The reality of general surgery training and increased complexity of abdominal wall hernia surgery

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 supervision in this field. Practicing general surgeons with a special interest in hernia surgery can undertake intensive further training in this area by participating in clinical work shadowing in hernia centers, workshops and congresses.
Source: Hernia - Category: Sports Medicine Source Type: research

Related Links:

ConclusionSimultaneous PAN is possible in patients with an abdominal apron who are undergoing VHR, with an acceptable risk of SSOs and other complications. This technique provides excellent exposure and with appropriate training is well within the remit of the general surgeon. This may save further operative management in the future and can offer patients improved self-esteem, mobility, and independence. Patient optimisation is key, paying careful attention to pre-operative weight loss, diabetic control, smoking cessation and respiratory function. VHR  + PAN is an important technique that should be in the rep...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractAimTo analyze the outcomes of component separation techniques (CST) to treat incisional hernias (IH) in a large multicenter cohort of patients.MethodsAll IH repair using CST, registered in EVEREG from July 2012 to December 2019, were included. Data on the pre-operative patient characteristics and comorbidities, IH characteristics, surgical technique, complications, and recurrence were collected. Outcomes between anterior (ACS) and posterior component separation (PCS) techniques were compared. Risk factors for complications and recurrences were analyzed.ResultsDuring the study period, 1536 patients underwent CST (45...
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionThe typical injury pattern of thoracoabdominal hernias includes disruption of the intercostal muscles, transversus abdominis, and commonly the internal oblique with an intact external oblique. Inferior rib displacement by hernia contents and unopposed pull of the abdominal musculature is common. Osseous or cartilaginous disruption always occurs unless the defect is bounded on at least one side by a floating rib.
Source: Hernia - Category: Sports Medicine Source Type: research
This study compares laparoscopic versus open umbilical hernia repairs in obese patients.MethodsAll patients with body mass index (BMI) ≥ 30 kg/m2 who underwent elective, open or laparoscopic repair of a primary umbilical hernia with mesh were identified from the Americas Hernia Society Quality Collaborative (AHSQC). A retrospective review of the prospectively collected data was conducted. Outcomes of interest included surgical site infections (SSI), surgical site occurrences requiring procedural intervention (SSOPI), hernia-related quality-of-life survey (HerQles), and long-term recurrence. A logistic regres...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractPurposeDespite the limited research in support of robotic inguinal hernia repair (RIHR), it is an increasingly adopted technique in surgical practice. While a major risk factor for the development of ventral hernias and subsequent complications, obesity in RIHR has not been investigated. The aim of this study was to compare the outcomes of RIHR between obese and non-obese patients.MethodsProspectively collected data surrounding RIHRs performed at a single center between 2013 and 2020 were retrospectively reviewed. Patients were divided into non-obese (
Source: Hernia - Category: Sports Medicine Source Type: research
CONCLUSION: The introduction of a composite mesh represents an alternative surgical technique for the repair of giant incisional hernias.PMID:33981429 | PMC:PMC8085897 | DOI:10.1016/j.amsu.2021.102340
Source: Annals of Medicine - Category: Internal Medicine Authors: Source Type: research
ConclusionOur study shows that patients with a recurrent incisional hernia have significantly more subcutaneous and visceral adipose tissue than those with a primary incisional hernia. Further studies in this area are required if we are to reduce the burden of recurrent hernia following repair of a primary incisional hernia.
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractIntroductionThe proportion of epigastric hernias in the total collective of all operated abdominal wall hernias is 3.6 –6.9%. The recently published guidelines for treatment of epigastric hernias of the European Hernia Society and the Americas Hernia Society recommend the use of a mesh for defect size of ≥ 1 cm, i.e., a preperitoneal flat mesh technique for sizes 1–4 cm, and laparoscopic IPOM technique f or defects >  4 cm and/or obesity. Against that background, this analysis of data from the Herniamed Registry now aims to explore trends in epigastric he...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractBackgroundIncisional hernias (IH) following abdominal surgery persist as morbid, costly, and multi-disciplinary surgical challenges. Using longitudinal, multi-state, administrative claims data (HCUP State Inpatient Databases (SID)); (HCUP State Ambulatory Surgery and Services Databases (SASD)), we aimed to characterize the epidemiology, outcomes, recurrence, and costs of IH.Study design529,108 patients undergoing abdominal surgery in 2010 across six specialties (colorectal, general/bariatric, hepatobiliary, obstetrics/gynecology, urology, and vascular) were identified within inpatient and ambulatory databases for F...
Source: Hernia - Category: Sports Medicine Source Type: research
Chirurg. 2021 Apr 1. doi: 10.1007/s00104-021-01383-z. Online ahead of print.ABSTRACTIn accordance with the guidelines suture procedures, a preperitoneal mesh technique, the laparoscopic intraperitoneal onlay mesh (IPOM) or the new minimally invasive techniques, i.e. the endoscopic mini/less open sublay (E/MILOS) technique, enhanced-view totally extraperitoneal (eTEP) repair and totally endoscopic sublay (TES) repair should be used for primary abdominal wall hernias (umbilical hernia, epigastric hernia) depending on the defect size and patient characteristics (obesity, rectus abdominis muscle diastasis). For incisional hern...
Source: Der Chirurg - Category: Surgery Authors: Source Type: research
More News: Databases & Libraries | Eating Disorders & Weight Management | Emergency Medicine | Gastroschisis Repair | Hernia | Hernia Repair | Laparoscopy | Learning | Lower Endoscopy | Obesity | Politics | Sports Medicine | Surgery | Training | Universities & Medical Training | Women | Workshops