Seven years of preoperative BTA abdominal wall preparation and the Macquarie system for surgical management of complex ventral hernia

Background: Loss of continuity of abdominal wall significantly affects the functions of protection of viscera, postural stabilization, and maintenance of intra-abdominal pressure. The newer understanding of abdominal wall reconstruction (AWR) aims at restoring abdominal wall anatomy and function, instead of simply patching the defect. We want to showcase the changing trends and results in hernia repair at a Medical Institution.Methods: This is an observational retrospective study conducted in RRMCH, Bengaluru from July 2018-2019 including all patients with ventral hernia undergoing the specified hernia repairs.Results: A total of 54 patients with ventral hernias undergoing routine hernia repairs/AWR surgeries were retrospectively analysed. The overall mean age was 46.62±12.44 year. Majority subjects were females (n=37; 68.5%), and overweight (Mean BMI=28.07±3.01/m2). 14 patients (25.92%), all males, had history of tobacco consumption. There were 38 (70.37%) primary ventral hernias and 7 recurrent hernias. Overall mean defect size was 10.2±0.4 cm. Most frequently performed was open retro rectus Hernioplasty (n=18; 33.33%), followed by open Preperitoneal Hernioplasty (n=17; 31.48%), laparoscopic intraperitoneal onlay mesh (IPOM) (n=16; 29.62%) and open transversus abdominis release (TAR) (n=3; 5.5%). On statistical analysis, it was found that Open repairs had higher post-operative pain (p=0.0005), longer hospitalization (p=0.0002) and higher incidence of surgical site events (p=0.0134) when compared to Laparoscopic repairs.Conclusion: As known already, minimally invasive techniques of hernia surgeries are shown to have acceptable outcomes when compared to radical open surgeries. Newer techniques of AWR are being employed to routine cases in larger numbers, and not just for complex reconstruction, at most centres with acceptable outcomes.

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Efficacy evaluation of case-specific approach for surgical treatment of incisional ventral hernia

Polish Journal of Surgery ◽

10.5604/01.3001.0014.9756 ◽

2021 ◽

Vol 93 (5) ◽

pp. 1-5

Author(s):

Svetlana Sokolova ◽

Andrey Sherbatykh ◽

Konstantin Tolkachev ◽

Vladimir Beloborodov ◽

Vadim Dulskiy ◽

...

Keyword(s):

Surgical Treatment ◽

Abdominal Wall ◽

Ventral Hernia ◽

Anterior Abdominal Wall ◽

Abdominal Wall Defect ◽

Long Term Results ◽

Treatment Results ◽

Specific Approach ◽

Incisional Ventral Hernia

The Aim of research is to improve the results of surgical treatment of incisional ventral hernia by applying a case-specific approach and a new method of plastic repair of anterior abdominal wall. The prospective controlled dynamic study is based on incisional ventral hernia treatment results with the use of meshed endoprostheses among 219 patients. On-lay alloplasty was used in patients younger than 60 years of age, without severe concomitant pathology, with small and medium hernias and anterior abdominal wall defect of up to 10 cm (W1 - W2). The article shows a selection algorithm for anterior abdominal wall plastic repair method. It goes through advantages of the author’s proprietary technique. The article displays frequency and patterns of complications, life quality of the patients after various prosthetic plastic repairs. In the main group, positive treatment results were observed in 65.0%, long-term results of the operation were observed in 88.4%, complications occurred in 13.6%, relapse in 4.5%. «On lay» treatment tactics showed positive results in 59.4%, long-term results of the operation were observed in 74.7%, complications occurred in 40%, relapse in 3.1%. After «sub lay» intervention, excellent results were observed in 40.0% of patients, long-term results of the operation were observed in 81.9%, complications occurred in 12%, and relapse in 1.4%.

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Abdominal wall

10.1093/med/9780198799481.003.0010 ◽

2021 ◽

pp. 431-448

Keyword(s):

Inguinal Hernia ◽

Incisional Hernia ◽

Abdominal Wall ◽

Ventral Hernia ◽

Femoral Hernia ◽

Rectus Sheath ◽

Groin Swelling

This chapter outlines the management of the patient with a inguinal hernia, femoral hernia, ventral hernia, incisional hernia, other less common abdominal wall hernias, rectus sheath haematoma or groin disruption. It details how to approach a patient with a groin swelling.

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