scholarly journals P139 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL REPAIR FOR SMALL AND MEDIUM PRIMARY UMBILICAL AND MIDLINE HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Kryspin Mitura
Keyword(s):  
Mesh Repair ◽  
Laparoscopic Approach ◽  
Mesh Size ◽  
Complication Rates ◽  
Linea Alba ◽  
Hernia Defect ◽  
Transabdominal Preperitoneal ◽  
Open Mesh Repair ◽  
Onlay Mesh

Abstract Aim Complications of open mesh repair for primary umbilical and midline hernias (PUMH) may lead to significant re-admissions and follow-up costs. Although laparoscopic intraperitoneal onlay mesh repair reduces infection rates, especially in overweight patients, it’s controversial in these hernias, mainly due to potential adhesions’ formation. Laparoscopic transabdominal preperitoneal technique (lap-TAPP) may address these issues, as it combines advantages of both open and laparoscopic approaches. The aim of this study is to present the initial results of lap-TAPP for PUMH in regard to its feasibility and complication rates. Material and Methods We evaluated 25 consecutive cases of lap-TAPP repair for PUMH. Patients’s characteristics, intraoperative findings, and postoperative complications after 30-days follow-up were analyzed. Results 21 male and 4 female patients were included in analysis (mean BMI 29.8 kg/m2). Surgery time was 82 minutes (55-120). We found 20 umbilical and 11 epigastric linea alba hernias. Mesh size was 144cm2 (120-225); mean hernia defect width was 25mm (10-40). In 9 patients (36%) the peritoneal rents were created which were easily closed with sutures. All patients were discharged on 1 POD with no complications. After 30-days we found no recurrences or bulging, no pain complaints. We found one subcutaneous small hematoma with no need for intervention. Conclusions Laparoscopic TAPP for small and medium PUMH is a safe and feasible technique with low complication rate. However, this method is technically demanding and time consuming while performed with laparoscopic approach as it requires precise and subtle plane dissection, and non-ergonomic closure hernia defect.

scholarly journals Retro rectus mesh repair for umbilical hernia in adults: a study of 50 cases

2019 ◽  
Vol 7 (1) ◽  
pp. 49
Author(s):  
Ketan Vagholkar
Keyword(s):  
Gold Standard ◽  
Surgical Outcome ◽  
Mesh Repair ◽  
Umbilical Hernia ◽  
Open Repair ◽  
Laparoscopic Approach ◽  
Open Technique ◽  
Surgical Practice ◽  
Local Complications ◽  
Onlay Mesh

Background: Umbilical hernia is one of the most commonly encountered hernia in surgical practice. A variety of repairs have been tried our ranging from open to laparoscopic. However controversy still persists as to which type of repair is the gold standard for umbilical hernia. Open technique comprises of the onlay mesh repair which is known to develop a variety of complications. Even laparoscopic approach also has failure rates as well as local complications. The aim of the study was to evaluate the surgical outcome of open retro rectus mesh repair for adult umbilical hernias.Methods: 50 consecutive cases of umbilical hernia were repaired by open technique with retro rectus placement of mesh.Results: There were no local complications or any recurrence in any of the fifty patients.Conclusions: Retro rectus placement of mesh in open repair of umbilical hernia in adults is a safe and effective modality of treatment. 

scholarly journals Comparative study of open mesh repair and Desarda’s no-mesh repair for inguinal hernia, in GMKMCH, Salem, India

2018 ◽  
Vol 5 (9) ◽  
pp. 3139
Author(s):  
Prakash . ◽  
Padmalakshmi Bharathi Mohan
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Surgical Site Infections ◽  
Wall Stiffness ◽  
Open Mesh Repair ◽  
Scrotal Edema ◽  
Background Mesh ◽  
Surgical Field ◽  
Repair Techniques

Background: Mesh repair has gained popularity among the surgical repair of hernias but has limitations. This study is being carried out to compare the effectiveness of Desarda’s no mesh repair, with Lichtenstein’s tension free repair.Methods: This prospective study was carried out in GMKMCH, Salem, over a period of 2 years. A total of 60 cases with inguinal hernia were included in the study. 30 patients were randomly subjected to Desarda’s technique and 30 patients underwent Lichtenstein’s repair. After surgery, patients were followed up and noted for complications like groin pain, surgical site infections, duration of hospital stay, duration to return to normal activity.Results: Operative time was 45 minutes in Desarda’s group and 50 minutes in the Lichtenstein group which was highly significant (p<0.01). On 2-year follow-up there were no recurrences in both groups. There were no surgical site infections in the Desarda’s group, compared to whereas Lichtenstein’s repair where had 4 (10%) recurrences. The occurrence of complications like loss of sensation over the groin, scrotal edema, abdominal wall stiffness was not seen in Desarda’s group, whereas its occurrence was highly significant (p<.01) in Lichtenstein’s group.Conclusions: Desarda’s no mesh technique is easy to learn and simple when compared to other no mesh repair techniques and requires no mesh. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints. Hence, Desarda’s no mesh repair is favourably comparable with Lichtenstein’s mesh repair.

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.

scholarly journals Adhesions to Mesh after Ventral Hernia Mesh Repair Are Detected by MRI but Are Not a Cause of Long Term Chronic Abdominal Pain

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Odd Langbach ◽  
Stein Harald Holmedal ◽  
Ole Jacob Grandal ◽  
Ola Røkke
Keyword(s):  
Abdominal Wall ◽  
Ventral Hernia ◽  
Predictive Value ◽  
Mesh Repair ◽  
Hernia Mesh ◽  
Open Mesh Repair ◽  
Mesh Shrinkage ◽  
Hernia Mesh Repair

Aim. The aim of the present study was to perform MRI in patients after ventral hernia mesh repair, in order to evaluate MRI’s ability to detect intra-abdominal adhesions.Materials and Methods. Single-center long term follow-up study of 155 patients operated for ventral hernia with laparoscopic (LVHR) or open mesh repair (OVHR), including analyzing medical records, clinical investigation with patient-reported pain (VAS-scale), and MRI. MRI was performed in 124 patients: 114 patients (74%) after follow-up, and 10 patients referred for late complaints after ventral mesh repair. To verify the MRI-diagnosis of adhesions, laparoscopy was performed after MRI in a cohort of 20 patients.Results. MRI detected adhesions between bowel and abdominal wall/mesh in 60% of the patients and mesh shrinkage in 20–50%. Adhesions were demonstrated to all types of meshes after both LVHR and OVHR with a sensitivity of 70%, specificity of 75%, positive predictive value of 78%, and negative predictive value of 67%. Independent predictors for formation of adhesions were mesh area as determined by MRI and Charlson index. The presence of adhesions was not associated with more pain.Conclusion. MRI can detect adhesions between bowel and abdominal wall in a fair reliable way. Adhesions are formed both after open and laparoscopic hernia mesh repair and are not associated with chronic pain.

Open Mesh Repair of Incisional Hernia Using a Sublay Technique: Long-Term Follow-up

2007 ◽  
Vol 32 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Martin Kurzer ◽  
Allan Kark ◽  
Simon Selouk ◽  
Philip Belsham
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Open Mesh Repair ◽  
Sublay Technique ◽  
Long Term Follow Up ◽  
Open Mesh

scholarly journals MESH REPAIR

2010 ◽  
Vol 17 (04) ◽  
pp. 608-610
Author(s):  
ABID HUSSAIN ◽  
ASIF IMRAN
Keyword(s):  
Mesh Repair ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Open Mesh Repair ◽  
Long Term Follow Up ◽  
Quasi Experimental ◽  
Male Patients ◽  
Open Mesh

Objectives: To determine the outcome of mesh repair in the patients undergoing inguinal hernia surgery. Setting: Margala Teaching Hospital Rawalpindi. Duration: June 2006 to June 2008Study Design: Quasi experimental. Patients & Methods: This study included the 50 male patients underwent open mesh repair. In the long term follow up, recurrence of the disease and wound infection were noted. Patients were consecutively selected. Results: Recurrence of hernia was observed in one out of 50 patients. Rest of the patients were alright. Conclusions: The mesh repair has low recurrence rate, it is tension free and is easily learned.

scholarly journals Experience of application of 3D-visualization in laparoscopic operations

2020 ◽  
Vol 87 (1-2) ◽  
pp. 35-38
Author(s):  
V. M. Zaporozhan ◽  
A. V. Malynovskyi
Keyword(s):  
3D Visualization ◽  
Abdominal Muscles ◽  
Hernia Defect ◽  
3D Laparoscopy ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernias ◽  
First Results ◽  
Dor’S Fundoplication ◽  
Ventral Hernias

Objective. Studying of first results of application of 3D visualization in various laparoscopic interventions. Materials and methods. There were performed 169 operations: 27 transabdominal preperitoneal plasties of inguinal hernias, 19 intraperitoneal alloplasties of umbilical and postoperative ventral hernias with suturing of hernia defect, 1 retromuscular alloplasty of umbilical hernia, 6 reconstructions of anterior abdominal wall for dyastasis of rectal abdominal muscles, 103 plasties of hiatal hernias with fundoplications, 7 Heller’s cardiomyotomies and Dor’s fundoplication, 1 subtotal, 3 atypical gastric resections and 2 sleeve gastric resections for obesity. Results. 3D laparoscopy have simplified and accelerated the parietal peritoneum suturing in conduction of transabdominal preperitoneal plasties of inguinal hernias, as well as while performance of intraperitoneal alloplasties of umbilical and postoperative ventral hernias – the hernia defect suturing. While doing the hiatal hernia plasty, fundoplication with crurorrhaphy 3D laparoscopy have provided the additional advantages of manipulations improvement in special anatomic zones. Analogous advantages were shown in gastric operations, using 3D visualization. Intra- and postoperative complications were absent, as well as the hernias recurrence in the 6 mo-1.5 yr follow-up. Conclusion. The 3D visualization guarantees a rapid and highly-precision performance of complex manipulations in technically hard anatomical zones. Further accumulation of the material and comparison of results of 3D and 2D laparoscopy in prospective investigations, using objective parameters, as well as studying of expediency for 3D visualization selective application, for instance while performance of the most complicated operative stages are necessary.

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