European Hernia Society guidelines on the closure of abdominal wall incisions

Sigitas TamulisVilniaus universiteto Gastroenterologijos, nefrourologijos ir chirurgijos klinika, Bendrosios chirurgijos centras, Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Šiuo metu Lietuvos chirurginėje praktikoje vartojama daug įvairių pilvo sienos išvaržų klasifikacijų, tačiau nėra vienos paprastos, unifikuotos, informatyvios, išsamios ir kartu lengvai atsimenamos išvaržų klasifikacijos. Tai sunkina gydymo rezultatų vertinimą, naujų gydymo būdų diegimą ir integraciją į Europos ir pasaulio pilvo sienos išvaržų diagnostiką, gydymą ir klinikinius tyrimus. Šio darbo tikslas – apžvelgti iki šiol naudotas klasifikacijas ir pateikti EHS klasifikaciją. Reikšminiai žodžiai: pilvo siena, išvarža, pirminė pilvo sienos išvarža, pooperacinė pilvo sienos išvarža, bambos išvarža, kirkšninė išvarža, epigastrinė išvarža, baltosios pilvo linijos išvarža, juosmeninė išvarža, Špigelio išvarža, pilvo sienos išvaržų klasifikacija. The european hernia society (ehs) abdominal hernia classification Sigitas TamulisVilnius Universitety, Clinic of Gastroenterology, Nephrourology and Surgery, Vilniaus University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] A number of abdominal wall hernia classifications are used in surgical practice in Lithuania. However, there is a lack of one simple, practical, informative, well memorizable, unified and integrated classification intended for all the surgical society. The purpose of this article was to review the abdominal wall hernia classifications commonly used in Lithuania and to present the new abdominal hernia classification proposed by the European Hernia Society. Key words: abdominal wall hernia, inguinal hernia, classification, incisional hernia, ventral hernia, umbilical hernia, epigastric hernia.

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A Large Single-Center ‘Experience of Open Lateral Abdominal Wall Hernia Repairs

The American Surgeon ◽

10.1177/000313481608200726 ◽

2016 ◽

Vol 82 (7) ◽

pp. 608-612 ◽

Cited By ~ 6

Author(s):

Puraj P. Patel ◽

Jeremy A. Warren ◽

Roozbeh Mansour ◽

William S. Cobb ◽

Alfredo M. Carbonell

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Hernia ◽

Lateral Wall ◽

Synthetic Mesh ◽

Mesh Placement ◽

Lateral Abdominal Wall ◽

Single Center Experience ◽

European Hernia Society ◽

Open Mesh Repair ◽

Mesh Reconstruction

Lateral abdominal wall hernias may occur after a variety of procedures, including anterior spine exposure, urologic procedures, ostomy closures, or after trauma. Anatomically, these hernias are challenging and require a complete understanding of abdominal wall, interparietal and retroperitoneal, anatomy for successful repair. Mesh placement requires extensive dissection of often unfamiliar planes, and its fixation is difficult. We report our experience with open mesh repair of lateral abdominal wall hernias. A retrospective review of a prospectively maintained database was performed to identify patients with a classification of lateral abdominal wall hernia who underwent an open repair. A total of 61 patients underwent open lateral hernia repairs. Mean patient age was 58 years (range 25–78), with a mean body mass index of 32 kg/m2 (range 19.0–59.1). According to the European Hernia Society classification, defects were located subcostal (L1, 14 patients), flank (L2, 33 patients), iliac (L3, 11 patients), and lumber (L4, 3 patients). Mean defect size was 78.6 cm2, with a mean greatest single dimension of 9.2 cm (range 2–25 cm). Retromuscular or interparietal repair was performed in 50.8 per cent, preperitoneal in 41.0 per cent, intraperitoneal in 6.6 per cent, and onlay in 1.6 per cent. The rate of surgical site occurrence was 49.2 per cent, primarily seroma and surgical site infection rate was 13.1 per cent. With a mean follow-up of 15.4 months, seven patients (11.5%) have documented recurrence. Synthetic mesh reconstruction of lateral wall hernias is challenging. Our experience demonstrates the safety and success of repair using synthetic mesh primarily in the retromuscular, interparietal, or preperitoneal planes.

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