scholarly journals Peritoneal flap mesh hernioplasty: A reliable option for difficulty in closure of complex ventral hernia: A case report

2020 ◽  
Vol 13 (2) ◽  
pp. 188-191
Author(s):  
Bhawani Khanal ◽  
Sunit Agrawal ◽  
Suresh Sah ◽  
Roshan Gurung ◽  
Rakesh Kumar Gupta
Keyword(s):  
Case Report ◽  
Ventral Hernia ◽  
Early Recurrence ◽  
Primary Defect ◽  
Complex Ventral Hernia ◽  
Peritoneal Flap ◽  
Ventral Hernias ◽  
Mesh Hernioplasty ◽  
Abdominal Compartment

Peritoneal flap mesh hernioplasty is a technique to deal with complex ventral hernias in which primary closure of the defect is not attainable. We are here presenting a case report of a 50-year-old gentleman with huge complex ventral hernia with loss of domain. The patient also had overlying ulcerated and blackish colored skin. Botulinum toxin was infiltrated into the muscles of anterior abdominal wall and was followed by peritoneal flap mesh hernioplasty after one month. The final outcome was complete closure of the midline with a healthy skin with no evidence of abdominal compartment syndrome. There was no evidence of early recurrence on follow up. Owing to the favorable outcome in this case, suitability of peritoneal flap mesh hernioplasty technique in treatment of complex ventral hernia could be explored further where closure of the primary defect is difficult.  

scholarly journals Evaluation of intra-abdominal adhesion formation after laparoscopic ventral hernia repair with composite mesh using abdominal ultrasound: a prospective observational study

2021 ◽  
Vol 8 (4) ◽  
pp. 1143
Author(s):  
Jainendra K. Arora ◽  
Manjunatha Sankal ◽  
Rohini Gupta Ghasi ◽  
Radhika Thakur
Keyword(s):  
Observational Study ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Prospective Observational Study ◽  
Adhesion Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Composite Mesh ◽  
Ventral Hernias

Background: Laparoscopic ventral hernia repair has revolutionized treatment of ventral hernia by offering shorter recovery time, decreased pain, reduced wound complications and lower recurrence rates as compared to conventional open hernia repair. But intra-abdominal mesh placement is associated with a high risk of complications including adhesions, bowel obstruction and fistula formation. Many different types of meshes with adhesion barriers have been developed to overcome these problems. This prospective observational study evaluated the outcomes of laparoscopic repair of ventral hernias in terms of Intra-abdominal adhesion formation with composite mesh using ultrasound.Methods: The study was conducted from August 2017 to February 2019. All patients underwent standard laparoscopic ventral hernias repair using composite mesh secured with tackers. Omentum was interposed between the mesh and underlying bowel. At a mean follow-up of one year, all patients were subjected to ultrasound examination using visceral slide technique to detect Intra-abdominal adhesions.Results: Our study included 50 patients with a mean age of 43 years (range 26-59 years) and mean body mass index of 29.07±2.35 kg/m2 (range, 24-33 kg/m2). Mean fascial defect size of hernia was 13.4±3.77 cm2 (range12-16 cm2). There were no mesh-related complications and recurrence during the follow-up period of 1 year.Conclusions: Laparoscopic ventral hernia repair using composite mesh seems to be a promising technique for treating ventral hernias. However, longer follow-up periods are needed to confirm effectiveness and safety of the composite mesh.

Early Recurrence of an Infantile Endodermal Oculomotor Nerve Cyst following Surgical Fenestration: A Case Report

2021 ◽  
Vol 56 (2) ◽  
pp. 157-162
Author(s):  
Victor M. Lu ◽  
Aditya Raghunathan ◽  
Michael J. Link ◽  
David J. Daniels
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Early Recurrence ◽  
Oculomotor Nerve ◽  
Rare Entity ◽  
Oculomotor Palsy ◽  
Case Presentation ◽  
Postoperative Course

Introduction: Infantile endodermal oculomotor nerve cyst (EONC) is an extremely rare entity. There are very few pediatric cases reported in the literature, and as expected, oculomotor palsy is the most common presenting symptom. To date however, the risk of recurrence of these lesions following surgical intervention is unclear due to a lack of long-term radiological follow-up. Case Presentation: We present a case of a 13-month-old male patient with an EONC and detail his surgical fenestration and postoperative course. Somewhat surprisingly, re-expansion occurred within 6 months and remained stable 2 years later. Discussion: A surgical approach to fenestration of an EONC in an infant is possible and should be performed by an expert neurosurgeon. Early recurrence is underreported in the current literature, and we encourage longer term radiological surveillance of these lesions after surgery to optimize primary and recurrent management in the future.

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 A Prospective, Single Arm, Multi-Center Study Evaluating the Clinical Outcomes of Ventral Hernias Treated with OviTex® 1S Permanent Reinforced Tissue Matrix: The BRAVO Study 12-Month Analysis

2021 ◽  
Vol 10 (21) ◽  
pp. 4998
Author(s):  
George DeNoto ◽  
Eugene P. Ceppa ◽  
Salvatore J. Pacella ◽  
Michael Sawyer ◽  
Geoffrey Slayden ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Hernia Recurrence ◽  
Patient Reported ◽  
Multi Center Study ◽  
Tissue Matrix ◽  
Ventral Hernias ◽  
Center Study

Background: Conflicting results from previous studies have led to dissent over whether surgical mesh is safe and effective in ventral hernia repair. A newer class of mesh known as a reinforced tissue matrix, combining a biologic scaffold and minimal polymer reinforcement, offers promise in reducing inflammatory response and increasing abdominal wall support. This study sought to assess the clinical utility of a reinforced tissue matrix (OviTex) in ventral hernia repair 12 months after implantation. Methods: This is a prospective, single-arm, multi-center study to evaluate the clinical performance of OviTex® 1S Permanent (OviTex) in the repair of primary or recurrent ventral hernias (VH) in consecutive patients (ClinicalTrials.gov/NCT03074474). The rate of surgical site occurrences (SSOs) was evaluated 90 days post-surgery as the primary endpoint. Hernia recurrence and the incidence of postoperative events were evaluated between three and 12 months as secondary endpoints. The incidence of other complications and patient-reported outcomes were also recorded. Results: Ninety-two (92) patients were enrolled in the study, of whom seventy-six (76) reached the 12-month follow-up. All patients were at least 18 years of age with a BMI of <40 kg/m2. Hernia defects were <20 × 20 cm, classified as class I–III according to the CDC wound classification system. Of the 76 patients who reached 12-month follow-up, twenty-six (34%) had previous VH repairs and thirteen (17%) had previous surgical infection. Sixty (79%) had factors known to increase the risk of recurrence. Twenty patients (26%) experienced SSOs, with ten (13%) requiring procedural intervention. Two of the 75 patients (2.7%) experienced a recurrence. Conclusions: The low rate of hernia recurrence and SSOs requiring intervention illustrates the potential that reinforced tissue matrices, and OviTex 1S, in particular, have to improve outcomes in VH repairs. Follow-up to 24 months is ongoing.

scholarly journals Is it safe to combine ventral hernia repair with bariatric surgery?

2020 ◽  
Vol 7 (10) ◽  
pp. 3455
Author(s):  
Ashok Kumar Mathur ◽  
Praveen Kumar Mathur
Keyword(s):  
Bariatric Surgery ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Optimal Time ◽  
Morbidly Obese ◽  
Onlay Mesh ◽  
Ventral Hernias

Obesity is one of the important precipitating factors for primary and incisional ventral hernias. There is controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing bariatric surgery. We reviewed our series of 250 patients who underwent bariatric surgery over 6 years period. 7 morbidly obese patients undergoing bariatric surgery had simultaneous ventral hernia repair. Roux-en-Y gastric bypass (RYGB) in 2 patients and laparoscopic sleeve gastrectomy (LSG) were done in 5 patients. 6 patients had primary midline paraumbilical hernia and 1 patient had large recurrent incisional hernia. Open intraperitoneal onlay mesh (IPOM) repair was done in 5 cases with hernia defect <5 cm. Sutured repair was done in 1 patient, recurrence occurred after 3 months. IPOM repair was done 6 months later after significant weight loss. 1 patient of large incisional hernia (10 cm defect) with cholelithiasis underwent open mesh hernioplasty and panniculectomy. Postoperative seroma occurred in one patient, it subsided after repeated aspirations. After average follow up of over 2 years there has been no recurrence.

Repair of High-Risk Incisional Hernias and Traumatic Abdominal Wall Defects with Porcine Mesh

2011 ◽  
Vol 77 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Matthew C. Byrnes ◽  
Eric Irwin ◽  
Dana Carlson ◽  
Amy Campeau ◽  
Jonathon C. Gipson ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Medical Records ◽  
Average Duration ◽  
Early Recurrence ◽  
Biologic Mesh ◽  
Fascial Closure ◽  
Abdominal Wall Defects ◽  
Technical Failures ◽  
Ventral Hernias

Complex ventral hernias represent a significant challenge to surgeons. We hypothesized that a wide underlay technique in combination with a novel biologic mesh would result in repair with a low recurrence rate. Medical records of patients undergoing ventral herniorrhaphy with Xen-Matrix biologic mesh were evaluated. All patients were evaluated for hernia recurrence both immediately and after 2 to 3 years. There were 57 patients included in the study. The overall recurrence rate was 7.2 per cent; however, all recurrences were early and were likely technical failures. The average duration of follow-up was 30.6 months with no further recurrences after the early technical failures. The average number of previous recurrences was 1.5. Fascial closure was obtained over the mesh in 84 per cent of patients, with component separation being necessary in 36 per cent of patients. Lack of fascial reapproximation over the mesh was associated with early recurrence (0 vs 55%, P < 0.0001). Complex ventral hernias can be repaired with a low recurrence rate. Our technique in combination with the XenMatrix biologic mesh provides for durable repair. Whenever possible, the fascia should be closed above the underlay mesh, because this technique provides a more durable repair than using the mesh as a “fascial bridge.”

scholarly journals Early Intracranial Aneurysm Recurrence after Microsurgical Clip Ligation: Case Report and Review of the Literature

2018 ◽  
Vol 79 (04) ◽  
pp. e93-e97
Author(s):  
Serge Marbacher ◽  
Alexander Spiessberger ◽  
Michael Diepers ◽  
Luca Remonda ◽  
Javier Fandino
Keyword(s):  
Case Report ◽  
Intracranial Aneurysm ◽  
Latency Period ◽  
Early Recurrence ◽  
Biological Behavior ◽  
Definitive Treatment ◽  
Anterior Communicating Artery ◽  
Pubmed Database ◽  
Early Imaging

AbstractMicrosurgical clip ligation is considered a definitive treatment for intracranial aneurysms (IAs), resulting in low rates of local recurrence that range from 0.2 to 0.5% and a latency period that averages about a decade. Our case report describes an early asymptomatic recurrence (i.e., without sentinel headache or seizure) less than 1 year after this 20-year-old woman underwent clip ligation of a ruptured anterior communicating artery (AComA) aneurysm. At recurrence, the patient underwent coiling of the regrowth; follow-up imaging at 6 and 18 months demonstrated complete IA occlusion. To review the putative risk factors of this rare phenomenon, the authors searched the PubMed database using the keywords “intracranial aneurysm,” “recurrence,” and “clipping” in various combinations. In the seven cases identified, all occurred in initially ruptured IA, which was often at the AComA, and six of seven patients were younger than 50 years old. Although most IA remnants grow slowly, early recurrence may represent a more aggressive biological behavior that warrants special attention in younger patients, positive rupture status, and unintended remnant of any size. In such a constellation, early imaging follow-up within the first 6 months may be warranted to rule out early IA recurrence

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