Read by QxMD icon Read

Component separation hernia

Antonio Espinosa-de-Los-Monteros, Héctor Avendano-Peza, Yuri W Novitsky
Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction...
September 2016: Plastic and Reconstructive Surgery. Global Open
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
Salvatore Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Prior abdominal wall radiotherapy (XRT) adversely affects wound healing, but data are limited on how prior XRT may affect abdominal wall reconstruction (AWR) outcomes. The purpose of this study was to determine whether prior abdominal wall radiotherapy is associated with a higher incidence of complications following AWR for a hernia or oncologic resection defect. METHODS: We performed a retrospective study of consecutive patients who underwent complex AWR using acellular dermal matrix (ADM) at a single center...
September 30, 2016: Annals of Surgical Oncology
Caitlin W Hicks, Katherine E Poruk, Pablo A Baltodano, Kevin C Soares, Said C Azoury, Carisa M Cooney, Peter Cornell, Frederic E Eckhauser
BACKGROUND: Sandwich ventral hernia repair (SVHR) may reduce ventral hernia recurrence rates, although with an increased risk of surgical site occurrences (SSOs) and surgical site infections (SSIs). Previously, we found that a modified negative pressure wound therapy (hybrid vacuum-assisted closure [HVAC]) system reduced SSOs and SSIs after ventral hernia repair. We aimed to describe our outcomes after SVHR paired with HVAC closure. METHODS: We conducted a 4-y retrospective review of all complex SVHRs (biologic mesh underlay and synthetic mesh overlay) with HVAC closure performed at our institution by a single surgeon...
August 2016: Journal of Surgical Research
Nergis Nina Suleiman, Lars Johan Marcus Sandberg
Symptomatic heterotopic ossification of abdominal surgical incisions is a rare occurrence. We present a 67-year-old man with severe discomfort caused by heterotopic ossification extending from the xiphoid to the umbilicus. The patient underwent an abdominal aortic aneurysm repair 3 years before our treatment. A 13 × 3.5 cm ossified lesion was excised. The resulting midline defect was closed using component separation and inlay Strattice. Tension-free midline adaptation of the recti muscles was achieved...
July 2016: Plastic and Reconstructive Surgery. Global Open
Ciara R Huntington, Tiffany C Cox, Laurel J Blair, Samuel Schell, David Randolph, Tanushree Prasad, Amy Lincourt, B Todd Heniford, Vedra A Augenstein
BACKGROUND: Biologic mesh choice in ventral hernia repair is challenging due to lack of prospective data. This study examines long-term, single-center biologic mesh outcomes. METHODS: Prospective operative outcomes data was queried for open ventral hernia repair with biologic mesh. Univariate and multivariate analysis were used to compare mesh outcomes. RESULTS: In the study, 223 patients underwent open ventral hernia repair with biologic mesh, including 40 with Alloderm, 23 AlloMax, 70 FlexHD, 68 Strattice, and 22 Xenmatrix...
August 12, 2016: Surgery
N D Appleton, K D Anderson, K Hancock, M H Scott, C J Walsh
INTRODUCTION Large, complicated ventral hernias are an increasingly common problem. The transversus abdominis muscle release (TAMR) is a recently described modification of posterior components separation for repair of such hernias. We describe our initial experience with TAMR and sublay mesh to facilitate abdominal wall reconstruction. METHODS The study is a retrospective review of patients undergoing TAMR performed synchronously by gastrointestinal and plastic surgeons. RESULTS Twelve consecutive patients had their ventral hernias repaired using the TAMR technique from June 2013 to June 2014...
August 11, 2016: Annals of the Royal College of Surgeons of England
Alexandre Balaphas, Philippe Morel, Romain Breguet, Michela Assalino
Giant hernias with loss of domain induce physiological modifications that impair quality of life and make more complex their surgical management. A good preparation of patients before surgery is the key to an eventless postoperative course. The progressive pre-operative pneumoperitoneum (PPP) is one of the described abdominal augmentation protocols which can help patients to tolerate hernia content reintegration and avoid components separation technique during hernia repair. This article describes the management of these complex patients...
June 15, 2016: Revue Médicale Suisse
Nathan W Kugler, Melanie Bobbs, Travis Webb, Thomas W Carver, David Milia, Jasmeet S Paul
BACKGROUND: The Modified Hernia Grading System (MHGS) was developed to risk stratify complex ventral hernia repairs (VHRs). MHGS grade 3 patients have mesh infections, dirty or contaminated fields, and/or violation of the alimentary tract. Reported surgical site infection (SSI) rates are over 40% after single-stage VHR in contaminated fields. In an attempt to decrease the SSI rate in MHGS grade 3 patients, we developed a dual-stage VHR (DSVHR) approach. METHODS: We reviewed adult general surgery patients undergoing DSVHR between January 2010 and June 2014...
July 2016: Journal of Surgical Research
Mojtaba Fayezizadeh, Arnab Majumder, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Optimal mesh reinforcement and operative technique for major abdominal wall reconstructions (AWR) remain debatable. Posterior component separation via transversus abdominis release (TAR) allows for wide sublay mesh reinforcement with durable reconstruction, and has been gaining popularity in recent years. Although biologic mesh has been associated with mixed results, outcomes of AWR with bioprosthetics have not been well elucidated to date. We evaluated our outcomes of TAR reconstructions with retromuscular porcine biologic mesh reinforcement...
September 2016: Journal of the American College of Surgeons
J Škach, R Harcubová, V Petráková, L Brzulová, M Krejbichová, K Kocmanová
INTRODUCTION: The authors introduce a unique programme in the Czech Republic focused on extreme herniology. Patients with giant complex ventral hernias (monster hernias) have been concentrated in a high-volume hernia center with the most advanced perioperative intensive care since 2012. The authors present their single centre experience with the support of literature. RESULTS: Between 20122015 we operated on 36 patients with a giant complex hernia. Minimal inclusion criteria for enrolment in the very heterogeneous group included: a defect over 15 cm wide, loss of domain of 20% and higher, and the mean surface area of at least 225 cm²...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Jorge Daes, Rodolfo J Dennis
BACKGROUND: Proper defect closure during abdominal wall reconstruction (AWR) is a key to improving cosmetic and functional results, and reducing morbidity. We have completed the initial prospective evaluation of a technique we previously described and published: endoscopic subcutaneous anterior component separation (ACS) as an adjunct to mainly laparoscopic AWR. We now present the long-term clinical and imaging follow-up results. STUDY DESIGN: Data were prospectively collected over a 3-year period (2012-2015) on patients who underwent AWR with endoscopic ACS...
June 22, 2016: Surgical Endoscopy
Andrzej Ratajczak, Adam Bobkiewicz, Kryspin Mitura, Ryszard Marciniak, Michał Drews
No abstract text is available yet for this article.
March 1, 2016: Polski Przeglad Chirurgiczny
Nirav K Desai, I Michael Leitman, Christopher Mills, Valentina Lavarias, David L Lucido, Martin S Karpeh
BACKGROUND: Components separation technique emerged several years ago as a novel procedure to improve durability of repair for ventral abdominal hernias. Almost twenty-five years since its initial description, little comprehensive risk adjusted data exists on the morbidity of this procedure. This study is the largest analysis to date of short-term outcomes for these cases. METHODS: The ACS-NSQIP database identified open ventral or incisional hernia repairs with components separation from 2005 to 2012...
May 2016: Annals of Medicine and Surgery
Joshua S Winder, Brittany J Behar, Ryan M Juza, John Potochny, Eric M Pauli
BACKGROUND: Ventral hernias are common sequelae of abdominal surgery. Recently, transversus abdominis release has emerged as a viable option for large or recurrent ventral hernias. Our objective was to determine the outcomes of posterior component separation via transversus abdominis release for the treatment of abdominal wall hernias in the first series of patients at one institution. METHODS: We performed a retrospective review of a prospectively maintained database of open ventral hernia repair patients to identify patients who underwent posterior component separation via transversus abdominis release at one institution from 2012 to 2015...
August 2016: Journal of the American College of Surgeons
Blair A Wormer, Ciara R Huntington, Samuel W Ross, Paul D Colavita, Amy E Lincourt, Tanushree Prasad, Ronald F Sing, Stanley B Getz, Igor Belyansky, B Todd Heniford, Vedra A Augenstein
BACKGROUND: The purpose of this prospective, randomized, double-blinded controlled trial was to investigate the utility of indocyanine green fluorescence angiography (ICG-FA) in reducing wound complications in complex abdominal wall reconstruction. MATERIALS AND METHODS: All consented patients underwent ICG-FA with SPY Elite after hernia repair and before flap closure. They were randomized into the control group, in which the surgical team was blinded to ICG-FA images and performed surgery as they normally would, or the experimental group, in which the surgery team viewed the images and could modify tissue flaps according to their findings...
May 15, 2016: Journal of Surgical Research
E H H Mommers, J A Wegdam, S W Nienhuijs, T S de Vries Reilingh
BACKGROUND: The components separation technique (CST) is frequently used for reconstructing large ventral hernias. Unfortunately, it is associated with a high wound complication rate up to 50 %, caused by large wound surface and inherent trauma to abdominal skin vascularization. An endoscopically assisted modification of the original technique (ECST) spares skin vascularization and reduces wound surface, supposedly reducing wound complications. This study accurately describes ECST step by step with detailed illustrations and report the results of a 27 patient cohort...
June 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Eric M Pauli, Ryan M Juza, Joshua S Winder
INTRODUCTION: Parastomal hernias are a complex surgical problem affecting a large number of patients. Recurrences continue to occur despite various methods of repair. We present a novel method of open parastomal hernia repair with retromuscular mesh reinforcement in a modified Sugarbaker configuration. METHODS: A full mildline laparotomy is performed and all adhesions are taken down. We then perform an open parastomal hernia repair by utilizing retromuscular dissection, posterior component separation via transversus abdominis release, and lateralization of the bowel utilizing a modified Sugarbaker mesh configuration within the retromuscular space...
August 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Kevin G Cornwell, Feng Zhang, William Lineaweaver
BACKGROUND: Component separation is a surgical strategy used to achieve abdominal wall reconstruction for patients with significant ventral hernias. With an increasing number of variations in procedural techniques and materials, the development of a small animal model of this surgery would allow for the controlled evaluation of variables with analytics not available in human clinical studies. To test this model, we investigated the reinforcement of these component repairs in rats with a bovine fetal collagen (BFC) scaffold...
April 2016: Journal of Surgical Research
Ramesh Punjani, Imran Shaikh, Vinne Soni
Repair of large ventral hernia is a challenge for even experienced surgeons, as there are large defects with large contents, often with loss of domain. The large defects were bridged by various plastic surgical procedures like myofascial flaps or free flaps with high recurrences and complications. More often, the bridging was done with artificial prosthesis, leaving the defects open. This was accomplished by either open surgery (onlay, inlay, sublay or underlay) or laparoscopic intraperitoneal onlay meshes (IPOMs)...
December 2015: Indian Journal of Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"