Open Retromuscular Repair of Parastomal Hernias with Synthetic Mesh

2017 ◽  
Vol 83 (8) ◽  
pp. 906-910 ◽  
Author(s):  
Lucas R. Beffa ◽  
Jeremy A. Warren ◽  
William S. Cobb ◽  
Bryan Knoedler ◽  
Joseph A. Ewing ◽  
...  
Keyword(s):  
Open Repair ◽  
Synthetic Mesh ◽  
Hernia Recurrence ◽  
Transversus Abdominis ◽  
Significant Morbidity ◽  
Transversus Abdominis Release ◽  
Exact Test ◽  
Retromuscular Repair ◽  
Repair Techniques

Parastomal hernias (PHs) cause significant morbidity in patients with permanent ostomies, and several laparoscopic and open repair techniques have been described. We report our experience with open retromuscular repair of PHs using permanent synthetic mesh. A prospectively maintained database was retrospectively reviewed to identify patients undergoing PH repair. Primary outcomes are surgical site occurrence, surgical site infection (SSI), and hernia recurrence. Variables were analyzed using Pearson's χ2 test or Fisher's exact test. Values of P < 0.05 were considered significant. Forty-six patients underwent retromuscular PH repair with permanent synthetic mesh. There were 26 patients with colostomies and 20 with ileostomies. All the patients were repaired using a keyhole retromuscular technique and direct passage of stoma through mesh. Transversus abdominis release was performed in 65.2 per cent of cases. Permanent synthetic polypropylene mesh was used in all cases. Surgical site occurrence occurred in 47.8 per cent of patients, SSI in 17.4 per cent, and hernia recurrence in 21.7 per cent. Resiting the stoma yielded the highest rate of SSI (40%) compared with leaving the stoma in situ (11.8%) or rematuring the stoma (0%; P = 0.011). Open keyhole retromuscular PH repair of PH with permanent synthetic mesh is safe, effective, and durable.

Endoscopic transversus abdominis release separation in the treatment of patients with midline incisional hernias

2020 ◽  
Vol 22 (3) ◽  
pp. 82-87
Author(s):  
V. A. Burdakov ◽  
A. A. Zverev ◽  
S. A. Makarov ◽  
V. V. Strizheletsky ◽  
G. M. Rutenburg ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Early Postoperative Period ◽  
Hernia Recurrence ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release ◽  
Totally Extraperitoneal ◽  
Transabdominal Preperitoneal ◽  
Simultaneous Operations ◽  
Ventral Hernias

Abstract. The issues of reconstruction of the anterior abdominal wall in patients with median postoperative ventral hernias remain relevant for many years. The paradigm of their treatment is gradually shifting towards functional minimally invasive reconstructions of the anterior abdominal wall. The indications and technical aspects of endoscopic posterior separation surgery are considered. The analysis of 70 transversus abdominis release was carried out. The average age of patients with postoperative ventral hernias was 61,210 years. The median follow-up was 14,28,2 months and the anaesthesia risk was 2,80,5. The mean hernia width was 151,773,7 cm2 and the implant size was 832,9243,3 cm2. In the early postoperative period complications were observed in 7 (10%) patients, including the one with retromuscular hematoma, four with retromuscular space infection and two with superficial vein thrombophlebitis. Late complications were observed in 6 (8,7%) patients, there were persistent seroma (3) and chronic pain (3). No hernia recurrence was detected during this period. Thus, the use of endoscopic abdominal wall separation reduces the risk of local complications compared to similar open surgery. At the same time, there is a low level of hernia recurrence and a satisfactory quality of life. In total there were 70 (100%) transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release operations performed, among them 14 (77,8%) were bilateral transversus abdominis release and 32 (61,5%) were unilateral transversus abdominis release 4 (22,2%) and 20 (38,4%) respectively were transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal 10 (14,3%) operations with combined access were performed: 3 (16,7%) and 7 (1,5%) respectively transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release. In 13 (18,6%) cases simultaneous operations occurred, including 7 (10%) laparoscopic cholecystectomy and 6 (8,6%) endoscopic inguinal hernioplasty.

scholarly journals Use of posterior component separation and transversus abdominis release in trauma and emergency general surgery patients: a case report and review of the literature

2019 ◽  
Vol 4 (1) ◽  
pp. e000268
Author(s):  
John J Como ◽  
Oliver L Gunter ◽  
Jose J Diaz ◽  
Vanessa P Ho ◽  
Preston R Miller
Keyword(s):  
General Surgery ◽  
Relevant Literature ◽  
Synthetic Mesh ◽  
Component Separation ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release ◽  
Emergency General Surgery ◽  
Recurrence Rates ◽  
Posterior Component Separation ◽  
Incisional Hernias

Posterior component separation with transversus abdominis release and implantation of synthetic mesh in the retromuscular space is a durable type of repair for many large incisional hernias with recurrence rates consistently less than 10%. The purported advantage of biologic prostheses in contaminated fields has recently been challenged, and the concern for placing synthetic mesh in contaminated fields may be overstated. There are almost no data specifically addressing the use of this type of repair for chronic incisional hernias in trauma and emergency general surgery patients, so research is needed on this patient population. In this review, a case of a trauma patient receiving posterior component separation with transversus abdominis release and implantation of synthetic mesh for a chronic incisional hernia resulting from a gunshot wound to the abdomen is presented, the technique is explained, and relevant literature is reviewed.

Comparison of Functional Ability Following Percutaneous and Open Surgical Repairs of Acutely Ruptured Achilles Tendons

1993 ◽  
Vol 2 (2) ◽  
pp. 115-127 ◽  
Author(s):  
Gregory J. Steele ◽  
Rod A. Harter ◽  
Arthur J. Ting
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Plantar Flexion ◽  
Secondary Purpose ◽  
Percutaneous Repair ◽  
Study Results ◽  
Male Patients ◽  
Flexion Strength ◽  
Repair Group ◽  
Repair Techniques

The purpose of our study was to evaluate the functional outcomes of two methods of surgical treatment of acute closed raptures of the Achilles tendon, specifically, the primary open repair and the percutaneous repair techniques, utilizing (a) isokinetic plantar flexion strength, (b) midcalf girth, (c) ankle joint proprioception, and (d) ankle range of motion values. As a secondary purpose, the frequency of reruptures and postsurgical complications were compared between techniques. Twenty male patients (mean age, 43.8 ± 9.4 years) who sustained complete, closed ruptures of the Achilles tendon participated in this study. Results of pairedttests revealed significant differences between postsurgical and contralateral normal limbs for 6 of 12 variables. Results of the ANOVAs revealed no significant differences between the open repair group and percutaneous repair group for any of the evaluative parameters. The significant deficits in postoperative isokinetic plantar flexion strength and midcalf girth measurements, irrespective of surgical technique, suggest an incompleteness of rehabilitation or, more likely, the physiological inability to regain these characteristics postoperatively.

scholarly journals Evaluating HER2 Gene Amplification Using Chromogenic In Situ Hybridization (CISH) Method In Comparison To Immunohistochemistry Method in Breast Carcinoma

2018 ◽  
Vol 6 (11) ◽  
pp. 1977-1981 ◽  
Author(s):  
Hadi Atabati ◽  
Amir Raoofi ◽  
Abdollah Amini ◽  
Reza Masteri Farahani
Keyword(s):  
Breast Cancer ◽  
In Situ Hybridization ◽  
Gene Amplification ◽  
Method Comparison ◽  
Her2 Expression ◽  
Her2 Gene ◽  
Cross Sectional ◽  
Exact Test ◽  
Chromogenic In Situ Hybridization

BACKGROUND: In patients with breast cancer, HER2 gene expression is of a great importance in reacting to Herceptin treatment. To evaluate this event, immunohistochemistry (IHC) has been done routinely on the basis of scoring it and so the patients were divided into 4 groups. Lately, as there have been disagreements about how to treat score 2 patients, chromogenic in situ hybridization (CISH) and florescence in situ hybridization (FISH) are introduced. Since CISH method is more convenient than FISH for gene amplification study, FISH has been substituted by CISH. AIM: The current study is conducted in order to investigate whether using CISH is a better method comparison to IHC method for determines HER2 expression in patients with breast cancer in. METHODS: In this cross-sectional descriptive analytical study, information of 44 female patients with invasive ductal breast cancer were gathered from Imam Reza and Omid Hospital in Mashhad. IHC staining was done for all patients in order to determine the level of HER2 expression, and after scoring them into 4 groups of 0, +1, +2 and +3, CISH staining was carried out for all 4 groups. At the end, results from both methods were statistically evaluated using SPSS software V.22.0. RESULTS: The average age of patients was 50.2 with the standard deviation of 10.96. Using IHC method was observed that 2.6% (1 patient), 26.3% (10 patients), 65.8% (25 patients) and 5.3% (2 patients) percentage of patients had scores of 0, +1, +2 and +3. On the other hand, CISH method showed 36 patients (90%) with no amplifications and 4 (10%) with sever amplifications. In a comparative study using Fisher's exact test (p = 0.000), we found a significant relation between IHC method and CISH method indicating that all patients showing severe amplifications in CISH method, owned scores of +2 and +3 in IHC method. CONCLUSION: According to the present study and comparing the results with similar previous studies, it can be concluded that CISH method works highly effective in determining HER2 expression level in patients with breast cancer. This method is also able to determine the status of patients with score +2 in IHC for their treatment with herceptin

Systematic review of transversus abdominis release in complex abdominal wall reconstruction

Hernia ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 5-15 ◽  
Author(s):  
J. A. Wegdam ◽  
J. M. M. Thoolen ◽  
S. W. Nienhuijs ◽  
N. de Bouvy ◽  
T. S. de Vries Reilingh
Keyword(s):  
Systematic Review ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release
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