scholarly journals P073 SYNCHRONOUS VERSUS DELAYED SURGICAL TREATMENT OF MORBID OBESITY AND VENTRAL HERNIA. PRELIMINARY RESULTS OF A RETROSPECTIVE SINGLE CENTER STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Gisella Barone ◽  
Camillo Leonardo Bertoglio ◽  
Marianna Maspero ◽  
Valerio Girardi ◽  
Lorenzo Morini ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Emergency Surgery ◽  
Mesh Repair ◽  
Primary Repair ◽  
Surgical Site Infections ◽  
Mean Value ◽  
Hernia Recurrence ◽  
Suture Repair ◽  
Obese Patients ◽  
Morbid Obese

Abstract Aim The worldwide increase in morbid obese patients raises controverises regarding the best timing of treatment for concomitant ventral hernias (VH). We present the preliminary experience at a referral center for bariatric surgery (BS): synchronous versus delayed ventral hernia repair (S-VHR, D-VHR) have been compared. Material and Methods From 2009, 40 consecutive morbid obese patients eligible for BS presented with concomitant VH. Symptoms and characteristics of the VH were evaluated to choose between S-VHR (28 patients), primary (n = 12) or mesh augmented (n = 16), and D-VHR (12 patients). 90-day postoperative complications and hernia recurrence were evaluated. Results 3 patients out of 16 in the mesh group experienced superficial surgical site infections. 4 patients in the D-VHR had a bowel incarceration within 20 days after BS and required emergency surgery with mesh implantation. No complications occurred in the primary repair group. The recurrence rate was around 19% in both groups of the S-VHR. Nonetheless the group that received mesh repair had a significant higher mean value of the defect. In the D-VHR cohort 1 patient was lost at follow up while 3 patients were not operated on due to inadequate weight loss. No recurrences occurred in the 4 patients requiring emergency surgery. Conclusions: D-VHR is associated with worse early postoperative outcomes; primary suture repair should be considered in preventing bowel incarceration but synchronous mesh repair is preferred in large symptomatic hernias for its acceptable postoperative morbidity and hernia recurrence at 1 year.

Recurrence and Pseudorecurrence after Laparoscopic Ventral Hernia Repair: Predictors and Patient-focused Outcomes

2014 ◽  
Vol 80 (2) ◽  
pp. 138-148 ◽  
Author(s):  
Stacey A. Carter ◽  
Stephanie C. Hicks ◽  
Reshma Brahmbhatt ◽  
Mike K. Liang
Keyword(s):  
Surgical Technique ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Multivariate Analyses ◽  
Surgical Site Infections ◽  
Hernia Recurrence ◽  
Laparoscopic Ventral Hernia Repair ◽  
Factors Associated ◽  
Hernia Size

Laparoscopic ventral hernia repair (LVHR) is gaining popularity as an option to repair abdominal wall hernias. Bulging after repair remains common after this technique. This study evaluates the incidence and factors associated with bulging after LVHR. Between 2000 and 2010, 201 patients underwent LVHR at two affiliated institutions. Patients who developed recurrence or pseudorecurrence (seroma or eventration) were analyzed with univariate and multivariate analyses to identify predictors of these complications. Of the 201 patients who underwent LVHR, 40 (19.9%) patients developed a seroma, 63 (31.3%) patients had radiographically proven eventration, and 25 (12.4%) patients had a hernia recurrence. On multivariate analysis, seromas were associated with number of prior ventral hernia repairs, surgical site infections, and prostate disease. Mesh eventration was associated with hernia size and surgical technique. Tissue eventration was associated with primary hernias and surgical technique. Hernia recurrence was associated with incisional hernias and mesh type used. Recurrence and pseudorecurrence are important complications after LVHR. Large hernia size, infections, and surgical technique are important clinical factors that affect outcomes after LVHR.

scholarly journals Long-term results of incisional hernia treatment

Medicina ◽  
2007 ◽  
Vol 43 (11) ◽  
pp. 855 ◽  
Author(s):  
Linas Venclauskas ◽  
Jolita Šilanskaitė ◽  
Jurga Kanišauskaitė ◽  
Mindaugas Kiudelis
Keyword(s):  
Physical Activity ◽  
Incisional Hernia ◽  
Mesh Repair ◽  
Study Groups ◽  
Hernia Recurrence ◽  
Suture Repair ◽  
Open Mesh Repair ◽  
Onlay Technique ◽  
Open Mesh

Ventral hernia is a common problem in general surgery practice. Incisional hernia can develop in 15–25% of patients after abdominal surgery. The aim of this study was to compare two different methods of incisional hernia surgery. Materials and methods. A retrospective analysis of database of surgery department from 1997 to 2000 was performed. All patients were divided into two groups. The first group patients were operated using open suture repair (keel technique); the second group patients – using open mesh repair (onlay technique). Long-term follow-up was done by a mail questionnaire. A special questionnaire was sent to all patients. Postoperative evaluation included pain and discomfort in the abdomen, physical activity, and recurrence rate after operation. Statistical evaluation was conduced using descriptive analysis: the unpaired Student t test to compare parametric criterions between two study groups, Mann-Whitney U test to compare the unpaired nonparametric criterions between two study groups, and X2 test to investigate nonparametric criterions between these groups. Results. A total of 202 patients (51 males, 151 females) with incisional hernia were operated during 1997–2000. One hundred seventy-one patients were in the keel technique group, and 31 patients in the onlay technique group. There were no significantly differences in age and sex between these groups. The hospitalization time was significantly longer in the open mesh repair group. The postoperative complication (wound seroma and suppuration) rate was significantly higher in the onlay technique group. One hundred sixty-one patients (79.7%) answered the questionnaire (133 in the keel technique group, 28 the in onlay technique group). The patients’ return to physical activity after surgery was significantly longer in the keel technique group. Forty-one patients (31%) had hernia recurrence in the keel technique group and 3 patients (11%) in the onlay technique group (P<0.05). There were no postoperative deaths in both groups. Conclusions. The rates of postoperative therapeutic complications and hernia recurrence are significantly lower after open mesh repair surgery. Return to normal physical activity after surgery is significantly longer after open suture repair surgery.

Mechanisms of Ventral Hernia Recurrence after Mesh Repair and a New Proposed Classification

2005 ◽  
Vol 201 (1) ◽  
pp. 132-140 ◽  
Author(s):  
Ziad T. Awad ◽  
Varun Puri ◽  
Karl LeBlanc ◽  
René Stoppa ◽  
Robert J. Fitzgibbons ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Hernia Recurrence

scholarly journals Clinical Outcomes of Open Ventral Hernia Repair in a Public Sector Hospital

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Syed Kashif Ali Shah ◽  
Gulshan Ali Memon ◽  
Khawar Saeed Jamali ◽  
Rafiq Ahmed Sahito ◽  
Habib Ur Rehman ◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Synthetic Mesh ◽  
Suture Technique ◽  
Wound Complications ◽  
P Value ◽  
Suture Repair ◽  
College Hospital ◽  
Primary Ventral Hernia ◽  
Surgical Unit

AbstractObjective:  This prospective study was designed to see the outcomes in two different types of surgical repairs (suture or mesh) of primary ventral hernia.Methods:  A total of 70 adult patients under went for elective primary ventral hernia suture or mesh repair at surgical unit-I of Peoples Medical College Hospital Nawabshah and Surgical Unit-I from March-2010 to Feb-2016 were included in this study on the basis of inclusion – exclusion criteria. Patient’s demographic characteristics, operative details, post-operative out-comes (complications and recurrence) were studied.Results:  A total number of 70 consecutive patients having primary ventral hernia under went for an elective open repair either with suture (32/45.7%) or synthetic mesh (38/54.3%) were evaluated in this study. Among these patients 52 (74.2%) and 18 (25.8%) were female and male respectively, with mean age of 51.5 ± 12. A total of 3(7.89%) patients had recurrence with Mesh Repair and 06(18.75%) with suture repair at 3 years follow-up, p-value = 0.176.Conclusion:  The mesh repair in ventral hernia has low wound complications and less recurrence of the hernia when compared with suture technique.

scholarly journals Approach to hernial defect in laparoscopic incisional hernia repair

2018 ◽  
Vol 5 (5) ◽  
pp. 1738
Author(s):  
Nijas N. A. ◽  
Sanjay N. Koppad
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Ventral Hernia Repair ◽  
Incisional Hernia Repair ◽  
Suture Repair ◽  
Recurrence Rates ◽  
Laparoscopic Incisional Hernia Repair ◽  
Contentious Issue ◽  
Open Mesh Repair

Background: Ventral hernias are the second most common type of abdominal hernias and account for approximately 10% of all hernias. Recurrence rates after open suture repair have been reported to be as high as 31% to 49%. Laparoscopic ventral hernia repair (LVHR) has been reported to have reduced recurrence rates as compared to open mesh repair, reduced infection rate, shorter recovery time and hospital stay. During LVHR, closure of the hernial defect is a contentious issue. Author describe our observations with the closure of hernial defect in LVHR in comparison to non-closure of defects in relation to seroma, pain, ileus, and recurrence.Methods: An observational study of closure versus non-closure of hernial defect in laparoscopic ventral hernia mesh repair was conducted in 81 patients from March 2016 to March 2017. Ventral hernia repair with mesh was done without closure of defect in 32 cases as compared to 49 cases in which closure of defect was done.Results: Seroma, pain, ileus and recurrence incidence are less in closure of defect in comparison to non-closure of defect in present study.Conclusions: With increasing experience, different theories and techniques have been described by different surgeons to overcome the intra operative and postoperative problems. During LVHR, closure of the hernial defect is a contentious issue. Closure of defect in the experience decreases rate of seroma formation. Closure of defect induce more post-operative pain but may be superior with regard to other important surgical outcomes. Duration of follow up is inadequate to conclude about incidence of recurrence in present study. 

Hand-assisted laparoscopic nephrectomy in morbidly obese patients

2020 ◽  
Vol 99 (6) ◽  
pp. 271-276
Keyword(s):  
Body Weight ◽  
Surgical Technique ◽  
Blood Loss ◽  
Hospital Stay ◽  
Kidney Cancer ◽  
The Body ◽  
Laparoscopic Nephrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbid Obese

Introduction: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. Methods: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were analyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. Results: The patient age was 38−67 years; the cohort included 2 females and 5 males, the body weight was 117−155 kg and the BMI was 40.3−501 kg/m2. Surgery time was 73−98 minutes, blood loss was 20−450 ml, and hospital stay was 5−7 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48–110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

scholarly journals Surgical site infection in mesh repair for ventral hernia in contaminated field: A systematic review and meta-analysis

2021 ◽  
Vol 63 ◽  
pp. 102173
Author(s):  
Mohamed Maatouk ◽  
Yacine Ben Safta ◽  
Aymen Mabrouk ◽  
Ghassen Hamdi Kbir ◽  
Anis Ben Dhaou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Meta Analysis ◽  
Site Infection ◽  
Contaminated Field

scholarly journals Impact of weight on stone-free rate during percutaneous nephrolithotomy

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Abdrabuh M. Abdrabuh
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operative Procedure ◽  
World Health ◽  
Fluoroscopy Time ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Co Morbidity ◽  
Stone Free Rate ◽  
Morbid Obese ◽  
Free Rate

Abstract Background To assess Impact of weight on stone-free rate during percutaneous nephrolithotomy. Methods Hundred and twenty-three PNL procedures were done between January 2016 and July 2017. The patients were divided into four groups according to the World Health Organization (WHO) classification of body mass index (BMI): < 25 ((group 1, average)), 25–29.9 (group 2, overweight), 30–39.9 (group 3, obese), and ≥ 40 kg/m2 (group 4, morbidly obese). All groups were compared as regarding preoperative variables, intra-operative procedure and postoperative results. Results The non-obese groups were younger in age than obese and morbid obese groups (P = 0.005). The difference in BMI was statistically significant between non-obese and obese groups (P = 0.0001). Most of females gender were obese and morbid obese (P = 0.0001) and most of the obese patients had left-sided renal stone (P = 0.001). Most of overweight and obese groups had radiopaque stones (P = 0.02). There were no statistically significant differences between all groups as regarding co-morbidity, stone size, stone locations, and hydronephrosis grade. Operative time (P = 0.034), length of hospital stay (P value = 0.014) and fluoroscopy time (P = 0.0001) were statistically significant differences between all groups. Number of accesses, access site, postoperative hemoglobin drop, post- operative complications, fate of residual stones and stone-free rate were not statistically significant differences between all groups. BMI was correlated with mean fluoroscopy time and mean hospitalization duration in our study as the time of hospitalization and time of x-ray exposure increase with obesity. Conclusion PNL is a safe and effective procedure for obese patients. BMI do not predict clearance post PNL.

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