Incisional hernia repair in a high-fidelity silicone model for open retro-muscular mesh implantation with preparation of the fatty triangle: validation and educational impact study

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 silicones were used to construct the incisional hernia model. Sample size for validation of the model was determined by a triangular testing approach. Operations from six beginners and six experts were assessed by three blinded-raters. Reliability and construct-validity were evaluated on a behaviorally anchored rating scale (highest score: 4) for the criteria: “instrument use”, “tissue handling”, “near misses and errors”, and “end-product quality”.ResultsThe model authentically mimicked an open median retromuscular mesh repair. Participants considered the procedure realistic.Reliability was excellent, ranging from 0.811 to 0.974 for “end-product quality”, and “tissue handling“ respectively.Construct-validity was confirmed with experts significantly outperforming beginners in the “use ...
Source: Hernia - Category: Sports Medicine Source Type: research

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Although preoperative administration of high-dose glucocorticoid may lead to improved recovery after operative procedures, this regimen has not been examined in patients undergoing abdominal wall reconstruction for repair of large ventral hernias. The aim of the current trial was to examine the effects of preoperative, single high-dose glucocorticoid on recovery after abdominal wall reconstruction.
Source: Surgery - Category: Surgery Authors: Source Type: research
ConclusionsLateral hernias present a greater challenge due to their anatomic location. An open technique with mesh fixation to bony structures is a promising solution to this complex problem.
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractProphylactic augmentation of the wound with mesh proposed by Kniepeiss et al is the world's first attempt to significantly reduce the risk of postoperative hernia in liver transplantation. Similar technique have been described 17 years ago in bariatric patients and confirmed by many studies in various clinical settings. The results of mesh hernia repair in patients on immunosuppressive therapy are not inferior from the data obtained from non- transplant surgery registers.To reduce the risk of using the mesh in patients scheduled for liver transplantation authors chose absorbable mesh, that maintains the mechanical ...
Source: Trials - Category: Research Source Type: clinical trials
ConclusionSurgeons performing laparoscopic excisional biopsy of the diaphragmatic peritoneum should consider the potential risk for iatrogenic diaphragmatic hernias.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionWe successfully performed single-incision retroperitoneal laparoscopic repair of superior lumbar hernia using self-fixating mesh.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
AbstractBackgroundMesh repair of parastomal hernia is widely accepted as superior to non-mesh repair, yet the most favorable surgical approach is a subject of continued debate. The aim of this study was to compare the clinical outcomes of open versus laparoscopic parastomal hernia repair.MethodsAn IRB-approved retrospective review was conducted comparing laparoscopic (LPHR) or open (OPHR) parastomal hernia repair performed between 2009 and 2017 at our facilities. Patient demographics, preoperative characteristics, operative details, and clinical outcomes were compared by surgical approach. Subgroup analysis was performed b...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionExperienced endoscopic laparoscopic hernia surgeons have the same or lower complication rates in TAPP therapy in complex inguinal and femoral hernias as in primary hernias with a high patient satifaction with the outcome of TAPP hernioplasty.
Source: European Surgery - Category: Surgery Source Type: research
ConclusionPerineal hernias can be repaired with robot-assisted laparoscopy. Furthermore, compared with the open and laparoscopic methods, suturing and mesh placement are easier with the robot approach.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
This study evaluates the relationship of PA to outcomes after open ventral hernia repair (OVHR).MethodsA prospective institutional database was queried for patients undergoing OVHR. Demographics, operative characteristics, and outcomes were evaluated by the reported PA and the administration of beta-lactam prophylaxis (BLP).ResultsAllergy histories were reviewed in 1178 patients. PA was reported in 21.6% of patients, with 55.5% reporting rash or hives, 15.0% airway compromise or anaphylaxis, and 29.5% no specific reaction. BLP was administered to 76.3% of patients, including 22.1% of PA patients and 89.9% of patients witho...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusion: Our network meta-analysis showed that there were no differences among the TAPP, TEP, and Lichtenstein procedures in terms of safety or effectiveness for treating inguinal hernias. However, TAPP and TEP could decrease the number of return-to-work days. A further study with more focus on this topic for inguinal hernia is suggested.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
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