Archive

Surgeons Beware: The Ergonomics of Robotic & Laparoscopic Hernia Repair

Brian Wca Tian*; Graziano Ceccarelli

    Minimally invasive techniques are gaining traction in the discipline of hernia repair. However, there still remains a significant learning curve, especially when repairing complicated hernias laparoscopically. At times, many surgeons find themselves contorting their hands and bodies in abnormal postures to perform certain segments of the operation.


The Utilisation of the Small Bite Closure Technique in Emergency Laparotomy – A Pilot Study

Hazim A Eltyeb*; Dorothy Wintrip; Amnah Khan; Frederick Dowker; D Light

    In this study, we investigate the effect of small bite closure compared to a cohort of mass closure in emergency abdominal surgery. Our primary outcomes are wound dehiscence and wound infection, and our secondary outcome is 30-day mortality.


Abdominal Wall Hernia Repair with Composite Meshes: Systematic Review and Meta-Analysis of Mesh-Related Complications

Montori Giulia*; Rosati Samanta; Ortenzi Monica; Mazzarolo Giorgio; Licitra Edelweiss; Dal Borgo Andrea; Balestra Gabriella; Podda Mauro; Sartori Alberto; Botteri Emanuele; Procida Giuseppa; Salemi Michelangelo; Agresta Ferdinando

    Umbilical and epigastric hernias are frequent clinical conditions with expected low complications. This systematic review and meta-analysis aimed to analized the complications associated to the intraperitoneal bicomponent meshes as Ventralex. Bard Composix Kugel. / FLaPp. / CMC. produced respectively by Bard and Dipromed SRL. These prostheses are the most frequently used composite meshes.


Right Sided Congenital Diaphragmatic Hernia

Alaoui Othmane*; Mahmoudi Abdelhalim; Khattala Khalid; Bouabdallah Youssef

    Congenital diaphragmatic hernia is a rare condition that affects approximately 1 in 2500-5000 births and has been classified as posterolateral, anterior or central.
The posterolateral defect occurs on the left side (85%), although it may involve the right side (13%) or be bilateral (2%). Equivalent survival has been reported for left-sided versus right-sided congenital diaphragmatic hernias, although the latter have been associated with a high incidence of pulmonary complications...


Structural Alterations of Hernioplasty Prostheses in Humans: Correlation between X-Ray Micro-Computed Tomography Observations and Histological Investigations

Gabrielle Voisard; Andreas Malekos; Alessandra Patera; Stephan Carl; Stefan Hartmann; Michele Griffa; Edoardo Mazza; Dominique Derome; Ze Zhang; Gaetan Brochu; Robert Guidoin*

    Background: After implantation, prostheses for hernia repair become encapsulated tissue as the result of foreign body reaction possibly causing structural deformations. The aim of this study is to use X-ray microtomography to obtain three-dimensional characterisation of pristine devices to serve as references for explanted prostheses harvested at reoperation and preserved in a solution of formalin...


Robotic vs Laparoscopic vs Open IncisionalHernia Repair: A Single-Institution Analysis of 145 Consecutive Robotic Cases

Zachary T Holtzapple; Jeremy J Heffner*

    Purpose: Incisional hernias are commonly known to occur as a complication of abdominal procedures. This potentially leads to increased healthcare costs and decreased favorable patient outcomes. This study is a retrospective data analysis to compare incisional hernia repairs performed robotically to historical trends in open and laparoscopic surgeries.


Laparoscopic Versus Open Mesh Repair for Ventral Hernia - A Population Based Matched Case Control Study

Darkahi B; Wollert S; Ljungdahl M; Graf W*

    Objective: Laparoscopic repair of a ventral hernia is a feasible alternative to conventional surgery but it is not known whether there are definite advantages with this approach. The present study was performed to compare laparoscopic Intraperitoneal Onlay Mesh repair (IPOM) with Open Mesh Repair (OMR).


Novel use of Bromelain in Management of Chronic Rectus Sheath Hematoma: A Case Report

Ernest Cheng; Amit Sarkar; Suhrid Lodh; Sarah J Valle; David L Morris

   Rectus sheath haematomas are uncommon causes of abdominal pain resulting from bleeding into the rectus sheath. We report a case of a 67-year-old female with a symptomatic, non-resolved chronic abdominal haematoma successfully treated with Bromelain. A 14-French pigtail drain was inserted into her haematoma allowing Bromelain administration and subsequent haematoma extraction. We demonstrated symptomatic improvement with minimal side effects and significant reduction in haematoma size.


CT Abdomen with Valsalva’s maneuver facilitates grip-based incisional hernia repair

Kallinowski F; Nessel R; Gorich J; Grimm A; Loffler T

    Background: Grip-based incisional hernia repair needs the accurate determination of the hernia defect area and of the distensibility of the hernia area. Both parameters can be derived using computerized tomography of the abdomen at rest and during Valsalva’s maneuver. The two existing ways of analysis are compared for the first time on ten patients in a prospective observational study.


Two-stage treatment of concomitant complicated right amyand’s hernia and incarcerated left inguinal hernia: Case report and review of the literature

Maria Tudela Lerma*; Enrique Mercader Cidoncha; Fernando Turégano Fuentes

    Amyand´s hernia is a rare condition defined by the inclusion of the appendix vermiformis within the hernia sac. Its diagnosis is very difficult in the pre-operative period. The clinical manifestation of incarcerated inguinal hernia generally masks the symptoms of acute appendicitis.


Incarceration of a diaphragmatic hernia complicated by a tension fecopneumothorax after left hemihepatectomy: Review of the literature and case report

B Scholtes*; J Pochhammer; M Schäffer

    Incarceration of abdominal organs in a diaphragmatic hernia is a potentially life-threatening condition. It is associated with significant morbidity and mortality. A successful management of this entity requires fast and correct diagnosis and prompt treatment.


Postoperative abdominal wound dehiscence in children: How to manage it?

Mohammed Elsherbeny

    Background/purpose: Burst abdomen is a dehiscence of the layers of the abdominal wall, including the peritoneum, with exposure of the intestines. It usually occurs between the 6th and 12th day postoperative. With an incidence of 0.4-1.2% following major abdominal surgery and a high morbidity and mortality, burst abdomen is a challenge for the abdominal surgeon.


Chemical components separation with the use of botulinum toxin A: A critical review for correction of ventral hernia

Yuri Justi Jardim; Gustavo Heluani Antunes de Mesquita; Leonardo Zumerkorn Pipek; Kayo Augusto de Almeida Medeiros; Barbara Justo Carvalho; Leandro RyuchiIuamoto; Diego Ramos Martines; Fernanda Nii; Daniel Reis Waisberg; Alberto Meyer

    Background: Ventral hernias are prevalent results in abdominal surgeries and may represent a surgical challenge in complex cases, mainly due to tension in the abdominal wall musculature. The failure of surgical correction may lead to a more morbid treatment for the patient, in addition to a considerable socioeconomic impact.


Unexpected life threat after incisional hernia repair

Mehmet Yildirim*; Ahmet Deniz Ucar; Hilmi Yazici; Burak Dede

    Intraoperative diagnosis of iatrogenic bowel injuries is usually not exceedingly difficult, because intestinal loops are often visible during dissection procedure. However, when they are confused with dense adhesions, all effort to prevent damage may be useless.


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