Novel retrograde puncture method to establish preperitoneal space for laparoscopic direct inguinal hernia repair with internal ring suturing

The aim of this study was to explore the clinical efficacy of a novel retrograde puncture approach to establish a preperitoneal space for laparoscopic direct inguinal hernia repair with inguinal ring suturing. Forty-two patients who underwent laparoscopic inguinal hernia repair with retrograde puncture for preperitoneal space establishment as well as inguinal ring suturing between August 2013 and March 2014 at our hospital were enrolled. Preperitoneal space was successfully established in all patients, with a mean establishment time of 6 min. Laparoscopic repairs were successful in all patients, with a mean surgical time of 26±15.1 min. Mean postoperative hospitalization duration was 3.0±0.7 days. Two patients suffered from postoperative local hematomas, which were relieved after puncturing and drainage. Four patients had short-term local pain. There were no cases of chronic pain. Patients were followed up for 6 months to 1 year, and no recurrence was observed. Our results demonstrate that preperitoneal space established by the retrograde puncture technique can be successfully used in adult laparoscopic hernioplasty to avoid intraoperative mesh fixation, and thus reduce medical costs.

Development of gluten-free cookie from medicinal plants (Guaraná - Paullinea cupana and Catuaba - Anemopaegma mirandum) aiming at copper, iron, and zinc supplementation

Two flavors of cookies were developed (savory and peppery) containing a mixture of plants such as "guaraná" (Paullinia cupana) and "catuaba" (Anemopaegma mirandum). A test of acceptance and buying intention was applied to 48 consumers through a structured hedonic scale of 9 points. Afterwards, the centesimal compositions of these cookies were obtained as well as their total contents of copper, iron, and zinc through the method of atomic absorption spectrometry with flame. Sensorial tests indicated that the cookies presented good acceptance with potential to sensorial growth. The amount of fibers in the samples, 3 g/100 g, surpassed expectations since the product was not invented with the intention of being a source of this nutrient. The total amount of copper (0.41 mg.100 g-1), iron (4.50 mg.100 g-1), and zinc (1.32 mg.100 g-1) was considered good. The cookies produced can be considered good sources of fibers, copper, iron, and zinc. Furthermore, they are beneficial to people affected by celiac disease because they lack gluten. They also present functional properties. In addition, the medicinal plants used are considered energetic.