Open retromuscular versus laparoscopic ventral hernia repair for medium-sized defects: where is the value?

AbstractPurposeThere is increasing emphasis on value in health care, defined as quality over cost required to deliver care. We analyzed outcomes and costs of repairing medium-sized ventral hernias to identify whether an open retromuscular or laparoscopic intraperitoneal onlay approach would provide superior value to the patient and healthcare system.MethodsA retrospective analysis of prospectively collected data from the Americas Hernia Society Quality Collaborative was performed for patients undergoing clean, elective repair of ventral hernias between 4 and 8  cm in width at our institution between 4/2013 and 12/2016 for whom at least 1-year follow-up was available. Recurrence rates, wound complications, length of stay, patient-reported outcomes, and perioperative costs were compared.ResultsOne hundred and eighty-six patients met criteria (105 open, 81 laparoscopic) with 93.5% having  ≥ 2-year follow-up. Patients undergoing laparoscopic repair had higher BMI, lower ASA classification, slightly lower prevalence of recurrent hernias and less prior mesh utilization, and slightly smaller hernias. Length of stay was shorter in the laparoscopic group (median 1 vs. 3 days,p 
Source: Hernia - Category: Sports Medicine Source Type: research

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ConclusionIn our hands, a significantly higher recurrence rate exists for children undergoing the PIRS method over LICPV techniques when treating inguinal hernias.
Source: Hernia - Category: Sports Medicine Source Type: research
Robotic-assisted laparoscopic surgery (RALS) is evolving as an important surgical approach in the field of general surgery. We aimed to evaluate the learning curve for RALS procedures involving repair of hiatal hernias.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Bariatric and foregut Source Type: research
Early adopters of robotic hernia repair have commonly approached small hernias for repair as comfort increased on the platform. We aim to investigate the early temporal outcomes of the robot assisted hernia repairs.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: General Surgery Source Type: research
This study aimed to evaluate the acute pain, chronic pain, and recurrence rate between these two fixation methods.MethodsAfter reviewing all patients in our prospective hernia repair database from February 2008 to December 2017, we identified 583 patients who underwent TEP with tack mesh fixation and 70 patients with glue fixation by a single surgeon. Acute post-operative pain and activity level were evaluated using a Visual Analog Score (VAS) and the modified Medical Outcome Study (MOS) score. The primary endpoint was chronic pain 6 months after TEP. The secondary endpoints were acute pain, activity level, complications, ...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractBackgroundBurnia is a suturless repair for inguinal hernias in girls. It is performed under laparoscopy by grabbing the sac, inverting it into the peritoneal cavity, and cauterizing. The aim of this study is to report our experience with single-site laparoscopic burnia (BURNIA) and compare them with open repair (OPEN).MethodsWith IRB approval, pediatric female patients younger than 18  years of age who underwent inguinal hernia repair between January 2015 and December 2017 were enrolled. Medical records were retrospectively reviewed. The patients were divided into two groups, BURNIA and OPEN.Results198 patient...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
This study was a retrospective review of a prospectively maintained hernia registry from the 1st of February 2019 to 29th of February 2020.Results353 ventral hernia repair cases were recorded of which 47% were incisional hernias and the remainder were primary hernias. The median age was 54  years with even distribution of males and females. Half of the patients were obese with a median BMI of 31 kg/m2. The private sector performed 190 cases (54%) and the public sector 163 cases (46%). The public sector had more current smokers undergoing elective repairs, 28% vs 15%,p = 0.01 and performed more emerg...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractIntroductionHow best to treat a small (
Source: Hernia - Category: Sports Medicine Source Type: research
Conclusion: Soakage of mesh in 0.5% bupivacaine solution before application in laparoscopic ventral hernia repair significantly reduces early post-operative pain. Trial Registration: Trial was registered with clinicaltrials. gov (NCT03035617) URL: https://clinicaltrials. gov
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
ConclusionES-ACS resulted in no atrophy of the lateral abdominal muscles in long-term CT follow-up. The procedure is a safe and effective adjunct to complex hernia repair in selected patients.
Source: Hernia - Category: Sports Medicine Source Type: research
In this study, we aimed to compare the effects of CO2 pneumoperitoneum on acid –base balance during transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) procedures for repair of inguinal hernias.MethodsThe study cohort comprised 100 patients who underwent repair of primary inguinal hernias from 1 June to 30 November 2019. The patients were randomly allocated to TAPP and TEP groups. Their acid –base balance was analyzed by comparing the results of blood gas analysis before and after the operative procedures and dynamic transcutaneous CO2 (TcCO2) changes during the procedures.ResultsThere were no s...
Source: Hernia - Category: Sports Medicine Source Type: research
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