Comment to: TESLAR for treatment of umbilical/paraumbilical hernia and rectus abdominus diastasis is associated with unacceptable persistent seroma formation. Should subcutaneous endoscopic mesh placement be abandoned?

Hernia ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1411-1412
Author(s):  
C. Claus ◽  
F. Malcher ◽  
L. T. Cavazzola
Keyword(s):  
Seroma Formation ◽  
Mesh Placement ◽  
Paraumbilical Hernia ◽  
Rectus Abdominus

scholarly journals A comparative study of closure versus non-closure of hernial defect in laparoscopic ventral hernia mesh repair

2019 ◽  
Vol 7 (1) ◽  
pp. 244
Author(s):  
Nandeesh M. ◽  
Akash M. V.
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Ventral Hernia Repair ◽  
Seroma Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Controlled Study ◽  
Fisher Exact Test ◽  
Mesh Placement ◽  
Open Mesh Repair

Background: Laparoscopic ventral hernia repair has better out comes when compared to open mesh repair. But closure of the hernial defect is still a contentious issue. This study is designed to compare the outcome of closure versus non-closure of hernia defect in laparoscopic ventral hernia repair.Methods: A 2 years prospective randomized controlled study was conducted on 60 patients undergoing elective laparoscopic ventral hernia repair in the Department of General Surgery (November 2016 to October 2018).Results: The patients in the two groups were analyzed using Chi-square, ANOVA, Fisher exact test, and results were formulated. The mean age of ventral hernia was 41 years and overall incidence more in females. Paraumbilical hernia is the commonest variety of ventral hernia and 63.3% hernias were reducible. Average post-operative length of hospital stay was 2 days with no difference in both the groups. Post-operative pain was more in intraperitoneal onlay mesh (IPOM) plus group. Seroma formation and Incidence of mesh bulge was found be more in IPOM group, but there was no difference in the incidence of chronic pain or recurrence rate between the two groups. All the above proved statistical significance.Conclusions: Primary defect closure in ventral hernia along with mesh placement in laparoscopy seems to have better outcome, with respect to less chance of seroma formation and mesh bulge.

scholarly journals Richter Paraumbilical Hernia Managed by Invagination: A Case Report and Review of Literature

2019 ◽  
pp. 1-3
Author(s):  
Khaled Ahmed ◽  
A Abo-elmagd ◽  
Khaled Ahmed
Keyword(s):  
Ventral Hernia ◽  
Bowel Perforation ◽  
Plain Radiograph ◽  
Bowel Loop ◽  
Low Grade ◽  
Case Presentation ◽  
Mesh Placement ◽  
Paraumbilical Hernia ◽  
Femoral Ring ◽  
Resection And Anastomosis

Background: Richter hernia is a peculiar type of enterocele, which may progress to fatal bowel perforation unless early intervention is made. It used to occur at femoral ring but occurrence at ventral hernia is extremely rare. Case presentation: We report a 60-year-old female patient with tender paraumbilical hernia with absolute constipation and vomiting. On examination the patient had a low-grade fever, while the swelling was tense, tender with no impulse on cough. Plain radiograph abdomen erect position was done revealing multiple air fluid level. Repair was done after invagination of the ischemic part of the bowel loop. Conclusion: ventral hernia may be of a Richter type. Management of ischemic loop in Richter hernia does not necessitate resection and anastomosis, as invagination only is enough. Repair of the defect is mandatory while mesh placement is conditional.

Lichtenstein Versus Desarda’s Technique of Hernia Repair

2020 ◽  
Vol 22 (2) ◽  
pp. 99-103
Author(s):  
Md Fardhus ◽  
AMSM Sharfuzzaman ◽  
Md Nayeem Dewan ◽  
Md Abul Hossain ◽  
Ahmed Sami Al Hasan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Operative Time ◽  
Seroma Formation ◽  
Age Group ◽  
Serous Fluid ◽  
Medical College ◽  
Randomized Control ◽  
And Gender

Aim: To compare Desarda’s versus Lichtenstein’s mesh repair in patients with unilateral, primary, reducible inguinal hernia in terms of mean operative time and seroma formation Methods: This randomized control trial conducted at Department of Surgery, Patuakhali Medical College & Hospital, Patuakhali. Eighty patients with unilateral, primary, reducible inguinal hernia were randomly distributed into two groups to undergo hernia repair i.e. Lichtenstein (L) and Desarda’s (D). Outcome was measured in terms of mean operative time and seroma formation. Seroma formation was defined as presence of enclosed cavity containing serous fluid determined by ultrasonography at 30th post-operative day. Results: Thirty three patients (41.25%) were above 50 years of age, whereas remaining 47 patients (58.75%) were below 50 years of age. Five patients (6.25%) were female and 75 patients(93.75%) were male. Seroma formation was 5% in Desarda’s group while 7.5% in Lichtenstein group (P> 0.05). Similarly difference in mean operative time was statistically non-significant. Seroma formation was common in older age group. There was no effect of smoking, obesity, operative time and gender on seroma formation. Conclusion: It is concluded that there is no difference in frequency of seroma formation and mean operative time in Desarda’s or Lichtenstein’s technique of hernia repair. Journal of Surgical Sciences (2018) Vol. 22 (2) : 99-103

Harmonic scalpel versus traditional ligation in axillary dissection for breast cancer: a retrospective multivariate analysis

2020 ◽  
Vol 99 (11) ◽  
Keyword(s):  
Breast Cancer ◽  
Axillary Dissection ◽  
Harmonic Scalpel ◽  
Breast Conserving Surgery ◽  
Seroma Formation ◽  
Nodal Involvement ◽  
Single Centre ◽  
Absorbable Material ◽  
Drain Removal ◽  
The Mean

Introduction: The aim of this pilot retrospective study is to evaluate the complication rate in patients after axillary dissection comparing preparation with harmonic scalpel vs traditional ligation technique, and to analyse risk factors for complications occurrence. Methods: 144 patients with 148 axillary dissections operated in a single centre between January 2014 and 2019 were included into the study. Axillary dissection was performed using harmonic scalpel in 73 and absorbable ligations in 70 cases. Results: Seroma formation was observed in 41 patients (56.2%) in the harmonic scalpel group and in 21 patients (30.0%) in the ligations group (p=0.003). The mean period from the surgery to drain removal was 4.0 days in the harmonic scalpel group and 3.0 days in the ligations group (p<0.001). The mean amount of the drained fluid after mastectomy was 300.9 ml in the harmonic scalpel group and 168.7 ml in the ligations group (p=0.005); after breast conserving surgery, it was 241.9 ml and 107.4 ml, respectively (p =0.023). Conclusion: In comparison with traditional ligations with absorbable material, axillary dissection using harmonic scalpel significantly increases the risk of postoperative seroma formation, prolongs the time from the surgery to drain removal, and increases the amount of drained fluid.ut any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.

Short-Term Outcomes Following Removal of Infected Hernia Mesh

2021 ◽  
pp. 000313482110241
Author(s):  
Christine Tung ◽  
Junko Ozao-Choy ◽  
Dennis Y. Kim ◽  
Christian de Virgilio ◽  
Ashkan Moazzez
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Smoking History ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Mesh Removal ◽  
Mesh Placement ◽  
Infected Mesh

There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.

Sign in / Sign up

Export Citation Format

Share Document