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Component separation hernia

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https://www.readbyqxmd.com/read/29068903/redefining-the-rectus-sheath-implications-for-abdominal-wall-repair
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28951658/robotic-ventral-hernia-repair-and-endoscopic-component-separation-outcomes
#7
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
#8
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...
September 23, 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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28738237/a-case-report-of-unexpected-pathology-within-an-incarcerated-ventral-hernia
#14
Erica D Kane, Katharine R Bittner, Michelle Bennett, John R Romanelli, Neal E Seymour, Jacqueline J Wu
INTRODUCTION: Incidence of hernial appendicitis is 0.008%, most frequently within inguinal and femoral hernias. Up to 2.5% of appendectomy patients are found to have Crohn's disease. Elucidating the etiology of inflammation is essential for directing management. PRESENTATION OF CASE: A 51-year-old female with achondroplastic dwarfism, multiple cesarean sections, and subsequent massive incisional hernia, presented with ruptured appendicitis within her incarcerated hernia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28726148/first-human-use-of-hybrid-synthetic-biologic-mesh-in-ventral-hernia-repair-a-multicenter-trial
#15
James G Bittner, Kevin El-Hayek, Andrew T Strong, Melissa Phillips LaPinska, Jin S Yoo, Eric M Pauli, Matthew Kroh
BACKGROUND: Mesh options for reinforcement of ventral/incisional hernia (VIH) repair include synthetic or biologic materials. While each material has known advantages and disadvantages, little is understood about outcomes when these materials are used in combination. This multicenter study reports on the first human use of a novel synthetic/biologic hybrid mesh (Zenapro(®) Hybrid Hernia Repair Device) for VIH repair. METHODS: This prospective, multicenter post-market clinical trial enrolled consecutive adults who underwent elective VIH repair with hybrid mesh placed in the intraperitoneal or retromuscular/preperitoneal position...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28705101/abdominal-wall-expanding-system-obviates-the-need-for-lateral-release-in-giant-incisional-hernia-and-laparostoma
#16
Dietmar Eucker, Andreas Zerz, Daniel C Steinemann
BACKGROUND: In large incisional hernias and after laparostoma midline closure may be impossible. A novel abdominal wall expander system (AWEX) is proposed and evaluated. METHODS: In patients with large incisional hernias and laparostoma where primary midline closure was impossible, AWEX was used. Patients undergoing abdominal wall reconstruction using AWEX between May 2012 and December 2015 were included. Intraoperative the abdominal wall was stretched by attaching the midline fascia borders to a retraction system under tension for 30 minutes...
October 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28689863/long-term-results-of-open-complex-abdominal-wall-hernia-repair-with-self-gripping-mesh-a-retrospective-cohort-study
#17
Leonard F Kroese, Lien H A van Eeghem, Joost Verhelst, Johannes Jeekel, Gert-Jan Kleinrensink, Johan F Lange
BACKGROUND: In case of complex ventral hernias, Rives-Stoppa and component separation technique are considered as favourable treatment techniques. However, mesh-related complications like recurrence, infection and chronic pain are still a common problem after mesh repair. Previous studies have reported promising results of the use of a self-gripping mesh (ProGrip™) in incisional hernia repair. This study aimed to evaluate the long term results of this mesh for complex ventral hernia treatment...
July 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28658342/robotic-transversus-abdominis-release-tar-is-it-possible-to-offer-minimally-invasive-surgery-for-abdominal-wall-complex-defects
#18
Maria Vitória França DO Amaral, José Ricardo Guimarães, Paula Volpe, Flávio Malcher Martins DE Oliveira, Carlos Eduardo Domene, Sérgio Roll, Leandro Totti Cavazzola
We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28501135/impact-of-hernia-volume-on-pulmonary-complications-following-complex-hernia-repair
#19
Elwin H H Mommers, Johannes A Wegdam, Sander van der Wolk, Simon W Nienhuijs, Tammo S de Vries Reilingh
BACKGROUND: Despite a multitude of evidence-based prediction models and risk factors for postoperative complications after ventral hernia repair, estimating a patient's risk of postoperative complications after ventral hernia repair remains challenging. In an attempt to improve the preoperative assessment of complex hernia patients, some studies have examined pulmonary changes after hernia repair hypothesizing that large hernias lead to pulmonary changes and increased pulmonary complication rates...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28489476/benefits-of-thoracic-epidural-analgesia-in-patients-undergoing-an-open-posterior-component-separation-for-abdominal-herniorrhaphy
#20
Daryl S Henshaw, Christopher J Edwards, Austin R Sellers, Gregory B Russell, Robert S Weller
An open posterior component separation (PCS) is a commonly utilized surgical approach for repair of complex abdominal wall defects and hernias. Although this approach may improve surgical outcomes, significant postoperative pain can be expected given the required laparotomy and extensive abdominal wall manipulation. Both systemic opioids and thoracic epidural analgesia (TEA) are viable postoperative analgesic options, and both are commonly utilized. Although the benefits of TEA have been investigated following a variety of surgeries, there is a paucity of literature related to its efficacy for this particular surgery...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
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