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Robotic Hernia Repair

Benjamin Wei, Bruce C Pittman
Morgagni hernia (MH) is a rare, congenital diaphragmatic hernia (CDH). The use of robotic surgery to repair MH in adults has recently been described in the literature, but only on two previous occasions. The objective of this report is to describe four cases of robotic repair of MH in adults performed by a single surgeon to better delineate an emerging approach to this rare condition. A retrospective review of patients who underwent robotic repair of MH by a single surgeon was performed. Four consecutive patients were identified and included...
November 21, 2018: Journal of Robotic Surgery
J T Halka, A Vasyluk, A Demare, A Iacco, R Janczyk
BACKGROUND: Although the open transversus abdominis release (oTAR) is an effective operation for large ventral hernias, it is historically associated with a relatively long length of stay. Robotic retromuscular transversus abdominis release (rTAR) allows minimally invasive repair of complex ventral hernias with shorter length of stay (LOS) compared to open repairs (TAR), but hybrid robotic TAR (hrTAR), partial open intervention via incision through the overlying hernia sac for fascial closure, may be required to accomplish effective repair of large defects...
November 19, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Muhammad Qais Luqman, Afzaal Mughal, Ronan Waldron, Iqbal Z Khan
Acquired abdominal intercostal hernia (AAIH) is an infrequent occurrence whereby intra-abdominal contents herniate into intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. These hernias are difficult to diagnose and should always be suspected when a chest wall swelling occur after major or minor trauma. Surgical repair is warranted in symptomatic patients. The majority of AAIHs are repaired through an open approach using tension-free mesh, with significant recurrence risk...
November 3, 2018: BMJ Case Reports
R Sharma, N Fadaee, E Zarrinkhoo, S Towfigh
PURPOSE: As more mesh is implanted for hernia repairs, mesh-related complications may increase, with some requiring mesh removal. We describe our experience as to indications and perioperative factors that surround hernia mesh removal. METHODS: All patients who underwent hernia mesh removal from the abdomen (ventral, flank) and pelvis (inguinal, femoral, obturator, perineal) were captured from a single hernia center database. RESULTS: Over 4...
December 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Adam Truong, Badr Saad Al-Aufey, Shirin Towfigh
BACKGROUND: Inguinal hernia repairs are among the most common operations performed worldwide. An increasing number is performed minimally invasively with mesh placed pre-peritoneally. Some situations may require mesh removal. This can be complex and challenging. We share our technique to remove pre-peritoneal mesh using a minimally invasive approach. METHODS: The multiple steps involved in robotic-assisted pre-peritoneal mesh removal are reviewed in detail, including preoperative planning, intraoperative positioning, review of anatomic landmarks, and systematic approach with technical tips to reduce complications...
October 24, 2018: Surgical Endoscopy
Alexander C Mertens, Rob C Tolboom, Hana Zavrtanik, Werner A Draaisma, Ivo A M J Broeders
INTRODUCTION: Published data regarding robot-assisted hiatal hernia repair are mainly limited to small cohorts. This study aimed to provide information on the morbidity and mortality of robot-assisted complex hiatal hernia repair and redo anti-reflux surgery in a high-volume center. MATERIALS AND METHODS: All patients that underwent robot-assisted hiatal hernia repair, redo hiatal hernia repair, and anti-reflux surgery between 2011 and 2017 at the Meander Medical Centre, Amersfoort, the Netherlands were evaluated...
October 22, 2018: Surgical Endoscopy
Jeffrey A Blatnik, L Michael Brunt
Abdominal wall hernia repair is one of the most common operations done by general surgeons today. Patients with incisional hernias can be extremely challenging to manage due to a number of factors that include obesity, prior hernia repairs, previous mesh placement, loss of domain, and other variables. The approach to patients with incisional hernias has evolved considerably over the last 20 years due to both advances in mesh technology and surgical approaches. Key factors in a successful outcome include modification of risk factors prior to surgery such as smoking cessation and weight reduction, selection of mesh appropriate to the hernia type and planned location of the mesh, and broad overlap of mesh beyond the margins of the hernia defect...
October 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Zhamak Khorgami, Wei T Li, Theresa N Jackson, C Anthony Howard, Guido M Sclabas
BACKGROUND: Robotic-assisted surgery (RAS) with its advantages continues to gain popularity among surgeons. This study analyzed the increased costs of RAS in common surgical procedures using the National Inpatient Sample. METHODS: Retrospective analysis of the 2012-2014 Healthcare Cost and Utilization Project-NIS was performed for the following laparoscopic/robotic procedures: cholecystectomy, ventral hernia repair, right and left hemicolectomy, sigmoidectomy, abdominoperineal resection, and total abdominal hysterectomy (TAH)...
October 16, 2018: Surgical Endoscopy
Joey A Jarrard, Michael R Arroyo, B Todd Moore
BACKGROUND: The true incidence of occult contralateral inguinal hernia is unknown; however, when found, there exists controversy as to whether or not they should be repaired. The aim of our study is to identify the incidence of contralateral incidental inguinal hernias in our surgical population, compare our results to previous studies timelining occult hernia identification to repair need, and generate debate as to whether incidental contralateral hernias should be repaired at the index operation...
October 16, 2018: Surgical Endoscopy
Victor Maciel, Wilmer Mata, Gabriel Arevalo, Marianna Zeichen, Timothy Glass
OBJECTIVE: To present our technique of robotic retrorectus parastomal hernia repair. BACKGROUND: Parastomal hernias represent a significant problem with high recurrence and long-term complications. An estimated of 120,000 new stomas are created per year with a prevalence of up to 800,000 patients in the U.S. 40-60% of these ostomies will never be reversed. Parastomal hernias cause skin breakdown and make adherence of ostomy appliances difficult, creating the need for frequent bag exchanges...
September 24, 2018: Journal of Robotic Surgery
F Muysoms, S Van Cleven, P Pletinckx, C Ballecer, A Ramaswamy
PURPOSE: The use of extraperitoneal mesh in place of intra-peritoneal mesh is gaining popularity in laparoscopic ventral hernia repair. We have adopted a robotic assisted laparoscopic technique using a lateral single-dock robotic access with retromuscular mesh placement after opening the ipsilateral posterior rectus fascia. In this study, we wanted to evaluate the changes in operative times during the initial experience with this novel technique. METHODS: The initial consecutive patients undergoing robotic assisted transabdominal retromuscular umbilical prosthetic repair (r-TARUP) using a 15 × 15 cm self-fixating mesh were prospectively entered in the study and the operative times during the separate steps of the surgical procedure were recorded...
December 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Sarah Mustafa, Elizabeth Handren, Drew Farmer, Estrellita Ontiveros, Gerald O Ogola, Steven G Leeds
OBJECTIVE: Resident education is evolving as more cases move from open to minimally invasive. Many programs struggle to incorporate minimally invasive surgery education due to increased operative time and higher cost when residents participate. The aim of this paper is to examine if the implementation of a robotics curriculum enhances minimally invasive surgical training. DESIGN: A retrospective review of all ventral and inguinal hernia cases performed from March 2013 to November 2017 was conducted to determine operative technique utilized (open, laparoscopic, or robotic) and resident involvement...
September 12, 2018: Journal of Surgical Education
Dario Amore, Carlo Bergaminelli, Davide Di Natale, Dino Casazza, Roberto Scaramuzzi, Carlo Curcio
Morgagni hernia is a relatively uncommon congenital diaphragmatic hernia in which abdominal contents protrude into the chest through the foramen of Morgagni. It usually occurs on the right side of the chest but may occur on the left side or in the midline. In adults, it commonly presents with non-specific symptoms such as dyspnea, cough, gastroesophageal reflux disease and other. Surgical repair should be always performed to prevent the risk of hernia incarceration. Transthoracic approach has been proposed especially in cases with indeterminate, anterior pericardial masses...
July 2018: Journal of Thoracic Disease
Ty Kirkpatrick, Bethany Zimmerman, Karl LeBlanc
BACKGROUND: Robotic-assisted surgery has proved to be a valuable modality in specialties such as urology and gynecology and has gained wide acceptance in those fields. Its value in general surgery, however, has had a slower acceptance rate among surgeons. This study reviews my first 150 cases using the robot for one of the most common general surgery operations-the repair of hernias. MATERIALS AND METHODS: All robotic hernia cases performed by a single surgeon were documented in an Excel? (Microsoft Corporation, Redmond, Washington) spreadsheet beginning in April, 2014...
November 11, 2018: Surgical Technology International
Ramon Diez-Barroso, Carlos H Palacio, Julian A Martinez, Konstantinos Makris, Nader N Massarweh, Christy Y Chai, Samir S Awad, Hop S Tran Cao
BACKGROUND: With the increasing use of the robotic platform in general surgery, whether 8-mm ports should be closed comes into question. We sought to characterize the incidence of port-site hernias (PSHs) among patients undergoing robotic-assisted general surgery. METHODS: A retrospective chart review of a single institutional database identified patients who underwent robotic-assisted general surgery from July 2010 to December 2016. For each patient, the number, type, location, and size of all ports were collected...
October 2018: Journal of Surgical Research
Vernissia Tam, Jeffrey Borrebach, Stefanie Altieri Dunn, Johanna Bellon, Herbert J Zeh, Melissa E Hogg
BACKGROUND: While proficiency-based robotic training has been shown to enhance skill acquisition, no studies have shown that training leads to improved outcomes or quality measures. METHODS: Board-certified general surgeons participated in an optional proficiency-based robotic training curriculum and outcomes from robotic hernia cases were analyzed. Multivariable analysis was performed for operative times to adjust for patient and surgical variables. RESULTS: Six out of 16 (38%) surgeons completed training and 210 robotic hernia cases were analyzed...
August 3, 2018: American Journal of Surgery
P L Tenzel, Z F Williams, R A McCarthy, W W Hope
PURPOSE: Given the difficulty of durable repairs, there is continued interest in hernia prevention. One emerging prevention technique for parastomal hernias is prophylactic mesh placement, whereby mesh is inserted during the index procedure as hernia prophylaxis. We evaluated our experience using prophylactic mesh when creating an ileal conduit. METHODS: We retrospectively reviewed patients undergoing robotic cystectomy with ileal conduit from 6/2010 to 8/2017. Patient demographics and operative/perioperative outcomes were documented...
October 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Yonggang Huang, Ping Wang
Direct suture repair with mesh reinforcement is the main surgical procedure in ventral hernia repair. The best place for mesh implantation is retromuscular space which means sublay. The most commonly used techniques are open sublay and laparoscopic IPOM repair. But open sublay repair may cause more trauma to the abdominal wall and result in more infections. Laparoscopic IPOM repair carries an increased risk in bowel injury, mesh-related complications and postoperative pain. Germany surgeon Reinpold developed a new technique defined as "MILOS concept" by combining the advantages of open sublay and laparoscopic IPOM repair...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Wen Tian, Yang Fei
Da Vinci robotic surgical system has brought giant evolution to minimally invasive surgery, and also improved the development of hernia surgery. Recently, Da Vinci robotic surgical system has been successfully applied to the repair of incisional hernia, inguinal hernia, and esophageal hiatal hernia. In the area of incisional herniorrhaphy, endowrist with 7 degrees of freedom, high definition and naked eye 3D imaging system can make Da Vinci robotic surgical system easy to complete the subtle suture in the anterior abdominal wall from the abdominal cavity...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Ali Fuat Atmaca, Nurullah Hamidi, Abdullah Erdem Canda, Murat Keske, Arslan Ardicoglu
PURPOSE: To assessment the safety of concurrent repair of inguinal hernia (IH) with mesh application during transperitoneal robotic-assisted radical prostatectomy(RARP). MATERIALS AND METHODS: Data of 20 patients (totally 25 procedures) who performed concurrent IH repair with mesh application during RARP were retrospectively enrolled in this study. Preoperative patient characteristics, intra and postoperative parameters (pathological Gleason grade, prostate volume at surgical specimen, operative time, herniorrhaphy time, estimated blood loss, complications, time of hospitalization, catheterization, and drainage) were evaluated...
November 17, 2018: Urology Journal
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