary unilateral inguinal hernia who underwent laparoscopic TEP repair between May 2013 and May 2018 were included in the study. The patients were separated into 7 groups. The learning curve parameters (duration of operation, rate of conversion to open surgery, intraoperative and postoperative complications) were recorded and statistically compared.
RESULTS: Of the 380 patients, 349 were male and 31 were female, and the mean age was 52±14.2 years. The mean duration of the operation was 46±25.9 minutes. There was a statistically significant difference between the groups in terms of surgical time. The duration of the operation plateaued at <1 hour after 60 surgeries. There was no statistically significant difference between the last 2 groups in terms of the duration of the operation. A total of 7 patients were converted to open surgery. There was no difference between groups in terms of the duration of hospitalization. The average follow-up period was 18 months (range: 3–63 months). Seroma and hematoma occurred in 3 patients and hernia recurrence was observed in 4 patients.
DISCUSSION AND CONCLUSION: It was concluded that a surgeon who has already performed a certain number of inguinal hernia operations can complete the learning curve for TEP repair after 60 operations when the appropriate technical conditions are provided, and that subsequent surgeries can be performed in an optimal time with low complication and recurrence rates.

INTRODUCTION: Inguinal hernia repair is one of the common procedures in surgical daily routine. The aim of this study was to present clinical outcomes and reccurency rates of laparoscopic total extraperitoneal hernia repair in recurrent inguinal hernia performed in our clinic.
METHODS: The data of patients who underwent laparoscopic total extraperitoneal herniorraphy between January 2012 and May 2018 were evaluated retrospectively.
RESULTS: 23 patients who underwent laparoscopic total extraperitoneal herniorraphy were included in this study. Mean age of the patients was 58.65. 12 patients were performed from left, 9 patients from right, 2 patients were performed bilaterally. Mean duration of the operation was 35 minutes, mean duration of hospitalization was 1 day.
DISCUSSION AND CONCLUSION: While planning surgical technique for recurrent inguinal hernia; if previous surgery was performed with anterior approach, posterior approach should be chosen, and vice versa.

Lumbar hernia is a rare type of abdominal wall hernias. Among acquired lumbar hernias, secondary cases are less common than spontaneous ones. Although infections can cause lumbar hernias, most of the secondary hernias develop following surgical procedures or different types of traumas. These types of hernia are treated in comply with the principles of incisional hernia treatment. Herein a case series of three consecutive patient with secondary lumbar hernias are presented. The etiology differs in each case. The hernias were repaired with hybrid technique (laparoscopic plus open) with no perioperative events.

Intragastric balloon (IGB) application in obesity treatment is an easily applied non-surgical method which has an effective weight loss potential. However, with increasing use in recent years, life-threatening complications have been reported in the literature. In addition to gastric perforation and intestinal obstruction due to serious complications, it has recently started to take its place in the literature. Thirteen cases of pancreatatitis due to IGB administration have been reported so far.In this study, a patient with morbid obese patient, acute abdominal pain and vomiting, who had intragastric balloon application five months ago, was evaluated.Biochemical and radiological work-up revealed total migration of the balloon to duodenum and acute pancreatitis due to compression effect.