scholarly journals External and internal oblique abdominis muscle release (eimr) for complex incisional hernia repair: Modification of partition surgical technique

2021 ◽  
pp. 69-76
Keyword(s):  
Incisional Hernia ◽  
Demographic Data ◽  
Incisional Hernia Repair ◽  
Intravesical Pressure ◽  
Hernia Surgery ◽  
Incisional Hernias ◽  
The Mean ◽  
And Gender ◽  
Relaxation Incision ◽  
Hernia Size

Incisional hernia is the name given to hernias that form in the incision site after abdominal operations. The only treatment option for incisional hernias is surgery and the repair of incisional hernias is still a serious issue for surgeons. The aim of this study is to present an alternative surgical treatment procedure for the treatment of incisional hernias. The study included patients who were diagnosed with complex incisional hernia and underwent surgery between November 2016 and December 2017. In addition to demographic data such as age and gender, the operative and postoperative morbidity and mortality rates were documented. The patients who underwent additional surgical procedure other than herniography were excluded from the study. The study included 16 patients who met the inclusion criteria. Of 16 patients, nine (56.25%) were male and seven (43.75%) were female. The mean age of the patients was 51.25 years and the mean body mass index was 25.3 kg/m2. The hernia size measured in the computed tomography was 11.01 cm on average in men and 11.56 cm on average in women. The intravesical pressure measured intraoperatively before the surgery was 3.4 mmHg on average. While the mean intravesical pressure was found as 12.25 mmHg after the abdomen was closed, the mean intravesical pressure was measured as 6.43 mmHg after the relaxation incision and graft installment. The duration of the surgery was 48 minutes on average. In the postoperative period, paralytic ileus responsive to treatment was observed in two patients and skin necrosis was observed in one patient. No pulmonary embolism, respiratory problems and compartment syndrome that may cause mortality developed in patients. No recurrence was observed in patients in the control one year after the surgery. The golden standard surgical method for the incisional hernia surgery has yet to be determined. There is still a need for prospective randomized studies. We believe that our technique can be an alternative to other techniques in the incisional hernia surgery due to its easy applicability and low rate of complications.

scholarly journals P062 IMPLEMENTATION OF ETEP (EXTENDED TOTALLY EXTRAPERITONEAL REPAIR) AS A NEW METHOD OF INCISIONAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Krzysztof Nowakowski ◽  
Ayman Waly Elkalash ◽  
thomas lahaye
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
New Method ◽  
Incisional Hernias ◽  
Totally Extraperitoneal ◽  
Artery Embolism ◽  
Sublay Technique ◽  
The Mean ◽  
Totally Extraperitoneal Repair

Abstract Aim To assess the outcomes of implementation of extended Totally Extraperitoneal Repair (eTEP) for incisional hernia in our clinic. Material and Methods In our clinic abdominal wall hernias are predominantly repaired in eMILOS (endoscopic Mini or Less Open Sublay)-technique. However, we hoped for advantages in repairing incisional hernias in eTEP-technique. From 19.09.2019 till 28.04.2021 there were 13 patients with incisional hernias included to be operated in eTEP-technique. Results Among 13 patients, mean age was 64,6 years (range 47 – 78 years), 7 females (54%) and 6 males (46%). Average diameter of the hernia was 6,46 cm (range 2 – 14 cm). The mean Body Mass Index of the patients was 29,41 kg/m² (range 18,4 – 48,76 kg/m²). The mean duration of the operation was 162,38 minutes (range 106 – 237 minutes). The mean surface of the mesh was 612 cm² (range 225 – 1200 cm²). Hospital stay lasted mean of 5,8 days (range 2 – 28 days). We observed one postoperative complication as a lung artery embolism occurred in one patient with preperitoneal heamatoma due to needed anticoagulation. Till today we have not observed any recurrence. Conclusions Our study shows that a new method of incisional hernia repair with mesh placement can be a safely implemented and may have advantages compering with other laparoscopic methods. It has low complication rate, shows good cosmetic results and is cost effective.

scholarly journals P018 COLLABORATIVE APPROACH FOR SIMULTANEOUS REPAIR OF COMPLEX INCISIONAL HERNIA AND STOMA REVERSAL

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Carles Olona ◽  
Aleidis Caro ◽  
Raquel Casanova ◽  
Beatriz Espina ◽  
Jordi Vadillo ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Surgical Techniques ◽  
Incisional Hernia Repair ◽  
Clinical Results ◽  
Intestinal Transit ◽  
Simultaneous Treatment ◽  
Incisional Hernias ◽  
The Mean

Abstract Aim The simultaneous repair of incisional hernias (IH) and the reconstruction of the intestinal transit may pose a challenge for many surgeons. Collaboration between units specialized in abdominal wall and colorectal surgery can favor simultaneous treatment. We present our experience in the collaboration between specialized units for the simultaneous treatment of complex incisional hernias and ostomy closure. Material and Methods Descriptive study of patients undergoing simultaneous surgery of complex IH repair and intestinal transit reconstruction in the period 2018.2021. All interventions were performed electively and with the collaboration of surgeons experts in abdominal wall and colorectal surgery. Demographic variables, hernias characteristics, surgical techniques, postoperative evolution, morbidity and mortality are recorded Results 16 patients are included. 8 with ileostomy, 3 lateral colostomies and 5 end colostomies . All the patients presented IH of the middle laparotomy and 12 had stomal hernias associated. The mean diameters of the IH were 16.2cm longitudinal and 11cm transverse. Intestinal transit was reconstructed in 15 cases (94%) and incisional hernia repair in 100%. Component separation was required in 75% of cases (8 posterior and 4 anterior). Morbidity in the first postoperative month was 18%, requiring 2 reoperations (12%). At the end of the mean follow-up of 10.8 months, 81% of the cases did not present complications. Conclusions The collaboration between specialist allows the use of advanced techniques in the simultaneous reconstruction of the abdominal wall and intestinal transit, with good clinical results and patient quality of life.

scholarly journals Patient-reported outcomes after incisional hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
N. van Veenendaal ◽  
M. M. Poelman ◽  
B. van den Heuvel ◽  
B. J. Dwars ◽  
W. H. Schreurs ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Patient Reported Outcomes ◽  
Incisional Hernia Repair ◽  
Hernia Surgery ◽  
Incisional Hernias ◽  
Patient Reported ◽  
Postoperative Symptoms

Abstract Purpose Patient-reported outcomes (PROs) are pivotal to evaluate the efficacy of surgical management. Debate persists on the optimal surgical technique to repair incisional hernias. Assessment of PROs can guide the selection of the best management of patients with incisional hernias. The objective of this cohort study was to present the PROs after incisional hernia repair at long term follow-up. Methods Patients with a history of incisional hernia repair were seen at the out-patient clinic to collect PROs. Patients were asked about the preoperative indication for repair and postoperative symptoms, such as pain, feelings of discomfort, and bulging of the abdominal wall. Additionally, degree of satisfaction was asked and Carolina Comfort Scales were completed. Results Two hundred and ten patients after incisional hernia repair were included with a median follow-up of 3.2 years. The main indication for incisional hernia repair was the presence of a bulge (60%). Other main reasons for repair were pain (19%) or discomfort (5%). One hundred and thirty-two patients (63%) reported that the overall status of their abdominal wall had improved after the operation. Postoperative symptoms were reported by 133 patients (63%), such as feelings of discomfort, pain and bulging. Twenty percent of patients reported that the overall status of their abdominal wall was the same, and 17% reported a worse status, compared to before the operation. Ten percent of the patients would not opt for operation in hindsight. Conclusion This study showed that a majority of the patients after incisional hernia repair still report pain or symptoms such as feelings of discomfort, pain, and bulging of the abdominal wall 3 years after surgery. Embedding patients’ expectations and PROs in the preoperative counseling discussion is needed to improve decision-making in incisional hernia surgery.

scholarly journals Initial Experience Of Laparoscopic Incisional Hernia Repair

1970 ◽  
Vol 5 (2) ◽  
pp. 41-45
Author(s):  
SK Biswas ◽  
MM Arefin ◽  
JC Saha ◽  
T Ahmed ◽  
MM Rahman
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Laparoscopic Repair ◽  
Operating Time ◽  
Incisional Hernia Repair ◽  
Safe Alternative ◽  
Laparoscopic Incisional Hernia Repair ◽  
Open Mesh Repair ◽  
The Mean ◽  
A Prospective Study

The laparoscopic incisional hernia repair is a safe alternative to open mesh repair. The procedure has the advantages of minimal access surgery and lower recurrence rate. A prospective study of laparoscopic incisional hernia repair of our first 11 patients was performed from July 2008 to December 2009. No serious intraoperative or postoperative morbidity was encountered, only two patients developed seroma. The mean operating time was 90 minutes (60 to 180 minutes). The mean day of discharge after surgery was 3 days (2-7 days). No patient developed a recurrence during mean follow up period of 10 months. Laparoscopic repair of incisional hernia has been shown to be feasible, safe and effective. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.Key Words: Incisional hernia; Laparoscopic repair; Mesh; Polypropylene DOI: 10.3329/fmcj.v5i2.6819Faridpur Med. Coll. J. 2010;5(2):41-45

scholarly journals OV10 LAPAROSCOPIC-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN HERNIA SURGERY - HOW WE DO IT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mário Rui Gonçalves ◽  
Conceição Antunes ◽  
Mariana Capinha ◽  
Ana Rita Arantes ◽  
Paulo Almeida ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Incisional Hernia Repair ◽  
Transversus Abdominis ◽  
Direct Visualization ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hernia Surgery ◽  
Surgical Department

Abstract Aim “COVID has been a great challenge for Hospitals around the world. At our surgical department a new protocol of TAP block was designed and implemented in our laparoscopic incisional ventral hernia repairs, to allow these patients to be operated in ambulatory regime, without compromising pain control and the outcomes. In this video we aim to present the technique for the Laparoscopic-guided TAP Block during a Laparoscopic IPOM Plus ventral hernia repair.” Material and Methods “We implemented this protocol in July 2020 and since then, we performed 18 TAP block in laparoscopic incisional hernia repairs, laparoscopic guided by the Surgeon or ultrasound-guided by the Anesthesiologist. In this case, the video reports to a Laparoscopic IPOM Plus incisional hernia repair performed on a 54-year-old patient, male, with obesity, arterial hypertension and dyslipidemia. He had a 6 centimeter incisional hernia post-colorectal surgery in 2013.” Results “As detailed in the video, we show all the steps to perform a TAP block under laparoscopic direct visualization” Conclusions “TAP block can be performed by the Surgeon, with direct visualization at the beginning of the laparoscopic procedure.”

scholarly journals P053 COMPARISON OF CLINICAL OUTCOMES BETWEEN INTRAPERITONEAL ONLAY MESH REPAIR (IPOM PLUS) AND ENHANCED-VIEW TOTALLY EXTRAPERITONEAL REPAIR (ETEP) FOR VENTRAL HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Hiroshi Hirukawa
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Transversus Abdominis ◽  
Incisional Hernias ◽  
Totally Extraperitoneal ◽  
Onlay Mesh ◽  
The Mean ◽  
Totally Extraperitoneal Repair ◽  
Hernia Size ◽  
Ventral Hernias

Abstract Aim We have been performing intraperitoneal on lay mesh repair (IPOM plus) as the standard laparoscopic procedure for ventral hernia in our department. We introduced enhanced-view totally extraperitoneal repair (eTEP) for ventral hernia repair in 2018, and have performed 31 cases so far. We compared the outcomes of IPOM Plus and eTEP at our institution. Material and Methods Ventral hernia cases who underwent surgery at our department between 2018 and 2020 were included in the study. The postoperative outcomes and complications of the IPOM Plus and eTEP groups were evaluated retrospectively. Results There were 12 cases of IPOM plus, and all were incisional hernias. There were 31 cases of eTEP, including 7 cases of primary hernias and 24 cases of incisional hernias. Transversus abdominis muscle release (TAR) was added in 24 cases. The mean hernia size was 6.6 x 7.9 cm with IPOM Plus and 8.0 x 10.1 cm with eTEP, and the average meshes size was 15.5 x 22.0 cm and 20.3 x 23.6 cm, respectively. The mean postoperative hospital stay was 7.8 days and 5 days. Postoperative complications included 1 case of mesh bulging and 1 case of recurrence in the IPOM Plus group, 1 case of seroma and 1 case of intestinal obstruction in the eTEP. Conclusions The surgical outcomes for ventral hernias up to 8 cm wide were similar for IPOM Plus and eTEP. The eTEP can insert a larger mesh and may be useful for wider hernias (>8cm).

scholarly journals SILS Incisional Hernia Repair: Is It Feasible in Giant Hernias? A Report of Three Cases

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Umut Barbaros ◽  
Tugrul Demirel ◽  
Aziz Sumer ◽  
Ugur Deveci ◽  
Mustafa Tukenmez ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Abdominal Wall ◽  
Single Incision ◽  
Anterior Abdominal Wall ◽  
Oral Intake ◽  
Operation Time ◽  
Incisional Hernia Repair ◽  
Composite Mesh ◽  
First Case ◽  
The Mean

Aim. Three incisional ventral abdominal wall hernias were repaired by placing a 20 × 30 cm composite mesh via single incision of 2 cm. Methods. All three cases had previous operations and presented with giant incisional defects clinically. The defects were repaired laparoscopically via single incision with the placement of a composite mesh of 20 × 30 cm. Nonabsorbable sutures were needed to hang and fix the mesh only in the first case. Double-crown technique was used in all of the cases to secure the mesh to the anterior abdominal wall. Results. The mean operation time was 120 minutes. The patients were mobilized and led for oral intake at the first postoperative day. No morbidity occurred. Conclusion. Abdominal incisional hernias can be repaired via single incision with a mesh application in experienced centers.

scholarly journals Triple mesh technique in repair of recurrent lumbar incisional hernia

2019 ◽  
Vol 7 (12) ◽  
pp. 4803
Author(s):  
Archit Pankaj Kumar Parikh ◽  
Parth Parikh ◽  
Dhaval Vadodariya ◽  
Jignesh P. Dave ◽  
Jatin G. Bhatt
Keyword(s):  
Incisional Hernia ◽  
Incisional Hernia Repair ◽  
Clinical Findings ◽  
Erector Spinae ◽  
Oblique Muscle ◽  
Diagnostic Modality ◽  
Incisional Hernias ◽  
Post Traumatic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Lumbar hernias occur infrequently and can be congenital, primary (inferior or Petit type, and superior or Grynfeltt type), post-traumatic, or incisional. They are bounded by the 12th rib, the iliac crest, the erector spinae, and the external oblique muscle. Most postoperative incisional hernias occur in nephrectomy or aortic aneurysm repair incisions for which various surgical method in context of meshplasty are available. In this case 60 yr. male hypertensive patient presented to the outpatient clinic of institute with recurrent left side lumbar incisional hernia, patient was previously operated for left side nephrolithiasis 15 years back and onlay meshplasty 2 years back for incisional hernia. The patient was operated under high risk for recurrent incisional hernia repair by triple layered meshplasties in the same sitting. Lumbar incisional hernias are often diffuse with fascial defects that are usually hard to appreciate. Computed tomography scan is the diagnostic modality of choice with adjuvant clinical findings, which allows differentiating them from abdominal wall musculature denervation atrophy complicating flank incisions. Repairing these hernias is difficult due to the surrounding structures for which our surgical approach included a triple mesh repair consisting of underlay, inlay and onlay meshplasty thereby anticipating further such incidences of incisional hernia.

scholarly journals Laparoscopic versus open incisional hernia repair: comparative non-randomized study

2017 ◽  
Vol 4 (7) ◽  
pp. 2216
Author(s):  
Wael Barakaat Ahmed Mohamed ◽  
Magdy Khalil Abdelmgeed
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Incisional Hernia Repair ◽  
P Value ◽  
Inclusion Criteria ◽  
Laparoscopic Incisional Hernia Repair ◽  
The Mean ◽  
Repair Group

Background: One of the most common complications of laparotomy is Incisional hernia, with an estimated incidence of 3-20%. The objective of this study was to compare the outcome of patients after laparoscopic and open incisional hernia repair.Methods: This was a prospective observational comparative study, in Sohag University Hospital, Sohag, Egypt. All adult patients who fulfilled our inclusion criteria underwent laparoscopic or open incisional hernia repair from September 2013 to September 2016 were included in the study. Primary outcome measure of this study was recurrence rate, wound infection. And secondary outcome measure of this study was operative time, postoperative complications and hospital stay.Results: Between September 2013 and September 2016, 60 patients with incisional hernia had fulfilled our inclusion criteria were operated at the general surgery department at Sohag university hospitals, Sohag, Egypt. 31 patients had open incisional hernia repair and 29 had laparoscopic incisional hernia repair. The mean age for laparoscopic repair group was 45.69±7.66 years and for open repair group was46.94±8.08 years p value 0.543. In laparoscopic group male to female ratio 20/9 was while in open group it was16/15 p value 0.197.the mean body mass index for laparoscopic group was29.83±3.56kg/m2 and for open group30.00±3.32kg/m2 p value= 0.873. the most significant finding was hospital stay which was significantly shorter in laparoscopic incisional hernia repair group p value was 0.000 as well as wound infections were significantly lower in laparoscopic incisional hernia repair group p value was 0.05. there was no significant difference between both groups as regard operative time, bowel injury intraoperative complication postoperative complications as well as recurrence rate. The mean follows uptime was 27.24±3.04 months for laparoscopic incisional hernia group and 27.12±3.06 months for open group.Conclusions: Laparoscopic incisional hernia repair is a safe alternative to laparoscopic incisional hernia repair with a shorter hospital stay and a lower wound complication.

scholarly journals Prolene Hernia System, Ultrapro Hernia System and 3D patch devices in the treatment of inguinal, femoral, umbilical and small incisional hernias in outpatient surgery

2010 ◽  
Vol 57 (2) ◽  
pp. 49-54 ◽  
Author(s):  
D. Dabic ◽  
S. Cerovic ◽  
B. Azanjac ◽  
B. Maric ◽  
I. Kostic
Keyword(s):  
Abdominal Wall ◽  
Outpatient Surgery ◽  
Operating Time ◽  
Young Patients ◽  
Normal Activity ◽  
Abdominal Wall Defects ◽  
Hernia Surgery ◽  
Incisional Hernias ◽  
Prolene Hernia System ◽  
The Mean

Introduction: The employment of a diversity of prosthetic materials and several types of mesh different in construction is opening a new chapter in hernia surgery and tension-free techniques are becoming a 'golden standard' for repairing abdominal wall defects, whereas the conventional methods, i.e. the tension techniques are performed on young patients having small direct, indirect, or femoral hernias. Aim: The aim of this retrospective study is to present the results of using Prolene Hernia System (PHS), Ultrapro Hernia System (UHS) and 3D Patch (3DP) devices in the treatment of inguinal, femoral, umbilical and small incisional hernias in outpatient surgery. Material and methods: From January 2006 to January 2009, 70 patients were operated on for abdominal wall hernias (54 inguinal, 4 femoral, 8 umbilical and 4 small incisional hernias) using PHS, UHS and 3DP devices. All the patients underwent surgery under local infiltrative anaesthesia. All the surgical operations were performed by a single surgeon, 19 of them in the General Hospital and 51 in a private polyclinic. Results: The mean size of the hernia defect in the inguinal, femoral and umbilical hernias was 2.5cm (1- 4cm), while in the incisional hernias it was 4.5cm (3- 6cm). The mean operating time was 2.4hrs (2-6hrs). There were no requirement for urinary drains. The mean follow-up was 18 months (0-36 months). The incidence of infection, chronic pain and recurrence was 0%. Three of the patients had complications: seroma in one patient with an incisional hernia and hematoma in two patients after inguinal hernia repair. Conclusion: The employment of PHS, UHS and 3DP devices, which have not yet been widely accepted in our hospitals, has had outstanding results in outpatient surgery. In addition, the type of anaesthesia and the 3D mesh construction prepare the way for a short hospital stay, smooth recovery and a swift return to normal activity.

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