Surgical “error traps” of open posterior component separation—transversus abdominis release
ConclusionsAvoidance of surgical error traps combined with technique mastery can lead to the successful repair of challenging abdominal wall defects using the TAR approach. (Source: Hernia)
Source: Hernia - October 20, 2020 Category: Sports Medicine Source Type: research

Trends in the use of patient-reported outcome measures for inguinal hernia repair: a quantitative systematic review
ConclusionsThere is heterogeneity in the use of patient-reported outcome measures in the field of inguinal hernia research. The use of hernia-specific instruments is increasing, the use of generic instruments is decreasing, and the use of domain-specific instruments remains consistently high. This study serves as a repository of all available patient-reported outcome measures relevant to patients undergoing inguinal hernia repair. (Source: Hernia)
Source: Hernia - October 19, 2020 Category: Sports Medicine Source Type: research

What are the trends in incisional hernia repair? Real-world data over 10  years from the Herniamed registry
AbstractIntroductionThere is an increasingly controversial debate about the best possible incisional hernia repair technique. Despite the good outcomes of laparoscopic IPOM, concerns about the intraperitoneal mesh placement and its potential intraabdominal complications have risen. Against that background, this paper now analyzes changes and trends in incisional hernia repair techniques in the recent decade.MethodsBetween 2010 and 2019 a total of 61,627 patients with primary elective incisional hernia repair were enrolled in the Herniamed Registry. The outcome results were assigned to the year of repair and summarized as c...
Source: Hernia - October 19, 2020 Category: Sports Medicine Source Type: research

Hernia research in developing countries: are we looking for needles in haystacks? Surgeons in action
(Source: Hernia)
Source: Hernia - October 17, 2020 Category: Sports Medicine Source Type: research

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique: a propensity-score-matched analysis in Dutch high-volume regional hospitals
ConclusionThis study compares TREPP with Lichtenstein and TEP in the presence of postoperative pain, recurrences and other adverse outcomes. After propensity-score matching, no statistically significant difference in postoperative pain or recurrences remained between either TREPP compared to Lichtenstein, or TREPP compared to TEP. Based on these results, TREPP, Lichtenstein and TEP showed comparable results in postoperative pain, recurrences and other surgical site complications. (Source: Hernia)
Source: Hernia - October 16, 2020 Category: Sports Medicine Source Type: research

Management of ventral hernia in patients with BMI   & gt;  30 Kg/m 2 : outcomes based on an institutional algorithm
ConclusionThe algorithm has shown encouraging results in the short-to-medium term. Long-term evaluation with a higher number of patients is needed to confirm its usefulness. (Source: Hernia)
Source: Hernia - October 12, 2020 Category: Sports Medicine Source Type: research

Tissue remodeling macrophages morphologically dominate at the interface of polypropylene surgical meshes in the human abdomen
ConclusionsThe chronic FBR to polypropylene meshes is associated with an M2 macrophage response, which is accompanied by collagen deposition and MMP-2 expression. These findings challenge the idea that mainly M1 macrophages are related to inflammation and highlights that iatrogenic attempts to polarize these cells towards the M2 phenotype may not be a solution to ameliorate the long-term foreign body reaction. (Source: Hernia)
Source: Hernia - October 8, 2020 Category: Sports Medicine Source Type: research

High recurrence rate of children ’s inguinal hernia after percutaneous internal ring suturing: a single-center study
ConclusionIn our hands, a significantly higher recurrence rate exists for children undergoing the PIRS method over LICPV techniques when treating inguinal hernias. (Source: Hernia)
Source: Hernia - October 6, 2020 Category: Sports Medicine Source Type: research

Identifying critical computed tomography (CT) imaging findings for the preoperative planning of ventral hernia repairs
ConclusionsCT reports vary in their reported imaging findings and often fail to include important preoperative hernia features. Future studies should aim to standardize imaging reports to better utilize CTs for the preoperative planning of abdominal wall reconstructions. (Source: Hernia)
Source: Hernia - October 5, 2020 Category: Sports Medicine Source Type: research

Successful management of the open abdomen with hydrocolloid dressing in a resource-constrained setting
ConclusionDespite not being an optimal management of an open abdomen, there are always a small group of these patients who lose abdominal domain, are critically ill or injured, and have prolonged hospitalization with an open abdomen. In this cohort, and especially in resource constraint settings, Hydrocolloid dressing is a cost-efficient, simple, and effective method to treat the ‘long-term’ open abdomens. (Source: Hernia)
Source: Hernia - October 2, 2020 Category: Sports Medicine Source Type: research

Value and patient appreciation of follow-up after endoscopic totally extraperitoneal (TEP) inguinal hernia repair
ConclusionTEP patients value a telephone follow-up time-point, however, long-term follow-up is not considered useful. Patients report postoperative complaints themselves, therefore performing follow-up serves no clinical purpose. The purpose of follow-up is patient satisfaction and registration for quality objectives. (Source: Hernia)
Source: Hernia - September 27, 2020 Category: Sports Medicine Source Type: research

Litigation claims following laparoscopic and open inguinal hernia repairs
ConclusionsThe rate of  litigation for clinical negligence in inguinal hernia surgery in the UK is increasing. Whilst there has been a recent increase in laparoscopic hernia repair claims, the volume and burden of claims related to open procedures remain greater. (Source: Hernia)
Source: Hernia - September 27, 2020 Category: Sports Medicine Source Type: research

Implications of the presence of the vermiform appendix inside an inguinal hernia (Amyand ’s hernia): a systematic review of the literature
ConclusionAH is a rare type of inguinal hernia usually complicated by appendicitis. Hernia reconstruction should be tailored to each patient individually according to the extent of inguinal canal inflammation. (Source: Hernia)
Source: Hernia - September 27, 2020 Category: Sports Medicine Source Type: research

A manual reduction of hernia under analgesia/sedation (Taxis) in the acute inguinal hernia: a useful technique in COVID-19 times to reduce the need for emergency surgery —a literature review
ConclusionsThe use of taxis in emergency inguinal hernia is a useful first line of treatment in areas or situations where surgical care is not immediately available, including the COVID-19 pandemic. Emergency surgery remains the mainstay of management in the strangulated hernia setting. (Source: Hernia)
Source: Hernia - September 27, 2020 Category: Sports Medicine Source Type: research

Comment to: analysing topics using different methods promotes constructive debates. Author's reply
(Source: Hernia)
Source: Hernia - September 27, 2020 Category: Sports Medicine Source Type: research

Correction to: European Hernia Society (EHS) guidance for the management of adult patients with a hernia during the COVID ‑19 pandemic
The originally published article: The surname and given name of authors, M. Pawlak and A.C. de Beaux has been incorrectly published. (Source: Hernia)
Source: Hernia - September 27, 2020 Category: Sports Medicine Source Type: research

Is the nerve in the inguinal canal really protected by an investing fascia? Is it a real entity?
(Source: Hernia)
Source: Hernia - September 25, 2020 Category: Sports Medicine Source Type: research

Should simultaneous stoma closure and incisional hernia repair be avoided?
This study examined combined stoma closure and incisional hernia repair compared with incisional hernia repair only.MethodsThis was a nationwide propensity-score matched study. Patients who underwent elective incisional hernia repair from 2007 –2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional hernia repair only. The primary outcome was reoperation for hernia recurrence, whereas secondary outcomes included anastomotic leakage, l ength of hospital stay, and 30-day reoperation and readmission rates.ResultsIn to...
Source: Hernia - September 24, 2020 Category: Sports Medicine Source Type: research

Alterations in the mechanical, chemical and biocompatibility properties of low-cost polyethylene and polyester meshes after steam sterilization
ConclusionThe process of steam sterilization significantly alters mechanical and structural properties of synthetic hernia mesh implants. Our findings do not support a use of low-cost meshes because of their unpredictable properties after steam sterilization. (Source: Hernia)
Source: Hernia - September 24, 2020 Category: Sports Medicine Source Type: research

Building a national hernia registry in South Africa: initial ventral hernia repair results from a diverse healthcare sector
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 - September 22, 2020 Category: Sports Medicine Source Type: research

Necessary duration of follow-up to assess complications of mesh in hernia surgery: a time-lapse study based on 460 explants
AbstractPurposeRisk of complications following hernia repair is the key parameter to assess risk/benefit ratio of a technique. As mesh devices are permanent, their risks are life-long. Too many reports in the past assessed mesh safety prematurely after short follow-ups. We aimed to explore what length of follow up would reveal the full extent of complications.MethodsTime lapses between implantation and excision were analyzed in 460 cases of meshes excised for complications after hernia repair. Patterns of percentage growth and time lapses at 50th and 95th percentiles were used to compare groups of different hernia type, ag...
Source: Hernia - September 21, 2020 Category: Sports Medicine Source Type: research

Science, daily practice and education: different sides of the same coin
(Source: Hernia)
Source: Hernia - September 21, 2020 Category: Sports Medicine Source Type: research

Evolving concepts in ventral hernia repair and physical therapy: prehabilitation, rehabilitation, and analogies to tendon reconstruction
ConclusionsThere are several anatomical and functional similarities between the linea alba and musculoskeletal tendons. Because of this reason, many of the surgical principles for musculoskeletal tendon repair and ventral hernia repair overlap. Distribution of tension is the main driving principle for both procedures. Suture material and configuration are chosen to maximize tension distribution among the tissue edges, as seen in the standard of care multistrand repairs for musculoskeletal tendons, as well as in the small bites for laparotomy technique described in the STITCH trial.Physical therapy is also one of the mainst...
Source: Hernia - September 20, 2020 Category: Sports Medicine Source Type: research

Assessment of potential influencing factors on the outcome in small ( & lt;  2 cm) umbilical hernia repair: a registry-based multivariable analysis of 31,965 patients
AbstractIntroductionHow best to treat a small (
Source: Hernia - September 19, 2020 Category: Sports Medicine Source Type: research

Single-blind randomized clinical trial of transinguinal preperitoneal repair using self-expanding mesh patch vs. Lichtenstein repair for adult male patients with primary unilateral inguinal hernia
AbstractPurposeThe aim of the study was to compare proportions of chronic postoperative inguinal pain (CPIP) and other surgical outcomes between transinguinal preperitoneal repair with modified Kugel patch (MK) and Lichtenstein repair (LR).MethodsTwo-hundred adult male patients with primary unilateral inguinal hernia were randomized into MK or LR groups. The primary endpoint was CPIP, pain at 6  months after surgery. Secondary outcomes included recurrence rate, incidence of postoperative complications, time until return to activities, inguinal pain and sensory disturbances assessed at 1 week, 1 month, 3, 6, ...
Source: Hernia - September 13, 2020 Category: Sports Medicine Source Type: research

Abdominal wall incisional hernia repair improves respiratory function: results after 3  years of follow-up
ConclusionThe improvement in respiratory measures suggests the importance of abdominal wall restoration to recover functional activity of respiratory function. (Source: Hernia)
Source: Hernia - September 13, 2020 Category: Sports Medicine Source Type: research

Management of complex hernias with loss of domain using daily and fractioned preoperative progressive pneumoperitoneum: a retrospective single-center cohort study
This study aims to refine the progressive preoperative pneumoperitonium (PPP) in patients with CHLD, to achieve an increased in wall dimensions.MethodsPatients presented with a CHLD undergoing PPP protocol were analyzed between May 2017 and May 2019. Our PPP protocol was to use two daily insufflations of 1000  ml of ambient air during a period of 14 days. We compared the abdominal cavity volume (ACV), the hernial sac volume (HSV) and the volume ratio (VR), before and after our refined PPP.ResultsDuring our evaluation period, the protocol was performed on 16 patients. The mean age was 55.73 ( ± 12.87...
Source: Hernia - September 13, 2020 Category: Sports Medicine Source Type: research

A new three-step hybrid approach is a safe procedure for incisional hernia: early experiences with a single centre retrospective cohort
ConclusionA three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low. (Source: Hernia)
Source: Hernia - September 11, 2020 Category: Sports Medicine Source Type: research

Role of the signs of obturator hernia in clinical practice
(Source: Hernia)
Source: Hernia - September 10, 2020 Category: Sports Medicine Source Type: research

Changes in the lateral abdominal wall following endoscopic subcutaneous anterior component separation
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)
Source: Hernia - September 9, 2020 Category: Sports Medicine Source Type: research

Emergency surgery of the abdominal wall hernias: risk factors that increase morbidity and mortality —a single-center experience
AbstractPurposeMorbidity and mortality are higher in urgently operated abdominal hernia cases compared to elective surgeries. The present study aims to investigate the factors that cause increased morbidity and mortality in emergency surgical operations.MethodsThe files of a total of 426 patients who were operated for non-reducible abdominal hernia between 2015 and 2020 were reviewed retrospectively. Patients ’ ages, genders, comorbidities, Charlson Comorbidity Index (CCI), ASA score, BMI, hernia types, duration of symptom, laboratory values, intestinal strangulations or necroses, whether intestinal resection was per...
Source: Hernia - September 9, 2020 Category: Sports Medicine Source Type: research

Watchful waiting vs repair for asymptomatic or minimally symptomatic inguinal hernia in men: a systematic review
ConclusionApplying a watchful waiting strategy to men with asymptomatic or minimally symptomatic inguinal hernia was safe, but two-thirds of patients crossed over to surgical repair within 10  years mainly due to pain. (Source: Hernia)
Source: Hernia - September 9, 2020 Category: Sports Medicine Source Type: research

Hernia research in developing countries: are we looking for needles in haystacks? There ’s still hope in our reality! Author’s reply
(Source: Hernia)
Source: Hernia - September 9, 2020 Category: Sports Medicine Source Type: research

Management of abdominal wound dehiscence: update of the literature and meta-analysis
ConclusionIncluded studies were of low to very low quality. The use of synthetic mesh results in a significantly lower rate of incisional hernia, whereas SSI rate was comparable to primary suture repair. (Source: Hernia)
Source: Hernia - September 7, 2020 Category: Sports Medicine Source Type: research

Learning inguinal hernia repair? A survey of current practice and of preferred methods of surgical residents
ConclusionThis study demonstrated a discrepancy between learning methods that are currently used by surgical residents to learn the open and endoscopic IHR and preferred learning methods. There is a need for more emphasis on practising before entering the OR. This would support surgical residents ’ training by first observing, then practising and finally performing the surgery in the OR. (Source: Hernia)
Source: Hernia - September 4, 2020 Category: Sports Medicine Source Type: research

Effect of carbon dioxide pneumoperitoneum on acid –base balance during laparoscopic inguinal hernia repair: a prospective randomized controlled study
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 - September 3, 2020 Category: Sports Medicine Source Type: research

The darn technique for small ( & lt;  2 cm diameter) midline hernias
ConclusionsThe darn repair for small primary midline hernias is quick and inexpensive with promising long-term results. It can be performed under local anaesthesia. It can serve as an alternative to mesh repair for defects less than 2  cm in maximum dimension. (Source: Hernia)
Source: Hernia - September 1, 2020 Category: Sports Medicine Source Type: research

A multi-center study on recurrent inguinal hernias: assessment of surgeons ’ compliance to guideline-based repair and evaluation of short-term outcomes
AbstractIntroductionAs patients with recurrent inguinal hernia (RIH) are at a higher risk of perioperative complications, international guidelines have been developed to mitigate these risks by recommending the reverse approach for repair. We aim to study the characteristics of RIH, compliance to guidelines-based repair (GR) and determine factors influencing compliance to guidelines.MethodsA retrospective study of patients with RIH was carried out at two tertiary institutions in Singapore, over 10 years from January 2010 to 2020.ResultsThere were 16 patients with bilateral recurrences and 214 patients with unilateral recur...
Source: Hernia - August 29, 2020 Category: Sports Medicine Source Type: research

Open inguinal hernia repair outcomes in liver transplant recipients versus patients with cirrhosis
AbstractPurposePatients with liver cirrhosis (LC) are at an increased risk for postoperative complications after open inguinal hernia repair (OIHR). It is possible that orthotopic liver transplant (OLT) recipients may have better outcomes, given reversal of liver failure pathophysiology. Therefore, we sought to compare mortality risk, complications, length of stay (LOS), and cost associated with OIHR in OLT recipients versus LC.MethodsFrom the National Inpatient Sample (NIS), using ICD-9 codes, we found 83 OLT recipients and 764 patients with LC who underwent OIHR between 2002 and 2014. We used logistic, negative binomial,...
Source: Hernia - August 27, 2020 Category: Sports Medicine Source Type: research

Enhancing the hole in patients with hernia: Does single-site surgery make any sense?
(Source: Hernia)
Source: Hernia - August 27, 2020 Category: Sports Medicine Source Type: research

Comment to: TESLAR for treatment of umbilical/paraumbilical hernia and rectus abdominus diastasis is associated with unacceptable persistent seroma formation. Should subcutaneous endoscopic mesh placement be abandoned?
(Source: Hernia)
Source: Hernia - August 24, 2020 Category: Sports Medicine Source Type: research

Comment to: the use of biosynthetic mesh in giant hiatal hernia repair: is there a rationale? A 3-year single-center experience
(Source: Hernia)
Source: Hernia - August 19, 2020 Category: Sports Medicine Source Type: research

Comment to: Is round ligament varicosity in pregnancy a common precursor for the later development of inguinal hernias? The prospective analysis of 28 patients over 9  years
(Source: Hernia)
Source: Hernia - August 18, 2020 Category: Sports Medicine Source Type: research

Minimally invasive repair for lateral ventral hernia: tailored approach from a hernia centre at a tertiary care institution
ConclusionThis case series gives a broad outline of possible MIS options available for LVH repair and recommendations for a tailored approach. The surgical technique needs to be individualized according to the size and anatomic location of the defect, other intra-operative findings and patient characteristics. (Source: Hernia)
Source: Hernia - August 17, 2020 Category: Sports Medicine Source Type: research

Obturator hernias: a systematic review of the literature
ConclusionOHs are not associated with specific symptoms and signs; thus, they constitute a diagnostic challenge, requiring a high level of clinical suspicion. Undoubtedly, CT scan of the abdomen is the gold standard diagnostic tool. Their operative repair is mandatory, with the laparoscopic approach demonstrating significant advantages over the open repair. (Source: Hernia)
Source: Hernia - August 8, 2020 Category: Sports Medicine Source Type: research

Variation in abdominal wall closure techniques in lower transverse incisions: a nationwide survey across specialties
ConclusionWe found significant variation in abdominal wall closure techniques in lower transverse incisions. Disagreement between the current guidelines within the specialties together with insufficient evidence on the closure of lower transverse incisions emphasizes the need for education as well as further studies. (Source: Hernia)
Source: Hernia - August 7, 2020 Category: Sports Medicine Source Type: research

A new semiresorbable mesh for primary inguinal repair: a preliminary observational study on quality of life and safety
AbstractBackgroundA currently unsolved problem of open inguinal hernia repair (IHR) is chronic postoperative inguinal pain (CPIP), which affects 10 –12% of patients after IHR. In the present paper, we explored the results of a newly designed partially absorbable mesh made of polypropylene and polylactic acid (HybridMesh®) for open hernia repair and its impact on postoperative safety, efficacy, comfort and pain.MethodsA prospective multicentric pilot trial was conducted in third-referral centers across Italy (n = 5). Inclusion criteria were unilateral primary inguinal hernia in patients of both genders and BMI 
Source: Hernia - August 6, 2020 Category: Sports Medicine Source Type: research

#herniasurgery on the #SoMe platform Twitter: the importance of communication in science
(Source: Hernia)
Source: Hernia - August 6, 2020 Category: Sports Medicine Source Type: research

Differences in the outcomes of scrotal vs. lateral vs. medial inguinal hernias: a multivariable analysis of registry data
ConclusionScrotal inguinal hernias demonstrated a very unfavorable relation with the postoperative complication rate, the rate of complication-related reoperations and the rate of general complications. But a very favorable association with chronic pain rates was identified at 1-year follow-up. Medial inguinal hernia had an unfavorable relation with the recurrence and pain rates. (Source: Hernia)
Source: Hernia - August 2, 2020 Category: Sports Medicine Source Type: research

Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry
ConclusionEmergency surgery for complicated hernia is burdened by high morbidity and mortality in elderly patients. Preoperative comorbidity played a pivotal role in predicting complications and mortality and therefore Charlson ’s comorbidity index could be adopted to select patients for elective operation (Source: Hernia)
Source: Hernia - July 30, 2020 Category: Sports Medicine Source Type: research