scholarly journals P088 SURGEON AS A RISK FACTOR OF REDUCED EURAHS QOL SCORE AFTER HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Jakub Woleský ◽  
Barbora Jíšová ◽  
Barbora East
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Internal Audit ◽  
Major Complication ◽  
Incisional Hernia Repair ◽  
Hernia Surgery ◽  
Post Surgery ◽  
Before And After

Abstract Aim Our aim was to analyze patient’s reported EuraHS QoL (quality of life) scores before and after hernia surgery. And find whether the result is surgeon dependent or not, because hernia repair often serves as a training surgery for young surgeons or is performed by surgeons with no hernia interest. However, even a simple groin hernia repair can lead to life-long pain or reduced QoL and the risk of complications following incisional hernia repair is much higher. Material and Methods We have utilized the EuraHS database and its QoL questionnaire and prospectively entered all patients undergoing any hernia repair at our department since Jan. 2019. Results 519 patients have been included. Many patients in the incisional hernia cohort have reported no or very little symptoms before the operation. Only 251 have completed their 1 month follow-up with the QoL questionnaire. 63 patients have been contacted and questioned 1 year post-surgery to this date. In 6 cases the QoL scores are lower than pre-repair. 45 patients had a record of major complication or reoccurrence requiring surgery so far. Unfortunately 31 of those did not fill up the QoL questionnaire. 37 were operated on by resident with a supervision of a surgeon without a hernia interest. Conclusions Results of hernia repair are surgeon dependent and an internal audit of current practices is needed at many general surgery departments.

scholarly journals Patient-reported outcomes after incisional hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
N. van Veenendaal ◽  
M. M. Poelman ◽  
B. van den Heuvel ◽  
B. J. Dwars ◽  
W. H. Schreurs ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Patient Reported Outcomes ◽  
Incisional Hernia Repair ◽  
Hernia Surgery ◽  
Incisional Hernias ◽  
Patient Reported ◽  
Postoperative Symptoms

Abstract Purpose Patient-reported outcomes (PROs) are pivotal to evaluate the efficacy of surgical management. Debate persists on the optimal surgical technique to repair incisional hernias. Assessment of PROs can guide the selection of the best management of patients with incisional hernias. The objective of this cohort study was to present the PROs after incisional hernia repair at long term follow-up. Methods Patients with a history of incisional hernia repair were seen at the out-patient clinic to collect PROs. Patients were asked about the preoperative indication for repair and postoperative symptoms, such as pain, feelings of discomfort, and bulging of the abdominal wall. Additionally, degree of satisfaction was asked and Carolina Comfort Scales were completed. Results Two hundred and ten patients after incisional hernia repair were included with a median follow-up of 3.2 years. The main indication for incisional hernia repair was the presence of a bulge (60%). Other main reasons for repair were pain (19%) or discomfort (5%). One hundred and thirty-two patients (63%) reported that the overall status of their abdominal wall had improved after the operation. Postoperative symptoms were reported by 133 patients (63%), such as feelings of discomfort, pain and bulging. Twenty percent of patients reported that the overall status of their abdominal wall was the same, and 17% reported a worse status, compared to before the operation. Ten percent of the patients would not opt for operation in hindsight. Conclusion This study showed that a majority of the patients after incisional hernia repair still report pain or symptoms such as feelings of discomfort, pain, and bulging of the abdominal wall 3 years after surgery. Embedding patients’ expectations and PROs in the preoperative counseling discussion is needed to improve decision-making in incisional hernia surgery.

scholarly journals OV10 LAPAROSCOPIC-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN HERNIA SURGERY - HOW WE DO IT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mário Rui Gonçalves ◽  
Conceição Antunes ◽  
Mariana Capinha ◽  
Ana Rita Arantes ◽  
Paulo Almeida ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Incisional Hernia Repair ◽  
Transversus Abdominis ◽  
Direct Visualization ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hernia Surgery ◽  
Surgical Department

Abstract Aim “COVID has been a great challenge for Hospitals around the world. At our surgical department a new protocol of TAP block was designed and implemented in our laparoscopic incisional ventral hernia repairs, to allow these patients to be operated in ambulatory regime, without compromising pain control and the outcomes. In this video we aim to present the technique for the Laparoscopic-guided TAP Block during a Laparoscopic IPOM Plus ventral hernia repair.” Material and Methods “We implemented this protocol in July 2020 and since then, we performed 18 TAP block in laparoscopic incisional hernia repairs, laparoscopic guided by the Surgeon or ultrasound-guided by the Anesthesiologist. In this case, the video reports to a Laparoscopic IPOM Plus incisional hernia repair performed on a 54-year-old patient, male, with obesity, arterial hypertension and dyslipidemia. He had a 6 centimeter incisional hernia post-colorectal surgery in 2013.” Results “As detailed in the video, we show all the steps to perform a TAP block under laparoscopic direct visualization” Conclusions “TAP block can be performed by the Surgeon, with direct visualization at the beginning of the laparoscopic procedure.”

Is Onlay Polypropylene Mesh Repair an Available Option for Incisional Hernia Repair? A Retrospective Cohort Study

2019 ◽  
Vol 85 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Oscar Cano-Valderrama ◽  
JosÉ L. Porrero ◽  
Esther Quirós ◽  
Oscar Bonachia ◽  
MarÍA J. Castillo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Onlay Mesh

Lately, incisional hernia repair (IHR) with onlay polypropylene mesh has been replaced by other surgical procedures. The aim of this study was to compare the complication and recurrence rate after onlay mesh repair and other surgical procedures for IHR. A retrospective cohort study of patients who underwent IHR in a single center was conducted. The data were obtained from electronic medical records. Patients who had been lost during follow-up were contacted for a visit in the clinic. Univariate and multivariate analysis was performed with Stata 13.0 to analyze the factors associated with postoperative complications and hernia recurrence. Between June 2004 and December 2015, 1078 patients underwent IHR in a single center. Onlay mesh repair was performed in 125 patients (11.6%). Other surgical procedures included Rives procedure (29.3%), sublay mesh repair (38.6%), intrabdominal mesh repair (17.1%), and primary closure (3.4%). After a mean follow-up of 2.8 years, 73 (7%) patients developed a recurrence. A higher percentage of complications were seen after onlay mesh repair than after other surgical procedures (22.4% vs 13.1%, P = 0.005). Nevertheless, recurrence was less frequent after onlay mesh repair (4.2% vs 7.1%, P = 0.241). Logistic regression discarded an association between onlay mesh repair and hernia recurrence or postoperative complications. Incisional hernia repair with onlay polypropylene mesh repair was not associated with a higher incidence of postoperative complications or recurrence rate. So, this procedure should not be discarded in selected patients presenting with incisional hernia.

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