Laparoscopic Closure of Fascial Defect

2018 ◽  
pp. 85-90
Author(s):  
Vashisht Madabhushi ◽  
J. Scott Roth
Keyword(s):  
Fascial Defect ◽  
Laparoscopic Closure

Early complications in surgery of umbilical and epigastric hernias

2020 ◽  
Vol 99 (5) ◽  
pp. 207-211
Keyword(s):  
Type 2 Diabetes ◽  
Recurrence Rate ◽  
Mesh Repair ◽  
Early Complications ◽  
Recurrence Rates ◽  
Fascial Defect ◽  
Epigastric Hernia ◽  
Mesh Implantation ◽  
Hernial Sac

ntroduction: Repairs of umbilical and epigastric hernias are common surgical procedures; the choice of the surgical method generally depends on the size of the hernial sac and fascial defect. Methods: Data of patients operated on for umbilical or epigastric hernias in our hospital during two years were assessed retrospectively. The study group included 264 patients; 212 had an umbilical hernia and 52 had an epigastric hernia. We assessed epidemiologic and clinical parameters and their correlation with the occurrence of early postoperative complications. We also looked for the recurrence rate, although during only a short follow-up period. Results: In the case of umbilical hernias, early complications occurred in 6.7% (11/165) after surgery with a simple suture and in 4.3% (2/47) with mesh repair, and the recurrence rates were 3% (5/165) and 21.3% (10/47), respectively. The risk of early complications was significantly higher in larger hernias. The recurrence rate increased with older age, an increased size of the hernial sac and fascial defect, and in patients with type 2 diabetes. In epigastric hernias, early complications occurred in 5.3% (1/19) after surgery with a simple suture and in 6.1% (2/33) with mesh repair. Recurrences only occurred in operations with mesh repair, in 9% (3/33). The risk of early complications was significantly higher in type 2 diabetes patients. Conclusion: Early complications were slightly more frequent in epigastric hernia repairs with mesh implantation, but this was not the case of umbilical hernias. We recommend mesh implantation in larger and borderline sized hernias to reduce the risk of recurrence.

Umbilical Fascial Defects are Common and Predict Trocar Site Hernias After Laparoscopic Appendectomy

2021 ◽  
pp. 000313482199506
Author(s):  
Steven M. Hernandez ◽  
Elizabeth A. Kiselak ◽  
Tania Zielonka ◽  
Scarlett Tucker ◽  
Melissa Blatt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Appendectomy ◽  
Medical Center ◽  
Area Under The Curve ◽  
Demographic Information ◽  
Fascial Defect ◽  
Trocar Site ◽  
Trocar Site Hernia ◽  
Preoperative Ct ◽  
Tomography Scan

Introduction Investigations have demonstrated that trocar site hernia (TSH) is an under-appreciated complication of laparoscopic surgery, occurring in as many as 31%. We determined the incidence of fascial defects prior to laparoscopic appendectomy and its impact relative to other risk factors upon the development of TSH. Methods TSH was defined as a fascial separation of ≥ 1 cm in the abdominal wall umbilical region on abdominal computerized tomography scan (CT) following laparoscopic appendectomy. Patients admitted to our medical center who had both a preoperative CT and postoperative CT for any reason (greater than 30 days after surgery) were reviewed for the presence of TSH from May 2010 to December 2018. CT scans were measured for fascial defects, while investigators were blinded to film timing (preoperative or postoperative) and patient identity. Demographic information was collected. Results 241 patients undergoing laparoscopic appendectomy had both preoperative and late postoperative CT. TSH was identified in 49 (20.3%) patients. Mean preoperative fascial gap was 3.3 ± 4.3 mm in those not developing a postoperative hernia versus 14.8 ± 7.3 mm in those with a postoperative hernia ( P < .0001). Preoperative fascial defect on CT was predictive of TSH ( P < .001, OR = 1.44), with an Area Under the Curve (AUC) of .921 (95%CI: .88–.92). Other major risk factors for TSH were: age greater than 59 years ( P < .031, OR = 2.48); and obesity, BMI > 30 ( P < .012, OR = 2.14). Conclusions The incidence of trocar site hernia was one in five following laparoscopic appendectomy. The presence of a pre-existing fascial defect, advanced age, and obesity were strong predictors for the development of trocar site hernia.

scholarly journals Primary versus Staged Closure of Exomphalos Major: Cardiac Anomalies Do Not Affect Outcome

2017 ◽  
Vol 28 (03) ◽  
pp. 279-284 ◽  
Author(s):  
Clare Rees ◽  
Lucinda Tullie ◽  
Agostino Pierro ◽  
Edward Kiely ◽  
Joe Curry ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Primary Closure ◽  
Single Center ◽  
Fascial Defect ◽  
Pentalogy Of Cantrell ◽  
Cardiac Anomalies ◽  
Intensive Care Stay ◽  
Congenital Cardiac Anomalies ◽  
Liver Herniation

Aim The objective of the study is to describe management of exomphalos major and investigate the effect of congenital cardiac anomalies. Methods A single-center retrospective review (with audit approval) was performed of neonates with exomphalos major (fascial defect ≥ 5cm ± liver herniation) between 2004 and 2014.Demographic and operative data were collected and outcomes compared between infants who had primary or staged closure. Data, median (range), were analyzed appropriately. Results A total of 22 patients were included, 20 with liver herniation and 1 with pentalogy of Cantrell. Gestational age was 38 (30–40) weeks, birth weight 2.7 (1.4–4.6) kg, and 13 (60%) were male. Two were managed conservatively due to severe comorbidities, 5 underwent primary closure, and 15 had application of Prolene (Ethicon Inc) mesh silo and serial reduction. Five died, including two managed conservatively, none primarily of the exomphalos. Survivors were followed up for 38 months (2–71). Cardiac anomalies were present in 20 (91%) patients: 8 had minor and 12 major anomalies. Twelve (55%) patients had other anomalies. Primary closure was associated with shorter length of stay (13 vs. 85 days, p = 0.02), but infants had similar lengths of intensive care stay, duration of parenteral feeds, and time to full feeds. Infants with cardiac anomalies had shorter times to full closure (28 vs. 62 days, p = 0.03), but other outcomes were similar. Conclusion Infants whose defect can be closed primarily have a shorter length of stay, but other outcomes are similar. Infants with more significant abdominovisceral disproportion are managed with staged closure; the presence of major cardiac anomalies does not affect surgical outcome.

Laparoscopic versus Open End Colostomy Closure: A Single-center Experience

2014 ◽  
Vol 80 (4) ◽  
pp. 361-365 ◽  
Author(s):  
Peter Studer ◽  
Beat SchnüRiger ◽  
Melika Umer ◽  
Dino KröLl ◽  
Daniel Inderbitzin ◽  
...  
Keyword(s):  
Conversion Rate ◽  
Hospital Length ◽  
Colostomy Closure ◽  
Hospital Length Of Stay ◽  
Perforated Diverticulitis ◽  
Continuous Variables ◽  
Single Center Experience ◽  
End Colostomy ◽  
Laparoscopic Closure

The aim of this study was to review our experience with laparoscopic end colostomy closure. A retrospective review of a prospectively entered database was performed. Proportions and continuous variables were compared using the Fisher's exact and the Mann-Whitney U tests, respectively. Within the study period, 53 patients underwent closure of end colostomies. The main reasons for the colonic resections were perforated diverticulitis (52.7%) and neoplasms (20.8%). In 28 patients (53%), laparoscopic closure (LC) was attempted. Demographics did not differ between the attempted LC and the primary open closure (OC) group. The conversion rate from an LC to an OC was 50 per cent (14 of 28), mostly as a result of adhesions (71.4%). Hospital length of stay (HLOS) was significantly longer for the OC than with the attempted LC group (15.4 ± 11.9 days vs 11.3 ± 8.5 days, P = 0.046). The overall complication rate was not different between the completed LC and the OC groups (43 vs 56%, P = 0.634). The majority of complications detected (91.1%) were minor and could be treated conservatively. The role of laparoscopy to close end colostomies is questionable, because the conversion rate is high. However, a shorter HLOS can be expected when laparoscopy is successful. To reduce morbidity resulting from prolonged operation times, it is crucial to convert early and pre-emptively if hostile adhesions are found.

Laparoscopic Closure of Patent Canal of Nuck for Female Indirect Inguinal Hernia

2001 ◽  
Vol 8 (1) ◽  
pp. 143-146 ◽  
Author(s):  
Chih-Feng Yen ◽  
Chin-Jung Wang ◽  
Shu-Ling Lin ◽  
Ping-Chiang Chang ◽  
Chyi-Long Lee ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Indirect Inguinal Hernia ◽  
Canal Of Nuck ◽  
Laparoscopic Closure

scholarly journals Laparoscopic Repair for Perforated Duodenal Ulcer

2015 ◽  
Vol 20 (3) ◽  
pp. 168-172
Author(s):  
Cotirleţ A. ◽  
Tincu E. ◽  
Coşa Raluca ◽  
Popa E. ◽  
Gavril Laura ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Laparoscopic Repair ◽  
Perforated Peptic Ulcer ◽  
Gastric Surgery ◽  
High Morbidity ◽  
Ulcer Disease ◽  
Surgical Emergencies ◽  
Abdominal Disease ◽  
Laparoscopic Closure ◽  
Prolonged Surgery

Abstract Perforated peptic ulcer (PPU), despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies but there is no consensus on whether the benefits of laparoscopic closure of perforated peptic ulcer outweigh the disadvantages such as prolonged surgery time and greater expense. However we can say that laparoscopic repair is a viable and safe surgical option for patients with perforated peptic ulcer disease and should be considered with the necessary expertise available.

Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence

2016 ◽  
Vol 45 (S1) ◽  
pp. O60-O69 ◽  
Author(s):  
Brad B. Nelson ◽  
Audrey A. Ruple-Czerniak ◽  
Dean A. Hendrickson ◽  
Eileen S. Hackett
Keyword(s):  
Factors Associated ◽  
Laparoscopic Closure

Comparison of Fibrin Glue, Laser Weld, and Mechanical Suturing Device for the Laparoscopic Closure of Ureterotomy in a Porcine Model

1997 ◽  
Vol 157 (4) ◽  
pp. 1487-1492 ◽  
Author(s):  
Stuart J. Wolf ◽  
Jon J. Soble ◽  
Stephen Y. Nakada ◽  
Heidi J. Rayala ◽  
Peter A. Humphrey ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Porcine Model ◽  
Laser Weld ◽  
Laparoscopic Closure
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