scholarly journals Can Hernia Sac to Abdominal Cavity Volume Ratio Predict Fascial Closure Rate for Large Ventral Hernia? Reliability of the Tanaka Score

2021 ◽  
Author(s):  
Aldo Fafaj ◽  
Jonah Thomas ◽  
Samuel J. Zolin ◽  
Sergio Mazzola Poli de Figueiredo ◽  
Luciano Tastaldi ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Abdominal Cavity ◽  
Volume Ratio ◽  
Fascial Closure ◽  
Cavity Volume ◽  
Closure Rate ◽  
Hernia Sac ◽  
Large Ventral Hernia

The role of computed tomography in optimizing the surgical treatment of ventral hernias

2021 ◽  
Vol 29 (1) ◽  
pp. 70-77
Author(s):  
K. Yu. Parkhomenko ◽  
V. A. Vovk
Keyword(s):  
Computed Tomography ◽  
Ventral Hernia ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Spiral Computed Tomography ◽  
Spiral Computed ◽  
Chronic Appendicitis ◽  
Hernia Sac ◽  
Ventral Hernias ◽  
Preoperative Examination

In spite of a high informative value, spiral computed tomography is currently an additional optional examination and it is not included in domestic and foreign preoperative examination protocols. Purpose – assessing the feasibility of spiral computed tomography in the complex of presurgery examination of patients with ventral hernias. Materials and methods. The paper deals with analyzing the diagnostic findings of 35 patients with ventral hernias treated at Surgery Department of Municipal Non-Commercial Enterprise of Kharkiv Regional Council “Regional Clinical Hospital” during 2018–2019 period. All patients were operated on after compulsory and additional examinations according to the existing guidelines. Spiral computed tomography was an additional examination for all patients. The frequency of symptoms detected by means of computed tomography and confirmed during surgery was analyzed.  Results. Most of the signs revealed during tomography and associated with the combined abdominal pathology, were completely confirmed by laparoscopic exploration of the abdominal cavity and pelvis. Spiral computed tomography was of particular value in patients clinically diagnosed with chronic appendicitis. When assessing the ventral hernia, it was possible not only to clearly determine its content and location towards the abdominal line, but also, before surgery, to calculate the width and length of the hernia gate and the volume of the organs in hernia sac. Unlike ultrasonography, computed tomography makes it possible to thoroughly evaluate the dimensions of the hernia gate and the state of the muscular aponeurotic layer of the anterior abdominal wall. Not least important is diagnosing the combined abdominal pathology, including the oncological one, which has no clinical manifestations but still has to be exposed to surgery. Conclusions. In the complex of preoperative examination of patients with ventral hernias, spiral computed tomography provides useful information on the anatomical features of ventral hernia and the combined abdominal pathology that requires surgical intervention. These data aid in planning a favorable type of hernioplasty of ventral hernia and simultaneous surgery. Spiral computed tomography is recommended to be added to the standard protocol of presurgery examination of patients with ventral hernias.

Use of Polypropylene Mesh in the Management of a Contaminated Large Ventral Hernia: A Contraindication or a Solution?

2013 ◽  
Vol 79 (12) ◽  
pp. 1298-1303 ◽  
Author(s):  
Fei Yang
Keyword(s):  
Ventral Hernia ◽  
Polypropylene Mesh ◽  
Perioperative Management ◽  
Abdominal Cavity ◽  
Mesh Size ◽  
Bladder Injury ◽  
Wound Debridement ◽  
Large Ventral Hernia ◽  
Hernia Size ◽  
Ventral Hernias

Management of contaminated large ventral hernias is still a challenge as a result of massive loss of muscular and fascial tissues in the abdominal wall, traditional contraindication to use of a prosthesis, and complicated perioperative management. This study aimed to provide a solution for this challenging dilemma using monofilament polypropylene mesh (Marlex; Bard) in the Sublay-Bridge fashion. Twenty-three consecutive patients with contaminated large ventral hernias from 2009 to 2011 were identified. Preoperatively, source of contamination at the surgical site was managed through oral antibiotics, wound débridement, and dressing change; the hernia content was reduced into the abdominal cavity gradually and an abdominal binder was applied. Marlex meshes in the Sublay-Bridge fashion were used in these patients. Demographic and perioperative data were collected. Fourteen males and nine females were included with a mean age of 52.5 ± 10.5 years and a mean body mass index of 25.2 ± 6.1 kg/m2. Twelve patients underwent ostomy takedown, which was the most common indication. Mean hernia size was 120.5 ± 18.5 cm2 and a mean mesh size was 380.0 ± 80.5 cm2. The mean operative time was 125.5 ± 35.5 minutes and the hospital stay was 10.0 ± 3.5 days. Twenty-three patients had a mean follow-up period of 12.5 ± 6.5 months. An iatrogenic bladder injury occurred because of severe prevesical adhesion attributed to previous prosthesis repair. There was no presentation of abdominal compartment syndrome. Four patients developed surgical site infection and managed with conservative therapy without mesh removal. Three patients had seromas and underwent aspiration guided by B-ultrasound. Three patients reported chronic foreign body sensation. No recurrence was followed up. Repair of contaminated large ventral hernia using a Marlex mesh in the Sublay-Bridge fashion is safe and efficient management. Perioperative management and operative technology play important roles in dealing with this problem.

scholarly journals Volume calculation of rats' organs and its application in the validation of the volume relation between the abdominal cavity and the hernial sac in incisional hernias with "loss of abdominal domain"

2014 ◽  
Vol 27 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Luz Marina Gonçalves de ARAÚJO ◽  
Leonardo Carvalho SERIGIOLLE ◽  
Helbert Minuncio Pereira GOMES ◽  
Daren Athiê Boy RODRIGUES ◽  
Carolina Marques LOPES ◽  
...  
Keyword(s):  
Direct Method ◽  
Left Kidney ◽  
Abdominal Cavity ◽  
Volume Ratio ◽  
Direct Calculation ◽  
Hernia Sac ◽  
Mathematical Formula ◽  
Volume Calculation ◽  
Incisional Hernias ◽  
Mathematical Calculation

BACKGROUND: The calculation of the volume ratio between the hernia sac and the abdominal cavity of incisional hernias is based on tomographic sections as well as the mathematical formula of the volume of the ellipsoid, which allows determining whether this is a giant hernia or there is a "loss of domain". As the images used are not exact geometric figures, the study of the volume of two solid organs of Wistar rats was performed to validate these calculations. AIM: To correlate two methods for determining the volume of the kidney and spleen of rats, comparing a direct method of observation of the volume with the mathematical calculation of this value. METHODS: The volume of left kidney, geometrically more regular, and spleen, with its peculiar shape, of ten animals was established in cubic centimeters after complete immersion in water with the aid of a beaker graduated in millimeters. These values were compared with those obtained by calculating the same volume with a specific mathematical formula: V = 4/3 × π × (r1 x r2 x r3). Data were compared and statistically analyzed by Student's t test. RESULTS: Although the average volume obtained was higher through the direct method (1.13 cm3 for the left kidney and 0.71 cm3 for the spleen) than the values calculated with the mathematical formula (0.81 cm3 and 0.54 cm3), there were no statistically significant differences between the values found for the two organs (p>0.05). CONCLUSION: There was adequate correlation between the direct calculation of the volume of the kidney and spleen with the result of mathematical calculation of these values in the animals' studies.

scholarly journals Method of prevention of postoperative gray allohernioplasty in laparoscopic ventral hernia

2018 ◽  
Vol 9 (1) ◽  
pp. 3-9
Author(s):  
Yu. V. Ivanov ◽  
D. N. Panchenkov ◽  
R. S. Chaikin ◽  
M. V. Zinovsky ◽  
A. S. Avdeev
Keyword(s):  
Intellectual Property ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Seroma Formation ◽  
Trans Position ◽  
Hernia Sac ◽  
Ventral Hernias ◽  
Hernial Orifice

The authors have developed a new method of seroma formation prevention after laparoscopic allohernioplasty in patients with postoperative ventral hernias. The results of the study showed that trans- position of hernia sac into the abdominal cavity and fixation to the unmodified abdominal wall around the perimeter of the hernial orifice can reliably eliminate Grajewo cavity and thereby to eliminate the possibility of seroma formation in the postoperative period. Federal service for intellectual property (Rospatent) decided to grant a patent for this method of seroma formation prevention at the surgery of postoperative ventral hernias as for the invention “Method of laparoscopic plasty of ventral hernias” (№2017120227/14(035085) from 17.01.2018).

A SCROTAL ABDOMEN IN AN ELDERLY PATIENT MANAGED BY HERNIOPLASTY WITHOUT DEBULKING OF THE HERNIA CONTENTS: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 15-17
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Piyas Sengupta ◽  
Tuhinsubhra Manda
Keyword(s):  
Elderly Patient ◽  
Abdominal Cavity ◽  
Wound Dehiscence ◽  
Uneventful Recovery ◽  
General Surgeon ◽  
Respiratory Compromise ◽  
Hernia Sac ◽  
Long Duration ◽  
Giant Inguinoscrotal Hernia ◽  
Mesh Hernioplasty

Background: Scrotal abdomen is not a common today, but most challenging case even in experienced general surgeon, as there is no standard surgical procedure. They present as a huge inguinoscrotal swelling for a longstanding, neglected to treatment, because fear of operative intervention and remote places where medical service is inadequate. The morbidity and mortality also high because of forced reduction of the herniated viscera to the abdominal cavity, which is accustomed to being relatively empty for long duration, may cause alteration in the intra-abdominal and intra-thoracic pressures, leading to complications such as ACS, precipitation of cardiovascular or respiratory compromise, hernia recurrence and wound dehiscence . We present this ca Case presentation: se of giant inguinoscrotal hernia of a 72 years old male who had difculty in performing his daily activities. Patient underwent emergency mesh repair after reduction of content through inguinal approach. Giant inguinal hernia containing almost whole abdomen with terminal 50 cm ileum, caecum, appendix, ascending colon, hepatic exure of colon and transverse colon with omentum in the hernia sac and the patient had an uneventful recovery with eventual discharge on postoperative day 8. The giant inguinal hernias are uncommon in today's surgical Conclusion: practice. Management of which is challenging with grave complications but early intervention and postoperative monitoring to raised IAP and its complications which can save the patient. We report this case of an elderly patient with an acute presentation of scrotal abdomen with contents as both direct and indirect component which has been managed successfully with tension free open mesh hernioplasty and biological repair without debulking of the hernia contents and this case supported by a review of the literature.

scholarly journals Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang
Keyword(s):  
Inguinal Hernia ◽  
Doppler Ultrasound ◽  
Vas Deferens ◽  
Abdominal Cavity ◽  
Undescended Testes ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Patent Processus Vaginalis ◽  
Contralateral Patent Processus Vaginalis ◽  
Laparoscopic Orchiopexy

Abstract Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

scholarly journals Effect of Negative Pressure Therapy on Open Abdomen Treatments. Prospective Randomized Study With Two Commercial Negative Pressure Systems

2021 ◽  
Vol 7 ◽  
Author(s):  
Thomas Auer ◽  
Siegfried Sauseng ◽  
Pavle Delcev ◽  
Peter Kohek
Keyword(s):  
Negative Pressure ◽  
Randomized Study ◽  
Secondary Peritonitis ◽  
Repeated Measure ◽  
Fascial Closure ◽  
Fistula Formation ◽  
Intestinal Damage ◽  
Closure Rate ◽  
Pressure Therapy ◽  
Significant Difference

Introduction: The use of negative pressure dressings for open abdominal therapy has made a great impact on strategies for open abdominal treatment. Observed intestinal damage and developement of fistula formation raises questions about safety of commonly used systems (AB-Thera). The most common used system uses foils for shielding intestines directly from negative pressure. As an alternative a system with open pore dressing in double layer film was introduced (Suprasorb CNP) and proved to safe in animal studies. We compared the effects of this two systems on patients requiring open abdominal treatment.Materials and methods: Patients with secondary peritonitis in at least two abdominal quadrants were included in this randomized study. Inclusion criteria were secondary peritonitis (ACS), abdominal compartment syndrome, and abdominal trauma combined with ACS and/or contaminated abdomen. Patients with active bleeding and pancreatitis were not included. We examined Mannheim peritonitis Index (MPI), bloodcount, PCT, amount of fluid collected, and morphological changes on the bowel. Data were collected on day 2, 4, 7, 14, 21, and 28. Primary end point was fascial closure. Examination was terminated in case of death and damage to the abdominal organs. Groups were compared using Mann Whitney U-test and chi square test. Trend evaluation was evaluated using an one way repeated measure analysis of variance. P-values below 0.05 was considered significat.Results: Thirty four patients were included between August 2010 and September 2012. There were no significant difference between two groups in MPI, age, and gender. Mean duration of treatment, WBC, CRP, and abdominal closure rate were not significantly different between groups. Suprasorb CNP System collected twice more fluid than AB-Thera and decreased PCT on significantly faster rate than AB-Thera. Four patients died (11%) and four patients developed enteric fistula (11%). Closure rate was achieved in 27 out of 34 Patients (79.5%). Closure rate was not significantly different between groups.Conclusion: The use of both systems proved to be efficient and safe. The application of well-dosed, moderate negative pressure on contaminated areas of the abdomen seems to have a lot of potential and it is worth directing greater research potential in this direction.

Sign in / Sign up

Export Citation Format

Share Document