Anterior component separation with sublay polypropylene mesh placement: An ideal way to deal with large ventral abdominal hernias.

2021 ◽  
Vol 28 (05) ◽  
pp. 731-736
Author(s):  
Sajid Rashid
Keyword(s):  
Recurrence Rate ◽  
Polypropylene Mesh ◽  
Component Separation ◽  
Effective Technique ◽  
Mesh Placement ◽  
Abdominal Hernias ◽  
Position Data ◽  
One Year ◽  
Study Setting ◽  
Anterior Component Separation

Objectives: To study the effectiveness of open anterior component separation technique for repair of large incisional abdominal hernias. To study the effect of addition of polypropylene mesh with open anterior CST in sublay position. Study Design: Experimental study. Setting: Department of Surgery, DHQ Hospital Rawalpindi. Period: January 2016 to November 2016. Material & Methods: Patients (n=19) were admitted through OPD electively by purposive non- probability sampling in accordance with the inclusion/exclusion criteria. patients were operated under general anaesthesia. Anterior CST was done by standard Ramirez technique. Polypropylene mesh was placed in sublay (retrorectus) position. Data obtained was analysed by SPSS-20 software to calculate SSI and Recurrence rate. Results: A total of 19 (n=19) patients were included in the study and operated upon.There were 61% males with average age of 42 years and 39% females of average31 years.Average defect size was 10.11 cm with SD  of 1.899 cm. Recurrence rate was 5.26%. SSI rate was 10.50%. Patients were followed up for one year for Recurrence of hernia. Conclusion: Anterior component separation is an effective technique for repair of otherwise inoperable large ventral abdominal hernias especially when combined with polypropylene mesh in sublay position. Addition of mesh in sublay position with CST signifantly reduces both recurrence and SSI rate.

scholarly journals Grynfeltt Hernia: A Deceptive Lumbar Mass with a Lipoma-Like Presentation

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jonathan R. Zadeh ◽  
Jessica L. Buicko ◽  
Chetan Patel ◽  
Robert Kozol ◽  
Miguel A. Lopez-Viego
Keyword(s):  
Polypropylene Mesh ◽  
Large Study ◽  
Open Repair ◽  
Abdominal Wall Defect ◽  
Wall Defect ◽  
Mesh Placement ◽  
Repair Technique ◽  
Abdominal Hernias ◽  
Lumbar Triangle ◽  
Over Time

The Grynfeltt-Lesshaft hernia is a rare posterior abdominal wall defect that allows for the herniation of retro- and intraperitoneal structures through the upper lumbar triangle. While this hernia may initially present as a small asymptomatic bulge, the defect typically enlarges over time and can become symptomatic with potentially serious complications. In order to avoid that outcome, it is advisable to electively repair Grynfeltt hernias in patients without significant contraindications to surgery. Due to the limited number of lumbar hernioplasties performed, there has not been a large study that definitively identifies the best repair technique. It is generally accepted that abdominal hernias such as these should be repaired by tension-free methods. Both laparoscopic and open techniques are described in modern literature with unique advantages and complications for each. We present the case of an unexpected Grynfeltt hernia diagnosed following an attempted lipoma resection. We chose to perform an open repair involving a combination of fascial approximation and dual-layer polypropylene mesh placement. The patient’s recovery was uneventful and there has been no evidence of recurrence at over six months. Our goal herein is to increase awareness of upper lumbar hernias and to discuss approaches to their surgical management.

scholarly journals POLYPROPYLENE MESH REPAIR IN ABDOMINAL WALL HERNIAS;

2017 ◽  
Vol 24 (10) ◽  
pp. 1566-1571
Author(s):  
Malik Azhar Hussain ◽  
Naveed Ashraf Malik
Keyword(s):  
Abdominal Wall ◽  
Recurrence Rate ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Open Repair ◽  
Demographic Data ◽  
Abdominal Wall Hernia ◽  
Quasi Experimental ◽  
Operative Notes ◽  
Study Setting

Objectives: To determine the beneficial out comes, recurrence rate andcomplications of the repair of abdominal wall hernia reinforced with polyprolene mesh. StudyDesign: This was a retrospective interventional quasi experimental study. Setting: Surgicaldepartments of Central Hospital and Prince Abdul Aziz Bin Musaad Hospital, Arar, SaudiArabia. Duration of Study: November 2012 to October 2016. Material and Methods: Adultpatients of both genders, who underwent repair for various abdominal wall hernias duringabove mentioned period, were included in the study. Their demographic data, relevant historyand physical examination, post-operative notes, prognosis and any complications, includingrecurrence, infection, adhesions, pain and mesh degradation were recorded in a pre-structuredquestionnaire. The data was then analyzed with standard statistical methods. Results: From atotal of 156 patients, 94 (60.3%) were males and 62 (39.7%) female between the age of 20 to75 years. There were relatively fewer complications, including seroma (12.8%), post-operativepain (9.6%), infection (3.8%), adhesions (0.6%) and no recurrence rate. The uneventful recoverywas observed in 73% of cases. Conclusions: Pure polypropylene mesh is economical than thenewer composite meshes for the open repair of abdominal wall hernia, is easily available andcaused relatively fewer complications with no recurrence rate.

scholarly journals One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jirarattanasopa Pichai ◽  
Banchasakjaroen Vanchalerm ◽  
Ratanasukon Mansing
Keyword(s):  
Photodynamic Therapy ◽  
Recurrence Rate ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Corrected Visual Acuity ◽  
Half Dose ◽  
One Year ◽  
The One ◽  
Different Doses

Abstract Background Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with consisting of different doses and power. This study aimed to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC. Methods A retrospective review of patients with chronic or recurrent CSC who were treated with either a half-dose or one-third-dose PDT, and had follow up 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline as well as 1, 3, 6 and 12 months post-PDT were assessed. Results Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04, for half-dose, P=0.148) and CRT improvement (125.6±24.6 μm for one-third-dose versus 139.1±16.54, for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months. Conclusion At 12 months, the one-third-dose PDT was effective in terms of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.

High recurrence rate after posterior component separation and keyhole mesh reconstruction for complex parastomal hernia: a case series study.

2021 ◽  
Author(s):  
Alvaro Robin Valle de Lersundi ◽  
Niccolo Ruppealta ◽  
Carlos San Miguel Mendez ◽  
Joaquin Muñoz Rodriguez ◽  
Marina Pérez Flecha ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Parastomal Hernia ◽  
Case Series ◽  
Component Separation ◽  
High Recurrence Rate ◽  
Posterior Component Separation ◽  
Case Series Study ◽  
Mesh Reconstruction ◽  
Series Study

scholarly journals OBTURATOR NERVE RLOCK

2009 ◽  
Vol 16 (01) ◽  
pp. 48-52
Author(s):  
NASEEM AHMED ◽  
Shahid Mahmood Rana ◽  
SYED MUHAMMAD ZAHEER HAIDER ◽  
Arshad Mahmood ◽  
FAIZAN AHMED ◽  
...  
Keyword(s):  
Nerve Block ◽  
Spinal Anaesthesia ◽  
Bladder Wall ◽  
Obturator Nerve ◽  
Physical Status ◽  
Effective Technique ◽  
Obturator Nerve Block ◽  
Partial Suppression ◽  
A Prospective Study ◽  
Study Setting

Objectives: To evaluate the efficacy of obturator nerve block combined with spinal anaesthesia for prevention of adductormuscle spasm and its associated complications during transurethral resection of bladder tumours located at its lateral and inferolateral wall.Study design: A prospective study. Setting: At AFIU Rawalpindi. Period: From January 2005 to December 2006. Material and methodFifty patients who had tumours at their lateral / inferolateral bladder wall of physical status ASA I - IV received spinal anaesthesia at 3r d or4l h lumbar space followed by obturator nerve block with a view to preventing adductor jerk during resection of tumour. Results: There wascomplete suppression of adductor jerk in 45 (90%) patients and surgery was completed smoothly. Two patients (4%) had mild adductorjerk and additional sedation was required. The block failed to work in 3 (6%) cases and required conversion to general anaesthesia. Thusthe procedure was successful in 94% (complete and partial suppression of jerk. Conclusion: We conclude that spinal anaesthesiacombined with obturator nerve block is an effective technique for preventing adductor jerk during TUR-BT, thus avoiding intra-operative andpost operative complication.

scholarly journals O50 ALTERATIONS IN THE ABDOMINAL WALL MUSCULATURE AFTER ENDOSCOPIC ANTERIOR AND OPEN POSTERIOR COMPONENT SEPARATION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Erling Oma ◽  
Jan Kim Christensen ◽  
Jorge Daes ◽  
Lars Nannestad Jorgensen
Keyword(s):  
Abdominal Wall ◽  
Case Series ◽  
Muscle Thickness ◽  
Component Separation ◽  
Fascial Closure ◽  
Lateral Abdominal Wall ◽  
Transverse Abdominis ◽  
Abdominal Wall Muscle ◽  
Anterior Component Separation

Abstract Aim Effects of component separation (CS) on abdominal wall musculature have only been investigated in smaller case series. The study aimed to compare abdominal wall alterations following endoscopic anterior component separation (EACS) or transverse abdominis release (TAR). Material and Methods Computed tomography scans were evaluated in patients who underwent open ventral hernia repair with TAR or EACS. Lateral abdominal wall muscle thickness and displacement were compared with preoperative images after bilateral CS and the undivided side postoperatively after unilateral CS. Results In total, 105 patients were included. The mean defect width was 12.2 cm. Fifty-five (52%) and 15 (14%) underwent bilateral and unilateral EACS, respectively. Five (5%) and 14 (13%) underwent bilateral and unilateral TAR, respectively. Sixteen (15%) underwent unilateral EACS and contralateral TAR. Complete fascial closure was achieved in 103 (98%) patients. The external oblique and transverse abdominis muscles were significantly laterally displaced with a mean of 2.74 cm (95% CI 2.29-3.19 cm) and 0.82 cm (0.07-1.57 cm) after EACS and TAR, respectively. The combined thickness of the lateral muscles was significantly decreased after EACS (mean decrease 10.5% [5.8-15.6%]) and insignificantly decreased after TAR (mean decrease 2.6% [-4.8-9.5%]), mean reduction difference EACS versus TAR 0.22 cm (-0.01-0.46 cm). One (1%) patient developed an iatrogenic linea semilunaris hernia after EACS. The recurrence rate was 19% after mean 1.7 years follow-up. Conclusions The divided muscle was significantly more laterally displaced after EACS compared with TAR. The thickness of the lateral muscles was slightly decreased after EACS and unchanged after TAR.

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