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

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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Perioperative Tablet-Based Telemonitoring After Abdominal Wall Hernia Surgery: Pilot Prospective Observational Cohort Study

JMIR Perioperative Medicine ◽

10.2196/15672 ◽

2020 ◽

Vol 3 (2) ◽

pp. e15672

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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Hernia rationing: an assessment of commissioning guidelines

Bulletin of The Royal College of Surgeons of England ◽

10.1308/rcsbull.2021.74 ◽

2021 ◽

Vol 103 (4) ◽

pp. 192-195

Author(s):

W Gewanter ◽

T Hubbard ◽

D Ferguson

Keyword(s):

Hernia Repair ◽

Abdominal Wall ◽

Surgical Repair ◽

Abdominal Wall Hernia ◽

Emergency Repair ◽

Number Of Patients ◽

Almost All ◽

Surgical Hernia Repair ◽

The Impact

Introduction Hernias are a common surgical condition. Most guidelines recommend repair in almost all cases. NHS Devon clinical commissioning group (CCG) guidelines restrict the commissioning of hernia repair. The aim of this study was to follow up a cohort of patients referred for hernia repair to assess the impact of commissioning guidelines on clinical outcomes. Methods All patients referred to a single UK surgeon with an abdominal wall hernia over a 12-month period were followed up to determine whether CCG criteria were initially met. If they were not, time to any subsequent surgical intervention was recorded. Results After exclusions, 106 patients referred for abdominal wall hernia repair were followed up. Of these, 53 (49%) fulfilled commissioning guidelines for surgical repair. Thirty-one patients (23%) who had an indication for surgical repair did not fulfil commissioning criteria. This group was followed up for a median of 1,112 days (range: 962–1,287 days). Twelve patients (39%) required an operation within 900 days with one of these (3%) requiring emergency repair. These 12 patients waited a mean of 232 days before being accepted for surgery. Conclusions A large number of patients who did not initially meet NHS Devon CCG’s criteria ultimately required surgery. Three per cent of this ‘watch and wait’ group required emergency repair. NHS Devon CCG guidelines do not effectively identify patients who can be managed safely without surgical hernia repair. The incidence of emergency repair in this group should inform the prioritisation of hernia repairs when restarting elective services that have been halted because of the COVID-19 pandemic.

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

Revista de Chimie ◽

10.37358/rc.18.6.6359 ◽

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.

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Biological Implants in Abdominal Wall Hernia Surgery

Cirugía Española (English Edition) ◽

10.1016/j.cireng.2013.09.006 ◽

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

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Watchful Waiting versus Surgery for Inguinal Hernia

10.1093/med/9780199384075.003.0018 ◽

2017 ◽

Author(s):

Rachel J. Kwon

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Clinical Case ◽

Watchful Waiting ◽

Surgical Repair ◽

Hernia Surgery ◽

Study Intervention ◽

Landmark Study

This chapter provides a summary of a landmark study in hernia surgery. For men with minimally symptomatic inguinal hernias, does deferring surgical repair until symptoms develop lead to worse outcomes with respect to pain and physical function? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving inguinal hernia repair.

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