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Pneumoperitoneum in ventral hernia repair

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https://www.readbyqxmd.com/read/27728945/a-clinical-quality-improvement-cqi-project-to-improve-pain-after-laparoscopic-ventral-hernia-repair
#1
Bruce Ramshaw, Brandie Forman, Eric Heidel, Jonathan Dean, Andrew Gamenthaler, Michael Fabian
Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months). Initiatives for improved patient outcomes during this period included the administration of a transversus abdominis plane (TAP) block and/or an intra-operative block with long-acting local anesthetic first, and then a low pressure pneumoperitoneum (LPP) system was implemented later in the project...
October 6, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27572061/preoperative-progressive-pneumoperitoneum-complementing-chemical-component-relaxation-in-complex-ventral-hernia-repair
#2
Kristen E Elstner, John W Read, Omar Rodriguez-Acevedo, Kevin Ho-Shon, John Magnussen, Nabeel Ibrahim
BACKGROUND: A rarely used technique for enabling closure of large ventral hernias with loss of domain is preoperative progressive pneumoperitoneum (PPP), which uses intermittent insufflation to gradually stretch the contracted abdominal wall muscles, increasing the capacity of the abdominal cavity. This allows the re-introduction of herniated viscera into the abdominal cavity and assists in closure of giant hernias which may otherwise be considered inoperable. METHODS: This was a prospective study assessing 16 patients between 2013 and 2015 with multi-recurrent ventral hernia...
August 29, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27465223/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-after-abdominal-wall-reconstruction-quaternary-syndromes
#3
A W Kirkpatrick, D Nickerson, D J Roberts, M J Rosen, P B McBeth, C C Petro, Frederik Berrevoet, M Sugrue, Jimmy Xiao, C G Ball
BACKGROUND AND AIMS: Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death...
July 27, 2016: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/27336744/-monster-hernia-programme-in-hernia-centre-liberec
#4
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
https://www.readbyqxmd.com/read/27068726/two-stage-endoscopic-repair-of-congenital-diaphragmatic-hernia
#5
Mehran Hiradfar, Reza Shojaeian, Mohamad Gharavi Fard
Minimally invasive surgery (MIS) in congenital diaphragmatic hernia (CDH) repair has recently been gaining popularity and is the first choice in most departments. Loss of space in an undeveloped abdomen may cause serious problems such as difficult visceral reduction and need for conversion or postoperative complications such as abdominal compartment syndrome. A 4-month-old boy with delayed diagnosis of CDH underwent MIS repair via thoracoscopy, but the abdominal space was not large enough to accept the herniated viscera so a wide transverse fasciotomy was performed via laparoscopy and an iatrogenic ventral hernia induced...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26860729/methods-of-abdominal-wall-expansion-for-repair-of-incisional-herniae-a-systematic-review
#6
REVIEW
N N Alam, S K Narang, S Pathak, I R Daniels, N J Smart
AIM: To systematically review the available literature regarding methods for abdominal wall expansion and compare the outcome of primary fascial closure rates. METHODS: A systematic search of Pubmed and Embase databases was conducted using the search terms "Abdominal wall hernia", "ventral hernia", "midline hernia", "Botulinum toxin", "botox", "dysport", "progressive preoperative pneumoperitoneum", and "tissue expanders". Study quality was assessed using the Methodological Index for Non-Randomised Studies...
April 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/26098595/pneumatic-positioning-and-mesh-fixation-in-laparoscopic-ventral-incisional-hernia-repair-new-surgical-technique-and-a-new-device
#7
Antonio Darecchio, Paolo Bocchi, Jan F Kukleta
AIM: To achieve full-surface contact of a prosthetic mesh with the abdominal wall (avoiding folds and wrinkles) in laparoscopic ventral/ incisional hernia repair (LVHR/ LIHR) and to fix the mesh with glue using a new surgical technique and a new device, developed for this specific procedure. MATERIAL OF STUDY: New surgical technique associated with a new surgical pneumatic device allows perfect positioning and extension of the intraperitoneal mesh and facilitates the glue application and mesh fixation...
May 2015: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/25848195/magnetic-resonance-visible-meshes-for-laparoscopic-ventral-hernia-repair
#8
Gernot Köhler, Leo Pallwein-Prettner, Oliver Owen Koch, Ruzica Rosalia Luketina, Michael Lechner, Klaus Emmanuel
BACKGROUND AND OBJECTIVES: We aimed to evaluate the first human use of magnetic resonance-visible implants for intraperitoneal onlay repair of incisional hernias regarding magnetic resonance presentability. METHODS: Ten patients were surgically treated with intraperitoneally positioned superparamagnetic flat meshes. A magnetic resonance investigation with a qualified protocol was performed on postoperative day 1 and at 3 months postoperatively to assess mesh appearance and demarcation...
January 2015: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/25386483/giant-inguinoscrotal-hernia-repaired-by-lichtensteins-technique-without-loss-of-domain-a-case-report
#9
Dinesh Hn, Jagadish Kumar Cd, Shreyas N
Giant inguinal hernia is a formidable surgical problem. It is defined as inguinal hernia extending up to mid thigh or below in standing position. Giant inguinal hernia is usually associated with compromised quality of life due to sexual discomfort and constant weight bearing. It is a challenge for the operating surgeon since it is rare. It may require multistage repair with recurrence being common. A 45-year-old male patient presented with Giant inguinal hernia and compromised quality of life due to pain and sexual discomfort...
September 2014: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/25375055/progressive-preoperative-pneumoperitoneum-ppp-as-an-adjunct-for-surgery-of-hernias-with-loss-of-domain
#10
V Oprea, O Matei, D Gheorghescu, D Leuca, F Buia, M Rosianu, M Dinca
BACKGROUND: forced repair of a giant abdominal wall defect end with unsatisfactory results despite development of prosthetics materials. The enlargement of abdominal wall dimensions could be realized altogether other methods with the aid of pneumo-peritoneum. The aim of the study is to evaluate early results of the method used for patients with giant incisional hernias. MATERIAL AND METHODS: between june 1998 - june 2013, 17 patients (4 males) with giant abdominal wall defects (incisional and inguinal hernias) were prepaired for radical surgery with pneumoperitoneum...
September 2014: Chirurgia
https://www.readbyqxmd.com/read/24947641/laparoscopy-is-safe-among-patients-with-congestive-heart-failure-undergoing-general-surgery-procedures
#11
Paul J Speicher, Asvin M Ganapathi, Brian R Englum, Steven N Vaslef
BACKGROUND: Over the past 2 decades, laparoscopy has been established as a superior technique in many general surgery procedures. Few studies, however, have examined the impact of the use of a laparoscopic approach in patients with symptomatic congestive heart failure (CHF). Because pneumoperitoneum has known effects on cardiopulmonary physiology, patients with CHF may be at increased risk. This study examines current trends in approaches to patients with CHF and effects on perioperative outcomes...
August 2014: Surgery
https://www.readbyqxmd.com/read/24428286/common-postoperative-findings-unique-to-laparoscopic-surgery
#12
Nicole M Hindman, Stella Kang, Manish S Parikh
The interpretation of images obtained in patients who have recently undergone abdominal or pelvic surgery is challenging, in part because procedures that were previously performed with open surgical techniques are increasingly being performed with minimally invasive (laparoscopic) techniques. Thus, it is important to be familiar with the normal approach used for laparoscopic surgeries. The authors describe the indications for various laparoscopic surgical procedures (eg, cholecystectomy, appendectomy, hernia repair) as well as normal postoperative findings...
January 2014: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/23657859/hybrid-ventral-hernia-repair-technique-and-results
#13
N Stoikes, M Quasebarth, L M Brunt
BACKGROUND: Open and laparoscopic approaches to ventral hernia repair are generally exclusive of each other. However, select patients with difficult hernias may benefit from combined open/laparoscopic hybrid techniques to avoid dissection of large subcutaneous flaps. METHODS: Seven patients underwent combined laparoscopic and open approaches for ventral hernia repair. Records were reviewed for technical details, demographics, hernia and mesh characteristics, and postoperative outcomes...
October 2013: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/23473433/-progressive-preoperative-pneumoperitoneum-in-patients-with-giant-hernias-of-the-abdominal-wall
#14
María Clara López Sanclemente, Joaquim Robres, Manuel López Cano, Joan Barri, Roberto Lozoya, Sergio López, M Angeles Vasco, M Carmen Buqueras, Helena Subirana, Rosa Jorba
INTRODUCTION: Patients with giant hernias with loss of domain require proper planning of surgical repair, because of the high associated comorbidity. The progressive preoperative pneumoperitoneum technique described by Goñi Moreno allows a more physiological adaptation of the patient and the abdominal cavity to the reinstatement of the viscera to the abdomen, enabling adequate surgical repair. The objective of this study was to analyze our experience in the treatment of this type of hernia...
August 2013: Cirugía Española
https://www.readbyqxmd.com/read/23292555/combined-laparoscopic-and-open-technique-for-the-repair-of-large-complicated-incisional-hernias
#15
Yun Ji, Xiaoli Zhan, Yuedong Wang, Jinhui Zhu
BACKGROUND: During laparoscopic incisional hernia repair, conversion to open surgery is sometimes needed, especially in cases of large complicated incisional hernias. No guidelines exist for determining when conversions should be considered. This study aimed to investigate the safety of a combined technique as an alternative to conversion in the laparoscopic repair of large complicated incisional hernias and to evaluate the impact of early conversion to the combined technique on patient outcome...
May 2013: Surgical Endoscopy
https://www.readbyqxmd.com/read/22392573/pre-operative-progressive-pneumoperitoneum-for-repair-of-a-large-incisional-hernia
#16
Abdul Haque M Quraishi, Mrinalini M Borkar, Mayur M Mastud, Gaurav G Jannawar
Large incisional hernias are difficult to treat surgically because of the post-operative respiratory complications and abdominal compartment syndrome. Pre-operative progressive pneumoperitoneum is a technique which has been used in such cases. We describe a case of a large incisional hernia, where this technique was employed by objectively calculating abdominal and hernial sac volumes on the basis of computerized tomography scan of abdomen with a satisfactory outcome. A review of literature and issues involved in pre-operative progressive pneumoperitoneum have been discussed...
June 2013: Updates in Surgery
https://www.readbyqxmd.com/read/21643882/impact-of-pressure-and-gas-type-on-adhesion-formation-and-biomaterial-integration-in-laparoscopy
#17
R Rosch, M Binnebösel, C D Klink, J Otto, K Junge, U P Neumann
BACKGROUND: Laparoscopic mesh repair of inguinal and incisional hernias has been widely adopted. Nevertheless, knowledge about the impact of pneumoperitoneum on mesh integration is rare. The present study investigates pressure and gas-dependent effects of pneumoperitoneum on adhesion formation and biomaterial integration in a standardized animal model. METHODS: Laparoscopic intraperitoneal onlay mesh implantation (IPOM) was performed in 32 female chinchilla rabbits using CO(2) or helium for pneumoperitoneum...
November 2011: Surgical Endoscopy
https://www.readbyqxmd.com/read/21355179/-laparoscopic-repair-of-abdominal-ventral-hernias
#18
A E Nicolau
This paper presents the surgical technique for ventral abdominal hernia repair, including median incisional hernia, umbilical hernia and epigastric hernia. The main stages of the surgical procedure are as follows: pinpointing the parietal defect, insufflation of pneumoperitoneum and placing the trocars, inspection and adhesiolysis of the peritoneal cavity, closure of the defect with extracorporeal transparietal U reverse stitches, preparing the mesh, introducing the mesh in the peritoneal cavity and fixing it with transfascial sutures and tackers...
November 2010: Chirurgia
https://www.readbyqxmd.com/read/21136098/single-port-access-prosthetic-repair-for-primary-and-incisional-ventral-hernia-toward-less-parietal-trauma
#19
Pascal Bucher, François Pugin, Philippe Morel
BACKGROUND: Although still under development, single-port access (SPA) approach may be of interest in patients prone to port-side incisional hernia, ensuring absence of increased fascial incision. This forms the basis for evaluating SPA for prosthetic ventral hernia repair. We report a new SPA technique of ventral hernia repair using working-channel endoscope, standard laparoscopic instruments, and 10-mm port. METHODS: Prospective experience with SPA prosthetic repair of primary and incisional ventral hernia in 52 patients for 55 ventral hernias is presented...
June 2011: Surgical Endoscopy
https://www.readbyqxmd.com/read/20932375/transvaginal-repair-of-a-large-chronic-porcine-ventral-hernia-with-synthetic-mesh-using-notes
#20
Ben Powell, Susan H Whang, Sharon L Bachman, J Andres Astudillo, Emanuel Sporn, Brent W Miedema, Klaus Thaler
BACKGROUND: Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. METHODS: Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single colpotomy was made using a 12-cm trocar for an overtube. The mesh was cut to size and placed through the trocar...
April 2010: JSLS: Journal of the Society of Laparoendoscopic Surgeons
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