scholarly journals P131 A NEW THREE-STEP HYBRID APPROACH IS A SAFE PROCEDURE FOR INCISIONAL HERNIA: EARLY EXPERIENCES WITH A SINGLE CENTRE RETROSPECTIVE COHORT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Matthijs Van den Dop ◽  
Gijs De Smet ◽  
Michaël Bus ◽  
Johan Lange ◽  
Sascha Koch ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Intraoperative Complications ◽  
Hybrid Approach ◽  
Operation Time ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Safe Procedure ◽  
Intraoperative Complication ◽  
Hybrid Repair

Abstract Aim In this study, a three-step novel surgical technique was developed for incisional hernia, in which a laparoscopic procedure with a mini-laparotomy is combined: so-called ‘three-step incisional hybrid repair’. The aim of this study was to reduce the risk of intestinal lacerations during adhesiolysis and recurrence rate by better symmetrical overlap placement of the mesh. Material and Methods From 2016 to 2020, 70 patients (65.7% females) with an incisional hernia of > 2 and ≤10 cm underwent an elective three-step incisional hybrid repair in two non-academic hospitals performed by two surgeons specialised in abdominal wall surgery. Intra- and postoperative complications, operation time, hospitalisation time and hernia recurrence were assessed. Results Mean operation time was 100 min. Mean hernia size was 4.8 cm; 45 patients (64.3%) had a hernia of 1–5 cm, 25 patients (35.7%) of 6–10 cm. Eight patients had a grade 1 complication (11.4%), five patients a grade 2 (7.1%), two patients (2.8%) a grade 4 complication and one patient (1.4%) a grade 5 complication. Five patients had an intraoperative complication (7.0%), two enterotomies, one serosa injury, one omentum bleeding and one laceration of an epigastric vessel. Mean length of stay was 3.3 days. Four patients (5.6%) developed a hernia recurrence during a mean follow-up of 19.5 weeks. Conclusions A three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low.

scholarly journals A new three-step hybrid approach is a safe procedure for incisional hernia: early experiences with a single centre retrospective cohort

Hernia ◽  
2020 ◽  
Author(s):  
L. Matthijs van den Dop ◽  
Gijs H. J. de Smet ◽  
Michaël P. A. Bus ◽  
Johan F. Lange ◽  
Sascha M. P. Koch ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Intraoperative Complications ◽  
Operation Time ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Perioperative Outcomes ◽  
Safe Procedure ◽  
Intraoperative Complication ◽  
Hybrid Repair

Abstract Purpose In this study, a three-step novel surgical technique was developed for incisional hernia, in which a laparoscopic procedure with a mini-laparotomy is combined: so-called ‘three-step incisional hybrid repair’. The aim of this study was to reduce the risk of intestinal lacerations during adhesiolysis and recurrence rate by better symmetrical overlap placement of the mesh. Objectives To evaluate first perioperative outcomes with this technique. Methods From 2016 to 2020, 70 patients (65.7% females) with an incisional hernia of > 2 and ≤ 10 cm underwent a elective three-step incisional hybrid repair in two non-academic hospitals performed by two surgeons specialised in abdominal wall surgery. Intra- and postoperative complications, operation time, hospitalisation time and hernia recurrence were assessed. Results Mean operation time was 100 min. Mean hernia size was 4.8 cm; 45 patients (64.3%) had a hernia of 1–5 cm, 25 patients (35.7%) of 6–10 cm. Eight patients had a grade 1 complication (11.4%), five patients a grade 2 (7.1%), two patients (2.8%) a grade 4 complication and one patient (1.4%) a grade 5 complication. Five patients had an intraoperative complication (7.0%), two enterotomies, one serosa injury, one omentum bleeding and one laceration of an epigastric vessel. Mean length of stay was 3.3 days. Four patients (5.6%) developed a hernia recurrence during a mean follow-up of 19.5 weeks. Conclusion A three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low.

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.

Patient reported outcomes after incisional hernia repair—establishing the ventral hernia recurrence inventory

2016 ◽  
Vol 212 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Rebeccah B. Baucom ◽  
Jenny Ousley ◽  
Irene D. Feurer ◽  
Gloria B. Beveridge ◽  
Richard A. Pierce ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Patient Reported Outcomes ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Patient Reported

scholarly journals 509 Surgeon and Facility Volume Play Significant Role in Hernia Recurrence and Reoperation After Open Incisional Hernia Repair

2014 ◽  
Vol 146 (5) ◽  
pp. S-1016-S-1017 ◽  
Author(s):  
Christopher T. Aquina ◽  
Fergal Fleming ◽  
Kristin N. Kelly ◽  
Christian P. Probst ◽  
Katia Noyes ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Significant Role ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence

scholarly journals Modified Peritoneal Flap Hernioplasty Versus Retromuscular Technique for Incisional Hernia Repair: a Retrospective Cohort Study

2019 ◽  
Vol 109 (4) ◽  
pp. 279-288 ◽  
Author(s):  
P. Petersson ◽  
A. Montgomery ◽  
U. Petersson
Keyword(s):  
Cohort Study ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Short Term ◽  
Peritoneal Flap ◽  
Incisional Hernia Recurrence

Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective single-center cohort study. Outcomes were evaluated from the Swedish Ventral Hernia Registry, by chart review, physical examination, and an abdominal wall complaints questionnaire. Results: The modified peritoneal flap hernioplasty group ( n = 78) had larger hernias (mean width 10.4 vs 8.5 cm, p = 0.005), more advanced Centers for Disease Control classification ( p = 0.009), and more simultaneous gastrointestinal-tract surgery (23.1% vs 11.5%, p = 0.041) than the retromuscular group ( n = 96). No difference in short-term complications was seen. Incisional hernia recurrence was lower in the modified peritoneal flap hernioplasty group (1.4% vs 10.3%, p = 0.023), and patients were more satisfied (93.8% vs 81.7%, p = 0.032). Follow-up time was shorter in the modified peritoneal flap hernioplasty group (614 vs 1171 days, p < 0.001). Conclusion: This retrospective study showed similar rates of short-term complications, despite more complex hernias in the modified peritoneal flap hernioplasty group. Furthermore, a lower incisional hernia recurrence rate for the modified peritoneal flap hernioplasty technique compared with the retromuscular technique used in our department was found. If this holds true with equally long follow-up remains to be proven.

scholarly journals Reconstruction of the abdominal wall in anatomical plans. Pre and post – operative keys in repairing “cold’’ incisional hernias.

2016 ◽  
Vol 89 (1) ◽  
pp. 117-121
Author(s):  
Florina Popa ◽  
Oana Rosca ◽  
Alexandru Georgescu ◽  
Claudio Cannistra
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Positive Impact ◽  
Incisional Hernia Repair ◽  
Repair Process ◽  
Hernia Recurrence ◽  
Reconstruction Procedure ◽  
Incisional Hernias ◽  
Claude Bernard

Background and aims. The clinical results of the vertical "vest-over-pants" Mayo repair were evaluated, and the risk factors for incisional hernia recurrence were studied. The purpose of this study is to point out the importance of reducing pre and post operative risk factors in the incisional hernia repair process in order to achieve a physiologically normal abdominal wall.Methods. Twenty patients diagnosed with incisional hernia underwent an abdominal reconstruction procedure using the Mayo (Paletot) technique at Bichat Claude Bernard Hospital between 2005 and 2015. All procedures were performed by a single surgeon and all patients were pre-operatively prepared, identifying all coexisting conditions and treating them accordingly before undergoing surgery.Results. All patients underwent at least one surgical operation before the hernia repair procedure and a quarter had experienced at least three, prior to this one. Nine patients had a body mass index of >30 kg/m2. Additional risk factors and comorbidities included obesity in 45%, diabetes mellitus in 10%, smoking in 55%, and high blood pressure in 40%.Hernia defect width was from 3 cm (25% F) to 15 cm (5% M) of which nine patients (45%) had a 10 cm defect. Most of the patients had an average hospitalization of 7 days. The patients were carefully monitored and were called on periodic consultations  after 3, 6, and 12 months from the moment of the procedure. Patient feedback regarding  hernia recurrence and complaints about the scar were noted. Physical examination is essential in determining the hernia recurrence therefore the scar was examined for any abnormalities that may  have occurred, which was defined as any palpable or detected fascial defect located within seven centimeters of the hernia repair. Post-operative complications: seroma formation, wound hematoma, superficial and deep wound infection, recurrences and chronic pain were followed and no complications were registered during the follow-up period.Conclusions. Reducing the risk factors to a minimum prior to surgery will increase the success of the incisional hernia repair and generate a positive impact on the patient’s quality of life. The lofty goal of significant weight loss prior to elective hernia has shown to be the key factor in using the Mayo technique for incisional hernia repair. This study demonstrates that the Mayo repair technique is a suitable and trustworthy  alternative for repairing incisional hernias with very good results. It’s costs are minimal and it can be easily reproduced, even by less experienced surgeons.

Sign in / Sign up

Export Citation Format

Share Document