Repair of Ventral Abdominal Wall Hernias

2020 ◽  
Author(s):  
Michael J. Rosen ◽  
Clayton C. Petro
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Incisional Hernia Repair ◽  
Population Based ◽  
Difficult Problem ◽  
Abdominal Wall Defects ◽  
Special Circumstances ◽  
Ventral Hernias

The repair of noninguinal abdominal wall defects is one of the most common procedures general surgeons perform. Despite this, there is little agreement or consensus in the literature as to the ideal approach for this difficult problem. In recent years, population-based studies have provided better data on the true failure rates associated with the various herniorrhaphies. Wound morbidity has also emerged as an important outcome measure, and definitions by the Ventral Hernia Working Group (VHWG) have begun to standardize such benchmarks. Future evidence will come from the large multi-institutional collaborations currently forming. This topic review discusses the classification of ventral hernias, abdominal wall anatomy, and choices of prosthetic materials. Incisional hernia repair is discussed, as are the operative steps and techniques for both an open and a laparoscopic ventral hernia repair. Special circumstances, including loss of abdominal domain and contaminated surgical fields, periumbilical hernia repair, and atypical ventral hernias are also described.  This review contains 10 figures, 18 tables, and 71 references. Keywords: Hernia, incisional hernia, mesh, laparotomy, laparoscopy, incarceration, surgical site infection, hernia repair

scholarly journals Da-Silva, Malmo Peritoneal Flap in Ventral and Incisional Hernia Repair Our Experience

2021 ◽  
Vol 11 (5) ◽  
pp. 353-357
Author(s):  
Chinmay Gandhi ◽  
Mahesh Zaware
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Local Population ◽  
Incisional Hernia Repair ◽  
Peritoneal Flap ◽  
Large Ventral Hernia ◽  
Tier 3 ◽  
Ventral Hernias ◽  
Ventral And Incisional Hernia

Large ventral hernia is a challenge to operate in tier 3 cities of India, because of economic constrains of local population. Here author reports three large ventral hernias operated with use of Da-Silva, Malmo peritoneal flap technique. Peritoneal flap should be integral part of abdominal wall repair procedures. It reduces cost, morbidity and mortality of a large ventral hernia repair. It is a useful method for repair of large ventral and incisional hernia when primary fascial closer is not achievable. Key words: peritoneal flap, ventral hernia, incisional hernia.

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.”

Opioid Use After Inguinal and Ventral Hernia Repair

2020 ◽  
Vol 86 (8) ◽  
pp. 965-970
Author(s):  
Jessica L. Millard ◽  
Robyn Moraney ◽  
Jordan C. Childs ◽  
Joseph A. Ewing ◽  
Alfredo M. Carbonell ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Inguinal Hernia Repair ◽  
Patient Reported Outcomes ◽  
Opioid Use ◽  
Patient Reported ◽  
Primary Ventral Hernia ◽  
Ventral Hernias

Background Recent data on opioid consumption indicate that patients typically require far less than is prescribed. Prisma Health Upstate Hernia Center adopted standardized postoperative prescribing after hernia repair and began tracking patient-reported opioid utilization. The aim of this study is to evaluate patient opioid use after hernia repair in order to guide future prescribing. Methods All patients who underwent primary ventral (umbilical and epigastric), incisional, and inguinal hernia repair between February and May 2019 were reviewed. Patients reported the number of opioid pills taken at their first postoperative visit and documented either in the progress note or in the Americas Hernia Society Quality Collaborative (AHSQC) patient-reported outcomes (PRO) questionnaire. All demographic, operative, and outcomes data were captured prospectively in the AHSQC. Opioid use reported as milligram morphine equivalents (MME). Results A total of 162 surgeries were performed during the study period, and 107 had patient-reported opioid use for analysis. Inguinal hernia repair was performed in 36 patients, 10 primary ventral hernia repairs, and 61 incisional hernia repairs. No opioid use was reported in 63.9% of inguinal hernias, 60% of primary ventral hernias, and 20% of incisional hernias. Inguinal hernia patients consumed a mean of 10.5 MME, primary ventral patients 11 MME, and incisional hernia patients 78.5 MME. Conclusion Patients require little to no opioid after primary ventral or inguinal hernia repair and opioid-free surgery is feasible. Incisional hernia is more heterogenous, but the majority of patients still required less opioid than previously thought.

Patient reported outcomes after incisional hernia repair—establishing the ventral hernia recurrence inventory

2016 ◽  
Vol 212 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Rebeccah B. Baucom ◽  
Jenny Ousley ◽  
Irene D. Feurer ◽  
Gloria B. Beveridge ◽  
Richard A. Pierce ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Patient Reported Outcomes ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Patient Reported

scholarly journals EP.TH.108A Descriptive Case Series of Incisional Hernia Repair Using Dual Mesh Technique

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Chloe Theodorou ◽  
Zia Moinuddin ◽  
David Van Dellen
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Surgical Techniques ◽  
Case Series ◽  
Incisional Hernia Repair ◽  
Fistula Formation ◽  
Mesh Technique ◽  
Dual Mesh

Abstract Aims Incisional hernias are a common complication after surgery that cause significant patient morbidity. Symptomatic patients are offered repair but many surgical techniques exist, with abdominal wall reconstruction becoming preferable for large complex defects. This paper describes our experience of abdominal wall reconstruction using a dual mesh technique. Method 22 patients underwent incisional hernia repair between March 2019 and September 2020. All patients received dual mesh, placed in retrorectus or transversalis fascial/retromuscular space. Absorbable BIO-A GORE mesh was used with a polypropylene mesh above. All patients were followed up to assess for complications and recurrence. Results No patients experienced fistula formation, long-term pain or obstructive symptoms. We report one true hernia recurrence (4.5%) and one case of infected mesh (4.5%), these both await further treatment. One patient had a proven wound infection which resolved with conservative treatment. 4 patients (18.2%) experienced seromas, 3 of these resolved spontaneously, one requiring image-guided drainage. Conclusion Incisional hernia repair using combination polypropylene and bio-absorbable mesh provides a safe and effective repair with low recurrence and incidence of surgical site occurrences in the short term. Longer follow up and further studies are needed to evaluate this mesh technique to support ongoing use of absorbable meshes in complex hernia repair.

scholarly journals Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Masatsugu Kuroiwa ◽  
Masato Kitazawa ◽  
Yusuke Miyagawa ◽  
Futoshi Muranaka ◽  
Shigeo Tokumaru ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Rare Case ◽  
Intestinal Tract ◽  
Incisional Hernia Repair ◽  
Small Bowel Resection ◽  
Fistula Formation ◽  
Mesh Migration ◽  
Incisional Surgical Site Infection

Background. Tension-free repair using mesh has become the standard treatment for abdominal wall incisional hernias. However, its postoperative complications reportedly include mesh infection, adhesions, and fistula formation in other organs. Here, we report an extremely rare case of mesh migration into the neobladder and ileum with entero-neobladder and neobladder-cutaneous fistulas. Case Presentation. An 80-year-old male who had undergone radical cystectomy 5 years ago and abdominal wall incisional hernia repair 3 years ago presented with fever and abdominal pain. Computed tomography (CT) scan revealed mesh migration into the neobladder and ileum. He was treated conservatively with antibiotics for a month but did not show improvement; hence, he was transferred to our hospital. He was diagnosed with mesh migration into the neobladder and ileum with complicated fistula formation. He underwent mesh removal, partial neobladder resection, and partial small bowel resection. He developed superficial incisional surgical site infection, which improved with drainage and antibiotics, and he was discharged 40 days after the surgery. Conclusions. We reported a rare case of mesh migration into the neobladder and ileum with fistula formation. Successful conservative treatment cannot be expected for this condition because mesh migration into the intestinal tract causes infection and fistula formation. Hernia repair requires careful placement of the mesh such that it does not come into contact with the intestinal tract. Early surgical intervention is important if migration into the intestinal tract is observed.

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