scholarly journals A Study of Intraperitoneal Onlay Mesh Repair Using Barbed Sutures for Abdominal Incisional Hernia

2021 ◽  
Vol 105 (1-3) ◽  
pp. 585-590
Author(s):  
Junpei Takashima ◽  
Keizo Taniguchi ◽  
Toshiaki Yasui ◽  
Masahiro Yamane ◽  
Yutaka Hattori ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Pain Scale ◽  
Barbed Suture ◽  
Intraperitoneal Onlay Mesh ◽  
Barbed Sutures ◽  
Duration Of Surgery ◽  
Onlay Mesh ◽  
The Mean ◽  
Hernial Orifice

Objective We investigated the validity of our intraperitoneal onlay mesh (IPOM) Plus technique with barbed sutures. Background Laparoscopic intraperitoneal onlay mesh repair has become a proven method for treating abdominal incisional hernias in recent years. There have been a few reports on the utility of IPOM Plus, which is IPOM + celiorrhaphy, although this method has not been widely discussed. We adopted the IPOM Plus technique with barbed sutures at our hospital and investigated the validity of this technique. Methods We included 7 patients who underwent IPOM Plus repair from 2015 to 2017 at our hospital. We excluded patients with a hernia hilum <2 cm or ≥10 cm, age < 20 years old, PS3 or more, and uncontrolled comorbidity. The hernial orifice was closed laparoscopically using barbed sutures and subsequently secured by tacking on an onlay mesh. Results The median hernial orifice size of the 7 patients was 45 mm (25 to 55 mm). Hernia onset occurred after laparotomy in all cases. In one case, an abdominal incisional hernia recurred after IPOM used to treat the condition 15 years earlier. The mean duration of surgery was 80.5 minutes (53 to 126 minutes), and the median pain scale score was 3 points (0 to 3 points), indicating little pain. None of the patients reported persistent postoperative pain. The mean duration of the postoperative hospital stay was a median of 3.5 days (2 to 5 days). Both short- and long-term outcomes indicated that no recurrence or complications, such as bulging or seroma, occurred. Conclusions IPOM Plus with intracavitary abdominal suturing using barbed suture for abdominal scar hernia repair may be a valid surgical procedure.

A COMPARATIVE STUDY BETWEEN ONLAY AND RETRORECTUS MESH REPAIR IN THE TREATMENT OF INCISIONAL HERNIAS

2021 ◽  
pp. 65-69
Author(s):  
S. Yashwanth ◽  
S. Dayakar
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hospital Stay ◽  
Wound Infection ◽  
Mesh Repair ◽  
Duration Of Surgery ◽  
Group A ◽  
Onlay Mesh ◽  
The Mean ◽  
Group B

INTRODUCTION: Over the years, surgeons tried the placement of mesh at different locations like On-lay, Under-lay, Sub-lay and pre-peritoneal, retroperitoneal intraperitoneal, Inter-muscular, etc. with each procedure having its advantages and disadvantages. Commonly Onlay and sub lay mesh repairs are done. Though the literature says, sub lay procedures have fewer complications and a high success rate. However, in a few studies, the ideal position for mesh repair appears to be retro muscular, where the force of abdominal pressure holds the mesh against deep surfaces of muscles. In this study, a comparison of both Onlay and retro rectus procedures with regards to the duration of surgery, postoperative complications like seroma, wound infection, wound dehiscence, and also the period of postoperative stay in the hospital. The aim of the study is To compare 'Onlay' versus 'retro rectus' mesh repair in inuencing the outcome in incisional hernia with regards to Duration of surgery, Postoperative complications like seroma formation, wound infection, Postoperative stay, Recurrences. PATIENTS AND METHODOLOGY: Type of Study: A Prospective comparative study Study Setting: Department of general surgery, Narayana Medical College & Hospital, Nellore.Study Period: November 2018 to September 2020 Study Sample: 50 cases, divided into two groups by random allocation technique. Groups A and B with 25 patients in each group. RESULTS: The mean age of cases in Group A is 40.48 years. The mean age of patients in Group B is 44.08 years. Youngest was 31 years and 36 years in group A and group B, respectively, and the eldest was 51 years and 53 years in group A and group B, respectively. In Group A, 11 were male, and 14 were female, and in Group B, 11 were male, and 14 were female. The male to female ratio in the study was 1:1.27. The mean Operative Time in Group A was 1.93 Hrs, and that in Group B was 2.98Hrs. Nine patients (36%) in group A and one patient (4%) in group B had seroma formation. Eight patients (32%) in group A and one patient (4%) in group B had a wound infection. The mean Hospital Stay in Group A was 5.44 Days, and Group B was 4.88 days. No short-term recurrences were noted in either of the two groups when followed for six months. CONCLUSION : Retrorectus mesh repair is an excellent alternative to Onlay mesh repair that may apply to incisional hernia. The mesh-related overall complication rate like seroma wound infections and hospital stay is less than Onlay mesh repair.

scholarly journals P127 ROBOTIC TRANSABDOMINAL RETRO-RECTUS HERNIA REPAIR VS. LAPAROSCOPIC INTRAPERITONEAL ONLAY MESH REPAIR: IMPROVING POSTOPERATIVE OUTCOMES

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mette Willaume ◽  
Lars Nannestad Jorgensen ◽  
Kristian Kiim Jensen
Keyword(s):  
Length Of Stay ◽  
Mesh Repair ◽  
Elective Surgery ◽  
Smoking Status ◽  
Tap Block ◽  
Analgesic Requirement ◽  
Intraperitoneal Onlay Mesh ◽  
Mesh Placement ◽  
Duration Of Surgery ◽  
Onlay Mesh

Abstract Aim “The optimal repair technique for small and medium-sized ventral hernias in obese patients remains unknown. We aimed to evaluate results after robotic-assisted laparoscopic transabdominal repair with retro-rectus mesh placement (rTARUP) compared with laparoscopic intraperitoneal onlay mesh repair (IPOM).” Material and Methods “Retrospective cohort study of consecutive patients undergoing rTARUP or IPOM repair for small or medium-sized primary ventral and incisional hernias. The primary outcome was postoperative need for transverse abdominis plane (TAP) block or epidural catheter, and secondary outcomes were 30-day complications, and length of stay. All patients underwent elective surgery and were followed for 30 days postoperatively.” Results “A total of 27 patients (rTARUP) and 32 (IPOM) were included. Patients in the two groups were comparable in terms of age, sex, comorbidities, smoking status, body mass index (BMI), and type of hernia. The median BMI was 32.4 kg/m2 and the fascial defect area was comparable (rTARUP median 16.8 cm2 vs. IPOM 11.7 cm2, P = 0.303). The duration of surgery was longer in the rTARUP group (median 117.2 min. vs. 84.4, P = 0.003), whereas the postoperative need for TAP block or epidural analgesics was less in the rTARUP group compared with IPOM (n = 14 vs. n = 1, P = 0.002). There were no severe complications or reoperations in the two groups. The length of stay was shorter in the rTARUP group (median 0 vs. 1 days, P < 0.001).” Conclusions “rTARUP was associated with reduced postoperative analgesic requirement and shorter length of stay compared with laparoscopic IPOM.”

scholarly journals Intraperitoneal-onlay-mesh repair with hernia defect closure via the hernial orifice approach: a case series of 49 patients

2021 ◽  
pp. 100418
Author(s):  
Manabu Mikamori ◽  
Yujiro Nakahara ◽  
Kazuya Iwamoto ◽  
Satoshi Hyuga ◽  
Atsushi Naito ◽  
...  
Keyword(s):  
Mesh Repair ◽  
Case Series ◽  
Defect Closure ◽  
Intraperitoneal Onlay Mesh ◽  
Hernia Defect ◽  
Onlay Mesh ◽  
Hernial Orifice

scholarly journals Comparative outcomes of open retrorectus versus laparoscopic intraperitoneal onlay mesh repair of ventral hernia in a tertiary care center

2021 ◽  
Vol 8 (4) ◽  
pp. 1226
Author(s):  
Vivek V. Mukhamale ◽  
Bhushankumar A. Thakur ◽  
Snehal Deotale ◽  
Rajas Mudgerikar
Keyword(s):  
Retrospective Study ◽  
Surgical Site Infection ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Site Infection ◽  
Single Institution ◽  
Intraperitoneal Onlay Mesh ◽  
Duration Of Surgery ◽  
Onlay Mesh

Background: The combined Rives-Stoppa technique has been adopted as the gold standard for open incisional hernia repair. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia. Based on this we have done single institution retrospective study of IPOM and open rectrorectus mesh repair for ventral hernia with size less than 5 cm.Methods: This study was single institution retrospective study, where we have analyzed the data of 30 patients in each group of ventral hernia, with median 18 months of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.Results: Our study consists of 30 heterogenous population with similar age distribution in each group, mean time for surgery was 70.83 min for open and 66.33 minutes for IPOM. There was surgical site infection in 3 patients operated by open procedure and 2 patients in IPOM procedure. Duration of hospital stay which is more in open retrorectus repaired patients, 5.47 (mean) days and less in laparoscopic IPOM repaired patients, 5.07 (mean) days. Recurrence in both groups of patients is not seen in 6 months follow up in our study.Conclusions: Study supports safety in terms of duration of surgery, postoperative pain, surgical site infection, duration of hospital stays and efficacy in terms of return of normal activity and recurrence, equally effective in both open retrorectus and laparoscopic IPOM repair of ventral hernia with size less than 5 cm.

scholarly journals Incidence of seroma in sublay versus onlay mesh repair of incisional hernia

2021 ◽  
Vol 61 ◽  
pp. 155-157
Author(s):  
Rashid Ibrahim ◽  
Sabry Abounozha ◽  
Adel Kheder ◽  
Talal Alshahri
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Onlay Mesh

scholarly journals Intraperitoneal Onlay Mesh in Ventral Hernia Repair – Experience in A Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 7 (2) ◽  
pp. 106-109
Author(s):  
Md Ezharul Haque Ratan ◽  
Hasina Alam
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Intraperitoneal Onlay Mesh ◽  
Diabetes Status ◽  
Onlay Mesh

Background: Ventral hernias are common problem in surgical practice. Repair of hernia by a prosthetic mesh is a well recognized procedure. But whether the procedure is to be done by open or laparoscopic technique is still a topic of discussion. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia in our country. We are evaluating the usefulness of this procedure as routine operation for ventral hernias.Methods: All patients attending at Bangladesh Institute of Research & Rehabilitation of Diabetes, Endocrine and Metabolic disorders (BIRDEM) outpatient department (OPD) with ventral hernia were approached and counseled for laparoscopic IPOM, but only those who agreed were included in this study. Fifty consecutive patients underwent IPOM by a single surgeon. Preoperative evaluation was done rationally and surgery performed by standard laparoscopic method. Age, sex, diabetes status and additional procedures done were evaluated. Post- operative follow up period was from 3 months to 75 months and any complication or recurrence were noted.Results: We are reporting 50 cases of laparoscopic IPOM, over a time period of 78 months (April 2010- September 2016). Eleven cases were male, 39 female (M: F=1:3.5). 35 (70%) cases were diabetic, 15 (30%) were non-diabetic. Mean age of the patients were 47.7yrs (male 47.7+9.5 yrs, female 47.7- 2.6 yrs, diabetic patients 47.7+ 2.5yrs, non-diabetic patients 47.7-5.9yrs). Indication for IPOM was paraumbilical hernia 29 cases (58%), incisional hernia 14 cases(28%), multiple incisional hernia 2 cases ( 2 large defect in one case, 5 defects of varying size in another patient), umbilical port hernia 2 cases, paraumbilical along with incisional hernia 1 case, epigastric hernia 1 case, lumber hernia 1 case. In 48 cases (96%) polypropylene mesh and only in 2 cases (4%) dual mesh were used. In addition to IPOM procedure, in same sitting laparoscopic cholecystectomy was done in 8 cases, Dilatation & Curettage in 1 case and adhesiolysis in 7 cases. None of the case required conversion to open, neither was there any intra-operative complication. In one case there was recurrence . In another case there was false recurrence due to development of ascites. Four patients developed seroma which were managed conservatively.Conclusion: Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty has proved to be an effective surgical procedure for ventral hernia repair. It provides much benefits with low complications and conversion in experienced hands.Birdem Med J 2017; 7(2): 106-109

scholarly journals P053 COMPARISON OF CLINICAL OUTCOMES BETWEEN INTRAPERITONEAL ONLAY MESH REPAIR (IPOM PLUS) AND ENHANCED-VIEW TOTALLY EXTRAPERITONEAL REPAIR (ETEP) FOR VENTRAL HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Hiroshi Hirukawa
Keyword(s):  
Ventral Hernia ◽  
Mesh Repair ◽  
Transversus Abdominis ◽  
Incisional Hernias ◽  
Totally Extraperitoneal ◽  
Onlay Mesh ◽  
The Mean ◽  
Totally Extraperitoneal Repair ◽  
Hernia Size ◽  
Ventral Hernias

Abstract Aim We have been performing intraperitoneal on lay mesh repair (IPOM plus) as the standard laparoscopic procedure for ventral hernia in our department. We introduced enhanced-view totally extraperitoneal repair (eTEP) for ventral hernia repair in 2018, and have performed 31 cases so far. We compared the outcomes of IPOM Plus and eTEP at our institution. Material and Methods Ventral hernia cases who underwent surgery at our department between 2018 and 2020 were included in the study. The postoperative outcomes and complications of the IPOM Plus and eTEP groups were evaluated retrospectively. Results There were 12 cases of IPOM plus, and all were incisional hernias. There were 31 cases of eTEP, including 7 cases of primary hernias and 24 cases of incisional hernias. Transversus abdominis muscle release (TAR) was added in 24 cases. The mean hernia size was 6.6 x 7.9 cm with IPOM Plus and 8.0 x 10.1 cm with eTEP, and the average meshes size was 15.5 x 22.0 cm and 20.3 x 23.6 cm, respectively. The mean postoperative hospital stay was 7.8 days and 5 days. Postoperative complications included 1 case of mesh bulging and 1 case of recurrence in the IPOM Plus group, 1 case of seroma and 1 case of intestinal obstruction in the eTEP. Conclusions The surgical outcomes for ventral hernias up to 8 cm wide were similar for IPOM Plus and eTEP. The eTEP can insert a larger mesh and may be useful for wider hernias (>8cm).

Sign in / Sign up

Export Citation Format

Share Document