Laparoscopic excision of infected mesh
(Source: Hernia)
Source: Hernia - August 24, 2019 Category: Sports Medicine Source Type: research

Perforated diverticulosis within an inguinal hernia
(Source: Hernia)
Source: Hernia - August 23, 2019 Category: Sports Medicine Source Type: research

Safety and efficacy of prophylactic resorbable biosynthetic mesh following midline laparotomy in clean/contemned field: preliminary results of a randomized double blind prospective trial
We present a double-blind randomized study examining feasibility, safety and incisional hernia rate using a prophylactic Bio-A biosynthetic stripe (Gore) in a sub-lay position after midline laparotomy in patients undergoing operations in clean-contaminated and contaminated field. One hundred patients who underwent a midline laparotomy of at least 10  cm in a clean-contaminated and contaminated field were considered. Patients were divided into two groups: [Group A closed in double layer using PDS 0 with WL/SL of 1:4; Group B closure in double layer using PDS 0 and sub-lay positioning a 3 cm-wide BIO A (Gore) strip...
Source: Hernia - August 20, 2019 Category: Sports Medicine Source Type: research

HTX-011 reduced pain intensity and opioid consumption versus bupivacaine HCl in herniorrhaphy: results from the phase 3 EPOCH 2 study
AbstractPurposeCurrently available local anesthetics have not demonstrated sufficient analgesia beyond 12 –24 h postoperatively. The purpose of the study was to assess the safety and efficacy of HTX-011 (bupivacaine and meloxicam in Biochronomer® polymer technology), a long-acting investigational anesthetic, in reducing both postoperative pain over 72  h and postoperative opioid use compared to bupivacaine hydrochloride (HCl).MethodsA phase 3, randomized, double-blind, active-controlled multi-center study (EPOCH 2; NCT03237481) in subjects undergoing unilateral open inguinal herniorrhaphy with mesh plac...
Source: Hernia - August 19, 2019 Category: Sports Medicine Source Type: research

Emergent groin hernia repair at a County Hospital in Guatemala: patient-related issues vs. health care system limitations
ConclusionA high number of patients present emergently for groin hernia repair at a county hospital in Guatemala compared to developed countries. Our data suggest that emergent hernias are likely the result of patient-related issues rather than health care system limitations. (Source: Hernia)
Source: Hernia - August 19, 2019 Category: Sports Medicine Source Type: research

Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair
ConclusionsWe successfully created a model for TAPP inguinal hernia repair training. The model is made of inexpensive synthetic and biological materials similar to the human tissue. The model is easy to reproduce and can be used in the training programs of surgical residents. (Source: Hernia)
Source: Hernia - August 19, 2019 Category: Sports Medicine Source Type: research

Population-based rates of hernia surgery in Ghana
ConclusionsThe rate of hernia operations fell short of estimated need. Most hernia repairs were performed at district hospitals, many without fully trained surgeons. Future global surgery benchmarking needs to address both overall surgical rates as well as rates for specific highly important operations. Countries can strengthen their planning for surgical care by defining their total, met, and unmet need for hernia surgery. (Source: Hernia)
Source: Hernia - August 19, 2019 Category: Sports Medicine Source Type: research

A systematic review on surgical treatment of primary epigastric hernias
AbstractObjectiveIn this systematic review, we evaluated all literature reporting on the surgical treatment of primary epigastric hernias, primarily focusing on studies comparing laparoscopic and open repair, and mesh reinforcement and suture repair.MethodsA literature search was conducted in Embase.com, PubMed and the Cochrane Library up to 24 April 2019. This review explicitly excluded literature on incisional hernias, ventral hernias not otherwise specified, and isolated (para)umbilical hernias. Primary outcome measures of interest were early and late postoperative complications.ResultsWe  obtained a total of ...
Source: Hernia - August 17, 2019 Category: Sports Medicine Source Type: research

Cutting through the fat: a retrospective analysis of clinical outcomes, cost, and quality of life with the addition of panniculectomy to ventral hernia repair in overweight patients
ConclusionsAt mean follow up of 2  years, VHR-PAN patients reported a comparable increase in QoL to those who received VHR alone without significantly different cost and complication rates. Concurrent VHR-PAN may therefore be a safe approach for overweight patients presenting with hernia and excess abdominal skin. (Source: Hernia)
Source: Hernia - August 16, 2019 Category: Sports Medicine Source Type: research

Emergency repair of complicated abdominal wall hernias: WSES guidelines
ConclusionsEmergency repair of complicated abdominal hernias remains one of the most common and challenging surgical emergencies worldwide. WSES aims to provide an essential version of the evidence-based guidelines focusing on the timing of intervention, laparoscopic approach, surgical repair following the Centers for Disease Control and Prevention (CDC) wound classification, antimicrobial prophylaxis and anesthesia in the emergency setting. (Source: Hernia)
Source: Hernia - August 12, 2019 Category: Sports Medicine Source Type: research

Minimising recurrence after primary femoral hernia repair; is mesh mandatory?
ConclusionsUse of different surgical approaches and types of repair for primary presentations of femoral hernia did not affect the recurrence rate or time to recurrence. Use of a pre-peritoneal mesh did not alter the recurrence rate or recurrence free survival, in either elective or emergency settings, compared to simple suture repair. Recurrence following primary femoral hernia repair tends to occur within the first post-operative year, suggesting that technical factors may be as important as suture or mesh failure. (Source: Hernia)
Source: Hernia - August 12, 2019 Category: Sports Medicine Source Type: research

Does complexity relate to compensation? A comparison of relative value units in initial versus recurrent inguinal hernia repair
This study aims to compare mean operative times and wRVUs per minute between primary and recurrent inguinal hernia repairs, the latter being considered as a more difficult procedure to perform.MethodsA retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was performed to identify all patients undergoing primary inguinal hernia repair and recurrent inguinal hernia repair by general surgeons over a 6-year period (2012 –2017). Calculation and comparison of mean operative times, wRVUs, and wRVU per minute were performed.ResultsA total of 134,391 pat...
Source: Hernia - August 10, 2019 Category: Sports Medicine Source Type: research

Telescopic dissection versus balloon dissection for laparoscopic totally extraperitoneal inguinal hernia repair (TEP): a registry-based randomized controlled trial
ConclusionsBD does not consistently result in 15-min time saving during TEP. Use of a disposable balloon dissector can be deferred in the experienced hands.Trial registrationClinicalTrials.gov (NCT03276871). (Source: Hernia)
Source: Hernia - August 6, 2019 Category: Sports Medicine Source Type: research

Correction to: Pure tissue repairs: a timely and critical revival
In the original publication, author group, abstract text, position of Figure  1, Figure 5 legend, Figure 6 (duplication of figure panels) and the conflict of interest statement were incorrectly published. The corrected text and the figures are given here. (Source: Hernia)
Source: Hernia - August 6, 2019 Category: Sports Medicine Source Type: research

Understanding the patient perspective after ventral hernia repair
ConclusionPRO assessments and meaningful communications between the physician and the patient can provide a comprehensive benefit –risk assessment prior to surgery, and may also improve patient understanding of what to expect during recovery from surgery. (Source: Hernia)
Source: Hernia - August 5, 2019 Category: Sports Medicine Source Type: research

Does perfusion matter? Preoperative prediction of incisional hernia development
ConclusionsAbsent patency of the abdominal wall vasculature is a novel risk factor for incisional hernia development in the setting of aortic disease. Preoperative assessment of perfusion may convey the risk of hernia development and may be a tool to guide measures such as prophylactic mesh placement to reduce the future risk of incisional hernia. (Source: Hernia)
Source: Hernia - August 2, 2019 Category: Sports Medicine Source Type: research

An 11-year analysis of reoperated groins after endoscopic totally extraperitoneal (TEP) inguinal hernia repair in a high volume hernia center
ConclusionsInguinal hernia recurrences were still observed in this high-volume hernia clinic. Recurrences were most frequently seen at their initial hernia site, the majority involving direct hernias. Isolated lipomas presenting as a pseudorecurrence were most frequently seen after correction of indirect hernias. In accordance with the current guidelines, reducing recurrence rates can be achieved by mesh fixation in bilateral, large and direct defects and by thoroughly reducing lipomas. (Source: Hernia)
Source: Hernia - July 28, 2019 Category: Sports Medicine Source Type: research

Comparing routine administrative data with registry data for assessing quality of hospital care in patients with inguinal hernia
AbstractIntroductionCollecting clinical data is viewed as the gold standard for assessing health-care quality. However, considerable investment is needed if the quality of care is to be recorded over a long period of time. Accordingly, the question arises as to whether routine administrative data may be used for quality assurance purposes if certain methodological standards are followed. This present study now compares the outcomes of inguinal hernia repair from the Herniamed Hernia Registry with routine data from Germany ’s largest sickness fund, the Local General Sickness Fund “AOK”.Materials and method...
Source: Hernia - July 24, 2019 Category: Sports Medicine Source Type: research

Mesh erosion after hiatal hernia repair: the tip of the iceberg?
ConclusionThe true incidence of mesh erosion after hiatal hernia repair may be higher than previously reported, and the erosion is more prone to occur after recurrent hiatal hernia repair. Mesh erosion can result in severe morbidity and sometimes require complex organ resection. Different kinds and shapes of prosthetic meshes can cause erosion; therefore, mesh should be used very selectively for hiatal hernia repair. The patient should be informed about the mesh placement and the possible mesh-related complications. (Source: Hernia)
Source: Hernia - July 23, 2019 Category: Sports Medicine Source Type: research

Could we reduce adhesions to the intra-abdominal mesh in the first week? Experimental study with different methods of fixation
This study mimics in an animal model a situation that can be found in clinical practice during laparoscopic inguinal hernioplasty. A polypropylene mesh could be exposed to the intra-abdominal cavity even when the peritoneum is closed due to different circumstances, with no options to guarantee the prosthetic material of being exposed to the intrabdominal viscera. Different options have been suggested to solve these situations, being proposed in this study to cover the visceral surface of the mesh with an absorbable sponge containing thrombin, fibrinogen, and clotting factors (Tachosil®, Nycomed, Takeda, Osaka, Japan), ...
Source: Hernia - July 23, 2019 Category: Sports Medicine Source Type: research

Validation and educational impact study of the NANEP high-fidelity simulation model for open preperitoneal mesh repair of umbilical hernia
AbstractObjectiveThe aim of the study was to develop, validate and analyze the educational impact of a high-fidelity simulation model for open preperitoneal mesh repair of an umbilical hernia.Summary of background dataThe number of surgical simulators available for training residents is limited. Primary for ethical reasons and secondary for the emerging pay-per-quality policies, practicing-on simulators rather than patients is considered gold standard. Validated full-procedural surgical models will become more and more important in training residents. Such models may assure that evidence-based standards regarding technical...
Source: Hernia - July 19, 2019 Category: Sports Medicine Source Type: research

Atraumatic laparoscopic intraperitoneal mesh fixation using a new laparoscopic device: an animal experimental study
ConclusionLaparoscopic mesh fixation with only the synthetic comonomer glue GLUBRAN® 2 is feasible, effective, and safe in intraperitoneal incisional/ventral hernia repair in this animal model. (Source: Hernia)
Source: Hernia - July 19, 2019 Category: Sports Medicine Source Type: research

En bloc removal of infected hernia mesh rather than “blue-ectomy”
(Source: Hernia)
Source: Hernia - July 19, 2019 Category: Sports Medicine Source Type: research

Editor ’s corner
(Source: Hernia)
Source: Hernia - July 18, 2019 Category: Sports Medicine Source Type: research

Inguinal hernia repair in centers of excellence. Author ’s reply
(Source: Hernia)
Source: Hernia - July 18, 2019 Category: Sports Medicine Source Type: research

Simple and safe thoracoscopic repair of neonatal congenital diaphragmatic hernia by a new modified knot-tying technique
ConclusionsThis special knot-tying technique is easy to learn and does not require any additional devices. It is a simple and accessible technique that can facilitate thoracoscopic repair of neonatal CDH within the limited space and with patch-repair. (Source: Hernia)
Source: Hernia - July 17, 2019 Category: Sports Medicine Source Type: research

Application of a novel material in the inguinal region using a totally percutaneous approach in an animal model: a new potential technique?
ConclusionThe introduction of a liquid material which solidifies after injection in a short time (hydrogel) using a needle is feasible. The combined CT-scan and US image guidance allows for the percutaneous placement of the needle in the required location. The introduced hydrogel remains in this space, corresponding to the inguinal region, without moving. The placed hydrogel compresses the posterior wall composed of the transversalis fascia, supporting the potential use of hydrogel for hernia defects. (Source: Hernia)
Source: Hernia - July 16, 2019 Category: Sports Medicine Source Type: research

Prophylactic mesh placement to avoid incisional hernias after stoma reversal: a systematic review and meta-analysis
AbstractPurposeTo provide an overview of the available literature on prevention of incisional hernias after stoma reversal, with the use of prophylactic meshes.MethodsA literature search of Pubmed, MEDLINE and EMBASE was performed. Search terms for stoma, enterostomy, mesh, prophylaxis and hernia were used. Search was updated to December 31th 2018. No time limitations were used, while English, Geman, Dutch and French were used as language restrictions. The primary outcome was the incidence of incisional hernia formation after stoma reversal. Secondary outcomes were mesh-related complications. Data on study design, sample s...
Source: Hernia - July 13, 2019 Category: Sports Medicine Source Type: research

Inguinal hernia repair in centers of excellence
(Source: Hernia)
Source: Hernia - July 5, 2019 Category: Sports Medicine Source Type: research

The gold-standard technique for inguinal hernia repair is the open approach
(Source: Hernia)
Source: Hernia - July 4, 2019 Category: Sports Medicine Source Type: research

Implementation of the small bites closure of abdominal midline incisions in clinical practice is correlated with a reduction in surgical site infections
ConclusionImplementation of small bites wound closure of abdominal midline incisions in clinical practice was correlated with a reduction in surgical site infections. (Source: Hernia)
Source: Hernia - June 28, 2019 Category: Sports Medicine Source Type: research

Herniation of gravid uterus through an incisional hernia with skin defect and uterine scar dehiscence
(Source: Hernia)
Source: Hernia - June 27, 2019 Category: Sports Medicine Source Type: research

Mesh fixation in open IPOM procedure with tackers or sutures? A randomized clinical trial with preliminary results
ConclusionsThe present study failed to show an advantage of tacks over suture fixation and even there are more severe adverse events. Using tacks significantly increases the costs of hernia repair. (Source: Hernia)
Source: Hernia - June 24, 2019 Category: Sports Medicine Source Type: research

Individual mesh size for open anterior inguinal hernia repair: an anthropometric study in Turkish male patients
ConclusionsThe intraoperative measurements for ideal mesh size in Lichtenstein repair of inguinal hernias may present somewhat different mesh dimensions in many patients. Individualization of mesh size may be of importance in surgical outcomes. (Source: Hernia)
Source: Hernia - June 20, 2019 Category: Sports Medicine Source Type: research

New, simple and reliable volumetric calculation technique in incisional hernias with loss of domain
AbstractIntroductionThe management of hernias with loss of domain is a challenging problem. It has been shown that the volume of the incisional hernia/peritoneal volume ratio
Source: Hernia - June 19, 2019 Category: Sports Medicine Source Type: research

Study of mesh infection management following inguinal hernioplasty with an analysis of risk factors: a 10-year experience
ConclusionsIt is recommended the approach of mesh removal is tailored as per the primary hernioplasty method. We analyzed the occurrence of risk factors for mesh infection in this study, but further studies are needed to develop a predictive model that is both internally and externally validated to evaluate the probability of mesh infection. (Source: Hernia)
Source: Hernia - June 11, 2019 Category: Sports Medicine Source Type: research

Enhanced recovery after surgical repair of incisional hernias
ConclusionsLike in other surgeries, ERPs were feasible and probably efficient to improve the post-operative course of incisional hernia patients. But the level of evidence remains low. (Source: Hernia)
Source: Hernia - June 8, 2019 Category: Sports Medicine Source Type: research

Contribution of heparin to recovery of incarcerated intestine in a rat incarcerated hernia model
ConclusionsThe results of this study are significant for planning the treatment of incarcerated inguinal hernia. Further, heparin is superior to procaine in terms of expedite recovery from intestinal incarceration. (Source: Hernia)
Source: Hernia - June 6, 2019 Category: Sports Medicine Source Type: research

State of the art: open mesh-based inguinal hernia repair
AbstractOpen inguinal hernia repair remains the most universal, ubiquitous, reliable, and cost-effective method of addressing the global burden of groin hernias. Advances in anatomic understanding and technique have refined a few well-established techniques that can address the majority of the burden of disease with low rates of morbidity, recurrence, and chronic pain. Prosthetic reinforcement has become routine because of the clear reduction in recurrence rates in general practice conferred by mesh and the less-appreciated consideration of simplification of the repair whereby operator variability, hernia type, anatomic va...
Source: Hernia - June 4, 2019 Category: Sports Medicine Source Type: research

Open versus laparoscopic mesh repair of primary unilateral uncomplicated inguinal hernia: a systematic review with meta-analysis and trial sequential analysis
ConclusionThis meta-analysis and trial sequential analysis report no difference in recurrence rates between laparoscopic and open primary unilateral inguinal hernia repairs. Rates of acute and chronic pain are significantly less in the laparoscopic group. (Source: Hernia)
Source: Hernia - June 3, 2019 Category: Sports Medicine Source Type: research

A systematic methodological review of non-randomised interventional studies of elective ventral hernia repair: clear definitions and a standardised minimum dataset are needed
ConclusionCurrently, non-randomised interventional studies of VH repair are methodologically poor. Clear outcome definitions and a standardised minimum dataset are needed. (Source: Hernia)
Source: Hernia - May 31, 2019 Category: Sports Medicine Source Type: research

Comment to: Umbilical hernia repair with composite prosthesis —a single-center experience. Porrero JL, Cano-Valderrama O, Villar S, et al.
(Source: Hernia)
Source: Hernia - May 27, 2019 Category: Sports Medicine Source Type: research

Mesh migration following abdominal hernia repair: author ’s reply
(Source: Hernia)
Source: Hernia - May 27, 2019 Category: Sports Medicine Source Type: research

Umbilical hernia repair with composite prosthesis: Author ’s reply
(Source: Hernia)
Source: Hernia - May 27, 2019 Category: Sports Medicine Source Type: research

Use of commercial mesh for hernia repair in a low resource setting: experience after 500 cases
ConclusionIn spite of resource limitations, the use of mesh for hernia repairs continues to rise and has overtaken tissue-based repairs in a sub-Saharan African setting. Results show good outcomes justifying continued use. (Source: Hernia)
Source: Hernia - May 25, 2019 Category: Sports Medicine Source Type: research

Needlescopic assisted internal ring suturing; a novel application of low-cost home-made instruments for pediatric inguinal hernia repair
ConclusionThis preliminary study showed that NAIRS after cauterization of the neck of the hernia sac in infants and children is safe, feasible, reproducible with excellent cosmetic results. (Source: Hernia)
Source: Hernia - May 25, 2019 Category: Sports Medicine Source Type: research

Comment on robotic inguinal hernia repair: is technology taking over?
(Source: Hernia)
Source: Hernia - May 25, 2019 Category: Sports Medicine Source Type: research

Long-term impact of incisional hernia on quality of life after colonic cancer resection
ConclusionsIncisional hernia subsequent to colonic cancer resection was associated with reduced QOL several years after surgery and should be considered taken into account when evaluating the long-term outcome of colonic cancer resection. (Source: Hernia)
Source: Hernia - May 24, 2019 Category: Sports Medicine Source Type: research

Primary unilateral not complicated inguinal hernia with an effective, cheap, less invasive, and easy operation: the Trabucco repair
ConclusionIn our experience of almost 30 years we have been able to experiment and refine more and more the sutureless technique proposed by Trabucco for the treatment of primitive inguinal hernia, peer to peer, improving the local anaesthesia and the ability to detect hidden defects during the repair (Spigelian included), reducing the width of the incisions and tractions on the tissues, introducing the concept of a gentle and bloodless “finger surgery” according to a minimally invasive, extremely anatomic, safe, inexpensive, very effective anterior open approach. (Source: Hernia)
Source: Hernia - May 22, 2019 Category: Sports Medicine Source Type: research

Wound protectors for improved exposure in open hernia repair
ConclusionOur results demonstrate that the use of disposable wound protectors provides superior surgical exposure for a given incision length compared to traditional techniques in the repair of ventral and open inguinal hernia repairs. (Source: Hernia)
Source: Hernia - May 21, 2019 Category: Sports Medicine Source Type: research