Does primary closure of direct inguinal hernia defect during laparoscopic mesh repair reduce the risk of early recurrence?
ConclusionClosure of direct inguinal hernia defects during laparoscopic mesh repair has been shown to reduce the incidence of early hernia recurrence in our retrospective study but future randomized controlled trials with large numbers would enable us to draw more robust conclusions and perhaps change the way we perform laparoscopic inguinal hernia repair. (Source: Hernia)
Source: Hernia - July 7, 2020 Category: Sports Medicine Source Type: research

Robotic iliopubic tract (r-IPT) repair: technique and preliminary outcomes of a minimally invasive tissue repair for inguinal hernia
ConclusionThe Nyhus-inspired robotic iliopubic tract (r-IPT) repair is an MIS approach to provide a non-mesh repair in inguinal hernia. The repair is safe with acceptable preliminary outcomes in low-risk patients. We propose the r-IPT repair to be a MIS option for non-mesh inguinal hernia repair in low-risk patients. (Source: Hernia)
Source: Hernia - July 7, 2020 Category: Sports Medicine Source Type: research

A multistage process leading to the development of a structured consent form and patient information leaflet for complex abdominal wall reconstruction (CAWR)
ConclusionThrough sharing the process that we undertook, we aim to support other abdominal wall units who wish to develop and improve their own consent process. (Source: Hernia)
Source: Hernia - July 7, 2020 Category: Sports Medicine Source Type: research

Hybrid robotic transversus abdominis release versus open: propensity-matched analysis of 30-day outcomes
AbstractPurposeTo examine the hospital length of stay (LOS) and 30  day outcomes of hybrid robotic transversus abdominis release (hrTAR) compared with open transversus abdominis release (oTAR).MethodsPatients receiving hrTAR were selected from the AHSQC database and propensity matched with a contemporary cohort of oTAR patients.ResultsThe cohort included 95 hrTAR and 285 oTAR patients. There was a significantly shorter median LOS in the hrTAR cohort (3 vs. 5  days,p 
Source: Hernia - June 30, 2020 Category: Sports Medicine Source Type: research

Return to outdoor walking, car driving, and sexual activity following elective inguinal hernia repair: surgeons ’ perspective versus patients’ reality
ConclusionsPatients reported that times for resumption of outdoor walking, driving, and sexual activity were significantly longer than those recommended by surgeons. Age, BMI, bilateral repair, and recurrent hernias were found to be factors affecting return time to different activities. (Source: Hernia)
Source: Hernia - June 26, 2020 Category: Sports Medicine Source Type: research

Staged complex abdominal wall hernia repair in morbidly obese patients
ConclusionsIn this study, staged mesh repair of complex abdominal wall hernias after bariatric surgery in morbidly obese patients was associated with acceptable morbidity and no hernia recurrences at approximately 1.5  year follow-up. (Source: Hernia)
Source: Hernia - June 24, 2020 Category: Sports Medicine Source Type: research

Endolaparoscopic retromuscular repair of smaller midline ventral hernias —too much for too little?
(Source: Hernia)
Source: Hernia - June 24, 2020 Category: Sports Medicine Source Type: research

Do drains have an impact on the outcome after primary elective unilateral inguinal hernia repair in men?
ConclusionDrains are used selectively in high-risk men with primary elective unilateral inguinal hernia repair. Drains are associated with intra- and postoperative complications rates and complication-related reoperation rate. Drains can serve as an indicator for early detection of complications. (Source: Hernia)
Source: Hernia - June 21, 2020 Category: Sports Medicine Source Type: research

Surgical treatment of diastasis recti: the importance of an overall view of the problem
ConclusionOur experience shows the importance of an overall view of the functional and cosmetic impairment created by DR. The surgeon should obtain an optimal repair of the function, by open or minimally invasive surgery, also considering the morphological aspects, which are very important for the patients in terms of QoL. (Source: Hernia)
Source: Hernia - June 20, 2020 Category: Sports Medicine Source Type: research

Using local hemostatic to prevent seromas in patients with large incisional hernias randomized controlled trial
ConclusionThe use of the local hemostatic agent Haemoblock can reduce the duration of the postoperative wound draining, shorten the period of inflammatory exudative processes in the postoperative wound, significantly reduce the number of puncture interventions for the postoperative wound, reduce the risk of the seromas formation and surgical site infections (SSI) associated with seroma, reduce the severity of pain and the need for analgesics. (Source: Hernia)
Source: Hernia - June 18, 2020 Category: Sports Medicine Source Type: research

Where are the hernias? A paradoxical decrease in emergency hernia surgery during COVID-19 pandemic
(Source: Hernia)
Source: Hernia - June 16, 2020 Category: Sports Medicine Source Type: research

Watchful waiting is an appropriate option for peritoneal dialysis candidates with an asymptomatic ventral hernia
ConclusionWatchful waiting may be an acceptable option for select patients with asymptomatic ventral hernias at the time of initial PD catheter placement. These findings highlight the need to better identify factors associated with asymptomatic ventral hernias that do not warrant concomitant repair to aid surgeons in the decision-making process. (Source: Hernia)
Source: Hernia - June 15, 2020 Category: Sports Medicine Source Type: research

A systematic review of the use of progressive preoperative pneumoperitoneum since its inception
ConclusionPreoperative progressive pneumoperitoneum (PPP) is a beneficial and safe technique to use in preparing patients with large hernias, but the procedure is not free of complications. The technique has evolved through the years and, although many variations exist, it is possible to establish an algorithm for its application. (Source: Hernia)
Source: Hernia - June 9, 2020 Category: Sports Medicine Source Type: research

Correction 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
The updated table has been copied below. (Source: Hernia)
Source: Hernia - June 9, 2020 Category: Sports Medicine Source Type: research

Comment to: Hernia research in developing countries —are we looking for needles in haystacks? Establishing databases is the key
(Source: Hernia)
Source: Hernia - June 6, 2020 Category: Sports Medicine Source Type: research

Closing peritoneal tear during laparoscopic inguinal hernia repair: simple and effective technique
ConclusionsPeritoneal tears occurring inadvertently during Laparoscopic TAPP/TEP procedure for repair inguinal hernia can be effectively sealed with simple bipolar diathermy (Source: Hernia)
Source: Hernia - June 4, 2020 Category: Sports Medicine Source Type: research

Non-coated versus coated mesh for retrorectus ventral hernia repair: a propensity score-matched analysis of the Americas Hernia Society Quality Collaborative (AHSQC)
ConclusionBarrier-coated mesh in the retrorectus position was associated with increased wound morbidity requiring procedural intervention. Due to a lack of clinical benefit, the use of more costly barrier-coated mesh in the retrorectus position is not justified for routine, open ventral hernia repairs at this time. (Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Laparoscopic versus open ventral hernia repair in the elderly: a propensity score-matched analysis
AbstractBackgroundVentral hernia repair is common in the expanding aging population, but remains challenging due to their frequent comorbidities. The purpose of this study is to compare the surgical outcomes of open vs. laparoscopic ventral hernia repair in elderly patients.MethodsPatients  ≥ 65 years of age that underwent elective open or laparoscopic ventral hernia repair were identified from the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database. To reduce potential selection bias, propensity scores were created for the likelihood of undergoing laparoscopic ...
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Prospective, multicenter, pairwise analysis of robotic-assisted inguinal hernia repair with open and laparoscopic inguinal hernia repair: early results from the Prospective Hernia Study
AbstractPurposeTo evaluate and compare peri-operative outcomes through 30  days, including pain and quality of life (QOL) through 3 months across three cohorts of inguinal hernia repair (IHR) patients (robotic-assisted, laparoscopic, and open IHR).MethodsThe Prospective Hernia Study is an ongoing, multicenter, comparative, open-label analysis of clinical and patient-reported outcomes from robotic-assisted surgery (RAS) versus open and RAS versus laparoscopic IHR procedures. Patient responses to the Carolinas Comfort Scale (CCS) questionnaire provided QOL outcomes.Results504 enrolled patients underwent unilateral ...
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Robotic assisted eTEP ventral hernia repair: Brazilian early experience
ConclusionWe present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. Although long term outcomes require further analysis, its feasibility and reproducibility in experienced surgeons hands are evident, with safe and acceptable early postoperative outcomes. (Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Implementing preoperative Botulinum toxin A and progressive pneumoperitoneum through the use of an algorithm in giant ventral hernia repair
ConclusionOur algorithm using both anterior or posterior component separation, together with  preoperative BTA injections and PPP, achieved an acceptable fascial closure rate. Further studies are needed to explore the individual potential of BTA injections and PPP, and to research whether these methods can prevent the need for component separation, as postoperative wound morbidity remains high in our study. (Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

The European Hernia Society classification applied to the rare cases of parastomal hernia after ileal conduit urinary diversion: a retrospective cohort of 96 patients
AbstractIntroductionTo determine the incidence and classification of parastomal hernia (PH) following ileal conduit urinary diversion and to identify risk factors for PH development.MethodsWe performed a retrospective review of our cystectomy database which includes benign and malignant cases from 2011 –2016. Patients with an abdominal CT at 24 ± 2 months post-operation were included. PH were classified according to the European Hernia Society (EHS) system. Regression analyses were performed on variables associated with parastomal hernia.ResultsA total of 96 patients were included in the stu...
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Learning curve in robotic transabdominal preperitoneal (rTAPP) ventral hernia repair: a cumulative sum (CUSUM) analysis
ConclusionsForty-six cases were needed to achieve steadily decreasing operative times. We can assume that ensuring good-quality repairs, through maintenance of peritoneal flap integrity, was gradually improved after sixty-one cases. Moreover, familiarization with port placements and robotic docking was accomplished after forty-three cases. (Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Health care disparity exists among those undergoing emergent hernia repairs in New York State
ConclusionRace is a contributing factor in who undergoes an emergent hernia repair in New York State. A significantly larger proportion of the African American population is undergoing hernia repair in the emergent setting. Socioeconomic status, as indicated by the significant number of Medicaid patients undergoing emergent hernia repairs, also plays a role. (Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Re-do surgery after prosthetic abdominal wall repair: intraoperative findings of mesh-related complications
ConclusionsLong-term implant results in abdominal wall repair and are not completely known, and literature is still lacking on this topic. Re-do surgery for subsequent pathological events may represent a way to increase our knowledge. (Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Comparison of ıncisional hernia models ın rats: an experimental study
AbstractPurposeIncisional hernia repair is a frequently performed operation worldwide. In this experimental study, our aim is to present the incisional hernia model after creating midline laparotomy and several type of defects on abdominal wall of the rats. Thereby, the method determined here may be used in future experimental incisional hernia repair studies.MethodsAfter approval, 32 male rats were randomly seperated into 4 groups of 8 animals each, and were operated to form an incisional hernia; Sham group, 5  cm incision group, 5 cm incision plus capitonnage group, and 5 cm incision plus 2 ×&...
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Hernia research in developing countries —are we looking for needles in haystacks?
(Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Mesh fixation in IPOM with cyanoacrylate glue, a matter of surface area? Author ’s Reply
(Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Comment to: Hernia research in developing countries —are we looking for needles in haystacks? Follow-up is the Achilles heel of every registry
(Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Comment to: Hernia research in developing countries —are we looking for needles in haystacks? Start small and progressively grow
(Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Comment to: Hernia research in developing countries: are we looking for needles in haystacks? Insights from the Danish model
(Source: Hernia)
Source: Hernia - June 3, 2020 Category: Sports Medicine Source Type: research

Comparative study of collagen and elastin content of abdominal wall fascia in inguinal hernia and non-hernia patients in an African population
AbstractPurposeAltered composition of collagen and elastin in abdominal fascia has been linked with the pathogenesis of hernias. This has not been studied amongst Africans who have hernia presentations which vary significantly from Caucasian cohorts. The aim of this study was to determine, and compare, the collagen and elastin contents of the transversalis fascia and rectus sheath of inguinal hernia patients with non-hernia controls.MethodsTwenty-five patients with solitary, primary, uncomplicated inguinal hernia and twenty-five non-hernia controls were evaluated. Biopsies of the transversalis fascia and anterior rectus sh...
Source: Hernia - June 2, 2020 Category: Sports Medicine Source Type: research

An early experience with transversus abdominis release for complex ventral hernias: a retrospective review of 100 cases
ConclusionsOur early results with TAR are encouraging. We have demonstrated that the repair allows anatomical reconstruction with a large sublay mesh while inflicting minimal morbidity. TAR can be a valuable tool in complex ventral hernia repair. (Source: Hernia)
Source: Hernia - May 6, 2020 Category: Sports Medicine Source Type: research

A comparison of robotic mesh repair techniques for primary uncomplicated midline ventral hernias and analysis of risk factors associated with postoperative complications
ConclusionRobotic PVHR contributes multiple techniques to a surgeon ’s armamentarium, such as IPOM, TAPP, and RM mesh placements. Patient characteristics as well as the potential consequences of each technique need to be taken into consideration when deciding the appropriate approach for the repair of primary uncomplicated midline ventral hernias. (Source: Hernia)
Source: Hernia - May 5, 2020 Category: Sports Medicine Source Type: research

The lateral rectus abdominis positioned stoma (LRAPS) trephine: the hope in Pandora ’s box
(Source: Hernia)
Source: Hernia - May 4, 2020 Category: Sports Medicine Source Type: research

Social determinants of health and outcomes of ventral hernia repair in a safety-net hospital setting
AbstractPurposeLower socioeconomic status has been shown to be predictive of poorer surgical outcomes in ventral hernia repair. Recently, safety-net hospitals have been attempting to address these disparities to improve the care of patients of lower socioeconomic status.MethodsA query of all patients undergoing ventral hernia repair at our institution between 2010 and 2019 was completed (n = 580). Patients not from identifiable New Jersey ZIP-codes were excluded (n = 572). ZIP codes were assigned quartiles based off socioeconomic variables including median household income, percent below poverty...
Source: Hernia - May 2, 2020 Category: Sports Medicine Source Type: research

A plea for unification of surgical guidelines in the COVID-19 outbreak
(Source: Hernia)
Source: Hernia - April 30, 2020 Category: Sports Medicine Source Type: research

Polytetrafluoroethylene versus polypropylene mesh during laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia: short- and long-term results of a double-blind clinical randomized controlled trial
AbstractPurposeAim of the study is to compare macroporous (>  1 mm2) polytetrafluoroethylene mesh (LP-PTFE) versus microporous (
Source: Hernia - April 30, 2020 Category: Sports Medicine Source Type: research

Hernia in the time of COVID-19
(Source: Hernia)
Source: Hernia - April 29, 2020 Category: Sports Medicine Source Type: research

Would surgeons be definitively forbidden to restore the abdominal wall without using a mesh?
(Source: Hernia)
Source: Hernia - April 27, 2020 Category: Sports Medicine Source Type: research

Laparoscopic posterior cruroplasty: a patient tailored approach
AbstractBackgroundDifferent surgical variations have been described for laparoscopic crural repair however, the technique is not standardized and left to the surgeons ’ preference.ObjectiveThe purpose of this study is to describe a standardized “patient tailored” approach for laparoscopic posterior cruroplasty in the setting of elective hiatal hernia repair.MethodsRetrospective single-center study was conducted (November 2015 to November 2019). The technical aspects of a standardized “patient tailored” laparoscopic posterior crural repair are described. Perioperative outcomes and patients&rsqu...
Source: Hernia - April 25, 2020 Category: Sports Medicine Source Type: research

Primary thoracoabdominal hernias
ConclusionsPrimary thoracoabdominal hernias require a high index of suspicion. Durable repair involves complex reconstruction of the thoracoabdominal wall including the diaphragm, intercostal space, rib fracture fixation, and mesh reinforcement of the abdominal wall with permanent fixation constructs. (Source: Hernia)
Source: Hernia - April 24, 2020 Category: Sports Medicine Source Type: research

Imaging modalities for inguinal hernia diagnosis: a systematic review
ConclusionsWe found that US had the highest sensitivity and specificity. However, it must be taken into consideration that performance is highly dependent on the operator ’s level of expertise. Based on this systematic review, ultrasound may be the preferred imaging modality when physical examination is inconclusive, given that local expertise in performing US examination for hernia disease is adequate. (Source: Hernia)
Source: Hernia - April 23, 2020 Category: Sports Medicine Source Type: research

Comparison of component separation technique, partition technique, and extended anterolateral thigh flap in complex abdominal wall closure
ConclusionThis study suggests that extended ALT flap provides the largest fascia defect closure, followed orderly by partition technique and CST, but requires longer operative time and hospitalization. There are no significant differences in postoperative complications between three groups. A prospective study with indications based on these findings is suggested. (Source: Hernia)
Source: Hernia - April 23, 2020 Category: Sports Medicine Source Type: research

Comparing apples and oranges will not guide treatment the right way in umbilical hernia repair: use either level-1 evidence or guidelines
(Source: Hernia)
Source: Hernia - April 22, 2020 Category: Sports Medicine Source Type: research

Effects of smoking and different BMI cutoff points on surgical site infection after elective open ventral hernia repair
The objective of this study was to analyze the relationship between different BMI thresholds, smoking, and SSI after open ventral hernia repair.MethodsAll patients who underwent an elective non-emergent open ventral hernia repair with mesh were extracted from the 2011 to 2016 NSQIP database. Bivariate, multivariate logistic regression, and Classification and Regression Tree (CART) analyses were used.ResultsOf 55,240 patients, 2,620 (4.7%) developed SSIs (superficial: 58.5%, deep:27%, organ –space: 16%). BMI (OR: 1.035; 95% CI:1.03–1.04;p 
Source: Hernia - April 21, 2020 Category: Sports Medicine Source Type: research

Analysing topics using different methods promotes constructive debates: authors ’ reply
(Source: Hernia)
Source: Hernia - April 21, 2020 Category: Sports Medicine Source Type: research

Could polypropylene mesh impair male reproductive organs? Experimental study with different methods of implantation
AbstractPurposeTo evaluate the vas deferens and testicles of rats submitted to bilateral inguinotomy and polypropylene (PP) mesh placement.MethodSixty Wistar rats were randomized into three groups: Control (inguinotomy only), mesh placement over the vas deferens (Mesh-DD) or under the spermatic funiculus (Mesh-SF). The following analyses were performed: vas deferens morphometry (lumen area and wall thickness), quantification of collagen fibers, spermatogenesis, apoptosis (cleaved caspase-3 and TUNEL) and cellular proliferation (Ki67). Quantitative gene expression (qPCR) for apoptosis and inflammatory cytokines were evaluat...
Source: Hernia - April 18, 2020 Category: Sports Medicine Source Type: research

The emerging role of sarcopenia as a prognostic indicator in patients undergoing abdominal wall hernia repairs: a systematic review of the literature
ConclusionThere is some evidence to suggest that BC techniques could be used to help predict surgical outcomes and allow early optimisation in AWH patients. However, the lack of consistency in chosen methodology, combined with the outdated definitions of sarcopenia, makes drawing any conclusions difficult. Whether body composition modification can be used to improve outcomes remains to be determined. (Source: Hernia)
Source: Hernia - April 16, 2020 Category: Sports Medicine Source Type: research

42nd Annual European Hernia Society Congress 2020
(Source: Hernia)
Source: Hernia - April 15, 2020 Category: Sports Medicine Source Type: research