Robotic ventral hernia repair in octogenarians: perioperative and long-term outcomes

AbstractVery few studies have documented perioperative outcomes of ventral hernia repair in octogenarians. The aim of this study is to report the perioperative and the long-term outcomes of robotic ventral hernia repair (RVHR) in aged 80 –89 years patients. From a prospectively maintained database, aged 80–89 years patients who underwent robotic procedures between 2013 and 2018 were analyzed retrospectively including perioperative outcomes and long-term follow-up. Complications were assessed with validated grading systems and index. 21 octogenarians with average age 83.48 were included. Intraperitoneal onlay mesh repair, transabdominal preperitoneal repair, retromuscular repair with or without transversus abdominis release technique were performed without conversion. The average operating time was 150 min. The mean hosp ital length of stay of all cohorts was 1.24 day. There was a strong correlation between operating time and hospital length of stay. The median follow-up was 23.5 months. According to Clavien–Dindo classification, grade-I and grade-II complications were observed in 23.8% and 28.6% patients, respe ctively; major complications (grade-III and IV) were not observed. The maximum Comprehensive Complication Index® score was 29.6. None of the patients experienced hernia recurrence or chronic pain. To our best knowledge this study is the first to present perioperative as well as long-term outcomes of octogenarian patients w...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research

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Conditions:   Inguinal Hernia;   Analgesia;   Pain, Acute;   Pain, Chronic;   Pain, Neuropathic Interventions:   Other: local anesthetic and dexmedetomidine;   Other: local anesthetic and placebo Sponsor:   Aretaieion University Hospital Recruiting
Source: - Category: Research Source Type: clinical trials
Publication date: Available online 23 May 2020Source: Annals of Medicine and SurgeryAuthor(s): Christoph Paasch, Jennifer Fiebelkorn, Gianluca De Santo, Sascha Azarhoush, Katherina Boettge, Stefan Anders, Ulrich Gauger, Martin Strik
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
We read with interest the report by Axman et  al1 entitled “Chronic pain and risk for reoperation for recurrence after inguinal hernia using self-gripping mesh.” We found this subject relevant because chronic pain after inguinal hernia repair remains one of the main postoperative complications than can cause chronic distress to patients. The authors reported a rate of 15% of patients with chronic pain after inguinal hernia repair, and although in their methods section they reported to have recorded how the surgeon handled the nerves, these data were not published.
Source: Surgery - Category: Surgery Authors: Source Type: research
García MJ Abstract Inguinodynia or chronic postoperative inguinal pain is a growing problem between patients who undergo surgical repair of an inguinal hernia. The change in results measurement proposed by many authors towards Patient Reported Outcome Measurement has underlined the importance of chronic postoperative inguinal pain, because of the great limitations in everyday life and the huge socioeconomic impact that it causes. In this article a narrative review of the available literature in PUBMED, EMBASE and Cochrane Library is performed and the most relevant aspects about epidemiology, etiology preve...
Source: Cirugia eEspanola - Category: Surgery Authors: Tags: Cir Esp Source Type: research
AbstractPurposeAim of the study is to compare macroporous (>  1 mm2) polytetrafluoroethylene mesh (LP-PTFE) versus microporous (
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionHigher EHS width classification, open procedure, female gender, higher BMI, and lateral EHS classification, as well as preoperative pain are the most important unfavorable influencing factors associated with a worse outcome in incisional hernia repair.
Source: Hernia - Category: Sports Medicine Source Type: research
Authors: Consalvo V, D'Auria F, Salsano V Abstract BACKGROUND: Chronic pain still occurs in 10-12% of patients who undergo surgical groin hernia repair. Considering the high prevalence of this pathology, we performed a single-center prospective study comparing the laparoscopic trans-abdominal pre-peritoneal (TAPP) approach to the standard surgical open technique for primary uncomplicated hernia repair. METHODS: A prospective cohort of 278 patients was extracted from our dataset: 121 received a laparoscopic TAPP approach, and 157 were treated by the Lichtenstein technique in case of inguinal hernia or by the dep...
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
Objective: Impact of inguinal hernia defect size as stratified by the European Hernia Society (EHS) classification I to III on the rate of chronic postoperative inguinal pain (CPIP). Background: CPIP is the most important complication after inguinal hernia repair. The impact of hernia defect size according to the EHS classification on CPIP is unknown. Methods: In total, 57,999 male patients from the Herniamed registry undergoing primary unilateral inguinal hernia repair including a 1-year follow-up were selected between September 1, 2009 and November 30, 2016. Using multivariable analysis, the impact of EHS inguina...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
ConclusionFor ventral and incisional hernia patients with multiple recurrence risk factors, a mesh-tack ratio MTR  ≤ 4:1 should be applied in laparoscopic IPOM Plus procedures.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionMesh position and deformation as shrinkage can be the mesh-related cause of pain. The incidence of CPIP in our patients is less than 2%. 3D-iron loaded meshes were monitored with MRI in CPIP patients and there was no mesh-related changes found in our study. The use of MRI-visible meshes will most likely help us to monitor mesh preparations and show potential time-dependent changes in mesh characteristics and consequent complications. In case of doubtful clinical postoperative hernia recurrence or chronic groin pain, mesh position can be identified by MRI and unnecessary surgical intervention can be avoided.
Source: Hernia - Category: Sports Medicine Source Type: research
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