Increasing hernia size requires higher GRIP values for a biomechanically stable ventral hernia repair
Publication date: Available online 19 April 2019Source: Annals of Medicine and SurgeryAuthor(s): F. Kallinowski, D. Gutjahr, M. Vollmer, F. Harder, R. NesselAbstractBackgroundIncreasing hernia sizes lead to higher recurrence rates after ventral hernia repair. A better grip might reduce the failure rates.Material and MethodsA biomechanical model delivering dynamic intermittent strain (DIS) was used to assess grip values at various hernia orifices. The model consists of a water-filled aluminium cylinder covered with tissues derived from pig bellies which are punched with a central defect varying in diameter. DIS was applied mimicking coughs lasting for up to 2 secs with peak pressures between 180 and 220 mmHg and a plateau phase of 0.1 secs. Ventral hernia repair was simulated with hernia meshes in the sublay position secured by tacks, glue or sutures as needed to achieve certain grip values. Grip was calculated taking into account the mesh: defect area ratio and the fixation strength. Data were assessed using non-parametric statistics.ResultsUsing a mesh classified as highly stable upon DIS testing (DIS class A) a reduced overlap without fixation led to early slippage (p
ConclusionIn advanced liver cirrhosis patients with refractory ascites, hernias can be safely treated with elective surgical repair. Mortality rate within 30 days did not differ by the presence or absence of refractory ascites. Elective hernia repair might be beneficial for treatment of abdominal wall hernia in cirrhotic patients with refractory ascites.
Publication date: Available online 9 September 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Amanda Muñoz, Victoria Pepper, Faraz A. Khan, Andrei RadulescuAbstractAnterior diaphragmatic hernias through the foramen of Morgagni are rare accounting for about 3% of surgically treated diaphragmatic hernias. Current management of Morgagni type diaphragmatic hernias involves surgical intervention, which is traditionally done by open laparotomy, laparoscopy or thoracoscopic approach. Here we present the case of a two year old female with a Morgagni type congenital diaphragmatic hernia (CDH) found during wo...
Conclusions: Our systematic review suggests that, in experienced hands, safety, feasibility and clinical outcomes of minimally invasive repair of IH in patients previously treated with prostatectomy, are comparable to those patients without previous RP.
Conclusion: In our opinion, the RRSM technique is an important tool in the armamentarium of the laparoscopic surgeon dealing with ventral abdominal hernias, allowing placement of polypropylene mesh in an extraperitoneal space. It allows significant cost savings as compared to the prevalent intraperitoneal onlay mesh repair.
Journal of Minimal Access Surgery 2019 15(4):362-362
This article describes the normal anatomy and anatomic abnormalities in application to the various approaches used in the surgical repair of a paraesophageal hernia.
Gastroesophageal reflux disease (GERD) is common in the morbidly obese population, and hiatal hernias are encountered in 20% to 52% of patients. Primary surgical repair of hiatal hernias, in particular the paraesophageal type, is associated with a higher recurrence rate in obese patients. Concomitant weight loss surgery may be advisable. Combined sleeve gastrectomy and paraesophageal hiatal hernia repair is feasible but can induce or worsen preexisting GERD. A Roux-en-Y gastric bypass offers advantages of more pronounced excess weight loss and better symptom control, albeit with a potentially higher rate of morbidity compa...
AbstractUmbilical hernias and epigastric hernias are some of the most common hernias in the world. Umbilical and epigastric hernia defects can range from small (
This study aims to address whether the low-dose acetylsalicylic acid increases bleeding and occurrence of postoperative complications after laparoscopic inguinal hernia repair when it was only ceased on the operation day.MethodFrom July 2017 to January 2019, 901 patients including 781 (86.7%) male and 120 (13.3%) female patients underwent laparoscopic inguinal hernia repair using trans-abdominal preperitoneal (TAPP) technique were recruited, among whom 152 (16.9%) had been taking low-dose (100 mg per day) acetylsalicylic acid which was continued during hospitalization except the operation day. The intra-operative ble...
Paraesophageal hernias (PEH) are common among patients with obesity. Most patients with severe obesity and a PEH will have it repaired at the time of bariatric surgery. However, it is unclear whether there is increased risk for repairing a PEH during bariatric surgery.