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Complex hernia

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https://www.readbyqxmd.com/read/28812464/congenital-diaphragmatic-hernia-with-liver-herniation-into-the-pericardial-sac-in-a-30-week-gestation-infant
#1
Nisha Patel, Christina Sollinger, Carl T D'Angio, Jeffrey M Vinocur, Kate G Ackerman, Philip J Katzman
Anterior diaphragmatic defects with pericardial involvement are extremely rare and diagnostically challenging entities encountered perinatally. While a majority of diaphragmatic defects occur in isolation, others are associated with multiple defects forming a complex of syndromes such as Pentalogy of Cantrell. Liver herniation into the pericardial sac poses a particular challenge and can mimic a pericardial tumor on prenatal ultrasound, yielding a different management course. The following case is an unusual presentation of a 30-week gestation female with an anterior midline diaphragmatic defect with liver herniation mimicking as a pericardial tumor, diagnosed at time of autopsy...
September 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28776154/sleeve-gastrectomy-after-liver-transplantation-feasibility-and-outcomes
#2
Michael Osseis, Andrea Lazzati, Chady Salloum, Concepcion Gomez Gavara, Philippe Compagnon, Cyrille Feray, Chetana Lim, Daniel Azoulay
BACKGROUND: Knowledge regarding the feasibility and safety of sleeve gastrectomy (SG) in obese liver transplant recipients is scarce. We report our experience of sleeve gastrectomy following liver transplantation (LT). METHODS: All patients who had undergone LT and subsequently underwent SG at our institution were retrospectively reviewed. Surgical outcomes, liver and kidney function tests, outcomes of obesity-related comorbidities, and excess weight loss were analyzed...
August 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#3
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard. Lack of operative autonomy may play a role...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28733748/preoperative-botulinum-toxin-a-enabling-defect-closure-and-laparoscopic-repair-of-complex-ventral-hernia
#4
Omar Rodriguez-Acevedo, Kristen E Elstner, Anita S W Jacombs, John W Read, Rodrigo Tomazini Martins, Fernando Arduini, Michael Wehrhahm, Colette Craft, Peter H Cosman, Anthony N Dardano, Nabeel Ibrahim
INTRODUCTION: Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair. METHODS: This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733746/comparative-analysis-of-perioperative-outcomes-of-robotic-versus-open-transversus-abdominis-release
#5
Luis A Martin-Del-Campo, Adam S Weltz, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Transversus abdominis release (TAR) has evolved as an effective approach to complex abdominal wall reconstructions. Although the role of robotics in hernia surgery is rapidly expanding, the benefits of a robotic approach for abdominal wall reconstruction have not been established well. We aimed to compare the impact of the application of robotics to the TAR procedure on the perioperative outcomes when compared to the open TAR repairs. METHODS: Case-matched comparison of patients undergoing robotic TAR (R-TAR) at two specialized hernia centers to a matched historic cohort of open TAR (O-TAR) patients was performed...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28732177/inguinal-hernia-in-athletes-role-of-dynamic-ultrasound
#6
William Kelton Vasileff, Mikhail Nekhline, Patricia A Kolowich, Gary B Talpos, Willam R Eyler, Marnix van Holsbeeck
BACKGROUND: Inguinal hernia is a commonly encountered cause of pain in athletes. Because of the anatomic complexity, lack of standard imaging, and the dynamic condition, there is no unified opinion explaining its underlying pathology. HYPOTHESIS: Athletes with persistent groin pain would have a high prevalence of inguinal hernia with dynamic ultrasound, and herniorrhaphy would successfully return athletes to activity. STUDY DESIGN: Case-control study...
July 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28730275/comparative-analysis-of-open-and-robotic-transversus-abdominis-release-for-ventral-hernia-repair
#7
James G Bittner, Sameer Alrefai, Michelle Vy, Micah Mabe, Paul A R Del Prado, Natasha L Clingempeel
BACKGROUND: Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair. METHODS: A single-center, retrospective review of patients who underwent o-TAR or r-TAR for VIH from 2015 to 2016 was conducted...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28704230/effect-of-esophageal-cancer-surgeon-volume-on-management-and-mortality-from-emergency-upper-gastrointestinal-conditions-population-based-cohort-study
#8
Sheraz R Markar, Hugh Mackenzie, Alan Askari, Omar Faiz, George B Hanna
OBJECTIVE: To study the influence of esophageal cancer surgeon volume upon mortality from upper gastrointestinal emergencies. BACKGROUND: Volume-outcome relationships led to the centralization of esophageal cancer surgery. METHODS: Hospital Episode Statistics data were used to identify patients admitted to hospitals within England (1997-2012). The influence of esophageal high-volume (HV) cancer surgeon status (≥5 resections per year) upon 30-day and 90-day mortality from esophageal perforation (EP), paraesophageal hernia causing obstruction or gangrene (PEH) and perforated peptic ulcer (PPU) was analyzed, independent of HV esophageal cancer center status and patient and disease-specific confounding factors...
July 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28689863/long-term-results-of-open-complex-abdominal-wall-hernia-repair-with-self-gripping-mesh-a-retrospective-cohort-study
#9
Leonard F Kroese, Lien H A van Eeghem, Joost Verhelst, Johannes Jeekel, Gert-Jan Kleinrensink, Johan F Lange
BACKGROUND: In case of complex ventral hernias, Rives-Stoppa and component separation technique are considered as favourable treatment techniques. However, mesh-related complications like recurrence, infection and chronic pain are still a common problem after mesh repair. Previous studies have reported promising results of the use of a self-gripping mesh (ProGrip™) in incisional hernia repair. This study aimed to evaluate the long term results of this mesh for complex ventral hernia treatment...
July 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28673874/post-operative-outcomes-after-single-port-laparoscopic-removal-of-adnexal-masses-in-patients-referred-to-gynecologic-oncology-at-a-large-academic-center
#10
Laura J Moulton, Amelia M Jernigan, Chad M Michener
OBJECTIVE: To report surgical and pathologic outcomes after single port laparoscopy (SPL) for adnexal masses in patients referred to a gynecologic oncology practice at a single academic institution. DESIGN: Retrospective analysis (Canadian Task Force Classification II.2). SETTING: A single academic institution with multiple hospital centers PATIENTS: Women who underwent at least one single port laparoscopic surgery for treatment of an adnexal mass from 2009-2015 after referral to a gynecologic oncology practice...
June 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28671890/management-of-infected-mesh-after-abdominal-hernia-repair-systematic-review-and-single-institution-experience
#11
Valeriy Shubinets, Martin J Carney, David L Colen, Michael N Mirzabeigi, Jason M Weissler, Michael A Lanni, Benjamin M Braslow, John P Fischer, Stephen J Kovach
BACKGROUND: Mesh infection after abdominal hernia repair is a devastating complication that affects general and plastic surgeons alike. The purpose of this study was 3-fold: (1) to determine current evidence for treatment of infected abdominal wall mesh via systematic review of literature, (2) to analyze our single-institution experience with treatment of infected mesh patients, and (3) to establish a framework for how to approach this complex clinical problem. METHODS: Literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, followed by single-institution retrospective analysis of infected mesh patients...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28671066/lesions-found-at-routine-meat-inspection-on-finishing-pigs-are-associated-with-production-system
#12
H Kongsted, J T Sørensen
Pigs raised under free-range conditions are expected to experience a higher level of animal welfare than conventionally raised pigs. However, free-range conditions may challenge prevention and treatment of diseases. In order to identify disease problems associated with raising conditions, this study compared slaughter lesions in pigs from conventional indoor, conventional free-range and organic free-range production systems. The study used data from 1,096,756 pigs slaughtered at one Danish abattoir from 1 January 2013 to 31 December 2015...
May 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28658342/robotic-transversus-abdominis-release-tar-is-it-possible-to-offer-minimally-invasive-surgery-for-abdominal-wall-complex-defects
#13
Maria Vitória França DO Amaral, José Ricardo Guimarães, Paula Volpe, Flávio Malcher Martins DE Oliveira, Carlos Eduardo Domene, Sérgio Roll, Leandro Totti Cavazzola
We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28641757/long-term-follow-up-of-congenital-diaphragmatic-hernia
#14
Laura E Hollinger, Matthew T Harting, Kevin P Lally
Increased survival of patients with congenital diaphragmatic hernia has created a unique cohort of children, adolescent, and adult survivors with complex medical and surgical needs. Disease-specific morbidities offer the opportunity for multiple disciplines to unite together to provide long-term comprehensive follow-up, as well as an opportunity for research regarding late outcomes. These children can exhibit impaired pulmonary function, altered neurodevelopmental outcomes, nutritional insufficiency, musculoskeletal changes, and specialized surgical needs that benefit from regular monitoring and intervention, particularly in patients with increased disease severity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28641754/ventilation-modalities-in-infants-with-congenital-diaphragmatic-hernia
#15
Francesco Morini, Irma Capolupo, Willem van Weteringen, Irwin Reiss
Neonates with congenital diaphragmatic hernia are among the more complex patients to support with mechanical ventilation. They have particular features that add to the difficulties already present in the neonatal patient. A ventilation strategy tailored to the patient's underlying physiology rather than mode of ventilation is a crucial issue for clinicians treating these delicate patients.
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28641752/congenital-diaphragmatic-hernia-associated-pulmonary-hypertension
#16
Matthew T Harting
Congenital diaphragmatic hernia (CDH) is a complex entity wherein a diaphragmatic defect allows intrathoracic herniation of intra-abdominal contents and both pulmonary parenchymal and vascular development are stifled. Pulmonary pathology and pathophysiology, including pulmonary hypoplasia and pulmonary hypertension, are hallmarks of CDH and are associated with disease severity. Pulmonary hypertension (PH) is sustained, supranormal pulmonary arterial pressure, and among patients with CDH (CDH-PH), is driven by hypoplastic pulmonary vasculature, including alterations at the molecular, cellular, and tissue levels, along with pathophysiologic pulmonary vasoreactivity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28637559/complex-abdominal-wall-hernia-repair-in-contaminated-surgical-fields-factors-affecting-the-choice-of-prosthesis
#17
Manuel López-Cano, María Teresa Quiles, José Antonio Pereira, Manuel Armengol-Carrasco, María Antonia Arbós Vía
To compare patients with complex abdominal wall hernias undergoing surgical repair using synthetic nonabsorbable or biologic meshes in contaminated fields. Retrospective review of 62 patients with complex abdominal wall hernia with surgical repair in an elective setting and in the context of a clean-contaminated or contaminated fields (January 2009-April 2015). Two groups according to the prosthesis (synthetic nonabsorbable, n = 48 or biologic, n = 14). Mean follow-up was 24.6 (15.8) months. Clean-contaminated wounds were significantly more frequent in the synthetic group...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28602526/resident-operative-experience-at-independent-academic-medical-centers-a-comparison-to-the-national-cohort
#18
Amit R T Joshi, Amber W Trickey, Benjamin T Jarman, Kara J Kallies, Robert Josloff, Jonathan M Dort, Ravi Kothuru
PURPOSE: Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a large representative sample of IAMCs to compare operative volume and variety, with a focus on low-volume procedures. METHODS: Accreditation Council for Graduate Medical Education Program Case Reports from 27 IAMCs were collected and analyzed for 3 academic years (2012-2015)...
June 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28598983/a-preclinical-evaluation-of-polypropylene-polylacticacid-hybrid-meshes-for-fascial-defect-repair-using-a-rat-abdominal-hernia-model
#19
Daniela Ulrich, Isabelle Le Teuff, Stephanie Huberlant, Patrick Carteron, Vincent Letouzey, Renaud de Tayrac
OBJECTIVES: Synthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP) mesh. METHODS: 72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control...
2017: PloS One
https://www.readbyqxmd.com/read/28597286/what-are-the-differences-in-the-outcome-of-laparoscopic-axial-i-versus-paraesophageal-ii-iv-hiatal-hernia-repair
#20
F Köckerling, Y Trommer, K Zarras, D Adolf, B Kraft, D Weyhe, R Fortelny, C Schug-Paß
INTRODUCTION: Comparison of elective laparoscopic repair of axial vs paraesophageal hiatal hernias reveals relevant differences in both the patient collectives and the complexity of the procedures. MATERIALS AND METHODS: The present uni- and multivariable analysis of data from the Herniamed Registry compares the outcome for 2047 (67.3%) (type I) axial with 996 (32.7%) (types II-IV) paraesophageal primary hiatal hernias following laparoscopic repair. RESULTS: Compared with the patients with axial hiatal hernias, patients with paraesophageal hiatal hernia were nine years older, had a higher ASA score (ASA III/IV: 34...
June 8, 2017: Surgical Endoscopy
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