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Morbid obesity, hernia repair

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https://www.readbyqxmd.com/read/28122076/factors-associated-with-long-term-outcomes-of-umbilical-hernia-repair
#1
Divya A Shankar, Kamal M F Itani, William J O'Brien, Vivian M Sanchez
Importance: Umbilical hernia repair is one of the most commonly performed general surgical procedures. However, there is little consensus about the factors that lead to umbilical hernia recurrence. Objective: To better understand the factors associated with long-term umbilical hernia recurrence. Design, Setting, and Participants: A retrospective cohort of 332 military veteran patients who underwent umbilical hernia repair was studied between January 1, 1998, and December 31, 2008, at the VA Boston Healthcare System...
January 25, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28072903/laparoscopic-treatment-of-giant-ventral-hernia-experience-of-35-patients
#2
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/28034772/incidence-and-outcomes-of-ventral-hernia-repair-after-robotic-retropubic-prostatectomy-a-retrospective-cohort-of-570-consecutive-cases
#3
A Ashfaq, K Ahmadieh, A A Shah, E M Garvey, A B Chapital, D J Johnson, K L Harold
BACKGROUND: Robotic retropubic prostatectomy (RRP) has become one of the most commonly performed robotic procedures in the United States. Ventral hernia (VH) has been increasingly recognized as an important complication after laparoscopic procedures, in general. However, data related to VH after robotic procedures is relatively scarce, especially after RRP. With increasing popularity of RRP, the purpose of this study was to look at the incidence of VH and outcomes of ventral hernia repair (VHR) after RRP...
February 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28013451/a-new-algorithm-to-reduce-the-incidence-of-gastroesophageal-reflux-symptoms-after-laparoscopic-sleeve-gastrectomy
#4
Ilhan Ece, Huseyin Yilmaz, Fahrettin Acar, Bayram Colak, Serdar Yormaz, Mustafa Sahin
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is one of the most prefered treatment option for morbid obesity. However, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. Asymptomatic GERD and hiatal hernia (HH) is common in obese patients. Therefore, it is important to identify the high risk patients prior to surgery. This study aims to evaluate efficacy of cruroplasty for HH during LSG in morbidly obese patients using ambulatory pH monitoring (APM) results, and to investigate the patients' selection criteria for this procedure...
December 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/28009730/ventral-hernia-management-expert-consensus-guided-by-systematic-review
#5
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/28000656/portomesenteric-venous-thrombosis-a-rare-but-probably-under-reported-complication-of-laparoscopic-surgery-a-case-series
#6
Yan Mei Goh, Ajay Tokala, Tarek Hany, Kishore G Pursnani, Ravindra S Date
Portomesenteric venous thrombosis (PMVT) is a rare but well-reported complication following laparoscopic surgery. We present three cases of PMVT following laparoscopic surgery. Our first case is a 71-year-old morbidly obese woman admitted for elective laparoscopic giant hiatus hernia (LGHH) repair. Post-operatively, she developed multi-organ dysfunction and computed tomography scan revealed portal venous gas and extensive small bowel infarct. The second patient is a 51-year-old man with known previous deep venous thrombosis who also had elective LGHH repair...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27896401/sleeve-gastrectomy-combined-with-the-simplified-hill-repair-in-the-treatment-of-morbid-obesity-and-gastro-esophageal-reflux-disease-preliminary-results-in-14-patients
#7
Daniel Gero, Lara Ribeiro-Parenti, Konstantinos Arapis, Jean-Pierre Marmuse
BACKGROUND: Our aim is to report our initial experience with a novel technique which addresses morbid obesity and gastro-esophageal reflux disease (GERD) simultaneously by combination of laparoscopic sleeve gastrectomy (LSG) and simplified laparoscopic Hill repair (sLHR). METHODS: Retrospective analysis of LSG+sLHR patients >5 months postoperatively includes demographics, GERD status, proton-pump inhibitor (PPI) use, body mass index (BMI), excess BMI loss (EBMIL), complications and GERD-Health Related Quality of Life (GERD-HRQL) questionnaire...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27800587/evaluation-of-antibiotic-pressurized-pulse-lavage-for-contaminated-retromuscular-abdominal-wall-reconstruction
#8
Arnab Majumder, Heidi J Miller, Parita Patel, Yuhsin V Wu, Heidi L Elliott, Yuri W Novitsky
BACKGROUND: Despite patient risk factors such as diabetes and obesity, contamination during surgery remains a significant cause of infections and subsequent wound morbidity. Pressurized pulse lavage (PPL) has been utilized as a method to reduce bacterial bioburden with promising results in many fields. Although existing methods of lavage have been utilized during abdominal operations, no studies have examined the use of PPL during complex hernia repair. METHODS: Patients undergoing abdominal wall reconstruction (AWR) in clean-contaminated or contaminated fields with antibiotic PPL, from January 2012 to May 2013, were prospectively evaluated...
October 31, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27642515/best-evidence-topic-should-ventral-hernia-repair-be-performed-at-the-same-time-as-bariatric-surgery
#9
Mohammed Saif Sait, Robin Som, Cynthia Michelle Borg, Avril Chang, Sasindran Ramar
A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In morbidly obese patients undergoing bariatric surgery, when a ventral hernia is picked up in clinic or intraoperatively is concurrent repair of the hernia better than delayed repair after weight loss with regards to complication rates? Using the reported search, 179 papers were found. 5 studies were deemed to be suitable to answer the question. All 5 studies assessed were non randomised studies either retrospective or prospective and the overall quality of these studies was poor...
November 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27495347/robotic-assisted-ventral-hernia-repair-a-multicenter-evaluation-of-clinical-outcomes
#10
Anthony Gonzalez, Ernesto Escobar, Rey Romero, Gail Walker, Jacqueline Mejias, Michelle Gallas, Eugene Dickens, Christopher J Johnson, Jorge Rabaza, Omar Yusef Kudsi
BACKGROUND: The open approach continues to be widely performed for ventral hernia repair, while the minimally invasive laparoscopic approach has grown adoption over the last decade. Recently, robotic operation was described as a new modality due to the ease for performing intracorporeal closure of the hernia defect. This study is one of the first multi-institutional case series evaluating robotic-assisted laparoscopic ventral hernia repairs, with the goal of describing robotic-assisted surgical techniques for ventral and incisional hernia repair and the outcomes in teaching and community hospital settings...
August 5, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27444828/laparoscopic-versus-open-inguinal-hernia-repair-in-patients-with-obesity-an-american-college-of-surgeons-nsqip-clinical-outcomes-analysis
#11
Dvir Froylich, Ivy N Haskins, Ali Aminian, Colin P O'Rourke, Zhamak Khorgami, Mena Boules, Gautam Sharma, Stacy A Brethauer, Phillip R Schauer, Michael J Rosen
INTRODUCTION: The laparoscopic approach to inguinal hernia repair (IHR) has proven beneficial in reducing postoperative pain and facilitating earlier return to normal activity. Except for indications such as recurrent or bilateral inguinal hernias, there remains a paucity of data that specifically identities patient populations that would benefit most from the laparoscopic approach to IHR. Nevertheless, previous experience has shown that obese patients have increased wound morbidity following open surgical procedures...
July 21, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27194265/open-versus-laparoscopic-unilateral-inguinal-hernia-repairs-defining-the-ideal-bmi-to-reduce-complications
#12
Ashley D Willoughby, Robert B Lim, Michael B Lustik
OBJECTIVES: Open inguinal hernia repair is felt to be a less expensive operation than a laparoscopic one. Performing open repair on patients with an obese body mass index (BMI) results in longer operative times, longer hospital stay, and complications that will potentially impose higher cost to the facility and patient. This study aims to define the ideal BMI at which a laparoscopic inguinal hernia repair will be advantageous over open inguinal hernia repair. METHODS: The NSQIP database was analyzed for (n = 64,501) complications, mortality, and operating time for open and laparoscopic inguinal hernia repairs during the time period from 2005 to 2012...
January 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27071928/intraoperative-assessment-of-the-effects-of-laparoscopic-sleeve-gastrectomy-on-the-distensibility-of-the-lower-esophageal-sphincter-using-impedance-planimetry
#13
Jessica L Reynolds, Joerg Zehetner, Sharon Shiraga, John C Lipham, Namir Katkhouda
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has emerged as an effective weight-loss procedure for morbid obesity that is also effective for treating comorbidities such as diabetes. However, it has been associated with the development of GERD postoperatively. The pathophysiology of post-LSG GERD is unknown, and current studies have shown conflicting results. The aim of our study is to shed light on this issue by investigating the effect of LSG on the lower esophageal sphincter (LES) function and the relationship of LES function to GERD symptoms...
April 12, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27046105/a-sign-on-ct-that-predicts-a-hazardous-ureteral-anomaly
#14
E S Allam, D Y Johnson, S G Grewal, F E Johnson
INTRODUCTION: An aberrant course of the distal ureter can pose a risk of ureteral injury during surgery for inguinal hernia repair and other groin operations. In a recent case series of inguinoscrotal hernation of the ureter, we found that each affected ureter was markedly anterior to the psoas muscle at its mid-point on abdominal CT. We hypothesized that this abnormality in the abdominal course of the ureter would predict the potentially hazardous aberrant course of the distal ureter...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27001587/incorporating-androgen-deprivation-with-dose-escalated-external-beam-radiotherapy-for-prostate-cancer
#15
Arie P Dosoretz, James B Yu
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/26982687/ventral-hernia-management-expert-consensus-guided-by-systematic-review
#16
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...
March 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/26581484/laparoscopic-undo-of-fundoplication-with-roux-en-y-gastric-bypass-in-a-morbidly-obese-patient-with-prior-nissen-s-fundoplication-a-video-report
#17
Palanivelu Praveenraj, Rachel M Gomes, Saravana Kumar, Palanisamy Senthilnathan, Ramakrishnan Parthasarathi, Subbiah Rajapandian, Chinnusamy Palanivelu
BACKGROUND: Roux-en-Y gastric bypass (RYGB) may be a better option for morbidly obese patients with gastroesophageal reflux (GERD) for long-term reflux control. It is recommended after fundoplication if a patient is morbidly obese with GERD with failed fundoplication or if bariatric surgery is planned with a prior successful fundoplication (Kim et al., Am Surg 80(7):696-703, 2014; Kambiz Zainabadi, Surg Endosc. 22(12):2737-40, 2008). Complete takedown of the wrap to avoid stapling over the fundoplication creating an obstructed, septated pouch is needed (Kambiz Zainabadi, Surg Endosc...
January 2016: Obesity Surgery
https://www.readbyqxmd.com/read/26508825/paraesophageal-hernia-repair-with-partial-longitudinal-gastrectomy-in-obese-patients
#18
Matthew Davis, John Rodriguez, Kevin El-Hayek, Stacy Brethauer, Philip Schauer, Andrea Zelisko, Bipan Chand, Colin O'Rourke, Matthew Kroh
BACKGROUND AND OBJECTIVES: Treatment of gastroesophageal reflux disease (GERD) with hiatal hernia in obese patients has proven difficult, as studies demonstrate poor symptom control and high failure rates in this patient population. Recent data have shown that incorporating weight loss procedures into the treatment of reflux may improve overall outcomes. METHODS: We retrospectively reviewed 28 obese and morbidly obese patients who presented from December 2007 through July 2013 with large or recurrent type 3 or 4 paraesophageal hernia...
July 2015: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/26337696/concomitant-bariatric-surgery-with-laparoscopic-intra-peritoneal-onlay-mesh-repair-for-recurrent-ventral-hernias-in-morbidly-obese-patients-an-evolving-standard-of-care
#19
Palanivelu Praveenraj, Rachel Maria Gomes, Saravana Kumar, Palanisamy Senthilnathan, Ramakrishnan Parthasarathi, Subbiah Rajapandian, Chinnusamy Palanivelu
BACKGROUND AND AIMS: Repair of recurrent ventral hernias (RVHs) has a high failure rate more so in the presence of obesity. The chronic increase in intra-abdominal pressure (IAP) associated with obesity might, in part, be an important implicating factor that needs to be addressed in these patients. Laparoscopic ventral hernia repair (LVHR) done with concomitant bariatric surgery in morbidly obese patients with RVHs may avoid multiple failures. We report our preliminary experience in treating RVHs in morbidly obese patients with laparoscopic intra-peritoneal onlay mesh (IPOM) repair and concomitant bariatric surgery...
June 2016: Obesity Surgery
https://www.readbyqxmd.com/read/26322822/a-case-report-on-management-of-synergistic-gangrene-following-an-incisional-abdominal-hernia-repair-in-an-immunocompromised-obese-patient
#20
N Merali, R A R Almeida, A Hussain
INTRODUCTION: We present a case on conservative management of salvaging the mesh in an immunocompromised morbidly obese patient, who developed a synergistic gangrene infection following a primary open mesh repair of an incisional hernia. PRESENTATION OF CASE: Our patient presented with a surgical wound infection, comorbidities were Chronic Lymphoblastic Leukemia (CLL), Body Mass Index (BMI) of 50, hypertension and diet controlled type-2 diabetes. In surgery, wide necrotic wound debridement, early and repetitive wound drainages with the use of a large pore polypropylene mesh and a detailed surgical follow up was required...
2015: International Journal of Surgery Case Reports
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