Paraesophageal Hernia Repair: A Still-Evolving Operation in Pursuit of Perfection
We are pleased to present this issue of Thoracic Surgery Clinics dedicated to the surgical repair of paraesophageal hernias. Over the decades, our understanding and approach to the management of patients with substantial transhiatal herniation of the stomach and other abdominal viscera into the chest have changed significantly, while simultaneously still adhering to the traditional principles of repair that have stood the test of time. Traditionally approached from the chest by open thoracotomy, abdominal approaches have become the dominant route of repair, with minimally invasive laparoscopic approaches being the route of choice for many surgeons.
ConclusionsThis meta-analysis indicates that MPR and PHS seem comparable to LR in terms of recurrence, chronic pain, time to return to work, inguinal paresthesia, testicular and scrotal problems, hematoma, seroma and wound infection. MPR and PHS seem comparable in terms of recurrence, chronic pain and wound infection.
ConclusionThe peritoneal flap hernioplasty is associated with few complications and a very low recurrence rate. We propose this technique as the method of choice for reconstruction of transverse abdominal incisional hernias when primary fascial apposition is not possible.
ConclusionsAlthough repair of recurrent PEHs are historically associated with worse outcomes, in this series, RAL recurrent PEH repairs have similar peri-operative and post-operative outcomes as compared to primary PEH repairs. Whether this is secondary to the potential advantages afforded by the robotic platform deserves further study.
Conclusion: It is important to consider mesh graft migration to viscus as a cause of persistent abdominal pain and bleeding per rectum irrespective of the time of presentation post hernia repair. PMID: 31788028 [PubMed]
AbstractBackgroundIncisional hernia repair requires detailed anatomic knowledge. Regarding median subxiphoidal hernias, the proper preparation of the fatty triangle is challenging. To foster proficiency-based training, a cost-efficient model for open median retromuscular mesh repair resembling the human body was developed, including the main anatomical structures related to the procedure. The aim is to create and validate a high-fidelity model on open retromuscular mesh repair suitable for"training before doing".Materials and methodsDifferent types of fabrics for imitation of connective tissue and 2-component sil...
ConclusionTAPP is a safe procedure for treat groin hernias, unless, mesh complications like foreign body reaction, deep-seated infection, mesh migration and perforation.
ConclusionsThe study gives a detailed picture of hospital care for inguinal hernia repair in Germany. Furthermore, it was noted that the risk of hernia recurrence decreases in line with a rising caseload of the treating hospital.
ConclusionWith technical modification of precostal access and pneumatic balloon dilation of both retro-rectus compartments, the complex procedure can be simplified through time saving and straightforward unidirectional ‘top-down’ dissection. The better overview facilitates the crossover for connecting both retro-rectus spaces. In addition, the cranial access allows the anterior- and posterior layers to be closed up to the xiphoid.
AbstractIntroductionTo date, little attention has been paid by surgical scientific studies to sex as a potential influence factor on the outcome. Therefore, there is a sex bias in the surgical literature. With an incidence of more than 20% after 3 years, incisional hernias are a common complication following abdominal surgical procedures. The proportion of women affected is around 50%. There are very few references in the literature to the influence of sex on the outcome of elective incisional hernia repair.Materials and methodsIn all, 22,895 patients with elective incisional hernia repair from the Herniamed Registry...
CONCLUSIONS: IHRT repair is a safe procedure at our medical center, with an acceptable rate of hernia recurrence, but it is not without complications. PMID: 31785777 [PubMed - as supplied by publisher]