Simultaneous Prosthetic Mesh Abdominal Wall Reconstruction with Abdominoplasty for Ventral Hernia and Severe Rectus Diastasis Repairs

Background: Loss of continuity of abdominal wall significantly affects the functions of protection of viscera, postural stabilization, and maintenance of intra-abdominal pressure. The newer understanding of abdominal wall reconstruction (AWR) aims at restoring abdominal wall anatomy and function, instead of simply patching the defect. We want to showcase the changing trends and results in hernia repair at a Medical Institution.Methods: This is an observational retrospective study conducted in RRMCH, Bengaluru from July 2018-2019 including all patients with ventral hernia undergoing the specified hernia repairs.Results: A total of 54 patients with ventral hernias undergoing routine hernia repairs/AWR surgeries were retrospectively analysed. The overall mean age was 46.62±12.44 year. Majority subjects were females (n=37; 68.5%), and overweight (Mean BMI=28.07±3.01/m2). 14 patients (25.92%), all males, had history of tobacco consumption. There were 38 (70.37%) primary ventral hernias and 7 recurrent hernias. Overall mean defect size was 10.2±0.4 cm. Most frequently performed was open retro rectus Hernioplasty (n=18; 33.33%), followed by open Preperitoneal Hernioplasty (n=17; 31.48%), laparoscopic intraperitoneal onlay mesh (IPOM) (n=16; 29.62%) and open transversus abdominis release (TAR) (n=3; 5.5%). On statistical analysis, it was found that Open repairs had higher post-operative pain (p=0.0005), longer hospitalization (p=0.0002) and higher incidence of surgical site events (p=0.0134) when compared to Laparoscopic repairs.Conclusion: As known already, minimally invasive techniques of hernia surgeries are shown to have acceptable outcomes when compared to radical open surgeries. Newer techniques of AWR are being employed to routine cases in larger numbers, and not just for complex reconstruction, at most centres with acceptable outcomes.

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Abdominal Wall Reconstruction

10.2310/ps.10056 ◽

2018 ◽

Author(s):

Gregory A. Dumanian

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Reconstruction ◽

Abdominal Wall Defects ◽

Gap Formation ◽

Rectus Diastasis ◽

Dramatic Form ◽

Tensile Forces ◽

Surgical Failure ◽

Pull Through ◽

Abdominal Shape

The closure of the abdominal wall defects is a fascinating field within surgery. The combined strength of sutures and scar after simple approximation of tissues in many cases does not suffice to contain the abdominal viscera and an incisional hernia results. Surgical failure can be seen immediately in the dramatic form of a dehiscence or can emerge slowly over time with a change in the abdominal shape and contour. This chapter delves into the theory and practicum of how a surgeon can approximate two halves of an abdominal wall together to resist the inherent tensile forces that exist and create a durable closure. This review contains 19 figures and 35 references Key Words: bioprosthetic, bridging, component release, force distribution, foreign body reaction, gap formation, hernia, laparotomy, mesh, perforator preservation, rectus diastasis, suture pull-through, TAR release

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Laparoscopic intracorporeal rectus aponeuroplasty (LIRA technique): a step forward in minimally invasive abdominal wall reconstruction for ventral hernia repair (LVHR)

Surgical Endoscopy ◽

10.1007/s00464-018-6070-y ◽

2018 ◽

Vol 32 (8) ◽

pp. 3502-3508 ◽

Cited By ~ 8

Author(s):

Julio Gómez-Menchero ◽

Juan Francisco Guadalajara Jurado ◽

Juan Manuel Suárez Grau ◽

Juan Antonio Bellido Luque ◽

Joaquin Luis García Moreno ◽

...

Keyword(s):

Minimally Invasive ◽

Hernia Repair ◽

Abdominal Wall ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Abdominal Wall Reconstruction

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Early Fascial Closure of the Damage Control Abdomen in Children

The American Surgeon ◽

10.1177/000313481007600517 ◽

2010 ◽

Vol 76 (5) ◽

pp. 497-501 ◽

Cited By ~ 2

Author(s):

Myrick C. Shinall ◽

Kaushik Mukherjee ◽

Harold N. Lovvorn

Keyword(s):

Abdominal Wall ◽

Ventral Hernia ◽

Damage Control ◽

Necrotizing Pancreatitis ◽

Abdominal Wall Reconstruction ◽

Acellular Dermal Matrix ◽

Fascial Closure ◽

Time Range ◽

Dermal Matrix ◽

Abdominal Closure

Traditional staged closure of the damage control abdomen frequently results in a ventral hernia, need for delayed abdominal wall reconstruction, and risk of multiple complications. We examined the potential benefits in children of early fascial closure of the damage control abdomen using human acellular dermal matrix (HADM). We reviewed our experience with five consecutive children sustaining intra-abdominal catastrophe and managed with damage control celiotomy. To accomplish early definitive abdominal closure, HADM was sewn in place as a fascial substitute; the skin and subcutaneous layers were approximated over silicone drains. The five patients ranged in age from 1 month to 19 years at the time of presentation. Intra-abdominal catastrophes included complex bowel injuries after blunt trauma in two children, necrotizing pancreatitis and gastric perforation in one teenager, necrotizing enterocolitis in one premature infant, and perforated typhlitis in one adolescent. All damage control wounds were dirty. Time range from initial celiotomy to definitive abdominal closure was 6 to 9 days. After definitive closure, one child developed a superficial wound infection. No patient developed a ventral hernia. After damage control celiotomy in children, early abdominal wall closure using HADM may minimize complications associated with delayed closure techniques and the need for additional procedures.

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Characteristics of Prosthetic Mesh and Autogenous Fascia in Abdominal Wall Reconstruction after Prolonged Implantation

Annals of Plastic Surgery ◽

10.1097/00000637-199212000-00005 ◽

1992 ◽

Vol 29 (6) ◽

pp. 508-511 ◽

Cited By ~ 21

Author(s):

Hani S. Matloub ◽

Paul Jensen ◽

Brad K. Grunert ◽

James R. Sanger ◽

N. John Yousif

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Reconstruction ◽

Prosthetic Mesh

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Su1309 - Ascending the Learning Curve of Robotic Transversus Abdominis Release (TAR) and Robotic Abdominal Wall Reconstruction for Complex Ventral Hernia Repair: A Single-Center Experience

Gastroenterology ◽

10.1016/s0016-5085(18)34283-5 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-1307

Author(s):

David Halpern ◽

Raelina S. Howell ◽

Harika Boinpally ◽

Cristina Magadan-Alvarez ◽

Patrizio Petrone ◽

...

Keyword(s):

Hernia Repair ◽

Learning Curve ◽

Abdominal Wall ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Abdominal Wall Reconstruction ◽

Transversus Abdominis ◽

Single Center ◽

Transversus Abdominis Release ◽

Single Center Experience

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Early experience with the use of prosthetic mesh as fascia replacement in structural abdominal wall reconstruction

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.37761 ◽

2007 ◽

Vol 40 (2) ◽

pp. 164

Author(s):

AO Oladele ◽

OO Lawal ◽

GH Alabi ◽

IA Adigun ◽

JK Olabanji

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Reconstruction ◽

Early Experience ◽

Prosthetic Mesh

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early experience with the use of prosthetic mesh as fascia replacement in structural abdominal wall reconstruction

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699196 ◽

2007 ◽

Vol 40 (02) ◽

pp. 164-169

Author(s):

I A Adigun ◽

J K Olabanji ◽

A O Oladele ◽

O O Lawal ◽

G H Alabi

Keyword(s):

Incisional Hernia ◽

Abdominal Wall ◽

Bowel Resection ◽

Anterior Abdominal Wall ◽

Enterocutaneous Fistula ◽

Abdominal Wall Reconstruction ◽

Early Experience ◽

Prosthetic Mesh ◽

Abdominal Wall Defects ◽

Black Patients

ABSTRACT Background: Abdominal wall defects occur from various causes and require reconstruction. autogenous tissue is often insufficient and incisional hernia often results. prosthetic mesh is a proven substitute to autogenous tissue but reports on its use is uncommon in our practice environment.Aim: the aim is to report our early experience with the use of prosthetic mesh in black patients in our practice environment.Materials and methods: the summaries of three patients with anterior abdominal wall defects which were managed with the use of a prosthetic mesh are presented as well as their intraoperative and postoperative photographs. one patient had intraperitoneal placement of the mesh and developed no complications.Results: one patient who had bowel resection developed a postoperative enterocutaneous fistula away from the site of the mesh and was managed conservatively. other patients had no complications.Conclusions: the use of prosthetic mesh is recommended.

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