Hybrid versus open retromuscular abdominal wall repair: early outcomes

ConclusionA review of patient outcomes after hybrid AWR highlights a trend towards shorter length of stay, lower hospital cost, and fewer complications without significant addition to operative time. Long-term studies on a larger number of patients are definitively needed to characterize the comprehensive benefits of this approach.
Source: Surgical Endoscopy - Category: Surgery Source Type: research

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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
AbstractBackgroundUtilization of robotic-assisted inguinal hernia repair (IHR) has increased in recent years, but randomized or prospective studies comparing outcomes and cost of laparoscopic and Robotic-IHR are still lacking. With conflicting results from only five retrospective series available in the literature comparing the two approaches, the question remains whether current robotic technology provides any added benefits to treat inguinal hernias. We aimed to compare perioperative outcomes and costs of Robotic-IHR versus laparoscopic totally extraperitoneal IHR (Laparoscopic –IHR).MethodsRetrospective analysis o...
Source: Surgical Endoscopy - Category: Surgery 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
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
Morbid obesity is associated with an increased rate of hiatal and paraesophageal hernias (PEH). Concomitant repair at the time of Roux-En-Y gastric bypass is technically feasible, safe, and lowers recurrence rates; however, the ideal operative management remains controversial. The use of reinforcing mesh may further lower recurrence rates in the bariatric patient population. The patient is a 49 year-old female with a history of morbid obesity (BMI 42) and long-standing reflux with dysphagia. Preoperative endoscopy was notable for esophagitis and a moderate-sized PEH.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study is a multicentre randomised controlled clinical trial. From November 2012 to May 2015, 193 patients undergoing LIVHR for primary incisional hernia with fascial defect size from 2 to 7  cm were recruited in 11 Finnish hospitals. Patients were randomised to either a laparoscopic (LG) or a hybrid (HG) repair group. The main outcome measure was hernia recurrence, evaluated clinically and radiologically at a 1-year follow-up visit. At the same time, chronic pain scores and QoL were a lso measured.ResultsAt the 1-year-control visit, we found no difference in hernia recurrence between the study groups. Altogether,...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionSynchronous VHR and BS in a bariatric unit is feasible with low recurrence rate. Laparoscopic VHR has lower complication rates than open, apart from seroma formation. Patients with diabetes have higher risk of infection.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractBackgroundAlthough inguinal hernia is one of the most common conditions requiring surgical treatment, no reliable information is available on the quality of life of patients with inguinal hernias before surgery. Additionally, patients with intense inguinal pain prior to surgery are more susceptible to postoperative chronic pain. In such cases, less invasive laparoscopic techniques can be used, allowing atraumatic mesh fixation to reduce postoperative pain. The aim of the study was to determine, whether these treatments for patients with preoperative pain would minimize upsetting experiences after surgery.Materials ...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsDGE following large hiatus hernia repair is associated with a negative impact on quality of life at follow-up to 12  months after surgery.
Source: World Journal of Surgery - Category: Surgery Source Type: research
ConclusionThe LIRA technique could be considered as an alternative to conventional CD or endoscopic component separation for medium defects under 10  cm in width. This technique obtained a “no tension” effect that could be related to a lower rate of postoperative pain with no recurrence or bulging, being a safe, feasible, and reproducible technique.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
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