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Ventral hernia

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https://www.readbyqxmd.com/read/29227530/systematic-review-and-network-meta-analysis-of-methods-of-mesh-fixation-during-laparoscopic-ventral-hernia-repair
#1
REVIEW
J J Baker, S Öberg, K Andresen, T W Klausen, J Rosenberg
BACKGROUND: Ventral hernia repairs are common and have high recurrence rates. They are usually repaired laparoscopically with an intraperitoneal mesh, which can be fixed in various ways. The aim was to evaluate the recurrence rates for the different fixation techniques. METHODS: This systematic review included studies with human adults with a ventral hernia repaired with an intraperitoneal onlay mesh. The outcome was recurrence at least 6 months after operation...
December 11, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29226882/concomitant-intraperitoneal-onlay-mesh-repair-with-endoscopic-component-separation-and-sleeve-gastrectomy
#2
P Praveen Raj, Siddhartha Bhattacharya, S Saravana Kumar, R Parthasarathi, C Palanivelu
Bariatric surgery can be safely combined with laparoscopic intraperitoneal onlay mesh (IPOM) repair. In case of large ventral hernias, laparoendoscopic component separation can also be combined to achieve tension-free closure of the defect. Concomitant bariatric surgery and hernia repair also offer the additional benefit of reduction in recurrence of hernias as obesity, one of the risk factors, is treated in the process. We present a case of 60-year-old man with a body mass index of 45.3 kg/m2 with a large recurrent ventral hernia...
December 11, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29226880/sewing-machine-technique-for-laparoscopic-mesh-fixation-in-intra-peritoneal-on-lay-mesh
#3
Khojasteh Sam Dastoor, Kaiomarz P Balsara, Asif Y Gazi
INTRODUCTION: Mesh fixation in laparoscopic ventral hernia is accomplished using tacks or tacks with transfascial sutures. This is a painful operation and the pain is believed to be more due to transfascial sutures. We describe a method of transfascial suturing which fixes the mesh securely and probably causes less pain. METHOD: Up to six ports may be necessary, three on each side. A suitable-sized mesh is used and fixed with tacks all around. A 20G spinal needle is passed from the skin through one corner of the mesh...
December 11, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29224911/the-hands-and-head-of-a-surgeon-modeling-operative-competency-with-multimodal-epistemic-network-analysis
#4
A R Ruis, Alexandra A Rosser, Cheyenne Quandt-Walle, Jay N Nathwani, David Williamson Shaffer, Carla M Pugh
BACKGROUND: This paper explores a method for assessing intraoperative performance by modeling how surgeons integrate psychomotor, procedural, and cognitive skills to manage errors. METHODS: Audio-video data were collected from general surgery residents (N = 45) performing a simulated laparoscopic ventral hernia repair. Errors were identified using a standard checklist, and speech was coded for elements related to error recognition and management. Epistemic network analysis (ENA) was used to model the integration of error management skills...
December 2, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29214543/comparison-of-biological-and-alloplastic-meshes-in-ventral-incisional-hernia-repair
#5
A Koscielny, S Widenmayer, T May, J Kalff, P Lingohr
PURPOSE: The aim of our retrospective analysis was to compare the results of incisional hernia repair by porcine small intestinal submucosa-derived (SIS) meshes with those obtained by alloplastic polypropylene-based (PP) meshes in comparable surgical indications by matched-pair design. We hypothesized that in incisional hernia, SIS mesh repair is associated with fewer recurrences and SSO than PP mesh repair in incisional hernias. METHODS: Twenty-four matched pairs (SIS vs...
December 6, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29198638/guideline-for-discharge-opioid-prescriptions-after-inpatient-general-surgical-procedures
#6
Maureen V Hill, Ryland S Stucke, Sarah E Billmeier, Julia L Kelly, Richard J Barth
BACKGROUND: There is a paucity of data to inform appropriate opioid prescribing for patients who are discharged after a hospital admission for a surgical procedure. STUDY DESIGN: We studied 333 inpatients discharged to home after bariatric, benign foregut, liver, pancreas, ventral hernia, and colon surgery. Chronic opioid users or patients who had complications were excluded. Home opioid usage was quantified in 90% of the remaining patients by questionnaires and phone surveys...
November 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29195912/procedure-specific-trends-in-surgical-outcomes
#7
Jason B Liu, Julia R Berian, Yaoming Liu, Mark E Cohen, Clifford Y Ko, Bruce L Hall
BACKGROUND: Quality improvement efforts have generally focused on hospital benchmarking, and processes and outcomes shared among all operations. However, quality improvement could be inconsistent across different types of operations. The objective of this study was to identify operations needing additional concerted quality improvement efforts by examining their outcomes trends. STUDY DESIGN: Ten procedures (colectomy, esophagectomy, hepatectomy, hysterectomy, pancreatectomy, proctectomy, total hip arthroplasty, total knee arthroplasty, thyroidectomy, and ventral hernia repair) commonly accrued into the American College of Surgeons NSQIP between 2008 and 2015 were included...
November 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29194083/management-of-reducible-ventral-hernias-clinical-outcomes-and-cost-effectiveness-of-repair-at-diagnosis-versus-watchful-waiting
#8
Lindsey L Wolf, Julius I Ejiofor, Ye Wang, Myriam G Hunink, Elena Losina, Adil H Haider, Douglas S Smink
OBJECTIVE: To compare long-term clinical and economic outcomes associated with 3 management strategies for reducible ventral hernia: repair at diagnosis (open or laparoscopic) and watchful waiting. BACKGROUND: There is variability in ventral hernia management. Recent data suggest watchful waiting is safe; however, long-term clinical and economic outcomes for different management strategies remain unknown. METHODS: We built a state-transition microsimulation model to forecast outcomes for individuals with reducible ventral hernia, simulating a cohort of 1 million individuals for each strategy...
November 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29187125/nitro-oleic-acid-no2oa-release-enhances-regional-angiogenesis-in-a-rat-abdominal-wall-defect-model
#9
Antonio D'Amore, Marco Fazzari, Hongbin Jiang, Samuel K Luketich, Michael E Luketich, Richard F Hoff, Daniel L Jacobs, Xinzhu Gu, Stephen F Badylak, Bruce A Freeman, William R Wagner
Ventral hernia is often addressed surgically by the placement of prosthetic materials, either synthetic or from allogeneic and xenogeneic biologic sources. Despite advances in surgical approaches and device design, a number of postsurgical limitations remain, including hernia recurrence, mesh encapsulation, and reduced vascularity of the implanted volume. The in situ controlled release of angiogenic factors from a scaffold facilitating abdominal wall repair might address some of these issues associated with sub-optimal tissue reconstruction...
November 29, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29183531/patterns-of-recurrence-and-mechanisms-of-failure-after-open-ventral-hernia-repair-with-mesh
#10
COMPARATIVE STUDY
Jeremy A Warren, Sean P McGrath, Allyson L Hale, Joseph A Ewing, Alfredo M Carbonell, William S Cobb
Recurrence after ventral hernia repair (VHR) remains a significant complication. We sought to identify the technical aspects of VHR associated with recurrence. Patients who underwent open midline VHR between 2006 and 2013 (n = 261) were retrospectively evaluated. Patients with recurrence (Group 1, n = 48) were compared with those without recurrence (Group 2, n = 213). Smoking, diabetes, and body mass index were not different between groups. More patients in Group 1 underwent clean-contaminated, contaminated, or dirty procedures (43...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29169820/robotic-and-hybrid-robotic-transversus-abdominis-release-may-be-performed-with-low-length-of-stay-and-wound-morbidity
#11
Joshua T Halka, Andrew Vasyluk, Alexander M DeMare, Randy J Janczyk, Anthony A Iacco
The objective of our study was to compare length of stay and wound complications after hybrid robotic transversus abdominis release (hrTAR) vs. robotic transversus abdominis release (rTAR) Two cohorts of patients undergoing robotic (rTAR) and hybrid robotic (hrTAR) performed by two surgeons at a single institution were analyzed. Mean length of stay (LOS) and incidence of surgical site occurrences (SSO) were compared. 57 patients undergoing rTAR and 25 patients undergoing hrTAR were analyzed. The hrTAR group had larger mean hernia dimensions and a larger proportion of men but otherwise the patient cohorts were similar...
November 13, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29159208/a-rare-presentation-of-spigelian-hernia-involving-the-appendix
#12
Ling Xu, Gurjeet Dulku, Richard Ho
Spigelian hernia (SH) is a rare entity accounting for 1-2% of ventral abdominal wall hernias. Elusive clinical signs and symptoms pose a diagnostic challenge and a consequent risk of strangulation. We present an emergent case of a Spigelian hernia involving the appendix.
2017: European Journal of Radiology Open
https://www.readbyqxmd.com/read/29152282/incarcerated-giant-uterine-leiomyoma-within-an-incisional-hernia-a-case-report
#13
Georgios Exarchos, Nikolaos Vlahos, Dionysios Dellaportas, Linda Metaxa, Theodosios Theodosopoulos
Uterine leiomyomas presenting as incarcerated or strangulated hernias in surgical emergencies are extremely rare and should be considered in the differential diagnosis in patients with known uterine fibroids and an irreducible ventral abdominal wall hernia. Detailed history and multidisciplinary approach optimize the diagnosis and decision making toward surgical treatment.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29151228/previously-implanted-intra-peritoneal-mesh-increases-morbidity-during-re-laparoscopy-a-retrospective-case-matched-cohort-study
#14
A Sharma, P Chowbey, N S Kantharia, M Baijal, V Soni, R Khullar
PURPOSE: Laparoscopic ventral hernia repair (LVHR) with intra-peritoneal mesh placement is standard surgical treatment of abdominal wall hernias. During laparoscopic re-intervention, we examined adhesions that develop after previous intra-peritoneal mesh placement and ascertained morbidity and risk of adverse events. METHODS: This is a retrospective, case-matched comparison of three patient groups-previous intra-peritoneal mesh (Group A), previous abdominal surgery (Group B) and no previous abdominal surgery (Group C)...
November 18, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29122528/safety-of-open-ventral-hernia-repair-in-high-risk-patients-with-metabolic-syndrome-a-multi-institutional-analysis-of-39-118-cases
#15
Dmitry Zavlin, Kevin T Jubbal, Jeffrey L Van Eps, Barbara L Bass, Warren A Ellsworth, Anthony Echo, Jeffrey D Friedman, Brian J Dunkin
BACKGROUND: Metabolic syndrome (MetS) entails the simultaneous presence of a constellation of dangerous risk factors including obesity, diabetes, hypertension, and dyslipidemia. The prevalence of MetS in Western society continues to rise and implies an elevated risk for surgical complications and/or poor surgical outcomes within the affected population. OBJECTIVE: To assess the risks and outcomes of multi-morbid patients with MetS undergoing open ventral hernia repair...
September 22, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29112002/surveillance-of-surgical-meshes-in-ventral-hernias-and-unpredictability-of-the-their-history
#16
Francesco Gossetti, Linda D'Amore, Francesca Ceci, Maria Romana Grimaldi, Paolo Negro
: The authors read the article "The importance of registries in the postmarketing surveillance of surgical meshes" by Kockerling et al, and they completely agree on the role of a clinical follow-up of surgical meshes even if they suggest that a surveillance longer than one year is advisable, particularly in IPOM repair, to collect not only late complications but also more serious adverse events. This seems be the only way to properly assess the safety of the mesh.
November 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29101640/computational-modeling-of-abdominal-hernia-laparoscopic-repair-with-a-surgical-mesh
#17
Silvia Todros, Paola Pachera, Nicola Baldan, Piero G Pavan, Silvia Pianigiani, Stefano Merigliano, Arturo N Natali
PURPOSE: Although new techniques and prostheses have been introduced in ventral hernia surgery, abdominal hernia repair still presents complications, such as recurrence, pain, and discomfort. Thus, this work implements a computational method aimed at evaluating biomechanical aspects of the abdominal hernia laparoscopic repair, which can support clinical research tailored to hernia surgery. METHODS: A virtual solid model of the abdominal wall is obtained from MRI scans of a healthy subject...
November 3, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29090265/postoperative-analgesic-efficiency-of-transversus-abdominis-plane-block-after-ventral-hernia-repair-a-prospective-randomized-controlled-clinical-trial
#18
Ion Chesov, Adrian Belîi
BACKGROUND AND AIMS: Effective postoperative analgesia is a key element in reducing postoperative morbidity, accelerating recovery and avoiding chronic postoperative pain. The aim of this study was to evaluate the effectiveness of ultrasound-guided Transversus Abdominis Plane (TAP) block, performed before surgical incision, in providing postoperative analgesia for patients undergoing open ventral hernia repair under general anaesthesia. METHODS: Seventy elective patients scheduled for open ventral hernia repair surgery under general anaesthesia were divided randomly into two equal groups: Group I received bilateral TAP block performed before surgical incision (n = 35); Group II received systemic postoperative analgesia with parenteral opioid (morphine) alone (n = 35)...
October 2017: Romanian journal of anaesthesia and intensive care
https://www.readbyqxmd.com/read/29081901/role-of-reduced-size-liver-bowel-grafts-in-the-abdominal-wall-transplantation-era
#19
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/29078909/infection-prevention-using-affinity-polymer-coated-synthetic-meshes-in-a-pig-hernia-model
#20
Jeffrey A Blatnik, Thimma R Thatiparti, David M Krpata, Sean T Zuckerman, Michael J Rosen, Horst A von Recum
BACKGROUND: Given concern for hernia mesh infection, surgeons often use biologic mesh which may provide reduced risk of infection but at the cost of decreased repair durability. We evaluated mesh coating to provide sustained release of antibiotics to prevent prosthetic mesh infection and also allow a durable repair. MATERIALS AND METHODS: Cyclodextrin-based polymer was crosslinked onto multifilament polyester mesh and loaded with vancomycin (1.75 mg/cm(2)). Pigs received modified meshes (n = 6) or normal, untreated meshes (n = 4), which were implanted into acute 10 × 5 cm ventral hernia, then directly inoculated with 10(6) colony-forming unit (CFU) of methicillin-resistant Staphylococcus aureus (MRSA)...
November 2017: Journal of Surgical Research
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