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Component separation hernia

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https://www.readbyqxmd.com/read/29349616/outcomes-of-utilizing-absorbable-mesh-as-an-adjunct-to-posterior-sheath-closure-during-complex-posterior-component-separation
#1
J S Winder, A Majumder, M Fayezizadeh, Y W Novitsky, E M Pauli
BACKGROUND: A minority of patients undergoing posterior component separation (PCS) have abdominal wall defects that preclude complete reconstruction of the visceral sac with native tissue. The use of absorbable mesh bridges (AMB) to span such defects has not been established. We hypothesized that AMB use during posterior sheath closure of PCS is safe and provides favorable outcomes. METHODS: We performed a retrospective review of consecutive patients undergoing PCS with AMB at two hernia centers...
January 18, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29344785/laparoscopic-intracorporeal-rectus-aponeuroplasty-lira-technique-a-step-forward-in-minimally-invasive-abdominal-wall-reconstruction-for-ventral-hernia-repair-lvhr
#2
Julio Gómez-Menchero, Juan Francisco Guadalajara Jurado, Juan Manuel Suárez Grau, Juan Antonio Bellido Luque, Joaquin Luis García Moreno, Isaías Alarcón Del Agua, Salvador Morales-Conde
BACKGROUND: Closing the defect (CD) during laparoscopic ventral hernia repair began to be performed in order to decrease seroma, to improve the functionality of the abdominal wall, and to decrease the bulging effect. However, tension at the incision after CD in large defects is related to an increased rate of pain and recurrence. We present the preliminary results of a new technique for medium midline hernias as an alternative to conventional CD. METHODS: A prospective controlled study was conducted from January 2015 to January 2017 to evaluate an elective new procedure (LIRA) performed on patients with midline ventral hernias (4-10 cm width)...
January 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29258479/surgical-treatment-strategies-for-giant-inguinoscrotal-hernia-a-case-report-with-review-of-the-literature
#3
Julia Isabelle Staubitz, Peter Gassmann, Daniel Wilhelm Kauff, Hauke Lang
BACKGROUND: An inguinoscrotal hernia is defined as "giant" if descending below the midpoint of the inner thigh of a patient in upright position. In developed countries this is a rare entity. In the literature different surgical techniques have been reported so far to achieve a successful treatment. CASE PRESENTATION: We present the case of a 63 year-old man suffering from a giant inguinoscrotal hernia, whom we treated using a combined open transabdominal and inguinal approach following an unsuccessful laparoscopic attempt...
December 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29226882/concomitant-intraperitoneal-onlay-mesh-repair-with-endoscopic-component-separation-and-sleeve-gastrectomy
#4
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/29203187/paratesticular-liposarcoma-masquerading-as-an-inguinal-hernia
#5
Kerry L Thomas, Ricardo J Gonzalez, Evita Henderson-Jackson, Jamie T Caracciolo
A man with left scrotal swelling felt to represent inguinal hernia underwent CT scan for reported bleeding after prostate biopsy. CT scan revealed a 15 cm extratesticular left scrotal mass containing both fat and soft tissue components, raising concern for dedifferentiated liposarcoma. At surgery and pathology, the mass was separate from the left testis, epididymis, and spermatic cord. Histopathologic findings were consistent with paratesticular dedifferentiated liposarcoma.
December 1, 2017: Urology
https://www.readbyqxmd.com/read/29183531/patterns-of-recurrence-and-mechanisms-of-failure-after-open-ventral-hernia-repair-with-mesh
#6
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/29164131/continuous-laparoscopic-closure-of-the-linea-alba-with-barbed-sutures-combined-with-laparoscopic-mesh-implantation-ipom-plus-repair-as-a-new-technique-for-treatment-of-abdominal-hernias
#7
Reiko Wiessner, Thomas Vorwerk, Claudia Tolla-Jensen, Alexander Gehring
Despite extensive experience and significant reduction of complications in recent years, laparoscopic treatment of complex abdominal hernias is a challenge even for the experienced endoscopic surgeon. Patients with severe incisional hernias or symptomatic rectus diastasis benefit from the closure of the linea alba as a morphological and physiological reconstruction of the abdominal wall followed by mesh implantation. Occasionally, an additional component separation is necessary. In open surgery, this is associated with very large wound areas, postoperative seromas, poor wound healing and, in the worst case, mesh infections...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/29068903/redefining-the-rectus-sheath-implications-for-abdominal-wall-repair
#8
Imran R A Punekar, Joseph S Khouri, Michael Catanzaro, Aizaz L Shaikh, Howard N Langstein
BACKGROUND: The abdominal wall is frequently manipulated in a variety of reconstructive procedures, and its anatomy is well described. Our clinical observations, however, contradict the standard depiction of the components of the abdominal wall at various levels - particularly regarding the course of the transversus abdominis muscle (TA). Therefore, we sought to characterize the components of the rectus sheath at various anatomic levels corresponding to surgical landmarks in order to define key points relevant to abdominal wall repair...
October 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29062460/heterotopic-ossification-encountered-during-a-complex-ventral-hernia-repair-case-report-and-literature-review
#9
Takintope Akinbiyi, Sanjeev Kaul
Introduction: Heterotopic ossification involves the formation of trabecular bone outside of its usual anatomic location. While it is a well-known entity in orthopedic and spinal injury literature, it has also been observed after midline laparotomy and severe burns. Methods/Case Report: We present a case of a 69-year-old man who presented for ventral hernia repair after a prolonged postoperative course following colectomy involving an open abdomen with eventual closure with skin grafting. Results: Two large calcified objects were encountered during the excision of the skin graft from the small intestine and during the component separation...
2017: Eplasty
https://www.readbyqxmd.com/read/29055880/component-separation-of-abdominal-wall-with-intraoperative-botulinum-a-presents-satisfactory-outcomes-in-large-incisional-hernias-a-case-report
#10
Lucas Torres Oliveira, Felipe Futema Essu, Gustavo Heluani Antunes de Mesquita, Yuri Justi Jardim, Leandro Ryuchi Iuamoto, Fábio Yuji Suguita, Diego Ramos Martines, Fernanda Nii, Daniel Reis Waisberg, Alberto Meyer, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque
PURPOSE: Transplantation patients have a series of associated risk factors that make appearance of incisional hernia (IH) more likely. A number of aspects of the closure of large defects remain controversial. In this manuscript, we present the repair of a large IH following liver transplantation through the technique of posterior components separation combined with the anterior, together with the intraoperative use of botulinum toxin A and the placement of mesh. As a secondary objective, we analyze the incidence of IH following liver transplantation in our service...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29053405/evolution-of-endoscopic-anterior-component-separation-to-a-precostal-access-with-a-new-cylindrical-balloon-trocar
#11
Gernot Köhler, Ines Fischer, Richard Kaltenböck, Michael Lechner, Bernhard Dauser, Lars Nannestad Jorgensen
INTRODUCTION: Endoscopic anterior component separation (ECS) techniques facilitate tension-free midline closure of wide ventral hernia defects. We describe a novel approach with a precostal incision and a new cylindrical ballon trocar. MATERIALS AND METHODS: A single-center analysis of 19 patients undergoing ECS between January 1, 2014 and August 2, 2017 was performed with regard to improvement of technique. We currently start with a lateral precostal incision. This access in a low-fat and stable area allows for easy identification of the external oblique muscle with the ribs functioning as dorsal abutment for entering the correct plane between external and internal oblique muscles...
October 20, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29052067/concomitant-open-ventral-hernia-repair-what-is-the-financial-impact-of-performing-open-ventral-hernia-with-other-abdominal-procedures-concomitantly
#12
Vashisht Madabhushi, Margaret A Plymale, John Scott Roth, Sara Johnson, Alex Wade, Daniel L Davenport
BACKGROUND: Open ventral hernia repair (VHR) is often performed in conjunction with other abdominal procedures. Clinical outcomes and financial implications of VHR are becoming better understood; however, financial implications of concomitant VHR during other abdominal procedures are unknown. This study aimed to evaluate the financial implications of adding VHR to open abdominal procedures. METHODS: This IRB-approved study retrospectively reviewed hospital costs to 180-day post-discharge of standalone VHRs, isolated open abdominal surgeries (bowel resection or stoma closure, removal of infected mesh, hysterectomy or oophorectomy, panniculectomy or abdominoplasty, open appendectomy or cholecystectomy), performed at our institution from October 1, 2011 to September 30, 2014...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29030835/a-new-technique-for-tension-free-reconstruction-in-large-incisional-hernia
#13
Gabriele Munegato, Landino Fei, Michele Schiano di Visconte, Danilo Da Ros, Luana Moras, Gabriele Bellio
In the surgical management of large incisional hernias, the main target is the closure of the abdominal wall defect on the midline without a dangerous increase in the intraabdominal pressure. In this setting, new intraperitoneal prosthesis and components separation techniques were proposed to solve this problem. Both solutions present some critical issues. A new surgical approach with a free lateral double layer prosthesis totally in polypropylene both sides (FLaPp®) is proposed to overcome this problem. This is a retrospective cohort analysis study with a prospectively collected database from two different Italian hospitals...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28951658/robotic-ventral-hernia-repair-and-endoscopic-component-separation-outcomes
#14
Rodolfo J Oviedo, Jarrod C Robertson, Apurva Sunder Desai
BACKGROUND AND OBJECTIVES: Robot-assisted hernia repair, combined with endoscopic component separation, has reduced recurrence and complication rates and allowed immediate intervention in obese patients. We sought to study surgical outcomes in this high-risk group of patients in a community hospital. METHODS: We conducted a retrospective chart review of ventral, incisional, and umbilical hernia repairs performed at a small community hospital by a single surgeon from March 2014 through November 2016, with statistical analysis of the surgical outcomes...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28942568/endoscopic-anterior-component-separation-a-novel-technical-approach
#15
B Dauser, S Ghaffari, C Ng, T Schmid, G Köhler, F Herbst
PURPOSE: Open anterior release of the external oblique fascia to enable midline closure of large abdominal wall defects is associated with relevant morbidity due to extensive subcutaneous dissection. Using endoscopic techniques, wound complications can be minimized. However, identification of the correct entry point (e.g. for balloon trocar insertion) can be challenging especially in adipose patients. We therefore present a technical modification facilitating the entire procedure. METHODS: A novel technique for endoscopic anterior component separation using a trocar system allowing blunt and sharp dissection under direct vision is described...
December 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28917019/the-trend-toward-minimally-invasive-complex-abdominal-wall-reconstruction-is-it-worth-it
#16
Igor Belyansky, Adam S Weltz, Udai S Sibia, Justin J Turcotte, Haley Taylor, H Reza Zahiri, T Robert Turner, Adrian Park
BACKGROUND: Open abdominal wall reconstruction (AWR) was previously one of the only methods available to treat complex ventral hernias. We set out to identify the impact of laparoscopy and robotics on our AWR program by performing an economic analysis before and after the institution of minimally invasive AWR. METHODS: We retrospectively reviewed inpatient hospital costs and economic factors for a consecutive series of 104 AWR cases that utilized separation of components technique (57 open, 38 laparoscopic, 9 robotic)...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28917016/predictors-of-outpatient-resource-utilization-following-ventral-and-incisional-hernia-repair
#17
Alex Wade, Margaret A Plymale, Daniel L Davenport, Sara E Johnson, Vashisht V Madabhushi, Erica Mastoroudis, Charlie Tancula, John Scott Roth
INTRODUCTION: Little is known about the predictors of increased ambulatory costs following open ventral and incisional hernia repair (VIHR); however, postoperative complications would be expected to be associated with an increased burden on outpatient resources. The purpose of this study is to evaluate the impact of perioperative factors on outpatient resource utilization following VIHR. METHODS: With IRB approval, the surgery scheduling system was queried to identify all cases of VIHR done at our institution over 3 years...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28811004/component-separation-technique-for-giant-incisional-hernia-a-systematic-review
#18
REVIEW
Bram Cornette, Dirk De Bacquer, Frederik Berrevoet
The component separation technique (CST) has gained popularity among general surgeons in the management of giant abdominal hernia. A systematic review of the MedLine and EMBASE databases was performed. 36 observational cohort studies were included for data-analysis and divided in 4 main groups: Open Anterior Approach (OAA), Transversus Abdominis Release (TAR), Laparoscopic Anterior Approach (LAA) and Perforator Preserving Approach (PPA). Surgical Site Occurrences (SSO) occurred in 21.4%, 23.7%, 20.3% and 16...
August 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28792430/component-separation-technique-for-repair-of-massive-abdominal-wall-defects-at-a-pediatric-hospital
#19
James D Vargo, Michael T Larsen, Gregory D Pearson
BACKGROUND: Massive defects of the abdominal wall are commonly repaired with the component separation technique (CST) when insufficient tissue exists to close the defect primarily. Although the utility of CST has been documented in cases of large ventral hernias in adults, its application to congenital and acquired defects in pediatric patients has been largely unreported. This study is a retrospective case series discussing the success of CST at a large pediatric hospital. METHODS: Seven patients with massive abdominal wall defects, including ventral hernia and omphalocele, repaired with CST at a pediatric hospital were identified as candidates...
November 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28740773/botulinum-toxin-a-as-an-adjunct-to-abdominal-wall-reconstruction-for-incisional-hernia
#20
Sinor Soltanizadeh, Frederik Helgstrand, Lars N Jorgensen
BACKGROUND: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current literature on the administration of BTA as adjunct to surgical repair of abdominal incisional hernias was investigated. METHODS: The electronic databases PubMed and Embase were searched for eligible studies...
June 2017: Plastic and Reconstructive Surgery. Global Open
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