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laparoscopic ventral hernia repair

John C Kubasiak, Mackenzie Landin, Scott Schimpke, Jennifer Poirier, Jonathan A Myers, Keith W Millikan, Minh B Luu
INTRODUCTION: Tobacco smoking is a known risk factor for complications after major surgical procedures. The full effect of tobacco use on these complications has not been studied over large populations for ventral hernia repairs. This effect is more important as the preoperative conditioning, and optimization of patients is adopted. We sought to use the prospectively collected ACS-NSQIP dataset to evaluate respiratory and infectious complications for patients undergoing both laparoscopic and open ventral hernia repairs...
October 17, 2016: Surgical Endoscopy
Alexandra M Moore, Lisa N Anderson, David C Chen
INTRODUCTION: Minimally invasive laparoscopic and robotic techniques for ventral hernia repair have evolved to achieve the benefits and minimize the limitations of both the open Rives-Stoppa sublay mesh repair and laparoscopic intraperitoneal onlay mesh (IPOM) repair. By combining the principles of a retromuscular repair with the benefits of a minimally invasive approach, these techniques attempt to decrease recurrence, increase functionality, exclude mesh from the viscera, limit infection and wound complications, and minimize pain...
October 6, 2016: Surgical Technology International
Bruce Ramshaw, Brandie Forman, Eric Heidel, Jonathan Dean, Andrew Gamenthaler, Michael Fabian
Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months). Initiatives for improved patient outcomes during this period included the administration of a transversus abdominis plane (TAP) block and/or an intra-operative block with long-acting local anesthetic first, and then a low pressure pneumoperitoneum (LPP) system was implemented later in the project...
October 6, 2016: Surgical Technology International
Kristy Kummerow Broman, Li-Ching Huang, Adil Faqih, Sharon E Phillips, Rebeccah B Baucom, Richard A Pierce, Michael D Holzman, Kenneth W Sharp, Benjamin K Poulose
BACKGROUND: Ventral hernia repair with mesh is increasingly common, but the incidence of long term complications that necessitate mesh explantation is unknown. We aimed to determine the epidemiology of mesh explantation after ventral hernia repair and to compare this with common bile duct injury, a dreaded complication of laparoscopic cholecystectomy. STUDY DESIGN: We evaluated a retrospective cohort of patients undergoing ventral hernia repair by linking the all-payers State Inpatient Databases and State Ambulatory Surgery Databases for NY, CA, and FL...
October 7, 2016: Journal of the American College of Surgeons
Shimpei Matsui, Nobuhiro Nitori, Ayu Kato, Yoshifumi Ikeda, Yuko Kiatagwa, Hirotoshi Hasegawa, Koji Okabayashi, Masashi Tsuruta, Masaki Kitajima
INTRODUCTION: Spigelian hernia (SH) is a rare ventral hernia occurring near the lateral border of the rectus muscle. The treatment remains controversial and depends on institutional expertise. Although laparoscopic surgery is a good adaptation for the repair of ventral hernias, only a few cases have been reported in the literature. Here, we report a case of totally extra-peritoneal (TEP) repair for bilateral SHs. PRESENTATION OF CASE: A 74-year-old Japanese man presented with asymptomatic bulges in the right lower abdominal quadrant...
September 30, 2016: International Journal of Surgery Case Reports
Rodolfo J Oviedo, Jarrod C Robertson, Sharifah Alrajhi
BACKGROUND AND OBJECTIVES: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. METHODS: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
A Tandon, K Shahzad, S Pathak, C M Oommen, Q M Nunes, N Smart
INTRODUCTION Laparoscopic incisional and ventral hernia repair (LIVHR) is widely accepted and safe but the type of mesh used is still debated. We retrospectively compared postoperative outcomes with two different meshes commonly used in LIVHR. METHODS This is a retrospective study of patients who underwent incisional hernia repair between January 2008 and December 2010. Two meshes were used: Parietex™ Composite (Covidien, New Haven, CT, USA) and the DynaMesh(®)-IPOM (FEG Textiltechnik mbH, Aachen, Germany)...
September 23, 2016: Annals of the Royal College of Surgeons of England
Katherine E Law, Caitlin G Jenewein, Samantha J Gannon, Shannon M DiMarco, Lakita J Maulson, Shlomi Laufer, Carla M Pugh
BACKGROUND: The study aim was to identify residents' coordination between dominant and nondominant hands while grasping for sutures in a laparoscopic ventral hernia repair procedure simulation. We hypothesize residents will rely on their dominant and nondominant hands unequally while grasping for suture. METHODS: Surgical residents had 15 min to complete the mesh securing and mesh tacking steps of a laparoscopic ventral hernia repair procedure. Procedure videos were coded for manual coordination events during the active suture grasping phase...
September 2016: Journal of Surgical Research
Katherine E Law, Eran C Gwillim, Rebecca D Ray, Anne-Lise D D'Angelo, Elaine R Cohen, Rebekah M Fiers, Drew N Rutherford, Carla M Pugh
BACKGROUND: The study investigates the relationship between motor coordination errors and total errors using a human factors framework. We hypothesize motor coordination errors will correlate with total errors and provide validity evidence for error tolerance as a performance metric. METHODS: Residents' laparoscopic skills were evaluated during a simulated laparoscopic ventral hernia repair for motor coordination errors when grasping for intra-abdominal mesh or suture...
October 2016: American Journal of Surgery
A Tandon, S Pathak, N J R Lyons, Q M Nunes, I R Daniels, N J Smart
BACKGROUND: Laparoscopic incisional and ventral hernia repair (LIVHR) is being used increasingly, with reported outcomes equivalent to those of open hernia repair. Closure of the fascial defect (CFD) is a technique that may reduce seroma formation and bulging after LIVHR. Non-closure of the fascial defect makes the repair of larger defects easier and reduces postoperative pain. The aim of this systematic review was to determine whether CFD affects the rate of adverse outcomes, such as recurrence, pseudo-recurrence, mesh eventration or bulging, and the rate of seroma formation...
August 22, 2016: British Journal of Surgery
S Harsløf, N Zinther, T Harsløf, C Danielsen, P Wara, H Friis-Andersen
PURPOSE: The choice of mesh and anchoring device in laparoscopic ventral hernia repair is controversial. Clinically important long-term properties of mesh and anchoring device such as mesh shrinkage have been sparsely investigated. Furthermore, the effect of various anchoring devices on mesh properties has never been examined. METHODS: In 20 sheep, using laparoscopy, we inserted three PhysiomeshTM (large pore, lightweight) and three VentralightTMST (small pore, mediumweight), anchored with ProTackTM, SecurestrapTM or GlubranTM, respectively...
August 11, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Anthony Gonzalez, Ernesto Escobar, Rey Romero, Gail Walker, Jacqueline Mejias, Michelle Gallas, Eugene Dickens, Christopher J Johnson, Jorge Rabaza, Omar Yusef Kudsi
BACKGROUND: The open approach continues to be widely performed for ventral hernia repair, while the minimally invasive laparoscopic approach has grown adoption over the last decade. Recently, robotic operation was described as a new modality due to the ease for performing intracorporeal closure of the hernia defect. This study is one of the first multi-institutional case series evaluating robotic-assisted laparoscopic ventral hernia repairs, with the goal of describing robotic-assisted surgical techniques for ventral and incisional hernia repair and the outcomes in teaching and community hospital settings...
August 5, 2016: Surgical Endoscopy
G Sharma, M Boules, S Punchai, A Strong, D Fryolich, N H Zubaidah, C O'Rourke, S A Brethauer, J Rodriguez, K El-Hayek, M Kroh
BACKGROUND: Currently there is no consensus on management of ventral hernias encountered during bariatric surgery (BS). This study aims to evaluate the incidence and outcomes of concomitant ventral hernia repair (VHR) during BS at our institution. METHODS: Patients who had concomitant VHR during BS from 2004 to 2015 were identified. Data collected included baseline demographics, comorbidities, perioperative parameters, surgical approach and postoperative outcomes...
August 5, 2016: Surgical Endoscopy
Henry Mercoli, Stylianos Tzedakis, Antonio D'Urso, Marius Nedelcu, Riccardo Memeo, Nicolas Meyer, Michel Vix, Silvana Perretta, Didier Mutter
BACKGROUND: Laparoscopic ventral hernia repair (LVHR) has become widely used. This study evaluates outcomes of LVHR, with particular reference to complications, seromas, and long-term recurrence. METHODS: A review of a prospective database of consecutive patients undergoing LVHR with intraperitoneal onlay mesh (IPOM) was performed at a single institution. Patient's characteristics, surgical procedures, and postoperative outcomes were analyzed and related to long-term recurrence...
August 5, 2016: Surgical Endoscopy
Ross O Downes
INTRODUCTION: The consensus about whether the single port approach is advantageous remains controversial. As the ambulatory service becomes the standard of care, techniques are in evolution to augment the patient experience in this setting. This forms the basis for evaluating SILS (Single Incision Laparoscopic Surgery) prosthetic ventral hernia repair in the ambulatory setting. We report a SILS technique of ventral hernia repair using the Stryker Ideal-eyes articulating laparoscope and standard laparoscopic instruments in the day-case setting...
2016: International Journal of Surgery Case Reports
David J Berler, Thomas Cook, Karl LeBlanc, Brian P Jacob
Laparoscopic ventral hernia repair (LVHR) remains a safe, reproducible, and popular method employed by surgeons to repair abdominal wall hernias. Patient selection, operative technique, instrumentation, and implant choice all remain surgeon dependent. Inherent in the technique is the option of using mesh. The decision of where to place the mesh and how to optimally fixate the mesh in the onlay, sublay, or intraabdominal positions also remain surgeon dependent and has been the subject of ongoing debates for the past two decades...
July 29, 2016: Surgical Technology International
Y Julia Chen, Desmond Huynh, Scott Nguyen, Edward Chin, Celia Divino, Linda Zhang
INTRODUCTION: The aim of the study is to investigate the outcomes of the da Vinci robot-assisted laparoscopic hernia repair of small-sized ventral hernias with circumferential suturing of the mesh compared to the traditional laparoscopic repair with trans-fascial suturing. METHODS: A retrospective review was conducted of all robot-assisted umbilical, epigastric and incisional hernia repairs performed at our institution between 2013 and 2015 compared to laparoscopic umbilical or epigastric hernia repairs...
July 22, 2016: Surgical Endoscopy
Juan Antonio Bellido Luque, Araceli Bellido Luque, Julio Gomez Menchero, Juan Manuel Suarez Grau, Joaquin García Moreno, Antonio Tejada Gomez, Juan Guadalajara Jurado
BACKGROUND: Laparoscopic ventral or incisional hernia repair requires intraperitoneal mesh placement. This is associated with an increase in adhesions, bowel obstruction and enterocutaneous fistula. Intraabdominal meshes are laparoscopically fixed using traumatic fixation methods that increase acute, chronic pain and adhesions to bowel loops. The aim was to check the safety and effectiveness of the laparoscopic approach in ventral or incisional hernia, using a self-adhesive mesh in the preperitoneal space without tacks or transfascial sutures, and to objectively assess its benefits and complications...
July 21, 2016: Surgical Endoscopy
H Le Gall, N Reibel, A De Runz, J Epstein, M Brix
INTRODUCTION: Abdominoplasty procedures sometimes reveal the presence of ventral hernias (umbilical or trocar-site hernias). Our objective is then to deal with the excess abdominal skin and fat tissue at the same time as the ventral hernia. This can be done with a single surgical procedure combining abdominoplasty with umbilical transposition and laparoscopic ventral hernia repair (LVHR) with mesh. The main objective of our study is to assess the outcome of the combined procedure of abdominoplasty and LVHR with mesh, compared to abdominoplasty alone...
July 14, 2016: Annales de Chirurgie Plastique et Esthétique
Jeroen Van Besien, Casper Sommeling, Koen Vindevoghel
Central mesh failure after laparoscopic repair of a ventral hernia is a rare finding. We present a case of a 42-year-old man with clear umbilical hernia recurrence 4 years after IPOM procedure with an oxidized cellulose composite polypropylene mesh, using the double crown technique. Laparoscopy showed that a segment of small intestine herniated through a central defect in the prosthesis. A primary repair of the umbilical hernia recurrence was performed through a small transverse infraumbilical incision suturing both the fascia and mesh with interrupted non-resorbable monofilament sutures...
May 26, 2016: Acta Chirurgica Belgica
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