Resident involvement in minimally-invasive vs. open procedures
The objective of this study was to evaluate the impact of resident involvement on surgical outcomes in laparoscopic compared to open procedures.MethodsThe American College of Surgeons National Surgical Quality Improvement Program 2007–2012 was queried for open and laparoscopic ventral hernia repair (VHR), inguinal hernia repair (IHR), splenectomy, colectomy, or cholecystectomy (CCY). Multivariable regression analyses were performed to assess the impact of resident involvement on surgical outcomes.ResultsIn total, 88,337 VHR, 20,586 IHR, 59,254 colectomies, 3,301 splenectomies, and 95,900 CCY were identified. Resident involvement was predictive for major complication during open VHR (AOR, 1.29; p
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]
Condition: Parastomal Hernia Intervention: Procedure: Laparascopic repair of parastomal hernia Sponsor: Aalborg University Hospital Completed
CONCLUSION: Upper GI surgeons need to have an index of suspicion for PEDH. They must investigate and operate these patients if this complication develops, since an immediate surgery has a high mortality and poor outcome. PMID: 31786839 [PubMed - in process]
This study examined the fidelity, and perceived usefulness of our developed simulation model by surgical residents and expert surgeons.MethodsA total of 66 Dutch surgical residents and ten international expert surgeons were included. All participants viewed a video-demonstration of LOIHR on the simulation model and subsequently performed the surgery themselves on the model. Afterward, they assessed the model by rating 13 statements concerning its fidelity (six model, three equipment, and four psychological) and six usefulness statements on a five-point Likert scale. One-sample Wilcoxon signed-rank test was used to compare ...
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...
This study examined outcomes, surgical complications, and revisions in patients treated with laparoscopic Nissen fundoplication for hiatal hernia and substantial gastroesophageal reflux disease. In total, 85 consecutive patients who underwent hernia repair with MIROMESH Biologic Matrix, a novel hepatic-derived surgical mesh served as subjects. Subjects were contacted by phone, consented, and participated in an Institutional Review Board-approved structured phone interview. Responses were acquired from 73 of the 85 patients. The gastroesophageal reflux disease health–related quality of life showed significant improvem...
Conclusions: Highly complex cases, marked by revisional status, need for mesh, large hernia size, and percutaneous endoscopic gastrostomy placement are likely at increased risk for PEs. Preoperative venous thromboembolism chemoprophylaxis should be considered in the majority of laparoscopic PEHR patients.
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.