Browsing by Author "Ulutas, Mehmet Esref"

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Comparison of Microwave Ablation and Lobectomy in the Treatment of Benign Thyroid Nodules
(Wiley, 2025) Turkoglu, Saim; Yilmaz, Abdullah Hilmi; Yokus, Adem; Ulutas, Mehmet Esref
Purpose: The purpose of this study is to evaluate the efficacy, safety, and advantages of microwave ablation (MWA) compared to lobectomy in the treatment of benign thyroid nodules. Methods: A total of 105 patients were included in the study, 49 in the MWA group and 56 in the surgical group. The mean age of the patients in the MWA group was 49.5 (+/- 12.8) and 40.2 (+/- 10.1) in the surgical group (p < 0.001). 81.6% of the patients in the MWA group were female and 18.4% were male. 83.9% of the patients in the surgical group were male and 16.1% were female (p = 0.75). Patients were followed for at least 12 months. The study was completed by comparing the two groups in terms of surgery-procedure times, complications, nodule sizes, thyroid function tests, symptoms, volume reduction rates (VRR), and cosmetic improvement scores. Results: The mean maximum nodule diameter in the patient group who underwent MWA was 3.5 (+/- 1) cm at the beginning and 2.3 (+/- 0.9) cm at the end of the 12th month (p < 0.001). VRR was 73.4% (+/- 14.8) at the end of the 12th month (p < 0.001). Cosmetic score was 2.5 (+/- 1) at the first month, 1.7 (+/- 1.1) at the third month, 1 (+/- 1) at the sixth month, and 0.6 (+/- 0.7) at the 12th month (p < 0.001). The procedure time was 15.4 (+/- 4.4) minutes in the patients in the MWA group, while it was 70.7 (+/- 17.2) minutes in the surgical group (p < 0.001). No complications developed in 48 patients (98%) in the MWA group and 38 patients (67.9%) in the surgical group (p = 0.005). Voice change occurred in three patients (5.4%) in the surgical group, hematoma in two (3.6%) patients and voice change in one (1.8%) patient in the MWA group. Hypothyroidism developed in eight patients in the surgical group, while hypothyroidism did not develop in the MWA group (p = 0.007). Conclusion: MWA is a safe and effective treatment method for benign thyroid nodules. It has many advantages over thyroidectomy, such as fewer complications, shorter procedure time, no need for hospitalization and general anesthesia, and good cosmetic results.
Mesh Displacement in Enhanced-View Totally Extraperitoneal Versus Totally Extraperitoneal Bilateral Inguinal Hernia Repair Without Mesh Fixation
(Elsevier Singapore Pte Ltd, 2025) Yilmaz, Abdullah Hilmi; Ulutas, Mehmet Esref; Turkoglu, Saim
Purpose: International guidelines recommend laparoscopic surgical repair for bilateral inguinal hernia. One of the laparoscopic procedures with rapid recovery, less chronic pain and less chance of infection is enhanced totally extraperitoneal (eTEP). The eTEP technique is useful in bilateral hernias, large inguinal-scrotal hernias, incarcerated hernias, obese patients and patients with a short distance between the umbilicus and pubic tubercle. However, eTEP inherently involves extensive extraperitoneal dissection. Both bilateral hernia repair and the use of the eTEP technique reveal that the extraperitoneal space is even larger. This can be considered as a factor for mesh displacement. The aim of this study was to compare eTEP and totally extraperitoneal (TEP) techniques without mesh fixation in bilateral laparoscopic inguinal hernia repair. Methods: Form January 2023 to June 2023, 40 consecutive patients with bilateral inguinal hernia were randomized into two groups; eTEP group (n = 20) and TEP group (n = 20) without mesh fixation. Study was registered at http://Clinicaltrials.gov (NCT06070207). The meshes were marked with three radiopague clips. Pelvic radiographs was performed to evaluate the displacement of the mesh. The primary outcome of this study was mesh displacement. In addition, this is the first study in the literature to compare eTEP and TEP technique in terms of mesh displacement without fixation in laparoscopic bilateral inguinal hernia. Results: There was no significant difference between the groups in terms of mesh displacement, recurrence, postoperative VAS scores, operation time, length of hospital stay, accidental pneumoperitoneum, hematoma, seroma formation and surgical site infection. Conclusion: There was no more mesh displacement in the eTEP group in which more extraperitoneal space was created. Both bilaterality and without mesh fixation did not cause any difference in mesh displacement in both groups. Despite both bilaterality and larger extraperitoneal space dissection, the absence of mesh fixation in the bilateral eTEP technique is safe. Mesh displacement in laparoscopic bilateral inguinal hernia repair is minimal and similar in the TEP and eTEP technique. Trial registration clinicaltrials number: NCT06070207. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).
Prospective Randomized Study Comparing Mesh Displacement in Enhanced-View Totally Extraperitoneal Versus Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair Without Mesh Fixation
(Springer, 2024) Yilmaz, Abdullah Hilmi; Ulutas, Mehmet Esref; Turkoglu, Saim
PurposeIn laparoscopic inguinal hernia repair, it is thought that the mesh can be displaced more in the enhanced-view totally extraperitoneal (eTEP) technique. The aim of this study was to compare eTEP and totally extraperitoneal (TEP) techniques without mesh fixation in terms of mesh displacement and hernia recurrence.MethodsBetween December 2022 and April 2023, 60 consecutive patients with unilateral inguinal hernia were randomized into two groups; eTEP group (n = 30) and TEP group (n = 30). There was without mesh fixation in both groups. Study was registered at http://Clinicaltrials.gov (NCT06070142). The mesh was marked with three radiopaque clips. Pelvic radiographs were performed to evaluate the displacement of the mesh. The primary outcome of this study was mesh displacement. In addition, this is the first study in the literature to compare eTEP and TEP techniques in terms of mesh displacement without fixation in laparoscopic inguinal hernia.ResultsThere was no significant difference between the groups in terms of mesh displacement, recurrence, postoperative VAS scores, length of hospital stay, hematoma, and seroma formation. The operation time was higher in the eTEP group and was statistically significant.ConclusionWithout mesh fixation, the eTEP technique does not increase the risk of mesh displacement and recurrence. The eTEP technique can be safely applied without mesh fixation in laparoscopic inguinal hernia repairs.Trial registrationClinicalTrials number: NCT06070142.