scholarly journals Current trends in diagnostic and treatment tactics in patients with strangulated ventral hernias

2021 ◽  
Vol 23 (4) ◽  
pp. 583-589
Author(s):  
B. I. Slonetskyi ◽  
М. I. Tutchenko ◽  
I. V. Verbytskyi ◽  
V. O. Kotsiubenko
Keyword(s):  
Abdominal Wall ◽  
Critical Evaluation ◽  
Abdominal Wall Hernia ◽  
Integrated Approach ◽  
Hernia Surgery ◽  
Tension Free ◽  
Urgent Surgery ◽  
Current Trends ◽  
Selective Approach ◽  
Ventral Hernias

The aim of the work. To analyze the world achievements in modern diagnostic and treatment tactics in patients with strangulated ventral hernias, as well as to outline promising and pragmatic directions for further research. The literature review presents current trends and views on the choice of individual components of the integrated diagnostic approach in patients with strangulated ventral hernias, and focuses on various principles of therapeutic tactics. The need to further improve the examination methods of abdominal organs, anterior abdominal wall, hernia contents (polypositional roentgenoscopy or roentgenography, ultrasound, CT, MRI) is emphasized and prospects of allohernioplasty and videolaparoscopic technologies with an integrated approach in choosing the method for correction or reconstruction of abdominal wall depending on the prognostic risk factors of postoperative complications are substantiated. Comparison of individual priorities of planned hernia surgery provided the opportunity to define the main directions in terms of urgent medical treatment features for patients with strangulated ventral hernias, taking into account a phasal nature of the pathological process and the availability and applicability of various synthetic implants. The literature analysis allowed for enough critical evaluation of the current state of tension-free allohernioplasty – the main fundamental principle of modern urgent surgery for ventral hernias and determining the main pragmatic directions of a selective approach in choosing the therapeutic tactics for patients with infected surgical wound. Conclusions. Urgent surgery of strangulated ventral hernias requires adequate and timely provision of individual and differentiated approaches in choosing the volume and method of surgery. Improvement of methods for predicting and preventing complications in patients with strangulated ventral hernias will expand the indications for the use of advanced types of tension-free hernioplasty.

Clinical and Biochimical Comorbidities and Complications in Abdominal Surgery Using Synthetic Prosthetic Material

2018 ◽  
Vol 69 (6) ◽  
pp. 1519-1523
Author(s):  
Vlad Dumitru Baleanu ◽  
Danut Vasile ◽  
Alexandru Marian Goganau ◽  
Paul Ioan Tomescu ◽  
Dragos Davitoiu ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Prosthetic Material ◽  
Hernia Surgery ◽  
Tension Free ◽  
Elective Repair ◽  
Scrotal Edema ◽  
Remarkable Recovery ◽  
Risks Assessment

Hernia can be defined as an organ disorder which protrudes the wall that contains it. Synthetic material for the repair of the abdominal wall are used frequently with good results and less complications. Our research included a number of 135 patients diagnosed with inguinal hernia hospitalized and operated in Clinical County Hospital of Craiova, between 1st January 2017-31 October 2017. The purpose of our work was to identify and analyze comorbidities and complications for inguinal hernia repaired with synthetic prosthetic material. hernia repair was performed in 135 patients, 16 were women and 119 were men. Tension free meshplasty was accomplished in 131 patients with uncomplicated inguinal hernia and herniorrhaphy was successfully performed at 4 patients with complicated inguinal hernia. From our study 107 patients had a remarkable recovery without any complication. Patients who underwent tension-free hernia surgery using prosthetic mesh,short-term complications were represented by 19 patients with urinary retention, 6 surgical local infection (superficial infections) and 2 scrotal edema. Nowadays surgeons try to find the best elective repair of inguinal hernia,to be safety for the patients despite of their age and with few complications and low mortality rate. Risks assessment include general conditions and associated comorbidities of the patients. In our study we reveal the type of comorbidities which we meet. We considered that it is significant to optimize cardiopulmonary status and the other comorbidities of the patient before to repair abdominal wall hernia in order to avoid both short and long term complication.

scholarly journals Biocompatibility of implants in planned and urgent hernia surgery

2021 ◽  
Vol 23 (1) ◽  
pp. 152-158
Author(s):  
B. I. Slonetskyi ◽  
M. I. Tutchenko ◽  
I. V. Verbytskyi ◽  
V. O. Kotsiubenko
Keyword(s):  
Surgical Intervention ◽  
Integrated Approach ◽  
Physicochemical Characteristics ◽  
Modern World ◽  
Hernia Surgery ◽  
Surgical Interventions ◽  
Selective Approach ◽  
Reparative Process ◽  
Clean Contaminated ◽  
Ventral Hernias

The aim of the work – to analyze modern scientific and practical achievements in the effectiveness of implants in planned and emergency hernia surgery and to identify promising areas for further research. The literature review presents modern views on the assessment of biocompatibility, effectiveness and appropriateness of the use of implants in planned and urgent hernia surgery. The importance of determining the main factors of ventral hernia occurrence, assessing the prognostic components of the reparative process course in the field of hernioplasty and methods of correction has been substantiated. Physicochemical characteristics of implants, which both historically and on an up-to-date level are used according to planned or urgent conditions for performing surgical intervention in patients with ventral hernias, are given. The necessity of using an integrated approach to choosing a method for correction or reconstruction of the abdominal wall, taking into account the biological and dynamic conditions of its state, is shown. The need for a selective approach to the choice of therapeutic tactics in patients, especially if hernia repair is necessary in conditions of a clean-contaminated or infected surgical wound, is emphasized. Conclusions. In order to improve the consequences of hernioplasty, it is necessary to assess patient's reserves and risks more thoroughly and comprehensively, as well as to make absolute indications for the use of implants. An improvement in the results of urgent and planned repair of ventral hernias is to perform surgical interventions only in surgery departments constantly provided with modern world achievements.

scholarly journals Current trends in hernia surgery in NHS England

2020 ◽  
Vol 102 (1) ◽  
pp. 25-27 ◽  
Author(s):  
M Pawlak ◽  
B Tulloh ◽  
A de Beaux
Keyword(s):  
Abdominal Wall ◽  
Primary Endpoint ◽  
Mesh Repair ◽  
Significant Proportion ◽  
Abdominal Wall Hernia ◽  
Suture Repair ◽  
Hernia Surgery ◽  
Current Trends ◽  
Primary Hernia ◽  
Prevention Of Recurrence

Background Mesh is recommended for the repair of most hernias when prevention of recurrence is the primary endpoint. However, mesh may be associated with increased complications for the patient. The aim of this study was to quantify the use of mesh for abdominal wall hernia surgery in NHS England in recent years. Materials and methods The NHS Digital Secondary Uses Service database for 2016/17 and 2017/18 was interrogated for numbers of patient undergoing elective primary hernia surgery. Using the specific hernia code inguinal (T201-9), umbilical (T241-9), incisional (T251-9) and other abdominal wall hernia (T271-9), the use of mesh or suture repair was determined. Recurrent and emergency hernia surgery were excluded. All data were provided by NHS RightCare. Results There are almost 100,000 hernia repairs performed annually in NHS England. For every four hernias, three are repaired with mesh. The percentage repaired by mesh varies by hernia type. Mesh repairs in inguinal, umbilical and incisional hernias accounted for 95%, 50% and 82%, respectively. Conclusions Mesh repair for all hernia types is more common than suture repair. However, for umbilical and other abdominal wall hernias, a significant proportion are repaired without the use of mesh.

Biological Implants in Abdominal Wall Hernia Surgery

2013 ◽  
Vol 91 (4) ◽  
pp. 217-223
Author(s):  
Manuel López Cano ◽  
Manuel Armengol Carrasco ◽  
María Teresa Quiles Pérez ◽  
María Antonia Arbós Vía
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Hernia Surgery ◽  
Biological Implants

Diagnosis of Mesh Infection after Abdominal Wall Hernia Surgery - Role of Radionuclide Methods

2011 ◽  
Vol 58 (110-111) ◽  
Author(s):  
Marinko Žuvela ◽  
Andrija Antić ◽  
Djordje Bajec ◽  
Dejan Radenković ◽  
Milorad Petrović ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Mesh Infection ◽  
Hernia Surgery

Specific improvement measures to reduce complications and mortality after urgent surgery in complicated abdominal wall hernia

Hernia ◽  
2011 ◽  
Vol 16 (2) ◽  
pp. 171-177 ◽  
Author(s):  
M. Á. Martínez-Serrano ◽  
J. A. Pereira ◽  
J. Sancho ◽  
N. Argudo ◽  
M. López-Cano ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Urgent Surgery ◽  
Improvement Measures ◽  
Complications And Mortality

scholarly journals Perioperative Tablet-Based Telemonitoring After Abdominal Wall Hernia Surgery: Pilot Prospective Observational Cohort Study (Preprint)

2019 ◽  
Author(s):  
Alexander Gräfitsch ◽  
Philipp Kirchhoff ◽  
Henry Hoffmann ◽  
Ralph F Staerkle ◽  
Savas D Soysal ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Surgical Repair ◽  
Abdominal Wall Hernia ◽  
Activity Levels ◽  
Hernia Surgery ◽  
Entire Study ◽  
Median Proportion ◽  
Activity Measurements ◽  
Outpatient Settings

BACKGROUND Hernia repairs account for millions of general surgical procedures performed each year worldwide, with a notable shift to outpatient settings over the last decades. As technical possibilities such as smartphones, tablets, and different kinds of probes are becoming more and more available, such systems have been evaluated for applications in various clinical settings. However, there have been few studies conducted in the surgical field, especially in general surgery. OBJECTIVE We aimed to assess the feasibility of a tablet-based follow up to monitor activity levels after repair of abdominal wall hernias and to evaluate a possible reduction of adverse events by their earlier recognition. METHODS Patients scheduled for elective surgical repair of minor abdominal wall hernias (eg, inguinal, umbilical, or trocar hernias) were equipped with a telemonitoring system, including a tablet, pulse oximeter, and actimeter, for a monitoring phase of 7 days before and 30 days after surgery. Descriptive statistical analyses were performed. RESULTS We enrolled 16 patients with a mean overall age of 48.75 (SD 16.27) years. Preoperative activity levels were reached on postoperative day 12 with a median of 2242 (IQR 0-4578) steps after plunging on the day of surgery. The median proportion of available activity measurements over the entire study period of 38 days was 69% (IQR 56%-81%). We observed a gradual decrease in the proportion of available data for all parameters during the postoperative course. Six out of ten patients (60%) regained preoperative activity levels within 3 weeks after surgery. Overall, patients rated the usability of the system as relatively easy. CONCLUSIONS Tablet-based follow up is feasible after surgical repair of minor abdominal wall hernias, with good adherence rates during the first couple of weeks after surgery. Thus, such a system could be a useful tool to supplement or even replace traditional outpatient follow up in selected general surgical patients.

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