The Implementation of an Acute Pain Service for Patients Undergoing Open Ventral Hernia Repair with Mesh and Abdominal Wall Reconstruction

2021 ◽  
Author(s):  
Engy T. Said ◽  
Ross E. Drueding ◽  
Erin I. Martin ◽  
Timothy J. Furnish ◽  
Minhthy N. Meineke ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Acute Pain ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Reconstruction ◽  
Acute Pain Service ◽  
Open Ventral Hernia Repair

National Outcomes for Open Ventral Hernia Repair Techniques in Complex Abdominal Wall Reconstruction

2015 ◽  
Vol 81 (8) ◽  
pp. 778-785 ◽  
Author(s):  
Samuel W. Ross ◽  
Bindhu Oommen ◽  
Ciara Huntington ◽  
Amanda L. Walters ◽  
Amy E. Lincourt ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Multivariate Regression ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Reconstruction ◽  
Wound Complications ◽  
Improvement Program ◽  
Major Complications ◽  
Open Ventral Hernia Repair

Modern adjuncts to complex, open ventral hernia repair often include component separation (CS) and/or panniculectomy (PAN). This study examines nationwide data to determine how these techniques impact postoperative complications. The National Surgical Quality Improvement Program database was queried from 2005 to 2013 for inpatient, elective open ventral hernia repairs (OVHR). Cases were grouped by the need for and type of concomitant advancement flaps: OVHR alone (OVHRA), OVHR with CS, OVHR with panniculectomy (PAN), or both CS and PAN (BOTH). Multivariate regression to control for confounding factors was conducted. There were 58,845 OVHR: 51,494 OVHRA, 5,357 CS, 1,617 PAN, and 377 BOTH. Wound complications (OVHRA 8.2%, CS 12.8%, PAN 14.4%, BOTH 17.5%), general complications (15.2%, 24.9%, 25.2%, 31.6%), and major complications (6.9%, 11.4%, 7.2%, 13.5%) were different between groups ( P < 0.0001). There was no difference in mortality. Multivariate regression showed CS had higher odds of wound [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.5–2.0], general (OR 1.5, 95% CI: 1.3–1.8), and major complications (OR 2.1, 95%, CI: 1.8–2.4), and longer length of stay by 2.3 days. PAN had higher odds of wound (OR 1.5, 95%, CI: 1.3–1.8) and general complications (OR 1.7, 95% CI: 1.5–2.0). Both CS and PAN had higher odds of wound (OR 2.2,95%, CI: 1.5–3.2), general (OR 2.5, 95%, CI: 1.8–3.4), and major complications (OR 2.2, 95%CI: 1.4–3.4), and two days longer length of stay. In conclusion, patients undergoing OVHR that require CS or PAN have a higher independent risk of complications, which increases when the procedures are combined.

Laparoscopic intracorporeal rectus aponeuroplasty (LIRA technique): a step forward in minimally invasive abdominal wall reconstruction for ventral hernia repair (LVHR)

2018 ◽  
Vol 32 (8) ◽  
pp. 3502-3508 ◽  
Author(s):  
Julio Gómez-Menchero ◽  
Juan Francisco Guadalajara Jurado ◽  
Juan Manuel Suárez Grau ◽  
Juan Antonio Bellido Luque ◽  
Joaquin Luis García Moreno ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Reconstruction

Reconstruction of the Abdominal Wall with Mesh II: Ventral Hernia Repair

2020 ◽  
Author(s):  
Samuel W. Ross ◽  
B. Todd Heniford ◽  
Vedra A. Augenstein
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Clinical Outcomes ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Reconstruction ◽  
Surgical Techniques ◽  
Patient Specific ◽  
Wound Complications ◽  
Robotic Hernia Repair

Incisional and Ventral hernia repair (VHR) is one of the most common surgical procedures in the world, and over the last two decades this field has enjoyed exponentially advances thanks to improvements in operative technique and biomechanical science. Truly complex hernias which are multiply recurrent, have active infections, loss of domain, presence of stomas, require component separation or panniculectomy, or have other exacerbating factors are truly challenging to manage operatively, and the multidisciplinary operations to repair them have become known collectively as abdominal wall reconstruction (AWR). Herein, we describe the surgical history of AWR, the current state of surgical techniques and mesh science, as well as novel areas for advancement of the field in the future. In particular, a focus on patient specific clinical outcomes such as hernia recurrence, wound complications, and quality of life has been made with regards to mesh position and selection. Our goal is to provide a comprehensive review of the state of the literature and our recommendations for AWR, for the Plastic, General, and Hernia surgeon alike. This review contains 7 figures, 3 tables, and 79 references. Keywords: ventral hernia repair, incisional hernia, abdominal wall reconstruction, mesh, pre-peritoneal hernia repair, pre-operative optimization, clinical outcomes, mesh position, surgical site infection, robotic hernia repair

Conflicts of Interest in Studies Related to Mesh Use in Ventral Hernia Repair and Abdominal Wall Reconstruction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yurie Sekigami ◽  
Tina Tian ◽  
Sydney Char ◽  
Jacob Radparvar ◽  
Jeffrey Aalberg ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Conflicts Of Interest ◽  
Abdominal Wall Reconstruction

scholarly journals A systemic analysis of patients undergoing open ventral hernia repair (2011-2017)

2018 ◽  
Vol 5 (7) ◽  
pp. 2567
Author(s):  
Esha A. Choudhry ◽  
Jenish Y. Sheth ◽  
Jitendra R. Darshan
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Wound Complications ◽  
Advantages And Disadvantages ◽  
Open Ventral Hernia Repair ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Group A

Background: The use of prosthetic mesh for reinforcing a hernia repair is considered most valid. Controversy exists regarding the use of the type of meshplasty. An insufficient evidence exists as to which type of mesh and mesh position (onlay, inlay, sublay (retrorectus) or preperitoneal) should be used. The effectiveness these methods have been systematically analysed in order to accelerate functional recovery and shorten hospitalization in patients undergoing open ventral hernia repair (VHR).Methods: This was a Prospective randomized single blinded comparative study conducted in the Department of Surgery at SMIMER hospital, Surat for patients presenting with the complaint of anterior abdominal wall hernia over a duration of 6 years (September 2011 - September 2017) with an average follow up period of 12 months, including 318 adult patients. All patients were preoperatively assessed clinically and by ultrasonography to confirm the diagnosis and randomized for open VHR after obtaining a well-informed written consent and satisfying the inclusion and exclusion criteria. 67% Patients (213/318) underwent retrorectus Meshplasty and were categorized into group A. The rest underwent Onlay (16.3% - 52/318)/Inlay (4.7% - 15/318)/Preperitoneal Meshplasty (11.9%-38/318) and were collectively (33% (105/318)) categorized into group B. Both Groups were Compared in terms differences in intra operative timing, intra operative complications, immediate post-operative outcome, early and delayed post- operative complications including readmission and recurrence rates.Results: Authors observed significantly lesser post-operative pain, higher well being, reduced wound complications and recurrence rate in group A. Mean duration of surgery was insignificantly higher for retrorectus meshplasty.Conclusions: Despite each method having its own advantages and disadvantages, retrorectus mesh repair was found superior because the mesh is placed with significant overlap under the muscular abdominal wall.

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