Discussion

DR JOHN SCOTT ROTH (Lexington, KY): The authors address a challenging and controversial area in the field of hernia by analyzing their experiences with hernia repair in clean-contaminated, contaminated, and infected hernias. These decisions have an impact on both patient outcomes and economic implications in hernia repair due to the increased risk of surgical site infection and hernia recurrence relative to clean hernia repair.
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Southern surgical association article Source Type: research

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ConclusionRace is a contributing factor in who undergoes an emergent hernia repair in New York State. A significantly larger proportion of the African American population is undergoing hernia repair in the emergent setting. Socioeconomic status, as indicated by the significant number of Medicaid patients undergoing emergent hernia repairs, also plays a role.
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionsForty-six cases were needed to achieve steadily decreasing operative times. We can assume that ensuring good-quality repairs, through maintenance of peritoneal flap integrity, was gradually improved after sixty-one cases. Moreover, familiarization with port placements and robotic docking was accomplished after forty-three cases.
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionOur algorithm using both anterior or posterior component separation, together with  preoperative BTA injections and PPP, achieved an acceptable fascial closure rate. Further studies are needed to explore the individual potential of BTA injections and PPP, and to research whether these methods can prevent the need for component separation, as postoperative wound morbidity remains high in our study.
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionWe present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. Although long term outcomes require further analysis, its feasibility and reproducibility in experienced surgeons hands are evident, with safe and acceptable early postoperative outcomes.
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractPurposeAltered composition of collagen and elastin in abdominal fascia has been linked with the pathogenesis of hernias. This has not been studied amongst Africans who have hernia presentations which vary significantly from Caucasian cohorts. The aim of this study was to determine, and compare, the collagen and elastin contents of the transversalis fascia and rectus sheath of inguinal hernia patients with non-hernia controls.MethodsTwenty-five patients with solitary, primary, uncomplicated inguinal hernia and twenty-five non-hernia controls were evaluated. Biopsies of the transversalis fascia and anterior rectus sh...
Source: Hernia - Category: Sports Medicine Source Type: research
In the paper by Angrisani et al, the authors tackle an important question, namely; what are the long term outcomes regarding gastroesophageal reflux disease (GERD) in patients undergoing sleeve gastrectomy (SG) [1]? Many surgeons consider GERD to be the Achilles heel of the SG, and it is one of the main reasons for conversion of the SG to other procedures such as the gastric bypass [2]. The last International Consensus Conference on SG demonstrated that over 50% of surgeons considered GERD to be a relative contrindication to the SG, and also that hiatal hernias (HH) should be repaired when encountered [3].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
AbstractBackgroundHiatal hernia repair performed at the time of laparoscopic sleeve gastrectomy (LSG) may reduce post-operative reflux symptoms. It is unclear whether intra-operative diagnosis of hiatal hernia varies among surgeons or if it affects outcomes.Study designSurgeons (n = 38) participating in a statewide bariatric surgery quality improvement collaborative reviewed 33 videos of LSG in which no hiatal hernia repair was performed. Reviewers were blinded to patient information and were asked whether they perceived a hiatal hernia. Surgeon characteristics and surge on-specific patient outcomes for LSG w...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractSublay mesh repair seems to be the most effective method for treating incisional hernias (IHs). The aim of this study was to report our experience with retromuscular repair and self-gripping mesh for the treatment of midline IHs. In addition, we provided a systematic review of the literature regarding the use of this novel combination. All patients undergoing elective IH repair from June 2016 to November 2018 were included. The self-gripping mesh was placed in the sublay position. Demographic data, defect sizes, postoperative complications and follow-up durations were collected. A systematic review of the available...
Source: Updates in Surgery - Category: Surgery Source Type: research
AbstractAdministration of botulinum toxin (BTX) is being used in cases of complex ventral hernia for the reconstruction of the linea alba and closure of the abdominal wall. However, there are no published results regarding the long-term effects of BTX and its implication in hernia recurrence. Our purpose is to evaluate the outcomes in hernia recurrence of the administration of BTX in complex ventral hernia repair. 36 patients underwent elective surgery for complex ventral hernia and were evaluated retrospectively. The study included patients with a transverse hernia defect  ≥ 100 mm and loss of domain...
Source: Updates in Surgery - Category: Surgery Source Type: research
ConclusionsOur early results with TAR are encouraging. We have demonstrated that the repair allows anatomical reconstruction with a large sublay mesh while inflicting minimal morbidity. TAR can be a valuable tool in complex ventral hernia repair.
Source: Hernia - Category: Sports Medicine Source Type: research
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