Abdominal cocoon: precipitated by laparoscopic gas insufflation

2021 ◽  
Vol 14 (4) ◽  
pp. e240024
Author(s):  
Karingattil George Mathew ◽  
Shakeel Akhtar ◽  
Saajan Ignatius Pius
Keyword(s):  
Umbilical Hernia ◽  
Open Repair ◽  
Young Male ◽  
Unexpected Finding ◽  
Abdominal Cocoon ◽  
Intraperitoneal Onlay Mesh ◽  
Sclerosing Peritonitis ◽  
Wise Decision ◽  
Onlay Mesh ◽  
Asymptomatic Phase

A young male in his early 30s presented to us with increasing swelling at the umbilicus, and an umbilical hernia was diagnosed. At laparoscopic intraperitoneal onlay mesh (IPOM) repair, an unexpected finding of a thin innocuous-looking fibrous film over the small bowel was noted. This finding presented a dilemma as to the probable pathology of this material, and a decision had to be made on whether laparoscopic IPOM could be continued. It was prudently decided to abandon the plan of placing a mesh intraperitoneally and an open repair of the umbilical hernia was done. In retrospect this was a wise decision, as, after 7 months he had to have a laparotomy for intestinal obstruction, when the classic thick fibrous encapsulating abdominal cocoon was seen. Hence here we have followed the evolution of the abdominal cocoon from its original asymptomatic phase to the classic encapsulating sclerosing peritonitis with probably laparoscopic gas insufflation being the precipitating factor.

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. 

Outcomes of Laparoscopic-Assisted, Open Umbilical Hernia Repair

2020 ◽  
Vol 86 (8) ◽  
pp. 1001-1004
Author(s):  
Jenny M. Shao ◽  
Sharbel A. Elhage ◽  
Tanu Prasad ◽  
Paul D. Colavita ◽  
Vedra A. Augenstein ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Umbilical Hernia ◽  
Patient Characteristics ◽  
Radiographic Examination ◽  
Intraperitoneal Onlay Mesh ◽  
Institutional Review ◽  
Umbilical Hernia Repair ◽  
Onlay Mesh ◽  
Laparoscopic Assisted

Umbilical hernia repair (UHR) is one of the most commonly performed hernia operations with reported recurrence rate from 1% to 54%. Our aim was to describe an open, laparoscopic-assisted (OLA) technique and its outcome in an institutional review board-approved prospective study at a tertiary hernia center from 2008 to 2019. All patients underwent a standard periumbilical incision, open dissection of the hernia, and closure of the fascial defect with laparoscopic intraperitoneal onlay mesh (IPOM) fixation with permanent tacks. A total of 186 patients were identified who underwent an OLA UHR repair. Patient characteristics are as follows: average age 52.8 ± 12.5 years, male gender 79.6%, body mass index 31.4 ± 8.0 kg/m2, and average hernia defect size of 2.8 ± 4.8 cm2. Forty-one (22.0%) patients had previous failed repair. Sixty-nine (37.1%) patients had another procedure performed at the time of the UHR, most commonly a laparoscopic transabdominal inguinal hernia repair (58%). The mean operative time was 87.3 ± 51.2 minutes, but only 63.9 ± 31.9 minutes for patients undergoing an OLA repair. There were no recurrences (0%) on abdominal physical or radiographic examination with an average follow-up of 16.5 ± 17.7 months. Postoperative complications included wound erythema (2.7%), hematomas (1.1%), seromas (2.7%), and 4.3% received postoperative oral antibiotics. One person was readmitted for seroma drainage, and another required reoperation for small bowel obstruction unrelated to the hernia repair. One patient had chronic pain requiring tack removal. With moderate follow-up, an OLA UHR with mesh appears to be a durable repair with favorable results, including those patients with recurrent hernias.

scholarly journals The Role of Mesh Implants in Surgical Treatment of Parastomal Hernia

Materials ◽  
2021 ◽  
Vol 14 (5) ◽  
pp. 1062
Author(s):  
Karolina Turlakiewicz ◽  
Michał Puchalski ◽  
Izabella Krucińska ◽  
Witold Sujka
Keyword(s):  
Parastomal Hernia ◽  
3D Structure ◽  
Surgical Techniques ◽  
Current Standard ◽  
Intraperitoneal Onlay Mesh ◽  
Stoma Formation ◽  
Causal Treatment ◽  
Onlay Mesh ◽  
Prophylactic Use ◽  
Mesh Implant

A parastomal hernia is a common complication following stoma surgery. Due to the large number of hernial relapses and other complications, such as infections, adhesion to the intestines, or the formation of adhesions, the treatment of hernias is still a surgical challenge. The current standard for the preventive and causal treatment of parastomal hernias is to perform a procedure with the use of a mesh implant. Researchers are currently focusing on the analysis of many relevant options, including the type of mesh (synthetic, composite, or biological), the available surgical techniques (Sugarbaker’s, “keyhole”, or “sandwich”), the surgical approach used (open or laparoscopic), and the implant position (onlay, sublay, or intraperitoneal onlay mesh). Current surface modification methods and combinations of different materials are actively explored areas for the creation of biocompatible mesh implants with different properties on the visceral and parietal peritoneal side. It has been shown that placing the implant in the sublay and intraperitoneal onlay mesh positions and the use of a specially developed implant with a 3D structure are associated with a lower frequency of recurrences. It has been shown that the prophylactic use of a mesh during stoma formation significantly reduces the incidence of parastomal hernias and is becoming a standard method in medical practice.

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