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Component separation hernia

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https://www.readbyqxmd.com/read/28187028/comparison-of-surgeon-specialty-in-open-ventral-hernia-repair
#1
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/28125536/wound-morbidity-in-minimally-invasive-anterior-component-separation-compared-to-transversus-abdominis-release
#2
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/28044960/transversus-abdominis-muscle-release-tar-for-large-incisional-hernia-repair
#3
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
#4
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
#5
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/28009730/ventral-hernia-management-expert-consensus-guided-by-systematic-review
#6
Mike K Liang, Julie L Holihan, Kamal Itani, Zeinab M Alawadi, Juan R Flores Gonzalez, Erik P Askenasy, Conrad Ballecer, Hui Sen Chong, Matthew I Goldblatt, Jacob A Greenberg, John A Harvin, Jerrod N Keith, Robert G Martindale, Sean Orenstein, Bryan Richmond, John Scott Roth, Paul Szotek, Shirin Towfigh, Shawn Tsuda, Khashayar Vaziri, David H Berger
OBJECTIVE: To achieve consensus on the best practices in the management of ventral hernias (VH). BACKGROUND: Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence. METHODS: A systematic review identified the highest level of evidence available for each topic. A panel of expert hernia-surgeons was assembled. Email questionnaires, evidence review, panel discussion, and iterative voting was performed...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27993696/long-term-outcomes-after-abdominal-wall-reconstruction-with-acellular-dermal-matrix
#7
Patrick B Garvey, Salvatore A Giordano, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Long-term outcomes data for hernia recurrence rates after abdominal wall reconstruction (AWR) with acellular dermal matrix (ADM) are lacking. The aim of this study was to assess the long-term durability of AWR using ADM. STUDY DESIGN: We studied patients who underwent AWR with ADM at a single center in 2005 to 2015 with a minimum follow-up of 36 months. Hernia recurrence was the primary end point and surgical site occurrence (SSO) was a secondary end point...
March 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27915385/substantial-variation-among-hernia-experts-in-the-decision-for-treatment-of-patients-with-incisional-hernia-a-descriptive-study-on-agreement
#8
D Kokotovic, I Gögenur, F Helgstrand
PURPOSE: Benign elective procedures give rise to heterogeneity in indication for surgery and surgical technique among specialized surgeons in a variety of surgical fields. The objective was to analyze the extent of agreement in surgical management among expert hernia surgeons when evaluating the same patient in a standardized setting. METHODS: Five Danish hernia experts answered questions concerning indication for surgery and surgical technique for 25 video recorded real-life clinical cases...
December 3, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27855958/prospective-multi-institutional-surgical-and-quality-of-life-outcomes-comparison-of-heavyweight-midweight-and-lightweight-mesh-in-open-ventral-hernia-repair
#9
Steven A Groene, Tanushree Prasad, Amy E Lincourt, Vedra A Augenstein, Ronald Sing, Brant Todd Heniford
BACKGROUND: Mesh choice in open ventral hernia repair (OVHR) remains controversial. Our aim was to analyze prospective outcomes among heavyweight, midweight, and lightweight (LW) mesh. METHODS: A study of the International Hernia Mesh Registry was performed for OVHR. Operative details, complications, recurrence, and quality of life (QOL) at 1, 6, 12, 24, and 36 months were evaluated. RESULTS: There were 549 OVHRs, 99 using heavyweight, 262 midweight, and 188 LW mesh...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27785629/effect-of-hernia-size-on-operative-repair-and-post-operative-outcomes-after-open-ventral-hernia-repair
#10
K E Poruk, N Farrow, F Azar, K K Burce, C W Hicks, S C Azoury, P Cornell, C M Cooney, F E Eckhauser
BACKGROUND: Ventral hernia repair (VHR) is a commonly performed operation, but analysis of patient outcomes based upon hernia size is lacking. We sought to identify differences in operative repair and post-operative morbidity and mortality after open VHR based on hernia defect size. METHODS: Patient and operative data were retrospectively reviewed on all patients undergoing open incisional VHR between January 2008 and February 2015 by a single surgeon at the Johns Hopkins Hospital...
October 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27757337/abdominal-closure-after-tram-flap-breast-reconstruction-with-transversus-abdominis-muscle-release-and-mesh
#11
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
https://www.readbyqxmd.com/read/27728955/laparoscopic-stapled-sublay-repair-with-self-gripping-mesh-a-simplified-technique-for-minimally-invasive-extraperitoneal-ventral-hernia-repair
#12
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 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27696169/prior-radiotherapy-does-not-affect-abdominal-wall-reconstruction-outcomes-evidence-from-propensity-score-analysis
#13
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
https://www.readbyqxmd.com/read/27565062/long-term-outcomes-of-sandwich-ventral-hernia-repair-paired-with-hybrid-vacuum-assisted-closure
#14
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
https://www.readbyqxmd.com/read/27536495/extensive-abdominal-wall-incisional-heterotopic-ossification-reconstructed-with-component-separation-and-strattice-inlay
#15
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
https://www.readbyqxmd.com/read/27528210/biologic-mesh-in-ventral-hernia-repair-outcomes-recurrence-and-charge-analysis
#16
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...
December 2016: Surgery
https://www.readbyqxmd.com/read/27513800/initial-uk-experience-with-transversus-abdominis-muscle-release-for-posterior-components-separation-in-abdominal-wall-reconstruction-of-large-or-complex-ventral-hernias-a-combined-approach-by-general-and-plastic-surgeons
#17
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
https://www.readbyqxmd.com/read/27487621/-giant-hernias-with-loss-of-domain-what-is-the-best-way-to-prepare-patients
#18
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
https://www.readbyqxmd.com/read/27451887/a-dual-stage-approach-to-contaminated-high-risk-ventral-hernia-repairs
#19
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
https://www.readbyqxmd.com/read/27349683/outcomes-of-retromuscular-porcine-biologic-mesh-repairs-using-transversus-abdominis-release-reconstruction
#20
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
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