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Complex hernia

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https://www.readbyqxmd.com/read/29164131/continuous-laparoscopic-closure-of-the-linea-alba-with-barbed-sutures-combined-with-laparoscopic-mesh-implantation-ipom-plus-repair-as-a-new-technique-for-treatment-of-abdominal-hernias
#1
Reiko Wiessner, Thomas Vorwerk, Claudia Tolla-Jensen, Alexander Gehring
Despite extensive experience and significant reduction of complications in recent years, laparoscopic treatment of complex abdominal hernias is a challenge even for the experienced endoscopic surgeon. Patients with severe incisional hernias or symptomatic rectus diastasis benefit from the closure of the linea alba as a morphological and physiological reconstruction of the abdominal wall followed by mesh implantation. Occasionally, an additional component separation is necessary. In open surgery, this is associated with very large wound areas, postoperative seromas, poor wound healing and, in the worst case, mesh infections...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/29131387/laparoscopic-mesh-repair-of-a-labial-hernia
#2
Philippe Grange, Fevzi Shakir, Ganesh Thiagamoorthy, George Araklitis, Dudley Robinson, Linda Cardozo
AIMS: To present a narrated video designed to demonstrate the steps involved in a laparoscopic mesh repair of a labial hernia. METHODS: This was in a 76-year-old woman who presented with a small bowel hernia in to her left labium majus. In 2014 she had a robotically assisted radical cystectomy for bladder cancer with anterior exenteration. She developed the hernia in February 2015 and initially a vaginal approach was attempted to repair the hernia (with layered non-absorbable sutures to close the fascia over the defect) at her local hospital, although this was unsuccessful...
November 13, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29096166/lung-and-liver-growth-and-retinoic-acid-status-in-human-fetuses-with-congenital-diaphragmatic-hernia
#3
Christine K C Loo, Michael A Pearen, Tamara N Pereira, Joanna Perry-Keene, Diane Payton, Grant A Ramm
BACKGROUND: Abnormal retinoic acid (RA) signalling is considered a major cause of congenital diaphragmatic hernia (CDH). Pulmonary hypoplasia and pulmonary hypertension are the major causes of morbidity and mortality in infants born with CDH. Experimental studies in animals have found that RA signalling is involved in lung and liver development, but animal models of CDH do not directly correlate with CDH in human fetuses. This study investigated if RA status is also linked to lung and liver growth in human fetuses with CDH...
October 30, 2017: Early Human Development
https://www.readbyqxmd.com/read/29090019/molecular-characterization-and-evaluation-of-complex-rearrangements-in-a-case-of-ring-chromosome-15
#4
Stuti Tewari, Naznin Lubna, Raju Shah, Ahmed B H Al-Rikabi, Krati Shah, Jayesh Sheth, Frenny Sheth
BACKGROUND: Ring chromosome 15 is a rare genetic entity. Only a few cases have been reported with characterization using molecular techniques. The clinical presentation is quite variable, as a result of differences in the breakpoints, haploinsufficiency of genes involved in deleted segment/s, level of mosaicism and ring instability resulting in a variability of rearrangement of genetic material. CASE PRESENTATION: The proband, a 2 months old boy, presented with small head size and facial dysmorphism...
2017: Molecular Cytogenetics
https://www.readbyqxmd.com/read/29081901/role-of-reduced-size-liver-bowel-grafts-in-the-abdominal-wall-transplantation-era
#5
REVIEW
Augusto Lauro, Anil Vaidya
The evolution of multi-visceral and isolated intestinal transplant techniques over the last 3 decades has highlighted the technical challenges related to the closure of the abdomen at the end of the procedure. Two key factors that contribute to this challenge include: (1) Volume/edema of donor graft; and (2) loss of abdominal domain in the recipient. Not being able to close the abdominal wall leads to a variety of complications and morbidity that range from complex ventral hernias to bowel perforation. At the end of the 90's this challenge was overcome by graft reduction during the donor operation or bench table procedure (especially reducing liver and small intestine), as well as techniques to increase the volume of abdominal cavity by pre-operative expansion devices...
September 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29071335/prevalence-of-untreated-surgical-conditions-in-rural-rwanda-a-population-based-cross-sectional-study-in-burera-district
#6
Rebecca G Maine, Allison F Linden, Robert Riviello, Emmanuel Kamanzi, Gita N Mody, Georges Ntakiyiruta, Grace Kansayisa, Edmond Ntaganda, Francine Niyonkuru, Joel M Mubiligi, Tharcisse Mpunga, John G Meara, Bethany L Hedt-Gauthier
Importance: In low- and middle-income countries, community-level surgical epidemiology is largely undefined. Accurate community-level surgical epidemiology is necessary for surgical health systems planning. Objective: To determine the prevalence of surgical conditions in Burera District, Northern Province, Rwanda. Design, Setting, and Participants: A cross-sectional study with a 2-stage cluster sample design (at village and household level) was carried out in Burera District in March and May 2012...
October 25, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29063307/prospective-evaluation-of-poly-4-hydroxybutyrate-mesh-in-cdc-class-i-high-risk-ventral-and-incisional-hernia-repair-18-month-follow-up
#7
John Scott Roth, Gary J Anthone, Don J Selzer, Benjamin K Poulose, James G Bittner, William W Hope, Raymond M Dunn, Robert G Martindale, Matthew I Goldblatt, David B Earle, John R Romanelli, Gregory J Mancini, Jacob A Greenberg, John G Linn, Eduardo Parra-Davila, Bryan J Sandler, Corey R Deeken, Guy R Voeller
BACKGROUND: Long-term resorbable mesh represents a promising technology for complex ventral and incisional hernia repair (VIHR). Preclinical studies indicate that poly-4-hydroxybutyrate (P4HB) resorbable mesh supports strength restoration of the abdominal wall. This study evaluated outcomes of high-risk subjects undergoing VIHR with P4HB mesh. METHODS: This was a prospective, multi-institutional study of subjects undergoing retrorectus or onlay VIHR. Inclusion criteria were CDC Class I, defect 10-350 cm(2), ≤ 3 prior repairs, and ≥ 1 high-risk criteria (obesity (BMI: 30-40 kg/m(2)), active smoker, COPD, diabetes, immunosuppression, coronary artery disease, chronic corticosteroid use, hypoalbuminemia, advanced age, and renal insufficiency)...
October 23, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29062460/heterotopic-ossification-encountered-during-a-complex-ventral-hernia-repair-case-report-and-literature-review
#8
Takintope Akinbiyi, Sanjeev Kaul
Introduction: Heterotopic ossification involves the formation of trabecular bone outside of its usual anatomic location. While it is a well-known entity in orthopedic and spinal injury literature, it has also been observed after midline laparotomy and severe burns. Methods/Case Report: We present a case of a 69-year-old man who presented for ventral hernia repair after a prolonged postoperative course following colectomy involving an open abdomen with eventual closure with skin grafting. Results: Two large calcified objects were encountered during the excision of the skin graft from the small intestine and during the component separation...
2017: Eplasty
https://www.readbyqxmd.com/read/29059610/diagnosis-and-operative-management-of-a-perforated-de-garengeot-hernia
#9
Alexi Bloom, Flavio E Baio, Keemberly Kim, Joseph S Fernandez-Moure, Michael Reader
INTRODUCTION: A de Garengeot hernia, a femoral hernia containing the appendix, is a difficult diagnosis often made intra-operatively when the hernia sac is opened. It is a rare finding, and complications are more frequent with a de Garengeot hernia. PRESENTATION OF CASE: A 92 year-old female presented to the emergency department (ED) complaining of abdominal pain. A computed tomographic (CT) scan of the abdomen and pelvis demonstrated a hernia anterior to the inguinal ligament without strangulation...
October 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29055880/component-separation-of-abdominal-wall-with-intraoperative-botulinum-a-presents-satisfactory-outcomes-in-large-incisional-hernias-a-case-report
#10
Lucas Torres Oliveira, Felipe Futema Essu, Gustavo Heluani Antunes de Mesquita, Yuri Justi Jardim, Leandro Ryuchi Iuamoto, Fábio Yuji Suguita, Diego Ramos Martines, Fernanda Nii, Daniel Reis Waisberg, Alberto Meyer, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque
PURPOSE: Transplantation patients have a series of associated risk factors that make appearance of incisional hernia (IH) more likely. A number of aspects of the closure of large defects remain controversial. In this manuscript, we present the repair of a large IH following liver transplantation through the technique of posterior components separation combined with the anterior, together with the intraoperative use of botulinum toxin A and the placement of mesh. As a secondary objective, we analyze the incidence of IH following liver transplantation in our service...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29049425/comparison-of-internal-medicine-and-general-surgery-residents-assessments-of-risk-of-postsurgical-complications-in-surgically-complex-patients
#11
James M Healy, Kimberly A Davis, Kevin Y Pei
Importance: Anticipating postsurgical complications is a vital physician skill, particularly when counseling surgically complex patients on their risks of intervention. Although internists and surgeons both counsel patients on surgical risks, it is uncertain who is better equipped to accurately anticipate surgical complications. Objective: To examine how internal medicine and general surgery trainees compare in their assessment of risk of surgically complex patients...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049186/combined-laparoscopic-and-open-technique-for-repair-of-congenital-abdominal-hernia-a-case-report-of-prune-belly-syndrome
#12
Qinghuang Ye, Yan Chen, Jinhui Zhu, Yuedong Wang
BACKGROUND: Prune belly syndrome (PBS) is a rare congenital disorder among adults, and the way for repairing abdominal wall musculature has no unified standard. MATERIALS AND METHODS: We described combining laparoscopic and open technique in an adult male who presented with PBS. Physical examination and radiological imaging verified the case of PBS. The deficiency of abdominal wall musculature was repaired by combining laparoscopic and open technique using a double-deck complex patch...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29036646/de-novo-deleterious-sequence-variants-that-alter-the-transcriptional-activity-of-the-homeoprotein-pbx1-are-associated-with-intellectual-disability-and-pleiotropic-developmental-defects
#13
Anne Slavotinek, Maurizio Risolino, Marta Losa, Megan T Cho, Kristin G Monaghan, Dina Schneidman-Duhovny, Sarah Parisotto, Johanna C Herkert, Alexander P A Stegmann, Kathryn Miller, Natasha Shur, Jacqueline Chui, Eric Muller, Suzanne DeBrosse, Justin O Szot, Gavin Chapman, Nicholas S Pachter, David S Winlaw, Bryce A Mendelsohn, Joline Dalton, Kyriakie Sarafoglou, Peter I Karachunski, Jane M Lewis, Helio Pedro, Sally L Dunwoodie, Licia Selleri, Joseph Shieh
We present eight patients with de novo, deleterious sequence variants in the PBX1 gene. PBX1 encodes a three amino acid loop extension (TALE) homeodomain transcription factor that forms multimeric complexes with TALE and HOX proteins to regulate target gene transcription during development. As previously reported, Pbx1 homozygous mutant mice (Pbx1-/-) develop malformations and hypoplasia or aplasia of multiple organs, including the craniofacial skeleton, ear, branchial arches, heart, lungs, diaphragm, gut, kidneys, and gonads...
September 22, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/29023150/incisional-hernia-repair-what-the-radiologist-needs-to-know
#14
Kushal R Parikh, Mahmoud Al-Hawary, John D Millet, Richard Burney, Jonathan Finks, Katherine Maturen
OBJECTIVE: Incisional hernias are becoming more prevalent with increases in the obesity of the population and the complexity of abdominal surgeries. Radiologists' understanding of these hernias is limited. This article examines abdominal wall anatomy, surgical techniques, the role of imaging (current and emerging), and complications from the surgical perspective, to enhance to the role of the radiologist. CONCLUSION: Knowledge of the relevant anatomy, surgical techniques, and postoperative complications in patients with incisional hernial repair can help the radiologist improve care...
December 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29018803/etiology-of-inguinal-hernias-a-comprehensive-review
#15
REVIEW
Stina Öberg, Kristoffer Andresen, Jacob Rosenberg
BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28958271/operative-outcomes-after-open-abdominal-wall-reconstruction-with-retromuscular-mesh-fixation-using-fibrin-glue-versus-transfascial-sutures
#16
COMPARATIVE STUDY
Adam S Weltz, Udai S Sibia, H Reza Zahiri, Alexa Schoeneborn, Adrian Park, Igor Belyansky
Ideal fixation techniques have not been fully elucidated at the time of complex open abdominal wall reconstruction (AWR). We compared operative outcomes and quality of life with retromuscular mesh fixation using fibrin glue (FG) versus transfascial sutures (TS). Retrospective review identified complex hernia patients who underwent open AWR with mesh from November 2012 through April 2016. Multivariate analysis examined postoperative outcomes between groups. Quality of life was assessed using the Carolinas Comfort Scale...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28925604/epidemiology-and-prognosis-of-congenital-diaphragmatic-hernia-a-population-based-cohort-study-in-utah
#17
Hari Shanmugam, Luca Brunelli, Lorenzo D Botto, Sergey Krikov, Marcia L Feldkamp
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a relatively frequent and severe malformation. Population-based data on clinical presentation and associated mortality are scarce. We examined a state-wide cohort of infants with a clinically validated diagnosis of CDH to assess their clinical profile, sociodemographic patterns, and infant mortality. METHODS: We identified CDH cases from Utah's statewide population-based surveillance program among the cohort of all pregnancy outcomes (live births, stillbirths, and pregnancy terminations) delivered from 1999 to 2011...
September 19, 2017: Birth defects research
https://www.readbyqxmd.com/read/28920648/hernia-repair-and-complex-abdominal-wall-reconstruction
#18
Christopher Senkowski, Mark Savarise, John S Roth, Jan Nagle
No abstract text is available yet for this article.
April 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28917019/the-trend-toward-minimally-invasive-complex-abdominal-wall-reconstruction-is-it-worth-it
#19
Igor Belyansky, Adam S Weltz, Udai S Sibia, Justin J Turcotte, Haley Taylor, H Reza Zahiri, T Robert Turner, Adrian Park
BACKGROUND: Open abdominal wall reconstruction (AWR) was previously one of the only methods available to treat complex ventral hernias. We set out to identify the impact of laparoscopy and robotics on our AWR program by performing an economic analysis before and after the institution of minimally invasive AWR. METHODS: We retrospectively reviewed inpatient hospital costs and economic factors for a consecutive series of 104 AWR cases that utilized separation of components technique (57 open, 38 laparoscopic, 9 robotic)...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28917016/predictors-of-outpatient-resource-utilization-following-ventral-and-incisional-hernia-repair
#20
Alex Wade, Margaret A Plymale, Daniel L Davenport, Sara E Johnson, Vashisht V Madabhushi, Erica Mastoroudis, Charlie Tancula, John Scott Roth
INTRODUCTION: Little is known about the predictors of increased ambulatory costs following open ventral and incisional hernia repair (VIHR); however, postoperative complications would be expected to be associated with an increased burden on outpatient resources. The purpose of this study is to evaluate the impact of perioperative factors on outpatient resource utilization following VIHR. METHODS: With IRB approval, the surgery scheduling system was queried to identify all cases of VIHR done at our institution over 3 years...
September 15, 2017: Surgical Endoscopy
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