scholarly journals P053 COMPARISON OF CLINICAL OUTCOMES BETWEEN INTRAPERITONEAL ONLAY MESH REPAIR (IPOM PLUS) AND ENHANCED-VIEW TOTALLY EXTRAPERITONEAL REPAIR (ETEP) FOR VENTRAL HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Hiroshi Hirukawa
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Transversus Abdominis ◽  
Incisional Hernias ◽  
Totally Extraperitoneal ◽  
Onlay Mesh ◽  
The Mean ◽  
Totally Extraperitoneal Repair ◽  
Hernia Size ◽  
Ventral Hernias

Abstract Aim We have been performing intraperitoneal on lay mesh repair (IPOM plus) as the standard laparoscopic procedure for ventral hernia in our department. We introduced enhanced-view totally extraperitoneal repair (eTEP) for ventral hernia repair in 2018, and have performed 31 cases so far. We compared the outcomes of IPOM Plus and eTEP at our institution. Material and Methods Ventral hernia cases who underwent surgery at our department between 2018 and 2020 were included in the study. The postoperative outcomes and complications of the IPOM Plus and eTEP groups were evaluated retrospectively. Results There were 12 cases of IPOM plus, and all were incisional hernias. There were 31 cases of eTEP, including 7 cases of primary hernias and 24 cases of incisional hernias. Transversus abdominis muscle release (TAR) was added in 24 cases. The mean hernia size was 6.6 x 7.9 cm with IPOM Plus and 8.0 x 10.1 cm with eTEP, and the average meshes size was 15.5 x 22.0 cm and 20.3 x 23.6 cm, respectively. The mean postoperative hospital stay was 7.8 days and 5 days. Postoperative complications included 1 case of mesh bulging and 1 case of recurrence in the IPOM Plus group, 1 case of seroma and 1 case of intestinal obstruction in the eTEP. Conclusions The surgical outcomes for ventral hernias up to 8 cm wide were similar for IPOM Plus and eTEP. The eTEP can insert a larger mesh and may be useful for wider hernias (>8cm).

scholarly journals P062 IMPLEMENTATION OF ETEP (EXTENDED TOTALLY EXTRAPERITONEAL REPAIR) AS A NEW METHOD OF INCISIONAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Krzysztof Nowakowski ◽  
Ayman Waly Elkalash ◽  
thomas lahaye
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
New Method ◽  
Incisional Hernias ◽  
Totally Extraperitoneal ◽  
Artery Embolism ◽  
Sublay Technique ◽  
The Mean ◽  
Totally Extraperitoneal Repair

Abstract Aim To assess the outcomes of implementation of extended Totally Extraperitoneal Repair (eTEP) for incisional hernia in our clinic. Material and Methods In our clinic abdominal wall hernias are predominantly repaired in eMILOS (endoscopic Mini or Less Open Sublay)-technique. However, we hoped for advantages in repairing incisional hernias in eTEP-technique. From 19.09.2019 till 28.04.2021 there were 13 patients with incisional hernias included to be operated in eTEP-technique. Results Among 13 patients, mean age was 64,6 years (range 47 – 78 years), 7 females (54%) and 6 males (46%). Average diameter of the hernia was 6,46 cm (range 2 – 14 cm). The mean Body Mass Index of the patients was 29,41 kg/m² (range 18,4 – 48,76 kg/m²). The mean duration of the operation was 162,38 minutes (range 106 – 237 minutes). The mean surface of the mesh was 612 cm² (range 225 – 1200 cm²). Hospital stay lasted mean of 5,8 days (range 2 – 28 days). We observed one postoperative complication as a lung artery embolism occurred in one patient with preperitoneal heamatoma due to needed anticoagulation. Till today we have not observed any recurrence. Conclusions Our study shows that a new method of incisional hernia repair with mesh placement can be a safely implemented and may have advantages compering with other laparoscopic methods. It has low complication rate, shows good cosmetic results and is cost effective.

scholarly journals A preliminary multicenter evaluation of endoscopic sublay repair for ventral hernia from China

2020 ◽  
Author(s):  
Rui Tang ◽  
Huiyong Jiang ◽  
Weidong WU ◽  
Tao Wang ◽  
Mengxiang Meng ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Intraoperative Complications ◽  
Mesh Fixation ◽  
Transversus Abdominis ◽  
Intraperitoneal Onlay Mesh ◽  
Patient Demographics ◽  
Onlay Mesh ◽  
Sublay Repair ◽  
Space Separation ◽  
Ventral Hernias

Abstract Background: For ventral hernia, endoscopic sublay repair (ESR) may overcome the disadvantages of open sublay and laparoscopic intraperitoneal onlay mesh repair. This retrospective study presents the preliminary multicenter results of ESR from China. The feasibility, safety, and effectiveness of ESR were evaluated; its surgical points and indications were summarized. Methods: The study reviewed 156 ventral hernia patients planned to perform with ESR in ten hospitals between March 2016 and July 2019. Patient demographics, hernia characteristics, operative variables, and surgical results were recorded and analyzed.Results: ESR was performed successfully in 153 patients, 135 with totally extraperitoneal sublay (TES) and 18 with transabdominal sublay (TAS). In 19 patients, TES was performed with the total visceral sac separation (TVS) technique, in which the space separation is carried out along the peritoneum, avoiding damage to the aponeurotic structure. Endoscopic transversus abdominis release (eTAR) was required in 17.0% of patients, and only 18.3% of patients required permanent mesh fixation. The median operative time was 135 min. Most patients had mild pain and resume eating soon after operation. No severe intraoperative complications occurred. Bleeding in the extraperitoneal space occurred in two patients and was stopped by nonsurgical treatment. Seroma and chronic pain were observed in 5.23% and 3.07% of patients. One recurrence occurred after TAS repair for an umbilical hernia.Conclusion: ESR is feasible, safe, and effective for treating ventral hernias when surgeons get the relevant surgical skills, such as the technique of “partition breaking,” TVS, and eTAR. Small-to-medium ventral hernias are the major indications.

scholarly journals A preliminary multicenter evaluation of endoscopic sublay repair for ventral hernia from China

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rui Tang ◽  
Huiyong Jiang ◽  
Weidong Wu ◽  
Tao Wang ◽  
Xiangzhen Meng ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Intraoperative Complications ◽  
Mesh Fixation ◽  
Transversus Abdominis ◽  
Intraperitoneal Onlay Mesh ◽  
Patient Demographics ◽  
Onlay Mesh ◽  
Sublay Repair ◽  
Space Separation ◽  
Ventral Hernias

Abstract Background For ventral hernia, endoscopic sublay repair (ESR) may overcome the disadvantages of open sublay and laparoscopic intraperitoneal onlay mesh repair. This retrospective study presents the preliminary multicenter results of ESR from China. The feasibility, safety, and effectiveness of ESR were evaluated; its surgical points and indications were summarized. Methods The study reviewed 156 ventral hernia patients planned to perform with ESR in ten hospitals between March 2016 and July 2019. Patient demographics, hernia characteristics, operative variables, and surgical results were recorded and analyzed. Results ESR was performed successfully in 153 patients, 135 with totally extraperitoneal sublay (TES) and 18 with transabdominal sublay (TAS). In 19 patients, TES was performed with the total visceral sac separation (TVS) technique, in which the space separation is carried out along the peritoneum, avoiding damage to the aponeurotic structure. Endoscopic transversus abdominis release (eTAR) was required in 17.0% of patients, and only 18.3% of patients required permanent mesh fixation. The median operative time was 135 min. Most patients had mild pain and resume eating soon after operation. No severe intraoperative complications occurred. Bleeding in the extraperitoneal space occurred in two patients and was stopped by nonsurgical treatment. Seroma and chronic pain were observed in 5.23 and 3.07% of patients. One recurrence occurred after TAS repair for an umbilical hernia. Conclusion ESR is feasible, safe, and effective for treating ventral hernias when surgeons get the relevant surgical skills, such as the technique of “partition breaking,” TVS, and eTAR. Small-to-medium ventral hernias are the major indications.

scholarly journals A preliminary multicenter evaluation of endoscopic sublay repair for ventral hernia from China

2020 ◽  
Author(s):  
Rui Tang ◽  
Huiyong Jiang ◽  
Weidong WU ◽  
Tao Wang ◽  
Xiangzhen Meng ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Intraoperative Complications ◽  
Mesh Fixation ◽  
Transversus Abdominis ◽  
Intraperitoneal Onlay Mesh ◽  
Patient Demographics ◽  
Onlay Mesh ◽  
Sublay Repair ◽  
Space Separation ◽  
Ventral Hernias

Abstract Background: For ventral hernia, endoscopic sublay repair (ESR) may overcome the disadvantages of open sublay and laparoscopic intraperitoneal onlay mesh repair. This retrospective study presents the preliminary multicenter results of ESR from China. The feasibility, safety, and effectiveness of ESR were evaluated; its surgical points and indications were summarized.Methods: The study reviewed 156 ventral hernia patients planned to perform with ESR in ten hospitals between March 2016 and July 2019. Patient demographics, hernia characteristics, operative variables, and surgical results were recorded and analyzed.Results: ESR was performed successfully in 153 patients, 135 with totally extraperitoneal sublay (TES) and 18 with transabdominal sublay (TAS). In 19 patients, TES was performed with the total visceral sac separation (TVS) technique, in which the space separation is carried out along the peritoneum, avoiding damage to the aponeurotic structure. Endoscopic transversus abdominis release (eTAR) was required in 17.0% of patients, and only 18.3% of patients required permanent mesh fixation. The median operative time was 135 min. Most patients had mild pain and resume eating soon after operation. No severe intraoperative complications occurred. Bleeding in the extraperitoneal space occurred in two patients and was stopped by nonsurgical treatment. Seroma and chronic pain were observed in 5.23% and 3.07% of patients. One recurrence occurred after TAS repair for an umbilical hernia.Conclusion: ESR is feasible, safe, and effective for treating ventral hernias when surgeons get the relevant surgical skills, such as the technique of “partition breaking,” TVS, and eTAR. Small-to-medium ventral hernias are the major indications.

scholarly journals A Preliminary Multicenter Evaluation of Endoscopic Sublay Repair for Ventral Hernia From China

2020 ◽  
Author(s):  
Rui Tang ◽  
Huiyong Jiang ◽  
Weidong WU ◽  
Tao Wang ◽  
Mengxiang Meng ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Intraoperative Complications ◽  
Mesh Fixation ◽  
Transversus Abdominis ◽  
Intraperitoneal Onlay Mesh ◽  
Patient Demographics ◽  
Onlay Mesh ◽  
Sublay Repair ◽  
Space Separation ◽  
Ventral Hernias

Abstract Background For ventral hernia, endoscopic sublay repair (ESR) may overcome the disadvantages of open sublay and laparoscopic intraperitoneal onlay mesh repair. This retrospective study presents the preliminary multicenter results of ESR from China. The feasibility, safety, and effectiveness of ESR were evaluated; its surgical points and indications were summarized. Methods The study reviewed 156 ventral hernia patients planned to perform with ESR in ten hospitals between March 2016 and July 2019. Patient demographics, hernia characteristics, operative variables, and surgical results were recorded and analyzed. Results ESR was performed successfully in 153 patients, 135 with totally extraperitoneal sublay (TES) and 18 with transabdominal sublay (TAS). In 19 patients, TES was performed with the total visceral sac separation (TVS) technique, in which the space separation is carried out along the peritoneum, avoiding damage to the aponeurotic structure. Endoscopic transversus abdominis release (eTAR) was required in 17.0% of patients, and only 18.3% of patients required permanent mesh fixation. The median operative time was 135 min. Most patients had mild pain and resume eating soon after operation. No severe intraoperative complications occurred. Bleeding in the extraperitoneal space occurred in two patients and was stopped by nonsurgical treatment. Seroma and chronic pain were observed in 5.23% and 3.07% of patients. One recurrence occurred after TAS repair for an umbilical hernia. Conclusion ESR is feasible, safe, and effective for treating ventral hernias when surgeons get the relevant surgical skills, such as the technique of “partition breaking,” TVS, and eTAR. Small-to-medium ventral hernias are the major indications.

scholarly journals A clinical study on ventral hernias in a tertiary care hospital

2017 ◽  
Vol 4 (8) ◽  
pp. 2600
Author(s):  
Sushrut Subhash Chavan ◽  
Tridip Dutta Baruah ◽  
Ganesh Babu C. P.
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Complex Problem ◽  
Care Hospital ◽  
Incisional Hernias ◽  
Operative Care ◽  
Time Of Presentation ◽  
Ventral Hernias

Background: Ventral hernias comprise the second most common hernia presentations in the surgical world. This study was undertaken to know the different clinical types, age incidence, predisposing factors for ventral hernia and also to study the post-operative results of different operative procedures.Methods: 250 cases of abdominal wall hernias were studied during the period of 3.5 years from January 2013 to June 2016. Out of which 150 cases were studied retrospectively from January 2013 to December 2014 with the help of the case sheets available in the MRD. The prospective study was done from January 2015 to June 2016 in which each patient was evaluated separately and thoroughly and his surgery planned so as to obtain satisfactory results. 69.6% were incisional hernias following an operation. 8% patients had presented with complications like irreducibility, obstruction and strangulation. The presence of associated diseases, large hernia, poor condition of local tissue (muscle), all make the surgical management of ventral hernia a complex problem. Either anatomical repair or Mesh repair were undertaken for all patients in this study.Results: Females were affected much more than the males. The proportion of females to males affected with ventral hernia was 5:1. Out of the three types of hernia that were studied only epigastric hernia showed more incidence in males whereas incisional and paraumbilical hernias were much more common in females. Most common age presentation was fourth and fifth decade. 92% of ventral hernias were uncomplicated at the time of presentation. In 100% of the cases swelling was the complaint followed by pain (18.8%). Previous surgery was the most common etiological factor in the development of ventral hernias (69.6%) followed by obesity (23.2%) In both groups mesh repair (63.6%) and anatomical repair (36.4%) there were no recurrences or deaths in the follow up period of 3 months.Conclusions: Ventral hernias are common surgical complaints. Prevention is the better treatment in the form of meticulous dissection and proper post-operative care to avoid incisional hernias. Presence of ventral hernia is an indication for surgery even in presence of co-morbid conditions like ascites, COPD, BPH as these patients are more prone for complications and of course these conditions need proper addressal. Mesh repair has nowadays become the standard of care but the results of the surgery depends upon the expertise of the surgeon.

scholarly journals A COMPARITIVE STUDY ON INTRA PERITONEAL ONLAY MESH REPAIR(IPOM) VS OPEN ONLAY MESH REPAIR FOR VENTRAL HERNIA

2020 ◽  
pp. 68-74
Author(s):  
Siddharth Kumar Sinha ◽  
Sanjay Singhal ◽  
Rudhee Sehgal ◽  
Dhaval Desai
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Mesh Repair ◽  
Ventral Hernia Repair ◽  
Open Repair ◽  
Onlay Mesh ◽  
Ventral Hernias

Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Ventral Hernias are second most common type of hernias accounting for 21 to 35% of all verities of hernias. The main danger of all forms of hernia is strangulation and hence need surgical intervention. Repair of ventral hernias can be technically challenging and a myriad of methods have been described. The most important distinctions in describing surgical management of ventral hernias are primary vs mesh repair and open vs laparoscopic repair. Mesh repair became the gold standard in elective management of most ventral hernias. In the recent era of Minimal invasive surgeries, laparoscopic ventral hernia repair is being favoured by patients as well as the surgeons when compared to open repair. There is need to evaluate and compare quality of life and pain scoring postoperatively between open repair and laparoscopic repair of ventral hernias. AIMS & OBJECTIVES- TO COMPARE SURGICAL OUTCOMES OF INTRA PERITONEAL ONLAY MESH REPAIR(IPOM) VS OPEN ONLAY MESH REPAIR FOR VENTRAL HERNIA ON VARIOUS PARAMETERS MATERIAL & METHODS-This study was conducted on 60 pts which were divided in 2 groups (30 Intra peritoneal onlay mesh repair- 30 open onlay mesh repair) CONCLUSION-Laparoscopic ventral hernia repair provides lesser post-operative pain, lesser complications, shorter hospital stay and lesser economic impact as they returned to returned to work early. Thus patients have less morbidity and improved quality of life. LVHR may be considered a primary approach for most ventral and incisional hernias unless contraindicated for laparoscopy

scholarly journals A preliminary multicenter evaluation of endoscopic sublay repair for ventral hernia from China

2020 ◽  
Author(s):  
Rui Tang ◽  
Huiyong Jiang ◽  
Weidong WU ◽  
Tao Wang ◽  
Mengxiang Meng ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Intraoperative Complications ◽  
Mesh Fixation ◽  
Transversus Abdominis ◽  
Intraperitoneal Onlay Mesh ◽  
Patient Demographics ◽  
Onlay Mesh ◽  
Sublay Repair ◽  
Space Separation ◽  
Ventral Hernias

Abstract Background: For ventral hernia, endoscopic sublay repair (ESR) may overcome the disadvantages of open sublay and laparoscopic intraperitoneal onlay mesh repair. This retrospective study presents the preliminary multicenter results of ESR from China. The feasibility, safety, and effectiveness of ESR were evaluated; its surgical points and indications were summarized. Methods: The study reviewed 156 ventral hernia patients planned to perform with ESR in ten hospitals between March 2016 and July 2019. Patient demographics, hernia characteristics, operative variables, and surgical results were recorded and analyzed.Results: ESR was performed successfully in 153 patients, 135 with totally extraperitoneal sublay (TES) and 18 with transabdominal sublay (TAS). In 19 patients, TES was performed with the total visceral sac separation (TVS) technique, in which the space separation is carried out along the peritoneum, avoiding damage to the aponeurotic structure. Endoscopic transversus abdominis release (eTAR) was required in 17.0% of patients, and only 18.3% of patients required permanent mesh fixation. The median operative time was 135 min. Most patients had mild pain and resume eating soon after operation. No severe intraoperative complications occurred. Bleeding in the extraperitoneal space occurred in two patients and was stopped by nonsurgical treatment. Seroma and chronic pain were observed in 5.23% and 3.07% of patients. One recurrence occurred after TAS repair for an umbilical hernia.Conclusion: ESR is feasible, safe, and effective for treating ventral hernias when surgeons get the relevant surgical skills, such as the technique of “partition breaking,” TVS, and eTAR. Small-to-medium ventral hernias are the major indications.

scholarly journals A Study of Intraperitoneal Onlay Mesh Repair Using Barbed Sutures for Abdominal Incisional Hernia

2021 ◽  
Vol 105 (1-3) ◽  
pp. 585-590
Author(s):  
Junpei Takashima ◽  
Keizo Taniguchi ◽  
Toshiaki Yasui ◽  
Masahiro Yamane ◽  
Yutaka Hattori ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Pain Scale ◽  
Barbed Suture ◽  
Intraperitoneal Onlay Mesh ◽  
Barbed Sutures ◽  
Duration Of Surgery ◽  
Onlay Mesh ◽  
The Mean ◽  
Hernial Orifice

Objective We investigated the validity of our intraperitoneal onlay mesh (IPOM) Plus technique with barbed sutures. Background Laparoscopic intraperitoneal onlay mesh repair has become a proven method for treating abdominal incisional hernias in recent years. There have been a few reports on the utility of IPOM Plus, which is IPOM + celiorrhaphy, although this method has not been widely discussed. We adopted the IPOM Plus technique with barbed sutures at our hospital and investigated the validity of this technique. Methods We included 7 patients who underwent IPOM Plus repair from 2015 to 2017 at our hospital. We excluded patients with a hernia hilum <2 cm or ≥10 cm, age < 20 years old, PS3 or more, and uncontrolled comorbidity. The hernial orifice was closed laparoscopically using barbed sutures and subsequently secured by tacking on an onlay mesh. Results The median hernial orifice size of the 7 patients was 45 mm (25 to 55 mm). Hernia onset occurred after laparotomy in all cases. In one case, an abdominal incisional hernia recurred after IPOM used to treat the condition 15 years earlier. The mean duration of surgery was 80.5 minutes (53 to 126 minutes), and the median pain scale score was 3 points (0 to 3 points), indicating little pain. None of the patients reported persistent postoperative pain. The mean duration of the postoperative hospital stay was a median of 3.5 days (2 to 5 days). Both short- and long-term outcomes indicated that no recurrence or complications, such as bulging or seroma, occurred. Conclusions IPOM Plus with intracavitary abdominal suturing using barbed suture for abdominal scar hernia repair may be a valid surgical procedure.

scholarly journals Ventral hernia from routine repairs to abdominal wall reconstruction: our initial experience

2020 ◽  
Vol 7 (10) ◽  
pp. 3348
Author(s):  
Sheetal Ishwarappagol ◽  
Rohit Krishnappa
Keyword(s):  
Abdominal Wall ◽  
Ventral Hernia ◽  
Abdominal Wall Reconstruction ◽  
Tobacco Consumption ◽  
Transversus Abdominis ◽  
Abdominal Pressure ◽  
Postural Stabilization ◽  
History Of ◽  
And Function ◽  
Ventral Hernias

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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