Is there an advantage to laparoscopy over open repair of primary umbilical hernias in obese patients? An analysis of the Americas Hernia Society Quality Collaborative (AHSQC)

This study compares laparoscopic versus open umbilical hernia repairs in obese patients.MethodsAll patients with body mass index (BMI) ≥ 30 kg/m2 who underwent elective, open or laparoscopic repair of a primary umbilical hernia with mesh were identified from the Americas Hernia Society Quality Collaborative (AHSQC). A retrospective review of the prospectively collected data was conducted. Outcomes of interest included surgical site infections (SSI), surgical site occurrences requiring procedural intervention (SSOPI), hernia-related quality-of-life survey (HerQles), and long-term recurrence. A logistic regression model was used to generate propensity scores.ResultsOf 1507 patients who met the inclusion criteria, 322 were laparoscopic, and 1185 were open cases. The laparoscopic group had higher mean BMI (37  ± 6 vs. 35 ± 5 kg/m2 ,P 
Source: Hernia - Category: Sports Medicine Source Type: research

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ConclusionSuturing technique has no significant effect on the surgical outcomes assessed regardless of open or laparoscopic technique.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
AbstractPurposeWe aimed to clarify the frequency and the clinical significance of deviation of the uterus in female pediatric inguinal hernia.MethodsWe retrospectively evaluated the data of 94 female pediatric inguinal hernia cases that were treated by laparoscopic percutaneous extraperitoneal closure. We assessed for correlations between uterine deviation and age, body weight, the size of the hernia orifice, and the presence of contralateral processus vaginalis (PV) patency.ResultsEighty-four of 94 cases were diagnosed with unilateral inguinal hernia. A total of 62 (73.8%) of these had uterine deviation to the hernia side...
Source: Pediatric Surgery International - Category: Surgery Source Type: research
ConclusionThere were no differences in short or long-term mortality between four university hospitals in Finland. However, some inter-hospital variation in postoperative outcomes was present.Level of evidenceLevel III.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
ConclusionO/E LHR is a well-validated standard for predicting outcomes and guiding prenatal counseling in CDH. We provide evidence that fetal MRI measurements of the contralateral lung volume corrected for gestational age were more accurate in predicting the need for ECMO and survival. Future prospective studies validating O/E CLV regarding outcomes and ECMO utilization are warranted.Level of evidenceLevel III, retrospective comparative study.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
ConclusionMultipoint biopsy should be performed when the biopsy results are inconsistent with clinical manifestations. Intraoperative laparoscopic identification of the transition zone may be necessary when TCA is suspected. Multisegment biopsy is needed to as a preventative measure for SS-HSCR if TCA is indicated during surgery. Further study is required to determine the optimal length and method of retention of segments.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
ConclusionComplex GS and OCL  + patients had the highest risk of undergoing secondary operations, especially those with gastrointestinal complications.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
This study assessed whether disparities in MIS-C in the United States by race and ethnicity exceed known disparities in coronavirus disease 2019 (COVID-19) incidence. Methods: We compared the distribution of race and ethnicity among patients with MIS-C (
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
ConclusionSimultaneous PAN is possible in patients with an abdominal apron who are undergoing VHR, with an acceptable risk of SSOs and other complications. This technique provides excellent exposure and with appropriate training is well within the remit of the general surgeon. This may save further operative management in the future and can offer patients improved self-esteem, mobility, and independence. Patient optimisation is key, paying careful attention to pre-operative weight loss, diabetic control, smoking cessation and respiratory function. VHR  + PAN is an important technique that should be in the rep...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractBackgroundIncisional hernias (IH) following abdominal surgery persist as morbid, costly, and multi-disciplinary surgical challenges. Using longitudinal, multi-state, administrative claims data (HCUP State Inpatient Databases (SID)); (HCUP State Ambulatory Surgery and Services Databases (SASD)), we aimed to characterize the epidemiology, outcomes, recurrence, and costs of IH.Study design529,108 patients undergoing abdominal surgery in 2010 across six specialties (colorectal, general/bariatric, hepatobiliary, obstetrics/gynecology, urology, and vascular) were identified within inpatient and ambulatory databases for F...
Source: Hernia - Category: Sports Medicine Source Type: research
CONCLUSION: Despite the ability to characterise ventral hernia morphology and recurrence with precision, most indexed studies do not employ imaging. Where imaging is used, data are often reported incompletely. Advances in knowledge: (1) This systematic review is the first to focus on the use of imaging in surgical studies of ventral hernia repair. (2) Studies of ventral hernia repair rarely use imaging, either to characterise hernias preoperatively or to diagnose recurrence, despite the latter being the primary outcome of most studies. (3) Failure to use imaging will result in incomplete hernia characterisat...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
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