Novel Technique for Full-Thickness Abdominal Wall Closure in Laparoscopic Ventral Hernia Repair.
Novel Technique for Full-Thickness Abdominal Wall Closure in Laparoscopic Ventral Hernia Repair. Surg Technol Int. 2019 Oct 01;35: Authors: Voeller GR, Chin AK, LeBlanc KA Abstract Laparoscopic ventral hernia repair incorporating a prosthetic mesh underlay, first described in 1993, has demonstrated a lower long-term recurrence rate versus open non-mesh repair. However, over the past 25 years, the laparoscopic approach to ventral/incisional hernias is utilized in only approximately 30% of cases. One of the reasons that prevents it from being utilized more often is the inability to readily, reliably, and easily close the fascial defect. A novel technique has been developed for full-thickness abdominal wall closure in laparoscopic ventral hernioplasty, utilizing puncture sites to place multiple self-locking ligature straps. Introduction of the straps into the abdominal cavity in orthogonal orientation to the skin surface, followed by subcutaneous retrieval of the contralateral tip of the strap, achieves incorporation of full-thickness abdominal wall on either side of the defect. The self-locking property of each strap allows tension to be applied in sequential fashion. Incremental tension application facilitates re-apposition of the borders in large defects. The increased width of the strap compared with conventional suture serves to resolve the force exerted upon tissue during the acute phase of defect closure. The instrumentation was tested in six ventral ...
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]
ConclusionTAPP is a safe procedure for treat groin hernias, unless, mesh complications like foreign body reaction, deep-seated infection, mesh migration and perforation.
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: Despite recent controversy, UK surgeons support the use of mesh in the repair of inguinal hernias with an open Lichtenstein repair being the most common choice. There has only been a modest increase in the use of laparoscopic surgery over the past 20 years. PMID: 31755727 [PubMed - as supplied by publisher]
In this study, we retrospectively reviewed 257 cases of acutely incarcerated or strangulated groin hernias repaired by a large group of surgeons practicing across academic or community hospitals affiliated with our institution. The objective of our study was to investigate the different management approaches performed at our institution (open versus laparoscopic, mesh versus tissue repairs) and their associated short- and long-term outcomes.
ConclusionA tailored approach is now employed and seen more so in hernia surgery and this fact is referred to and highlighted in the contemporaneous hernia guidelines published to date. In addition, with the increasing complexity of abdominal wall surgery, the number of procedures actually performed by trainees is no longer considered adequate to overcome any recognized learning curve. Therefore, to supplement general surgery training young surgeons should be offered a clinical fellowship to obtain an additional qualification as an abdominal wall surgeon and thus improve their clinical and operative experience under superv...
Conditions: Ventral Hernia; Umbilical Hernia; Epigastric Hernia Intervention: Procedure: Ventral Hernia Repair Sponsor: The Cleveland Clinic Recruiting
ConclusionWe strongly recommend employing a combined laparoscopic and thoracoscopic approach for an emergency repair of a tension gastrothorax in a hemodynamically stable patient as, it poses all the advantages of minimal access surgery and is available, at smaller centres, even in an emergency.
CONCLUSION: For the comparison of surgical techniques and outcomes, prospective randomized studies should be designed to standardize broad-based surgical techniques. PMID: 31701494 [PubMed - in process]