scholarly journals P127 ROBOTIC TRANSABDOMINAL RETRO-RECTUS HERNIA REPAIR VS. LAPAROSCOPIC INTRAPERITONEAL ONLAY MESH REPAIR: IMPROVING POSTOPERATIVE OUTCOMES

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mette Willaume ◽  
Lars Nannestad Jorgensen ◽  
Kristian Kiim Jensen
Keyword(s):  
Length Of Stay ◽  
Mesh Repair ◽  
Elective Surgery ◽  
Smoking Status ◽  
Tap Block ◽  
Analgesic Requirement ◽  
Intraperitoneal Onlay Mesh ◽  
Mesh Placement ◽  
Duration Of Surgery ◽  
Onlay Mesh

Abstract Aim “The optimal repair technique for small and medium-sized ventral hernias in obese patients remains unknown. We aimed to evaluate results after robotic-assisted laparoscopic transabdominal repair with retro-rectus mesh placement (rTARUP) compared with laparoscopic intraperitoneal onlay mesh repair (IPOM).” Material and Methods “Retrospective cohort study of consecutive patients undergoing rTARUP or IPOM repair for small or medium-sized primary ventral and incisional hernias. The primary outcome was postoperative need for transverse abdominis plane (TAP) block or epidural catheter, and secondary outcomes were 30-day complications, and length of stay. All patients underwent elective surgery and were followed for 30 days postoperatively.” Results “A total of 27 patients (rTARUP) and 32 (IPOM) were included. Patients in the two groups were comparable in terms of age, sex, comorbidities, smoking status, body mass index (BMI), and type of hernia. The median BMI was 32.4 kg/m2 and the fascial defect area was comparable (rTARUP median 16.8 cm2 vs. IPOM 11.7 cm2, P = 0.303). The duration of surgery was longer in the rTARUP group (median 117.2 min. vs. 84.4, P = 0.003), whereas the postoperative need for TAP block or epidural analgesics was less in the rTARUP group compared with IPOM (n = 14 vs. n = 1, P = 0.002). There were no severe complications or reoperations in the two groups. The length of stay was shorter in the rTARUP group (median 0 vs. 1 days, P < 0.001).” Conclusions “rTARUP was associated with reduced postoperative analgesic requirement and shorter length of stay compared with laparoscopic IPOM.”

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 Comparative outcomes of open retrorectus versus laparoscopic intraperitoneal onlay mesh repair of ventral hernia in a tertiary care center

2021 ◽  
Vol 8 (4) ◽  
pp. 1226
Author(s):  
Vivek V. Mukhamale ◽  
Bhushankumar A. Thakur ◽  
Snehal Deotale ◽  
Rajas Mudgerikar
Keyword(s):  
Retrospective Study ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Site Infection ◽  
Single Institution ◽  
Intraperitoneal Onlay Mesh ◽  
Duration Of Surgery ◽  
Onlay Mesh

Background: The combined Rives-Stoppa technique has been adopted as the gold standard for open incisional hernia repair. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia. Based on this we have done single institution retrospective study of IPOM and open rectrorectus mesh repair for ventral hernia with size less than 5 cm.Methods: This study was single institution retrospective study, where we have analyzed the data of 30 patients in each group of ventral hernia, with median 18 months of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.Results: Our study consists of 30 heterogenous population with similar age distribution in each group, mean time for surgery was 70.83 min for open and 66.33 minutes for IPOM. There was surgical site infection in 3 patients operated by open procedure and 2 patients in IPOM procedure. Duration of hospital stay which is more in open retrorectus repaired patients, 5.47 (mean) days and less in laparoscopic IPOM repaired patients, 5.07 (mean) days. Recurrence in both groups of patients is not seen in 6 months follow up in our study.Conclusions: Study supports safety in terms of duration of surgery, postoperative pain, surgical site infection, duration of hospital stays and efficacy in terms of return of normal activity and recurrence, equally effective in both open retrorectus and laparoscopic IPOM repair of ventral hernia with size less than 5 cm.

Surgical Procedures and Results of Modified Intraperitoneal Onlay Mesh Repair for Inguinal Hernia After Radical Prostatectomy

2020 ◽  
Vol 30 (11) ◽  
pp. 1189-1193
Author(s):  
Masakazu Ohuchi ◽  
Noriyuki Inaki ◽  
Kunihiko Nagakari ◽  
Shintaro Kohama ◽  
Kazuhiro Sakamoto ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Radical Prostatectomy ◽  
Surgical Procedures ◽  
Mesh Repair ◽  
Intraperitoneal Onlay Mesh ◽  
Onlay Mesh

scholarly journals Single-Incision Laparoscopic Intraperitoneal Onlay Mesh Repair for the Treatment of Multiple Recurrent Inguinal Hernias

2014 ◽  
Vol 18 (3) ◽  
pp. e2014.00354 ◽  
Author(s):  
Hanh Minh Tran ◽  
Kim Tran ◽  
Marta Zajkowska ◽  
Vincent Lam ◽  
Wayne Hawthorne
Keyword(s):  
Mesh Repair ◽  
Single Incision ◽  
Intraperitoneal Onlay Mesh ◽  
Inguinal Hernias ◽  
Onlay Mesh

scholarly journals Frailty in the over 65’s undergoing elective surgery (FIT-65) – a three-day study examining the prevalence of frailty in patients presenting for elective surgery

2021 ◽  
Author(s):  
Sarah Harrison ◽  
David Alexander Harvie ◽  
Lewis Matthews ◽  
Frances Wensley
Keyword(s):  
Length Of Stay ◽  
Elective Surgery ◽  
Smoking Status ◽  
Perioperative Complications ◽  
Surgical Patients ◽  
Early Screening ◽  
Cross Sectional ◽  
Operative Data ◽  
Frail Patients ◽  
The Uk

Abstract Background Frailty increases the risk of perioperative complications, length of stay, and the need for assisted-living after discharge. As the UK population ages the number of frail patients presenting for elective surgery in the UK is likely to grow. Despite the potential benefits of early diagnosis, frailty is not uniformly screened for in UK elective surgical patients and its prevalence remains unclear. The primary aim of this study was to assess the prevalence of frailty in patients aged over 65 years undergoing elective surgery. Methods We performed a prospective cross-sectional observational study in eight UK hospitals. Data were collected over three consecutive days with follow-up at 30 days. HRA approval was obtained (REC 20/SC/0121) and signed informed consent obtained. Participants were eligible for inclusion if they were 65 years or older and undergoing elective surgery. Pre-operative data were collected from hospital notes by anaesthetic trainees. A member of the research team blinded to the pre-operative dataset screened the participant for frailty pre-operatively using the Reported Edmonton Frail Scale (REFS). Post-operative data were collected from the notes on day of surgery and at 30 days. Participants were defined as “frail” if they scored 8 or more on the REFS. Results 228 participants were recruited during the study period of whom 218 proceeded to surgery. There were 103 females and 115 males. Median age was 75 years (interquartile range 70-80). Thirty-seven participants (17.0%) were identified as frail. Frail patients were older, had a higher ASA score, were more likely to have carers and were more likely to be anaemic and present with ECG abnormalities. There were no differences in gender, BMI, place of residence or smoking status for patients identified as frail versus non-frail. There was no difference in length-of-stay between frail and non-frail patients, although those identified as frail were less likely to be discharged to their own home. Conclusion We found the prevalence of frailty in a mixed population of elective surgical patients aged 65 or over to be 17.0%. Furthermore, we found the REFS to be a practical tool for pre-operative frailty screening. Frail patients presented for elective surgery with modifiable co-morbidities which could have been optimised pre-operatively. Early screening could highlight frail patients, allowing time for pre-operative planning and evidence-based optimisations of comorbidities. We therefore encourage the adoption of frailty assessment as a routine part of pre-operative assessment.

Sign in / Sign up

Export Citation Format

Share Document