Robotic retromuscular ventral hernia repair and transversus abdominis release: short-term outcomes and risk factors associated with perioperative complications

Hernia ◽  
2019 ◽  
Vol 23 (2) ◽  
pp. 375-385 ◽  
Author(s):  
F. Gokcal ◽  
S. Morrison ◽  
O. Y. Kudsi
Keyword(s):  
Risk Factors ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Perioperative Complications ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release ◽  
Short Term ◽  
Factors Associated

Risk Factors Associated With Adverse Outcomes After Ventral Hernia Repair With Component Separation

2021 ◽  
Vol 258 ◽  
pp. 299-306
Author(s):  
Deangelo H. Ferguson ◽  
Ciara G. Smith ◽  
Olubode A. Olufajo ◽  
Ahmad Zeineddin ◽  
Mallory Williams
Keyword(s):  
Risk Factors ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Adverse Outcomes ◽  
Component Separation ◽  
Factors Associated

Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair

2017 ◽  
Vol 32 (2) ◽  
pp. 727-734 ◽  
Author(s):  
James G. Bittner ◽  
Sameer Alrefai ◽  
Michelle Vy ◽  
Micah Mabe ◽  
Paul A. R. Del Prado ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release

The Chosen Few: Disproportionate Resource Use in Ventral Hernia Repair

2013 ◽  
Vol 79 (8) ◽  
pp. 815-818 ◽  
Author(s):  
Benjamin K. Poulose ◽  
William C. Beck ◽  
Sharon E. Phillips ◽  
Kenneth W. Sharp ◽  
William H. Nealon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Resource Use ◽  
Ventral Hernia Repair ◽  
Hospital Charges ◽  
Total Hospital ◽  
Factors Associated ◽  
Hospital Resources ◽  
Project Data

The objectives of this study were to determine if disproportionately small numbers of patients use more resources for ventral hernia repair (VHR) and to identify factors associated with this group. Patients undergoing VHR were identified using national 2009 Healthcare Cost and Utilization Project data. Mean total hospital charges (THCs) were calculated and patients were divided into high charges (HC, greater than 50% mean THC) and low charges (LC, 50% or less mean THC) groups. Multivariate analysis was used to identify factors associated with the HC group. We estimated 181,000 hospitalizations for VHR in 2009 with mean THC of $54,000. Fifteen per cent of patients comprised the HC group with 85 per cent in the LC group. The HC group had higher THC ($173,000 vs $32,000; P < 0.05), increased mean length of stay (16.0 vs 4.1 days, P < 0.05), and higher mortality (6.3 vs 0.6%, P < 0.05). Risk factors for HC included congestive heart failure (odds ratio [OR], 2.2; 95% confidence interval [CI], 2.0 to 2.5), chronic lung disease (OR, 1.3; 95% CI, 1.2 to 1.4), Asian race (OR, 2.5; 95% CI, 1.7 to 3.7), nonelective operation (OR, 1.9; 95% CI, 1.6 to 2.3), and male gender (OR, 1.2; 95% CI, 1.1 to 1.3). For inpatient VHR, a remarkably small proportion of patients use disproportionately high hospital resources. The identified risk factors can help surgeons predict patients who are likely to consume large amounts of resources.

Acute Kidney Injury After Large Ventral Hernia Repair Requiring Transversus Abdominis Release

2021 ◽  
pp. 000313482110508
Author(s):  
H. David Schaeffer ◽  
Nicole E. Sharp ◽  
Kathryn Jaap ◽  
John Semian ◽  
Mohanbabu Alaparthi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Kidney Injury ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release ◽  
History Of ◽  
Postoperative Aki ◽  
Separation Of Components

Background Acute kidney injury (AKI) is a known postoperative complication of open ventral hernia repair contributing to increased costs, hospital length of stay, and mortality. The aim of this study was to identify whether the muscle injury that occurs in a posterior separation of components via transversus abdominis release (TAR) contributes to a higher incidence of postoperative AKI. Methods A retrospective cohort study of patients who underwent open retrorectus ventral hernia repair with and without TAR at a single institution between 2012 and 2019 was performed. Patients who underwent a separation of components via either unilateral or bilateral transversus abdominis release were compared to those who did not undergo TAR as part of their hernia repair (non-TAR). The outcome of interest was the development of postoperative AKI. Acute kidney injury was defined as an increase in creatinine of greater than 50% of the preoperative baseline. Univariate and multivariate analyses were performed to determine the influence of TAR on the development of AKI. Results There were 523 patients who met inclusion criteria, of which 159 (30.4%) had a TAR as part of their retrorectus hernia repair. No differences were found in preoperative characteristics between the TAR and non-TAR group including age, gender, history of kidney disease, or history of diabetes. By contrast, the TAR group had significantly greater median estimated blood loss (100 mL vs 75 mL, P < .01), mean positive intraoperative fluid balance (2255 mL vs 1887 mL, P < .01), and operative duration (321 min vs 269 min, P < .001). The rate of AKI in the TAR group was 11% (n = 18) vs 6% (n = 23, P = .0503) in the non-TAR group. On multivariate analysis controlling for patient characteristics and intraoperative factors, TAR was the only factor with a significantly increased odds of AKI (OR 1.97, 95% CI 0.994-3.905, P = .0521). Conclusions In patients with large ventral hernias requiring retrorectus repair, performing a TAR is associated with a nearly 2-fold increase in the development of postoperative AKI. These findings suggest that these patients should be optimized perioperatively with emphasis on fluid resuscitation, limiting nephrotoxic medications and monitoring urine output.

An Evaluation of Fascial Closure Techniques in Open Ventral Hernia Repair: Practice Patterns and Short-Term Outcomes

2019 ◽  
Vol 85 (11) ◽  
pp. 1213-1218
Author(s):  
Sarah S. Fox ◽  
Li-Ching Huang ◽  
W. Borden Hooks ◽  
John P. Fischer ◽  
William W. Hope
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Recurrence Rate ◽  
Ventral Hernia Repair ◽  
Fascial Closure ◽  
Absorbable Suture ◽  
Short Term ◽  
Closure Technique ◽  
Interrupted Suture ◽  
Open Ventral Hernia Repair

The best method for fascial closure during hernia repair remains unknown. This study evaluates the impact of fascial closure techniques on short-term outcomes. All patients undergoing open ventral hernia repair were queried using the Americas Hernia Society Quality Collaborative database. Analysis was stratified by suture type (absorbable and permanent) and technique (figure-of-eight, running, and interrupted). Outcome measures included SSI, surgical site occurrence (SSO), SSO requiring intervention, recurrence rate, and quality of life. Descriptive statistics and logistic regression were used. The study included 6544 patients. Two-thirds of surgeons closed fascia during ventral hernia repair with absorbable suture and one-third with permanent suture. In the absorbable group, 17 per cent used figure-of-eight, 46 per cent running, and 4 per cent interrupted suture. In the permanent group, 13 per cent used figure-of-eight, 8 per cent running, and 11 per cent interrupted suture. There was no significant association between SSO and closure technique ( P = 0.2). However, SSO and suture type were significant ( P < 0.001) with the odds of SSO for closure with absorbable suture being 62 per cent higher than the odds of permanent. Fascial closure technique and suture type had no significant association ( P > 0.5) with SSI, SSO requiring intervention, hernia recurrence rate, or HerQLes or NIH PROMIS 3a scores at 30 days or 6 months. Fascial closure technique and suture material do not have a major impact on outcomes in ventral hernia repair. Despite a significantly higher rate of SSO for absorbable sutures than permanent, this did not increase the rate of interventions.

Perioperative factors associated with pain following open ventral hernia repair

2019 ◽  
Vol 33 (12) ◽  
pp. 4102-4108 ◽  
Author(s):  
Walker Ueland ◽  
Margaret A. Plymale ◽  
Daniel L. Davenport ◽  
John Scott Roth
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Factors Associated ◽  
Open Ventral Hernia Repair
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