Recommendations on postoperative strain and physical labor after abdominal and hernia surgery: an expert survey of attendants of the 41st EHS Annual International Congress of the European Hernia Society
ConclusionFollowing groin hernia repair (Lichtenstein/endoscopic technique) and laparoscopic operation, the majority agreed on the proposal of 2  weeks refraining from physical strain. Four weeks of no physical strain were considered appropriate by a majority after laparotomy and open incisional hernia repair. However, the results showed substantial variation in the ratings, which indicates uncertainty even in this selected cohort of hernia surgery experts and emphasizes the need for further scientific evaluation. This is particularly remarkable, because a lack of evidence that early postoperative strain leads to high...
Source: Hernia - February 24, 2021 Category: Sports Medicine Source Type: research

Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results
ConclusionsA totally endoscopic technique (TES) for the treatment of lateral hernias is described. The technique revealed to be reliable, safe and cost-effective. The first results are promising, but larger studies with longer follow-up periods are recommended to determine the real clinical value. (Source: Hernia)
Source: Hernia - February 18, 2021 Category: Sports Medicine Source Type: research

A structured pathway for developing your complex abdominal hernia service: our York pathway
ConclusionA structured pathway for complex abdominal wall hernia service is one way to improve patient experience and streamline services. The relevance of pathways for the hernia surgeon is discussed alongside this pathway. This may provide a useful guide to those wishing to establish similar personalised pathways within their own units and allow them to expand their service. (Source: Hernia)
Source: Hernia - February 18, 2021 Category: Sports Medicine Source Type: research

Prioritization criteria of patients on scheduled waiting lists for abdominal wall hernia surgery: a cross-sectional study
ConclusionExplicit criteria for prioritization in the waiting lists may be the consumption of analgesics for patients with incisional/ventral hernia and frailty for patients with inguinal hernia. A reasonable approach seems to establish separate waiting lists for incisional/ventral hernia and inguinal hernia repair. (Source: Hernia)
Source: Hernia - February 18, 2021 Category: Sports Medicine Source Type: research

Inguinal hernia repair among men: development and validation of a preoperative risk score for persistent postoperative pain
AbstractPurposePersistent postoperative pain (PPP) is a prevalent complication after inguinal hernia repair. The aim of this study was to develop and validate a preoperative risk score for PPP.MethodsWe developed the risk score based on a cohort of 2,508 Danish men, who answered a questionnaire six months after inguinal hernia repair performed 2015 –2016. PPP was defined as a numerical rating scale score ≥ 2 during activity six months postoperatively. Logistic regression analyses were undertaken to determine statistically significant predictors of PPP. Univariable analysis selected potential predicto...
Source: Hernia - February 11, 2021 Category: Sports Medicine Source Type: research

Endoscopic retromuscular technique (eTEP) vs conventional laparoscopic ventral or incisional hernia repair with defect closure (IPOM  +) for midline hernias. A case–control study
ConclusionEndoscopic retromuscular technique shows significant lower postoperative pain, better functional recovery and cosmesis than IPOM  + without differences in intra/postoperative complications (except seroma rate) or recurrences during the follow-up. eTEP requires longer operative time. (Source: Hernia)
Source: Hernia - February 10, 2021 Category: Sports Medicine Source Type: research

Cost analysis of inguinal hernia repair: the influence of clinical and hernia-specific factors
ConclusionFrom a purely economic point of view, older age and multimorbidity are demographic cost-driving factors that cannot be influenced. The national hospital reimbursement system needs to consider and compensate for these factors. Emergency operations need to be prevented by early elective treatment. Long postoperative stays and postoperative complications need to be prevented by proper preoperative check-ups and accurate treatment. (Source: Hernia)
Source: Hernia - February 8, 2021 Category: Sports Medicine Source Type: research

Evaluation of information on the Internet regarding surgical mesh for hernia repair: analysis of websites found through three popular search engines
ConclusionsThese results emphasize the challenges of using an Internet search engine to find comprehensive and appropriate information regarding surgical mesh. This manuscript underscores the importance for physicians to direct patients toward specific websites to mitigate their exposure to websites that are biased and not appropriate for patients searching for an accurate and comprehensive overview of surgical mesh. (Source: Hernia)
Source: Hernia - February 7, 2021 Category: Sports Medicine Source Type: research

Clinical benefits of routine examination and synchronous repair of occult inguinal hernia during laparoscopic peritoneal dialysis catheter insertion: a single-center experience
ConclusionRLEOH with a synchronous repair during PD catheter insertion confers clinical benefits in reducing the risk of developing IH after starting PD and the need for a metachronous repair. This is a safe and reasonable approach. (Source: Hernia)
Source: Hernia - February 6, 2021 Category: Sports Medicine Source Type: research

Risk factors, outcomes, and complications associated with combined ventral hernia and enterocutaneous fistula single-staged abdominal wall reconstruction
ConclusionRisk factors for developing ECF were IBD and history of abdominal wound infections. Single-staged combined ECF reconstruction was associated with reoperations, soft tissue infections and hematomas. DM and surgical-site complications were associated with ECF recurrence. (Source: Hernia)
Source: Hernia - February 4, 2021 Category: Sports Medicine Source Type: research

Mesh fixation in IPOM with glue, a matter of solution?
(Source: Hernia)
Source: Hernia - February 1, 2021 Category: Sports Medicine Source Type: research

Seroma after TEP, preventable or not? Author ’s reply
(Source: Hernia)
Source: Hernia - February 1, 2021 Category: Sports Medicine Source Type: research

Diastasis recti: low evidence, expert (and non-expert) opinion, and the daily reality —a path to be created
(Source: Hernia)
Source: Hernia - January 30, 2021 Category: Sports Medicine Source Type: research

Shouldice standard 2020: review of the current literature and results of an international consensus meeting
ConclusionAfter a 75-year history of the Shouldice repair the technique should continue to merit consideration by all hernia surgeons. After this consensus meeting a clear binding standard of the Shouldice technique for all interested surgeons is proposed. (Source: Hernia)
Source: Hernia - January 27, 2021 Category: Sports Medicine Source Type: research

Slowly absorbable mesh in contaminated incisional hernia repair: results of a French multicenter study
ConclusionThe use of a biosynthetic absorbable mesh (Phasix ®) is safe in a contaminated surgical field, with satisfying immediate postoperative and 1-year results.Trial registrationThe study is registered on Clinical Trial ID: NCT04132986. (Source: Hernia)
Source: Hernia - January 25, 2021 Category: Sports Medicine Source Type: research

Comment to: intestinal erosions following inguinal hernia repair: a systematic review
(Source: Hernia)
Source: Hernia - January 22, 2021 Category: Sports Medicine Source Type: research

Ventral hernia repair with synthetic mesh in a contaminated field: a systematic review and meta-analysis
AbstractPurposeThe use of mesh in ventral hernia repair becomes especially challenging when associated with a contaminated field. Permanent synthetic mesh use in this setting is currently debated and this discussion is yet to be resolved clinically or in the literature. We aim to systematically assess postoperative outcomes of non-absorbable synthetic mesh (NASM) used in ventral hernia repair in the setting of contamination.MethodsA literature search of PubMed, Embase, Scopus, Cinahl, and Cochrane Library identified all articles from 2000 –2020 that examined the use of NASM for ventral hernia repair in a contaminated...
Source: Hernia - January 19, 2021 Category: Sports Medicine Source Type: research

Local, regional, and general anesthesia for inguinal hernia repair: the importance of the study, the patient population, and surgeon ’s experience
(Source: Hernia)
Source: Hernia - January 18, 2021 Category: Sports Medicine Source Type: research

The experimental methodology and comparators used for in vivo hernia mesh testing: a 10-year scoping review
ConclusionsThe current practice of in vivo mesh testing lacks standardisation. There is significant inconsistency in every category of testing, both in methodology and comparators. We would call upon hernia organisations and materials testing institutions to discuss the need for a standardised approach to this field. (Source: Hernia)
Source: Hernia - January 12, 2021 Category: Sports Medicine Source Type: research

Comment to: “Outcomes of concomitant mesh placement and intestinal procedures during open ventral hernia repair”
(Source: Hernia)
Source: Hernia - January 12, 2021 Category: Sports Medicine Source Type: research

Should surgeons repair symptomatic, clinically occult, radiologically evident, inguinal hernias? A case –control study of patient-reported outcomes
ConclusionThere is no difference in pain, restriction to function or cosmesis in symptomatic clinically occult, radiologically evident inguinal hernia patients following either surgical or conservative management. A clear definition and further studies are essential to deliver better care for this population of patients. (Source: Hernia)
Source: Hernia - January 11, 2021 Category: Sports Medicine Source Type: research

The value and role of mosquito meshes in low resource and poor income settings: author ’s reply
(Source: Hernia)
Source: Hernia - January 11, 2021 Category: Sports Medicine Source Type: research

Intestinal erosion rate following transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) inguinal hernia repair: does the surgical approach matter?
(Source: Hernia)
Source: Hernia - January 11, 2021 Category: Sports Medicine Source Type: research

Lower recurrence rate after groin and primary ventral hernia repair performed by high-volume surgeons: a systematic review
ConclusionHigh-volume surgeons seemed to have lower rates of hernia recurrence after groin as well as primary ventral hernia repair and our data supports the need for centralization of groin hernia repair on individual surgeons. (Source: Hernia)
Source: Hernia - January 6, 2021 Category: Sports Medicine Source Type: research

Causes of prolonged hospitalization after open incisional hernia repair: an observational single-center retrospective study of a prospective database
ConclusionCauses for prolonged hospitalization after OIHR were possibly reducible. Future efforts to improve the ERAS regime and reduce LOS after OIHR should focus on pain treatment- and prevention, alternatives to epidural treatment, and well-defined, evidence-based discharge criteria. (Source: Hernia)
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Early drain removal does not increase the rate of surgical site infections following an open transversus abdominis release
ConclusionsEarly removal of abdominal wall surgical drains at discharge irrespective of drain output does not increase the prevalence of infectious morbidity following TAR. It is likely safe to remove all drains at discharge regardless of drain output. (Source: Hernia)
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Surgical management of infected abdominal wall mesh: an analysis using the American Hernia Society Quality Collaborative
AbstractIntroductionSeveral management strategies exist for the treatment of infected abdominal mesh. Using the American Hernia Society Quality Collaborative, we examined management patterns and 30-day outcomes of infected mesh removal with concomitant incisional hernia repair.MethodsAll patients undergoing incisional hernia repair with removal of infected mesh were identified. A complete repair (CR) was defined as fascial closure with mesh; a partial repair (PR) was defined as fascial closure without mesh or no fascial closure with mesh. A two-tailedp value less than or equal to 0.05 was considered statistically significa...
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Laparoscopic treatment (reTAPP) for recurrence after laparoscopic inguinal hernia repair
ConclusionReTAPP surgery for recurrences after previous TAPP repair proved to be safe and was associated with a shorter length of hospital stay and morbidity and recurrence rates comparable to OS at a highly specialized center. Randomized studies with a larger number of cases are necessary to confirm these findings and draw more robust and objective conclusions. (Source: Hernia)
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Prevention of incisional hernia with a reinforced tension line (RTL) versus primary suture only in midline laparotomies: 3-year follow-up in a randomized clinical trial
ConclusionsThe RTL technique is useful in the prevention of IH when compared with PSO in high-risk midline laparotomy patients, and it is not associated with a higher percentage of complications.Trial registrationLocal Committee CI-HRAEB-2013-020. March 13, 2013.Clinical trialsNCT02136628, retrospectively registered. (Source: Hernia)
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Safety and efficacy of absorbable and non-absorbable fixation systems for intraperitoneal mesh fixation: an experimental study in swine
ConclusionCapsure ™ fixation system provided higher peel strength that the other tested devices in our swine model of intraperitoneal mesh fixation. Our findings generate the hypothesis that this type of fixation may be superior in a clinical setting. Clinical trials with long-term follow-up are required to assess the safety and efficacy of mesh fixation systems in hernia surgery. (Source: Hernia)
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Safety and efficacy in inguinal hernia repair: a retrospective study comparing TREPP, TEP and Lichtenstein (SETTLE)
AbstractBackgroundThis pilot trial investigates whether the trans rectus sheath extra-peritoneal (TREPP) mesh repair is a safe and effective procedure compared to the currently most performed inguinal hernia repair techniques TEP and Lichtenstein.MethodsThree hundred patients older than 18  years with unilateral inguinal hernia were included in this retrospective cohort study, of which 58 (19.3%) underwent TREPP, 190 (63.3%) TEP and 52 (17.3%) Lichtenstein. The primary outcome of this study was inguinal hernia recurrence rate within 1 year after surgery. Secondary objectives were ch ronic post-operative inguinal ...
Source: Hernia - January 5, 2021 Category: Sports Medicine Source Type: research

Inadequate awareness of adherence to ARRIVE guidelines, regarding reporting quality of hernia models repaired with meshes: a systematic review
AbstractPurposeResearch papers involving animal studies often display poor reporting standards, leading to lower study reproducibility. We aim to determine the difference in reporting animal studies regarding abdominal wall hernia repair with mesh placement, before and after the publication of ARRIVE-2010 (Animal Research: Reporting of In Vivo Experiments) guidelines. Furthermore, we aim to present the most up-to-date reporting quality using the updated ARRIVE-2020 as criteria.MethodsAll animal studies concerning hernia repair with meshes were systematically searched. Articles published in the 5  years leading up to t...
Source: Hernia - January 4, 2021 Category: Sports Medicine Source Type: research

Comparing the outcomes of external oblique and transversus abdominus release using the AHSQC database
AbstractPurposeMyofascial release techniques at the time of complex hernia repair allow for tension-free closure of the midline fascia. Two common techniques are the open external oblique release (EOR) and the transversus abdominis release (TAR). Each technique has its reported advantages and disadvantages, but there have been few comparative studies. The purpose of this project was to compare the outcomes of these two myofascial release techniques.MethodsThe Americas Hernia Society Quality Collaborative (AHSQC) database was queried and produced a data set on 24 May 2018. All patients undergoing open incision hernia repair...
Source: Hernia - January 4, 2021 Category: Sports Medicine Source Type: research

Abdominal wound dehiscence is dangerous: a nationwide study of 14,169 patients undergoing elective open resection for colonic cancer
AbstractPurposeThe potential impact of abdominal wound dehiscence on long-term survival after elective abdominal surgery is largely unknown. The aim of this study was to examine the impact of abdominal wound dehiscence on survival and incisional hernia repair after elective, open colonic cancer resection.MethodsThis was a nationwide cohort study based on merged data from Danish national registries, comprising patients subjected to elective, open resection for colonic cancer between May 1, 2001 and January 1, 2016. Multivariable Cox Regression analysis and propensity score matching was applied to adjust for confounding. The...
Source: Hernia - January 4, 2021 Category: Sports Medicine Source Type: research

Preventing incisional ventral hernias: important for patients but ignored by surgical specialities? A critical review
ConclusionMeticulous closure of the incision is significant for every patient. Raising awareness of the His is necessary in all surgical disciplines that work withing the abdomen or retroperitoneum. Across all specialties, surgeons should aim for a
Source: Hernia - January 4, 2021 Category: Sports Medicine Source Type: research

Linear versus volumetric CT analysis in predicting tension-free fascial closure in abdominal wall reconstruction
AbstractBackgroundImproved outcomes of abdominal wall reconstruction (AWR) have been shown when tension-free fascial closure (TFFC) is achieved. Our objective was to determine the clinical and radiologic predictors of TFFC in patients undergoing AWR.Study designWe conducted a single institution retrospective cohort study of adults who underwent AWR between 2007 and 2018. Demographics, hernia characteristics and operative data were collected. Linear and volumetric variables were obtained from preoperative abdominal CT scans, the latter following 3D reconstruction. Logistic regression was used to evaluate predictors of TFFC....
Source: Hernia - January 3, 2021 Category: Sports Medicine Source Type: research

Management of ventral hernia defect during enterocutaneous fistula takedown: practice patterns and short-term outcomes from the Abdominal Core Health Quality Collaborative
ConclusionsSurgeons participating in the ACHQC predominantly resect ECFs and repair the associated hernias with sublay mesh with or without a myofascial release. Morbidity remains high, most closely related to wound complications, as such, concomitant definitive repairs should be entertained with caution. (Source: Hernia)
Source: Hernia - January 2, 2021 Category: Sports Medicine Source Type: research

Long term comparative evaluation of two types of absorbable meshes in partial abdominal wall defects: an experimental study in rabbits
ConclusionEighteen months after the implant both materials showed good compatibility but the biodegradation of Phasix ™ and Protexa™ was incomplete. No signs of hernia were observed at 18 months with the stress–stretch relations being similar for both implants, regardless of the more compliant abdominal wall repaired with Protexa™ at short term. (Source: Hernia)
Source: Hernia - November 30, 2020 Category: Sports Medicine Source Type: research

Comment to: The transversus abdominis plane block reduces the cumulative need of analgesic medication following inguinal hernia repair in TAPP technique: a retrospective single center analysis among 838 patients
(Source: Hernia)
Source: Hernia - November 30, 2020 Category: Sports Medicine Source Type: research

Treatment of small ( & lt;  2 cm) umbilical hernias: guidelines and current trends from the Herniamed Registry
AbstractIntroductionBased on meta-analyses and registry data, the European Hernia Society and the Americas Hernia Society have published guidelines for the treatment of umbilical hernias. These recommend that umbilical hernia should generally be treated by placing a non-absorbable (permanent) flat mesh into the preperitoneal space with an overlap of the hernia defect of 3  cm. Suture repair should only be considered for small hernia defects of less than 1 cm. Hence, the use of a mesh in general is subject to controversial debate particularly for small (
Source: Hernia - November 25, 2020 Category: Sports Medicine Source Type: research

Application of 3D reconstruction through CT to measure the abdominal cavity volume in the treatment of external abdominal hernia
In this study, we found that there was no significant difference in the abdominal cavity volumes between these two groups (VR vs. DR  = 7857.316 ± 2035.786 cm3 vs. 7967.268  ± 2925.792 cm3,P >  0.05). Besides, the correlation analysis between the measured values of VR method and DR method showed there was a significant positive correlation (r = 0.922,P 
Source: Hernia - November 23, 2020 Category: Sports Medicine Source Type: research

Hernia width explains differences in outcomes between primary and incisional hernias: a prospective cohort study of 9159 patients
ConclusionAfter correcting for hernia width, most outcomes do not significantly differ between PH and IH, indicating that not hernia type, but hernia width is an important factor contributing to the differences between PH and IH. (Source: Hernia)
Source: Hernia - November 23, 2020 Category: Sports Medicine Source Type: research

Role of the signs of obturator hernia in clinical practice: Author's reply
(Source: Hernia)
Source: Hernia - November 23, 2020 Category: Sports Medicine Source Type: research

Correction to: Combining anterior and posterior component separation for extreme cases of abdominal wall reconstruction
The original article can be found online. (Source: Hernia)
Source: Hernia - November 23, 2020 Category: Sports Medicine Source Type: research

Non reducible inguinal hernias in Malawi: an occupational hazard
ConclusionNon-reducible inguinal hernias largely affect young male farmers in Malawi. Delays to care can limit economic productivity for this rural population, as well as, yield considerable risk of mortality. While specific patient and institutional factors must be further elucidated, increased awareness, public health prioritization, and surgical capacity building is needed to reduce further hernia-related morbidity and mortality. (Source: Hernia)
Source: Hernia - November 21, 2020 Category: Sports Medicine Source Type: research

Hernia reviewers
(Source: Hernia)
Source: Hernia - November 21, 2020 Category: Sports Medicine Source Type: research

Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry
AbstractPurposeDefinitive fascial closure is an essential treatment objective after open abdomen treatment and mitigates morbidity and mortality. There is a paucity of evidence on factors that promote or prevent definitive fascial closure.MethodsA multi-center multivariable analysis of data from the Open Abdomen Route of the European Hernia Society included all cases between 1  May 2015 and 31 December 2019. Different treatment elements, i.e. the use of a visceral protective layer, negative-pressure wound therapy and dynamic closure techniques, as well as patient characteristics were included in the mul...
Source: Hernia - November 21, 2020 Category: Sports Medicine Source Type: research

Outcomes of concomitant mesh placement and intestinal procedures during open ventral hernia repair
AbstractPurposeThe concept of mesh use during open ventral hernia repair with a concomitant intestinal procedure remains controversial and it remains unclear whether the SSI profile of contaminated fields in this setting more closely resembles clean-contaminated or dirty wounds.MethodsPatients who underwent an open ventral hernia repair and intestinal procedures were extracted from the ACS-NSQIP database. Data analysis was performed for mesh versus no mesh groups in aggregate and matched cohorts. The 30-day outcomes including mortality, morbidity, surgical site infections (SSI), readmission, reoperation, and length of stay...
Source: Hernia - November 20, 2020 Category: Sports Medicine Source Type: research

Editor ’s corner
(Source: Hernia)
Source: Hernia - November 20, 2020 Category: Sports Medicine Source Type: research

It ’s not just an ileus: disparities associated with ileus following ventral hernia repair
AbstractPurposeWe sought to identify risk factors associated with postoperative ileus following ventral hernia repair.MethodsUtilizing the Nationwide Inpatient Sample (NIS) from 2008 to 2012, we identified adult patients that underwent either open or laparoscopic hernia repair for umbilical and ventral hernias with a diagnosis of umbilical/ventral hernia. We excluded cases with diagnosis of obstruction and bowel gangrene that underwent bowel resection, or with missing data. Risk variables of interest were age, sex, race, income status, insurance status, elective admission, comorbidity status (using the validated van Walrav...
Source: Hernia - November 19, 2020 Category: Sports Medicine Source Type: research