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"Ventral hernia"

Frederik Berrevoet
Management of a patient with an open abdomen is difficult, and the primary closure of the fascial edges is essential to obtain the best patient outcome, regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh-mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%...
2018: Frontiers in Surgery
Steve Halligan, Sam G Parker, Andrew A Plumb, Alastair C J Windsor
Complex ventral hernia (CVH) describes large, anterior, ventral hernias. The incidence of CVH is rising rapidly due to increasing laparotomy rates in ever older, obese and co-morbid patients. Surgeons with a specific interest in CVH repair are now frequently referring these patients for imaging, normally computed tomography scanning. This review describes what information is required from preoperative imaging and the surgical options and techniques used for CVH repair, so that radiologists understand the postoperative appearances specific to CVH and are aware of the common complications following surgery...
March 12, 2018: European Radiology
H Hande Aydinli, Colin Peirce, Erman Aytac, Feza H Remzi
INTRODUCTION: Abdominal wound closure is a challenge in patients undergoing colorectal surgery with a complex history of multiple abdominopelvic operations. Loss of domain of the abdominal fascia because of prior laparotomies precludes the use of simple, everyday abdominal wound closure techniques. Furthermore, ongoing intra-abdominal sepsis, with or without a concurrent entero- or colocutaneous fistula, increases the risk of postoperative morbidity and mortality in this patient population...
April 2018: Diseases of the Colon and Rectum
J D Hodgkinson, C A Leo, Y Maeda, P Bassett, S M Oke, C J Vaizey, J Warusavitarne
PURPOSE: This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519-526, 1990), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709-716, 2012), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair...
March 7, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Julie L Holihan, Deepa Cherla, Katherine J Blair, Steven S Chua, Joseph P Hasapes, Eduardo J Matta, Kaustubh G Shiralkar, Venkateswar R Surabhi, Varaha S Tammisetti, Tien C Ko, Mike K Liang
BACKGROUND: Previous studies suggest that agreement between readers of computed tomography (CT) scans for the diagnosis of a ventral hernia (VH) is poor (32% agreement, κ = 0.21). Recommendations were developed by surgeons and radiologists after determining common reasons for disagreement among CT reviewers; however, the long-term effect of adoption of these recommendations has not been assessed. The aim of this quality improvement (QI) project was to determine whether the incorporation of recommendations developed by surgeons and radiologists improves agreement among reviewers of CT scans in diagnosing a VH...
April 2018: Journal of Surgical Research
Sabrina Trippoli, Erminia Caccese, Giorgio Tulli, Pierluigi Ipponi, Claudio Marinai, Andrea Messori
BACKGROUND: In the clinical literature on abdominal hernia repair, no sound criteria have been established to support the use of biological meshes as opposed to synthetic ones. Furthermore, the information on biological meshes is quite scarce, and so their place in therapy has not yet been defined. METHODS: The treatment of primary and incisional ventral hernia was the target intervention evaluated in our analysis. Our study consisted of the following phases: a) Identification of the biologic meshes available on the market; b) Literature search focused on efficacy and safety of these meshes; c) Analysis of the findings derived from the literature search...
March 1, 2018: International Journal of Surgery
Steve Halligan, Sam G Parker, Andrew A Plumb, Chris Pj Wood, Richard W Bolton, Susan Mallett, Alastair Cj Windsor
OBJECTIVE: Complex ventral hernia repair is performed increasingly, exacerbated by the obesity epidemic. Imaging can characterise hernia morphology and diagnose recurrence. By systematic review we investigated the extent to which studies employ imaging. METHODS: The PubMed database was searched for studies of ventral hernia repair January 1995 to March 2016. Hernias of all size were eligible. Independent reviewers screened articles and extracted data from selected studies related to study design, use of pre- and post-operative hernia imaging, and the proportion of subjects imaged...
February 27, 2018: British Journal of Radiology
Caleb J Fan, Hung-Lun Chien, Matthew J Weiss, Jin He, Christopher L Wolfgang, John L Cameron, Timothy M Pawlik, Martin A Makary
BACKGROUND: Despite strong evidence demonstrating the clinical and economic benefits of minimally invasive surgery (MIS), utilization of MIS in the Medicare population is highly variable and tends to be lower than in the general population. We sought to compare the post-operative and economic outcomes of MIS versus open surgery for seven common surgical procedures in the Medicare population. METHODS: Using the 2014 Medicare Provider Analysis and Review Inpatient Limited Data Set, patients undergoing bariatric, cholecystectomy, colectomy, hysterectomy, inguinal hernia, thoracic, and ventral hernia procedures were identified using DRG and ICD-9 codes...
February 26, 2018: Surgical Endoscopy
Brian Hill, Rohan Kambeyanda, Donna Fewell, Stewart Bryant, Kevin O Delaney, Fernando A Herrera
PURPOSE: In this study, we reviewed our institution's experience using component separation for repair of ventral hernias. METHODS: This was a retrospective review of all component separations for ventral hernia between July 2009 and December 2015. Recorded data included body mass index (BMI), preoperative albumin, smoking history, comorbidities, additional procedures, length of surgery, hospitalization, recurrence, and postoperative complications. RESULTS: One hundred ninety-six component separations were performed in the study period...
February 23, 2018: Annals of Plastic Surgery
Michael Kennedy, Kaylene Barrera, Andrew Akelik, Yohannes Constable, Michael Smith, Paul Chung, Gainosuke Sugiyama
Background and Objectives: Ventral hernia repair is one of the most commonly performed general surgery procedures, and minimally invasive approaches are increasingly preferred. The physiologic repair offered by the preperitoneal approach is favorable, with reduced complications, but it remains a technical challenge. The robotic platform allows for enhanced instrument flexibility and ease of operation. We conducted a retrospective review of our experience with robotic transabdominal preperitoneal repair (rTAPP) versus robotic intraperitoneal onlay mesh (rIPOM) at a tertiary care hospital in an urban setting...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
D Heise, R Eickhoff, A Kroh, M Binnebösel, U Klinge, C D Klink, U P Neumann, A Lambertz
BACKGROUND: The open abdomen with mesh implantation, followed by early reoperation with fascial closure, is a modern surgical approach in difficult clinical situations such as severe abdominal sepsis. As early fascial closure is not possible in many cases, mesh-mediated fascial traction is helpful for conditioning of a minimized ventral hernia after open abdomen. The aim of this study was to evaluate the clinical utilization of an innovative elastic thermoplastic polyurethane mesh (TPU) as an abdominal wall inlay in a minipig model...
February 22, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Daisuke Ieda, Ikumi Hori, Yuji Nakamura, Hironori Ohshita, Yutaka Negishi, Tsutomu Shinohara, Ayako Hattori, Takenori Kato, Sachiko Inukai, Katsumasa Kitamura, Tomoki Kawai, Osamu Ohara, Shinji Kunishima, Shinji Saitoh
INTRODUCTION: Filamin A (FLNA) is located in Xq28, and encodes the actin binding protein, filamin A. A mutation in FLNA is the most common cause of periventricular nodular heterotopia (PVNH), but a clear phenotype-genotype correlation has not been established. Indeed, some patients with a FLNA mutation have recently been shown to additionally have Ehlers-Danlos-like collagenopathy or macrothrombocytopenia. In an attempt to establish a clearer correlation between clinical symptoms and genotype, we have investigated a phenotype that involves thrombocytopenia in a patient with a truncation of the FLNA gene...
February 12, 2018: Brain & Development
I N Haskins, C M Horne, D M Krpata, A S Prabhu, L Tastaldi, Arielle J Perez, S Rosenblatt, B K Poulose, M J Rosen
INTRODUCTION: Postoperative wound events following ventral hernia repair are an important outcome measure. While efforts have been made by hernia surgeons to identify and address risk factors for postoperative wound events following VHR, the definition of these events lacks standardization. Therefore, the purpose of our study was to detail the variability of wound event definitions in recent ventral hernia literature and to propose standardized definitions for postoperative wound events following VHR...
February 10, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Benjamin K Poulose, DeAngelo A Harris, Sharon Phillips, Randy J Janczyk, Jonathan Yunis, Guy R Voeller, Alfredo Carbonell, Jeremy Warren, Nathaniel Stoikes, David Webb, William W Hope, Michael Rosen
BACKGROUND: Early readmission after ventral hernia repair (VHR) can hinder patient recovery and increase resource use. The objective of this study was to evaluate the effectiveness of the Americas Hernia Society Quality Collaborative (AHSQC) Early Readmission Reduction Initiative in reducing early readmissions after VHR. STUDY DESIGN: Risk factors for early readmission and best practices of surgeons with the lowest readmission rates after VHR were determined through collaborative learning...
February 8, 2018: Journal of the American College of Surgeons
Mohamed M Ibrahim, Luke P Poveromo, Richard R Glisson, Agustin Cornejo, Alfredo E Farjat, Ken Gall, Howard Levinson
PURPOSE: Approximately 348,000 ventral hernia repairs are performed annually in the United States and the incisional hernia recurrence rate is approximately 20% as a result of suture and mesh device failure. Device failure is related to changes at the suture/tissue interface that leads to acute or chronic suture pull-through and surgical failure. To better manage mechanical tension, we propose a modified mesh design with extensions and demonstrate its mechanical superiority. METHODS: Comparative uniaxial static tensile testing was conducted on polypropylene suture and a modified mesh...
February 2, 2018: Journal of Biomechanics
Leonard F Kroese, Jean-Francois Gillion, Johannes Jeekel, Gert-Jan Kleinrensink, Johan F Lange
BACKGROUND: Primary and incisional hernias are often pooled in publications studying hernia symptoms, treatment, or surgical outcomes. The question rises whether this is justified or if primary and incisional hernia should be considered as two separate entities. The aim of this prospective cohort study is to compare primary and incisional ventral hernias regarding patient characteristics, hernia characteristics, surgical characteristics, and postoperative complications. MATERIALS AND METHODS: A registry-based, prospective cohort study was performed...
January 26, 2018: International Journal of Surgery
Peter A Walker, Audriene C May, Jiandi Mo, Deepa V Cherla, Monica Rosales Santillan, Steven Kim, Heidi Ryan, Shinil K Shah, Erik B Wilson, Shawn Tsuda
BACKGROUND: The utilization of robotic platforms for general surgery procedures such as hernia repair is growing rapidly in the United States. A limited amount of data are available evaluating operative outcomes in comparison to standard laparoscopic surgery. We completed a retrospective review comparing robotic and laparoscopic ventral hernia repair to provide safety and outcomes data to help design a future prospective trial design. METHODS: A retrospective review of 215 patients undergoing ventral hernia repair (142 robotic and 73 laparoscopic) was completed at two large academic centers...
February 6, 2018: Surgical Endoscopy
Hisham Hussan, Emmanuel Ugbarugba, Michael T Bailey, Kyle Porter, Bradley Needleman, Sabrena Noria, Benjamin O'Donnell, Steven K Clinton
BACKGROUND AND AIMS: Clostridium difficile infection (CDI) is major health care concern with reports linking it to obesity. Our aim was to investigate the little known impact of the two most common bariatric surgeries, Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), on risk of CDI admissions. METHODS: This is a retrospective cohort study using the 2013 Nationwide Readmission Database. We examined inpatient CDI rates within 120 days after RYGB (n = 40,059) and VSG (n = 45,394)...
February 5, 2018: Obesity Surgery
Colin G DeLong, Justin A Doble, Amber L Schilling, Eric M Pauli, David I Soybel
BACKGROUND: After open complex ventral hernia repair (cVHR), chronic pain has a significant impact on quality of life and processes of care. METHODS: Records of 177 patients undergoing cVHR were reviewed in order to characterize the burden of managing postoperative pain in the first post-operative year following open cVHR. RESULTS: In this cohort, 91 patients initiated at least one unsolicited complaint of pain, though phone call (37), unscheduled clinic visit (45) or evaluation in the emergency room (9); among these an actionable diagnosis was found in 38 (41...
February 2, 2018: American Journal of Surgery
Tarkan Ünek, Selman Sökmen, Tufan Egeli, Vildan Avkan Oğuz, Hülya Ellidokuz, Funda Obuz
BACKGROUND: The repair of difficult abdominal wall defects (AWDs) continues to be a crucial and demanding issue for surgeons. This study aimed to present the risk factors and the long-term results of usage of an expanded-polytetrafluoroethylene (e-PTFE) synthetic mesh for the AWR of difficult abdominal wall defects. METHODS: This study included 156 adult patients who underwent difficult AWR with e-PTFE mesh for incisional hernia, ventral hernia, and created AWDs of various etiopathologies...
February 2, 2018: Asian Journal of Surgery
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