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Ventral hernia

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https://www.readbyqxmd.com/read/28214477/hospital-wide-porcine-mesh-conversion-results-in-cost-savings-with-equivalent-clinical-outcomes
#1
Nickolas Byrge, Mary C Mone, Daniel Vargo
BACKGROUND: A variety of biologic mesh is available for ventral hernia repair. Despite widely variable costs, there is no data comparing cost of material to clinical outcome. METHODS: Biologic mesh product change was examined. A prospective survey was done to determine appropriate biologic mesh utilization, followed by a retrospective chart review of those treated from Sept. 2012 to Aug. 2013 with Strattice™ and from Sept. 2013 to Aug. 2014 with Permacol™. Outcome variables included complications associated with each material, repair success, and cost difference over the two periods...
February 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28188621/the-analgesic-efficacy-of-pre-operative-bilateral-erector-spinae-plane-esp-blocks-in-patients-having-ventral-hernia-repair
#2
K J Chin, S Adhikary, N Sarwani, M Forero
Laparoscopic ventral hernia repair is an operation associated with significant postoperative pain, and regional anaesthetic techniques are of potential benefit. The erector spinae plane (ESP) block performed at the level of the T5 transverse process has recently been described for thoracic surgery, and we hypothesised that performing the ESP block at a lower vertebral level would provide effective abdominal analgesia. We performed pre-operative bilateral ESP blocks with 20-30 ml ropivacaine 0.5% at the level of the T7 transverse process in four patients undergoing laparoscopic ventral hernia repair...
February 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28187028/comparison-of-surgeon-specialty-in-open-ventral-hernia-repair
#3
Chris M Reid, Michael G Brandel, Amanda A Gosman
BACKGROUND: Ventral hernia repair is a common procedure and is undertaken by surgeons with varying training backgrounds. Outcomes after hernia repair depend on numerous factors, some being patient or surgeon specific. It remains unclear what the ideal roles are for general and plastic surgeons in open ventral hernia repair. We hypothesized that open ventral hernia repair by plastic surgeons is safe and comparable with general surgeons. METHODS: We performed a retrospective observational study using data from the National Surgical Quality Improvement Program database from 2007 to 2013...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28181089/ventral-hernia-repair-in-patients-with-abdominal-loss-of-domain-an-observational-study-of-one-institution-s-experience
#4
F K Azar, T C Crawford, K E Poruk, N Farrow, P Cornell, O Nadra, S C Azoury, K C Soares, C M Cooney, F E Eckhauser
PURPOSE: Abdominal wall hernias are a common problem. The success of abdominal wall reconstruction decreases with increasing hernia size. This study summarizes the outcomes of one surgeon's experience using a "sandwich" technique for hernia repair in patients with loss of abdominal domain. METHODS: We reviewed our ventral hernia repair (VHR) experience from 2008 to 2015 among patients with loss of domain, as defined by a hernia defect greater than 300 cm(2). The percent of herniation through the defect, defined by a hernia sac-to-abdominal cavity volume ratio, was measured on preoperative CT scans by four independent reviewers and averaged...
February 8, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28167228/comparison-of-conflict-of-interest-among-published-hernia-researchers-self-reported-to-the-centers-of-medicare-and-medicaid-services-open-payments-database
#5
Oscar A Olavarria, Julie L Holihan, Deepa Cherla, Cristina A Perez, Lillian S Kao, Tien C Ko, Mike K Liang
INTRODUCTION: Many healthcare providers have financial interests and relationships with healthcare companies. In order to maintain transparency, investigators are expected to disclose their conflicts of interest (COI). Recently, the Centers of Medicare and Medicaid Services (CMS) developed an open payment database of COI reported by industry. We hypothesize there is discordance between industry-reported and physician self-reported COI among ventral hernia publications. METHODS: PubMed was searched for ventral hernia studies accepted for publication between June 2013 and October 2015 and published by authors from the United States...
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28161483/onlay-with-adhesive-use-compared-to-sublay-mesh-placement-in-ventral-hernia-repair-was-chevrel-right-an-americas-hernia-society-quality-collaborative-analysis
#6
Ivy N Haskins, Guy R Voeller, Nathaniel F Stoikes, David L Webb, Robert G Chandler, Sharon Phillips, Benjamin K Poulose, Michael J Rosen
BACKGROUND: The use of mesh during ventral hernia repair (VHR) is a well-accepted concept. However, the ideal location of mesh placement remains heavily debated. While VHR with onlay mesh placement has been historically associated with a high rate of wound events, this surgical approach is technically less challenging than VHR with sublay mesh placement. The purpose of this study is to compare onlay mesh placement with adhesive fixation to sublay mesh placement 30-day wound events using the Americas Hernia Society Quality Collaborative (AHSQC) database...
February 1, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28132109/bridging-with-reduced-overlap-fixation-and-peritoneal-grip-can-prevent-slippage-of-dis-class-a-meshes
#7
F Kallinowski, F Harder, T G Silva, A Mahn, M Vollmer
PURPOSE: Ventral hernia repair can be performed safely using meshes which are primarily stable upon dynamic intermittent straining (DIS) at recommended overlap. In specific clinical situations, e.g., at bony edges, bridging of the hernial orifice with reduced overlap might be necessary. To gain insight into the durability of various applications, two different meshes with the best tissue grip known so far were assessed. METHODS: The model uses dynamic intermittent strain and comprises the repetition of submaximal impacts delivered via a hydraulically driven plastic containment...
January 28, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28125536/wound-morbidity-in-minimally-invasive-anterior-component-separation-compared-to-transversus-abdominis-release
#8
Brodie Parent, Dara Horn, Lauren Jacobson, Rebecca P Petersen, Marcelo Hinojosa, Robert Yates, Andrew S Wright, Otway Louie
BACKGROUND: Transversus abdominis release is a novel approach for myofascial advancement in ventral hernia repair and has been hypothesized to have lower rates of wound complication than anterior component separation. METHODS: Patients who had a ventral hernia repair with either transversus abdominis release or minimally invasive anterior component separation from January of 2010 to January of 2016 were enrolled in this retrospective cohort study. Patient characteristics were collected through chart review...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28088603/hospital-readmissions-after-surgery-how-important-are-hospital-and-specialty-factors
#9
Robert H Hollis, Laura A Graham, Joshua S Richman, Melanie S Morris, Hillary J Mull, Tyler S Wahl, Edith Burns, Laurel A Copeland, Gordon L Telford, Amy K Rosen, Kamal F Itani, Jeffrey Whittle, Todd H Wagner, Mary T Hawn
BACKGROUND: Hospital readmission rates after surgery may represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. STUDY DESIGN: For general, orthopedic, and vascular specialties at Veterans Affairs hospitals during 2008-2014, 30-day risk-adjusted readmission rates were estimated for six high-volume procedures and each specialty...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28079045/hernia-of-the-umbilical-cord-associated-with-a-patent-omphalomesenteric-duct
#10
M Raicevic, I Filipovic, S Sindjic-Antunovic
Congenital hernia of the cord is a different type of ventral abdominal wall defect in which the bowel usually herniates into the base of normally inserted umbilical cord through a patent umbilical ring. It is rare congenital anomaly with incidence of 1 in 5000. Although it was described as a distinct entity since 1920s it is often misdiagnosed as a small omphalocele. We present an unusal case of term male newborn with umbilical cord hernia associated with patent omphalomesenteric duct. The diagnose was made after birth despite antenatal ultrasound scans and it is managed successfully with uneventful recovery...
January 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28078462/assessment-of-predictive-factors-for-recurrence-in-laparoscopic-ventral-hernia-repair-using-a-bridging-technique
#11
P Hauters, J Desmet, D Gherardi, S Dewaele, H Poilvache, P Malvaux
AIM: To assess the long-term incidence and predictive factors for recurrence after laparoscopic ventral hernia repair using a bridging technique. METHODS: The study group consisted of 213 consecutive patients operated by laparoscopy for primary ventral (n = 158) or incisional hernia (n = 55) between 2001 and 2014. Patients had a repair without fascia closure by intra-peritoneal onlay placement of a Parietex(®) composite mesh centred on the defect with an overlap of at least 3 cm...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28076885/cross-linking-of-porcine-acellular-dermal-matrices-negatively-affects-induced-neovessel-formation-using-platelet-rich-plasma-in-a-rat-model-of-hernia-repair
#12
Joseph S Fernandez-Moure, Jeffrey L Van Eps, Leif Peterson, Beverly A Shirkey, Zachary K Menn, Fernando Cabrera, Azim Karim, Ennio Tasciotti, Bradley K Weiner, Warren A Ellsworth
The degree of crosslinking within acellular dermal matrices (ADM) seems to correlate to neovascularization when used in ventral hernia repair (VHR). Platelet-rich plasma (PRP) enhances wound healing through several mechanisms including neovascularization, but research regarding its effect on soft tissue healing in VHR is lacking. We sought to study the effect of crosslinking on PRP-induced neovascularization in a rodent model of bridging VHR. We hypothesized that ADM crosslinking would negatively affect PRP-induced neovessel formation...
January 11, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28072903/laparoscopic-treatment-of-giant-ventral-hernia-experience-of-35-patients
#13
Michele Grande, Giorgio Lisi, Michela Campanelli, Simona Grande, Dario Venditti, Casimiro Nigro, Francesca Cabry, Massimo Villa
BACKGROUND: Minimal access surgery for incisional hernia repair is still debated, especially for giant wall defects. Laparoscopic repair may reduce pain and hospital stay. This study was designed to evaluate the feasibility of the laparoscopic technique in giant hernia. MATERIALS AND METHODS: From 2007 to 2013, 35 consecutive patients with giant ventral hernia, according to the Chevrel classification, underwent laparoscopic repair. Fourteen patients were obese, with a body mass index (BMI) > 30 and in 21 patients the mean BMI was 24 (range 22-28)...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#14
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
January 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28050665/a-prospective-assessment-of-clinical-and-patient-reported-outcomes-of-initial-non-operative-management-of-ventral-hernias
#15
Julie L Holihan, Juan R Flores-Gonzalez, Jiandi Mo, Tien C Ko, Lillian S Kao, Mike K Liang
BACKGROUND: Little is known about the clinical or patient-reported outcomes with non-operative management of ventral hernias. The aim of this prospective study is to determine the clinical and patient-reported outcomes of patients undergoing initial non-operative treatment of their ventral hernia. STUDY DESIGN: This was a prospective observational study of patients undergoing non-operative management of ventral hernias. Primary outcome was rate of surgical repair of the ventral hernias...
January 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28046723/su-f-t-27-a-comparative-case-study-among-four-modalities-for-the-superficial-treatment-of-squamous-cell-carcinoma
#16
M Ashenafi, N Koch, J Peng, L Terwillinger, J Wilder, D McDonald, C Mart, J Jenrette, K Vanek
PURPOSE: We performed a comparative planning study among High Dose Rate (HDR) brachytherapy, superficial electrons, Volume Modulated Arc Therapy (VMAT), and Helical IMRT (Tomotherapy) for squamous cell carcinoma of the abdominal wall with consideration for the underlining bowel. METHODS: A 69-year old female presented with squamous cell carcinoma protruding 8mm beyond the anterior skin surface of the midabdomen was considered for treatment. The patient had a ventral hernia which resulted in the reduction of the abdominal wall thickness and the adjacent small bowel being the dose limiting structure...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28044960/transversus-abdominis-muscle-release-tar-for-large-incisional-hernia-repair
#17
Valentin Oprea, Victor Gheorghe Radu, Doru Moga
: Background: complex ventral hernia repair is a frequent and challenging topic. Reconstructive techniques are numerous but most of them are unable to achieve the goals of hernioplasty. Posterior component separation with transverses abdominis muscle release (TAR) is a novel approach that offers a solution for complex ventral hernias. METHOD: The posterior rectus sheath is incised and the retrorectus plane is developed. In a modification of the Rives-Stoppa technique, the transversus abdominis is released medial to the linea semilunaris to expose a broad plane that extends from the central tendon of the diaphragm superiorly, to the space of Retzius inferiorly, and laterally to the retro-peritoneum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28039655/the-effect-of-component-separation-technique-on-quality-of-life-qol-and-surgical-outcomes-in-complex-open-ventral-hernia-repair-ovhr
#18
Laurel J Blair, Tiffany C Cox, Ciara R Huntington, Steven A Groene, Tanushree Prasad, Amy E Lincourt, Kent W Kercher, B Todd Heniford, Vedra A Augenstein
INTRODUCTION: Outcomes following OVHR may be affected by type of component separation. In this study, outcomes including QOL of patients undergoing OVHR were evaluated based on the utilization of transversus abdominis release (TAR), posterior rectus sheath release (PRSR) alone or in combination with external oblique release (EOR + PRSR). METHODS: A prospective, single-institution study following open ventral hernia repair involving component separation was performed from May 2005 to April 2015...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28039640/hands-on-2-0-improving-transfer-of-training-via-the-society-of-american-gastrointestinal-and-endoscopic-surgeons-sages-acquisition-of-data-for-outcomes-and-procedure-transfer-adopt-program
#19
Jonathan Dort, Amber Trickey, John Paige, Erin Schwarz, Brian Dunkin
BACKGROUND: Practicing surgeons commonly learn new procedures and techniques by attending a "hands-on" course, though trainings are often ineffective at promoting subsequent procedure adoption in practice. We describe implementation of a new program with the SAGES All Things Hernia Hands-On Course, Acquisition of Data for Outcomes and Procedure Transfer (ADOPT), which employs standardized, proven teaching techniques, and 1-year mentorship. Attendee confidence and procedure adoption are compared between standard and ADOPT programs...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28038715/research-residents-perceptions-of-skill-decay-effects-of-repeated-skills-assessments-and-scenario-difficulty
#20
Grace F Jones, Katherine Forsyth, Caitlin G Jenewein, Rebecca D Ray, Shannon DiMarco, Carla M Pugh
INTRODUCTION: Skills decay is a known risk for surgical residents who have dedicated research time. We hypothesize that simulation-based assessments will reveal significant differences in perceived skill decay when assessing a variety of clinical scenarios in a longitudinal fashion. METHODS: Residents (N = 46; Returning: n = 16, New: n = 30) completed four simulated procedures: urinary catheterization, central line, bowel anastomosis, and laparoscopic ventral hernia repair...
December 11, 2016: American Journal of Surgery
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