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mesh repair in hernia

R W Radwan, A Gardner, H Jayamanne, B M Stephenson
Introduction The open prosthetic repair of inguinal hernias under local anaesthesia (LA) is well established, with the concept of intraoperative 'pre-emptive analgesia' evolving so that patients are as comfortable as possible. We used a peri-incisional LA solution in patients undergoing day-case inguinal hernioplasty under general anaesthesia (GA) and recorded use of analgesia in the immediate postoperative period. Methods In this observational cohort study, 100 consecutive unselected men underwent open inguinal hernia repair as a day case...
March 15, 2018: Annals of the Royal College of Surgeons of England
Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike
Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study...
March 14, 2018: Keio Journal of Medicine
Frederik Berrevoet
Management of a patient with an open abdomen is difficult, and the primary closure of the fascial edges is essential to obtain the best patient outcome, regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh-mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%...
2018: Frontiers in Surgery
Hirofumi Kawanaka, Shoji Hiroshige, Nobuhide Kubo, Teijiro Hirashita, Takeshi Masuda, Yushi Kaisyakuji, Tadahiro Tajiri, Akinori Egashira, Toshifumi Matsumoto, Tokujiro Yano
BACKGROUND: Obturator hernia (OH) is a rare but serious disease associated with high morbidity and mortality because of patients' advanced age and comorbidities. This study evaluated the feasibility of a laparoscopic approach for OH. STUDY DESIGN: We retrospectively reviewed the records of 32 patients (median age: 84 years; 31 women) with OH treated between 2003 and 2016. RESULTS: Five patients with incidental OH underwent totally extraperitoneal (TEP) repair...
March 6, 2018: Journal of the American College of Surgeons
J D Hodgkinson, C A Leo, Y Maeda, P Bassett, S M Oke, C J Vaizey, J Warusavitarne
PURPOSE: This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519-526, 1990), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709-716, 2012), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair...
March 7, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Kristoffer Andresen
Inguinal hernias are a protrusion of the peritoneum through a weakening in the groin in which abdominal content (intestines or fat) can herniate and cause a bulge. Inguinal hernias can be painful and require surgery. Worldwide, approximately 20 million patients are operated each year, with 10,000 in Denmark. The repair of inguinal hernias causes pain and 16% of patients experience chronic pain six months after the standard, open, mesh-based Lichtenstein technique. Therefore, surgeons are trying to improve the techniques by finding new ways of operating...
March 2018: Danish Medical Journal
Stina Öberg, Kristoffer Andresen, Tobias W Klausen, Jacob Rosenberg
BACKGROUND: Chronic pain affects 10%-12% of patients after inguinal hernia repairs. Some have suggested that less foreign material may theoretically prevent pain. If the prevalence of chronic pain is less after nonmesh repairs, selected hernias might be repaired without mesh. Our aim was to clarify if nonmesh repairs are superior to mesh repairs regarding chronic pain. METHODS: For this systematic review, searches were conducted in five databases. The main outcome was chronic pain reported a minimum of six months after mesh and nonmesh repair in adult patients with a primary inguinal hernia...
March 2, 2018: Surgery
Sabrina Trippoli, Erminia Caccese, Giorgio Tulli, Pierluigi Ipponi, Claudio Marinai, Andrea Messori
BACKGROUND: In the clinical literature on abdominal hernia repair, no sound criteria have been established to support the use of biological meshes as opposed to synthetic ones. Furthermore, the information on biological meshes is quite scarce, and so their place in therapy has not yet been defined. METHODS: The treatment of primary and incisional ventral hernia was the target intervention evaluated in our analysis. Our study consisted of the following phases: a) Identification of the biologic meshes available on the market; b) Literature search focused on efficacy and safety of these meshes; c) Analysis of the findings derived from the literature search...
March 1, 2018: International Journal of Surgery
Michael J Fitzgerald, Sarah Ullrich, Kumar Singh, Oren Misholy, Peter Kingham, Mary S Brady
Parastomal hernia repair remains a significant surgical challenge. Recurrence after standard "keyhole" or primary suture repair is common. We adopted and modified a new technique using a construct shaped like an inverted top hat. We review our experience over the last six years in the first 30 patients (31 consecutive procedures). Of these 31 procedures, six (19%) resulted in a parastomal hernia recurrence with a median follow-up of 31 months (range 0.5-80). Four of the recurrences occurred in our initial experience, when we constructed the top hat of xenograft alone...
February 22, 2018: American Journal of Surgery
Ralph F Staerkle, Henry Hoffmann, Ferdinand Köckerling, Daniela Adolf, Reinhard Bittner, Philipp Kirchhoff
BACKGROUND: A considerable number of patients undergoing incisional hernia repair are on anticoagulant or antiplatelet therapy or have existing coagulopathy which may put them at higher risk for postoperative bleeding complications. Data about the optimal treatment of these patients are sparse. This analysis attempts to determine the rate of postoperative bleeding complications following incisional hernia repair and the consecutive rate of reoperation among patients with coagulopathy or receiving antiplatelet and anticoagulant therapy (higher risk group) compared to patients who do not have a higher risk (normal risk group)...
February 28, 2018: Surgical Endoscopy
N Asakage
BACKGROUND: There has been confusion in the anatomical recognition when performing inguinal hernia operations in Japan. From now on, a paradigm shift from the concept of two-dimensional layer structure to the three-dimensional space recognition is necessary to promote an understanding of anatomy. ANATOMY AND EMBRYOLOGY: Along with the formation of the abdominal wall, the extraperitoneal space is formed by the transversalis fascia and preperitoneal space. The transversalis fascia is a somatic vascular fascia originating from an arteriovenous fascia...
February 27, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Marco Aurelio Rendón-Medina, Rodolfo Omar Ávalos-Abreu, Jocelyn Saucedo-Saldivar, Erick Sánchez-Tellez, Marco Garcia-Puig
INTRODUCTION: A Giant Hiatal Paraesophageal Hernia (GPEH) is a Hiatal Hernia (HH) that includes more than 30% of the stomach in the thorax. The gold standard form of repair today is the laparoscopic abdominal approach in elective scenarios. Laparoscopic HH repair advantages include, less postoperative pain, small incisions, reduced postoperative respiratory complications are reduced, shorter hospital stay. The objective of this paper is to describe a patient undergoing with upper intestinal obstruction and a GPEH Type IV, approached laparoscopically...
July 25, 2017: International Journal of Surgery Case Reports
Ivo Soldo, Ivo Baća, Marko Sever, Ivan Zoričić, Martin Grbavac, Rosana Troskot Perić, Zoran Čala, Maja Karaman Ilić, Anamaria Soldo, Branko Bakula
We report on three cases of diaphragmatic (Morgagni) hernia with different clinical presentation. It is important to consider the possibility of this rare but potentially very dangerous condition in patients with respiratory problems and pain in the upper abdomen. Before laparoscopy, two different approaches were used in diaphragmatic hernia operations (abdominal and thoracic approach). Laparoscopy has brought significant changes in the treatment of diaphragmatic hernia. It is important to stress that laparoscopic diaphragmatic surgical therapy uses stronger mesh than the mesh used to repair an inguinal hernia...
June 2017: Acta Clinica Croatica
Julio Bissoli, Homero Bruschini
Pelvic organ prolapse (POP) has borrowed principles of treatment from hernia repair and in the last two decades we saw reinforcement materials to treat POP with good outcomes in terms of anatomy but with alarming complication rates. Polypropylene meshes to specifically treat POP have been withdrawn from market by manufactures and a blank space was left to be filled with new materials. Macroporous monofilament meshes are ideal candidates and electrospinning emerged as a reliable method capable of delivering production reproducibility and customization...
2018: International Journal of Biomaterials
Kazuya Takabatake, Takeshi Kubota, Hirotaka Furuke, Chikage Kato, Takuma Kishimoto, Tatuya Kumano, Kenichiro Imura, Katsumi Shimomura, Jun Ikeda, Fumihiro Taniguchi, Yasuhiro Shioaki
Re-laparotomy with resection of the mesh after abdominal incisional hernia repair may cause recurrence of the hernia and infection of the mesh. In the present study, we performed laparoscopic distal gastrectomy(LDG)for early gastric cancer without the resection of the mesh in such a case. A 82-year-old man who had undergone abdominal vascular replacement, cholecystectomy, abdominal incisional hernia repair with the mesh, sigmoidectomy had local recurrence of gastric cancer after endoscopic submucosal resection...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Fernando Ruiz-Jasbon, Kristina Ticehurst, Jukka Ahonen, Jonny Norrby, Marie-Lois Ivarsson
Background and Objectives: The role of long-term degradable implants in reducing the risk of chronic postoperative pain after inguinal hernia repair is still unclear. A pilot study using a synthetic long-term resorbable mesh in Lichtenstein repair showed good results regarding pain and discomfort in patients with indirect inguinal hernia (IH) without recurrences, but higher recurrence rate in patients with direct inguinal hernia (DH). The purpose of this study was to assess the incidence of pain and early recurrence in patients with LIH surgically treated with the TEP technique using a long-term degradable mesh...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Michael Kennedy, Kaylene Barrera, Andrew Akelik, Yohannes Constable, Michael Smith, Paul Chung, Gainosuke Sugiyama
Background and Objectives: Ventral hernia repair is one of the most commonly performed general surgery procedures, and minimally invasive approaches are increasingly preferred. The physiologic repair offered by the preperitoneal approach is favorable, with reduced complications, but it remains a technical challenge. The robotic platform allows for enhanced instrument flexibility and ease of operation. We conducted a retrospective review of our experience with robotic transabdominal preperitoneal repair (rTAPP) versus robotic intraperitoneal onlay mesh (rIPOM) at a tertiary care hospital in an urban setting...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
K Mitura, S Kozieł
BACKGROUND: In low-resource countries, a suture repair is still in common use due to the limited access to commercial mesh implants. The search for less expensive alternatives to the synthetic meshes has led to using mosquito nets. Sterilized mosquito net appears to be a low-cost and commonly available product that closely resembles commercially available meshes. However, the extent to which sterilization alters the structure of mosquito nets is still unknown. The aim of this research was to assess the effects of different sterilization types on physico-mechanical properties of mosquito nets...
February 22, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Gabriele Böhm, Jürgen Groll, Karl-Heinz Heffels, Nicole Heussen, Peter Ink, Hamid Patrick Alizai, Ulf Peter Neumann, Reinhild Schnabel, Ursula Mirastschijski
Polypropylene meshes are standard for hernia repair. Matrix metalloproteinases play a central role in inflammation. To reduce the inflammatory response and improve remodelling with an associated reduction of hernia recurrence, we modified polypropylene meshes by nanofibre coating and saturation with the broad-spectrum matrix metalloproteinase inhibitor GM6001. The aim was to modulate the inflammatory reaction, increase collagen deposition and improve mesh biointegration. Polypropylene meshes were surface-modified with star-configured NCO-sP(EO -stat-PO) and covered with electrospun nanofibres (polypropylene-nano) and GM6001 (polypropylene-nano-GM)...
January 1, 2018: Journal of Biomaterials Applications
Ayse V Dikmen, Cagri Guneri, Serdar Yalcin, Onur Acikgoz, Esat Ak, Sadettin Cetiner
A 74-year-old male patient with prostate cancer under remission was admitted with left inguinoscrotal swelling. He underwent scrotal ultrasound demonstrating a giant in-guinoscrotal hernia. Contrast-enhanced computerized tomography of the abdomen and pelvis demonstrated a left pelvic kidney associated with severe hydroureteronephrosis secondary to a ureteral inguinoscrotal hernia. Upon exploration with left inguinal incision, a paraperitoneal ureteral in-guinoscrotal hernia and a hypertrophic left spermatic cord were observed...
November 2017: Current Urology
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