Hernia最新文献

{"title":"Correction to: Proposal for a uniform protocol and checklist for cadaveric courses for surgeons with special interest in open abdominal wall reconstruction.","authors":"Gaurav V Kulkarni, Toby Hammond, Dominic Slade, Knut Borch, Alexios Theodorou, Luis Blazquez, Javier Lopez-Monclus, Miguel Angel Garcia-Urena","doi":"10.1007/s10029-024-03250-2","DOIUrl":"https://doi.org/10.1007/s10029-024-03250-2","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"53"},"PeriodicalIF":2.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it: using physics and progressive defect tensioning to close large hernia defects during MIS ventral hernia repair.","authors":"Xavier Pereira, Pedro De Oliveira, Daniel Tagerman, Gustavo Romero-Velez, Rockson Liu, Flavio Malcher","doi":"10.1007/s10029-024-03230-6","DOIUrl":"https://doi.org/10.1007/s10029-024-03230-6","url":null,"abstract":"<p><strong>Introduction: </strong>Closure of large hernia defects with minimally invasive surgery has long-been a challenge. Barbed sutures have helped us bridge this technical gap, but their off-label use is not well studied.</p><p><strong>Materials and methods: </strong>We describe a suturing technique for minimally invasive ventral hernia repair (MIS-VHR) termed \"progressive defect tensioning\" and explore its theoretical advantages. Progressive defect tensioning utilizes barbed sutures to progressively and evenly re-approximate the fascia along the entire defect length. Tension is then sequentially applied to each throw, distributing the load across multiple anchor points along the closure. This redistribution of tension is explained using a physics model to depict its theoretical benefit. We also explore how biomechanical properties, such as tissue creep and hysteresis, impact closure of complex defects.</p><p><strong>Results: </strong>Our initial, proof-of-concept cohort of 12 patients with hernias larger than 10 cm undergoing MIS-VHR had acceptable perioperative outcomes compared to the literature.</p><p><strong>Conclusions: </strong>Ultimately, progressive defect tensioning leverages the properties of barbed sutures and the biomechanics of fascia to achieve optimal tension distribution during MIS-VHR.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"55"},"PeriodicalIF":2.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical recognition of dissection layers, nerves, vas deferens, and microvessels using artificial intelligence during transabdominal preperitoneal inguinal hernia repair.","authors":"Kazuhito Mita, Nao Kobayashi, Kunihiko Takahashi, Takashi Sakai, Mayu Shimaguchi, Michitaka Kouno, Naoyuki Toyota, Minoru Hatano, Tsuyoshi Toyota, Junichi Sasaki","doi":"10.1007/s10029-024-03223-5","DOIUrl":"10.1007/s10029-024-03223-5","url":null,"abstract":"<p><strong>Purpose: </strong>In laparoscopic inguinal hernia surgery, proper recognition of loose connective tissue, nerves, vas deferens, and microvessels is important to prevent postoperative complications, such as recurrence, pain, sexual dysfunction, and bleeding. EUREKA (Anaut Inc., Tokyo, Japan) is a system that uses artificial intelligence (AI) for anatomical recognition. This system can intraoperatively confirm the aforementioned anatomical landmarks. In this study, we validated the accuracy of EUREKA in recognizing dissection layers, nerves, vas deferens, and microvessels during transabdominal preperitoneal inguinal hernia repair (TAPP).</p><p><strong>Methods: </strong>We used TAPP videos to compare EUREKA's recognition of loose connective tissue, nerves, vas deferens, and microvessels with the original surgical video and examined whether EUREKA accurately identified these structures. Intersection over Union (IoU) and F1/Dice scores were calculated to quantitively evaluate AI predictive images.</p><p><strong>Results: </strong>The mean IoU and F1/Dice scores were 0.33 and 0.50 for connective tissue, 0.24 and 0.38 for nerves, 0.50 and 0.66 for the vas deferens, and 0.30 and 0.45 for microvessels, respectively. Compared with the images without EUREKA visualization, dissection layers were very clearly recognized and displayed when appropriate tension was applied.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"52"},"PeriodicalIF":2.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing patterns of opioid prescribing after outpatient ventral hernia repair with mesh.","authors":"Kimberly P Woo, Xinyan Zheng, Amitabh P Goel, Rana M Higgins, Anthony A Iacco, Todd S Harris, Jeremy A Warren, Michael Reinhorn, Clayton C Petro","doi":"10.1007/s10029-024-03247-x","DOIUrl":"https://doi.org/10.1007/s10029-024-03247-x","url":null,"abstract":"<p><strong>Purpose: </strong>Despite efforts to minimize opioid prescribing, outpatient ventral hernia repair (VHR) with mesh remains notoriously painful, often requiring postoperative opioid analgesia. Here, we aim to characterize patterns of opioid prescribing for the heterogenous group of patients and procedures that comprise mesh-based, outpatient VHR.</p><p><strong>Methods: </strong>The Abdominal Core Health Quality Collaborative registry was queried for patients undergoing VHR with mesh who were discharged the same or next day between January 2019 to October 2023. Procedures were broadly classified by approach and mesh location: open, minimally-invasive with intraperitoneal mesh (MIP), and minimally-invasive with retromuscular or preperitoneal mesh (MRPP). Surgeon-reported opioid prescription quantity and patient-reported 30-day consumption data were reviewed.</p><p><strong>Results: </strong>Of 2,795 patients who met inclusion criteria (46.1% open, 22.7% MIP, 31.2% MRPP), approximately 80% of patients consumed ≤ 10 tablets of opioid pain medication (open 87.7%, MIP 78.4%, MRPP 84.2%). For patients who were prescribed ≤ 10 tablets, the median number of unconsumed tablets was 5 (IQR 0-8). For patients who were prescribed > 10 tablets, the median number of unconsumed tablets was 10 or more (open 10 [IQR 2-16], MIP 10 [IQR 2-18], MRPP 12 [IQR 5-16]). The number of tablets consumed was positively correlated with the number of tablets prescribed (Kendall's rank correlation = 0.232, p < 0.001).</p><p><strong>Conclusion: </strong>Regardless of technique, for outpatient VHR with mesh, the fewer opioid tablets prescribed, the fewer tablets patients consumed. Decreasing the prescription quantity to ≤ 10 tablets, coupled with preoperative patient education, may help minimize excess opioid prescribing while still achieving adequate pain control.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"54"},"PeriodicalIF":2.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Relationship between immune cell traits, circulating inflammatory cytokines, and the risk of incisional hernia after gastric surgery.","authors":"Hekai Shi, Heng Song, Qian Wu, Ligang Liu, Zhicheng Song, Yan Gu","doi":"10.1007/s10029-024-03241-3","DOIUrl":"https://doi.org/10.1007/s10029-024-03241-3","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"51"},"PeriodicalIF":2.6,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management strategy of giant inguinoscrotal hernia-a case series of 24 consecutive patients surgically treated over 17 years period.","authors":"Milan Zuvela, Danijel Galun, Aleksandar Bogdanovic, Ivan Palibrk, Marija Djukanovic, Rade Miletic, Marko Zivanovic, Milos Zuvela, Marinko Zuvela","doi":"10.1007/s10029-024-03242-2","DOIUrl":"https://doi.org/10.1007/s10029-024-03242-2","url":null,"abstract":"<p><strong>Purpose: </strong>Management of giant inguinoscrotal hernia (GIH) is still a challenging procedure associated with a higher risk of intraabdominal hypertension and abdominal compartment syndrome as a life-threatening condition. The aim of the study was to present our management strategy for GIH.</p><p><strong>Methods: </strong>This is a retrospective review of a case series including 24 consecutive patients with 25 GIH who underwent reconstructive surgery from January 2006 to June 2023, at the University Clinic for Digestive Surgery and Hernia Center Zuvela. A combined surgical strategy was applied: the modified Rives repair for groin hernias alone, Rives combined with organ resection to reduce hernia contents, and Rives combined with procedures for abdominal cavity enlargement. A surgical approach was defined based on the patient's general health, the volume of the hernia sac, and perioperative parameters.</p><p><strong>Results: </strong>All patients were male aged between 43 and 82 years. Rives was the only procedure in 12 patients. In addition to Rives, omentectomy was performed in four patients and intestinal resection in one. Abdominal cavity enlargement was performed following Rives hernioplasty in 9 patients. The median operative time was 215 min (range, 70-720). Surgical complications occurred in seven patients. In-hospital mortality was 12.5%. There was no groin hernia recurrence.</p><p><strong>Conclusion: </strong>Our strategy is a single-stage treatment including modified Rives repair with or without additional procedures for abdominal cavity enlargement or hernia volume reduction, tailored to the individual patient characteristics. The procedure is associated with a higher risk of major morbidity requiring a well-trained intensive care unit team.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"50"},"PeriodicalIF":2.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term inguinal pain comparing TEP to Lichtenstein repair: the TEPLICH RCT 8 years follow-up.","authors":"A Gutlic, U Petersson, P Rogmark, A Montgomery","doi":"10.1007/s10029-024-03246-y","DOIUrl":"10.1007/s10029-024-03246-y","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein.</p><p><strong>Material and methods: </strong>A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed.</p><p><strong>Results: </strong>A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5-10.75 years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p < 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1-8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p < 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain.</p><p><strong>Conclusions: </strong>RCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"49"},"PeriodicalIF":2.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lichtenstein repair for giant inguinoscrotal hernia: a retrospective case-control study.","authors":"Jin Cuihong, Wang Fan, Shen Yingmo","doi":"10.1007/s10029-024-03248-w","DOIUrl":"https://doi.org/10.1007/s10029-024-03248-w","url":null,"abstract":"<p><strong>Purpose: </strong>Giant inguinoscrotal hernia (GISH) is a rare condition in high-income regions, and the management presents a significant challenge for surgeons. A retrospective analysis was conducted of a single center's experience in treating GISH by Lichtenstein approach. The objective was to gain insight into the characteristics of GISH and assess the clinical efficacy of the Lichtenstein approach, as well as the degree of improvement in patient quality of life (QoL).</p><p><strong>Methods: </strong>Data from consecutive GISH patients who had undergone Lichtenstein repair at our institution from December 2018 to December 2023 were prospectively collected. The control group for the 1:2 matched case-control study was selected from pure inguinal hernia patients who underwent Lichtenstein repair during the same period. The demographics and surgical characteristics were analyzed. QoL and surgical satisfaction were respectively evaluated using the Carolina Comfort Scale and Numerical Rating Scale.</p><p><strong>Results: </strong>A total of 51 patients with GISH who underwent Lichtenstein repair were identified, and 102 patients with a pure inguinal hernia who underwent Lichtenstein repair were included in the control group. Patients in the GISH group exhibited a higher BMI than those in the control group; they also had a significantly longer hernia duration and a higher incidence of irreducible bulge. Additionally, the GISH patients had significantly higher ASA scores. All the Lichtenstein procedures were uneventful. There were more additional surgical procedures in GISH group, including hernia sac resection in 50 patients (98%) and adhesion release in 23 patients (45.1%). Five patients with GISH underwent omentectomy and one patient underwent testicular resection due to severe adhesions. The GISH group exhibited a higher incidence of postoperative complications. Five patients experienced urinary retention, and one intestinal obstruction. Two patients underwent surgical drainage under local anesthesia at one month postoperatively and made a full recovery. At six months postoperatively, the mean CCS score for the patients was 0.5 ± 0.8, with 21 patients (20.6%) scoring ≥ 2 out of the 23 categories. The results of the surgical satisfaction survey indicated that 130 patients (85.0%) gave a score of 5, reflecting high levels of satisfaction after Lichtenstein hernioplasty.</p><p><strong>Conclusion: </strong>Patients with GISH typically have a long medical history, a high proportion of irreducible masses, and severe comorbidities, making surgery challenging. However, Lichtenstein repair remains a feasible and safe with high patient satisfaction and improved postoperative quality of life.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"48"},"PeriodicalIF":2.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is mesh pore size associated with the outcome in laparo-endoscopic inguinal hernia repair? - a registry-based multivariable analysis.","authors":"F Köckerling, J Wrede, D Adolf, D Jacob, H Riediger","doi":"10.1007/s10029-024-03235-1","DOIUrl":"https://doi.org/10.1007/s10029-024-03235-1","url":null,"abstract":"<p><strong>Introduction: </strong>In inguinal hernia repair, mesh weight and pore size are used to describe the mesh characteristics. One meta-analysis of laparo-endoscopic inguinal hernia repairs identified 12 prospective randomized controlled trials (RCTs) with 2,909 patients who had all been treated with lightweight (≤ 50 g/m²) or heavyweight (> 70 g/m²) meshes. None of the 12 RCTs gave details of the pore size. There were more recurrences when using lightweight meshes, in particular in the case of medial defects without mesh fixation and/or large defects. In terms of pain, no significant differences were seen. This retrospective analysis of data from the Herniamed Registry now aims to analyze whether mesh pore size is related to the outcome in laparo-endoscopic inguinal repair.</p><p><strong>Materials and methods: </strong>To analyze the association between mesh pore size and the outcome in laparo-endoscopic inguinal repair, it was necessary to select meshes with comparable properties. Polyester meshes and PTFE meshes had to be excluded and polypropylene and polyvinylidene fluoride meshes (PVDF) were included. 83,768 included patients were retrospectively analyzed. The meshes analyzed were eight small-pore and 13 large-pore meshes. Using a binary logistic regression model, it is possible to simultaneously analyze several factors being potentially associated with the outcome.</p><p><strong>Results: </strong>Higher BMI, lower weight meshes, higher ASA score and medial EHS classification were associated with a higher risk of recurrence. It was not possible to find any significant association between pore size and recurrences at one-year follow-up. This also applied for pain on exertion and pain requiring treatment.</p><p><strong>Conclusion: </strong>No association was identified between the pore size of the meshes used in laparo-endoscopic inguinal repair and the recurrence rate, pain on exertion rate or the rate of chronic pain requiring treatment at one-year follow-up.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"47"},"PeriodicalIF":2.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does inguinal hernia with ovary and/or fallopian tube in female children after herniotomy affect secondary sexual characteristics and/or fertility? A long-term retrospective study.","authors":"Kun Duan, Chao Jin, Rongchao Yang, Wei Zhang, Hui Hui","doi":"10.1007/s10029-024-03237-z","DOIUrl":"https://doi.org/10.1007/s10029-024-03237-z","url":null,"abstract":"<p><strong>Background: </strong>The risk of injury to the ovary and/or fallopian tube during herniotomy is notably high when these structures are involved in the hernial contents of female children. This study evaluates the impact of herniotomy involving the ovary and fallopian tube on secondary sexual characteristics and fertility.</p><p><strong>Methods: </strong>The medical records for all female children with inguinal hernia who underwent surgery from January 2000 to December 2010 were reviewed retrospectively (n = 1623).</p><p><strong>Results: </strong>A total of 20 female children aged between 2 years and 12 years (mean 5.5years) were diagnosed with ovary and/or fallopian tube contents within their inguinal hernia sacs. Preoperative B-ultrasound confirmed these findings in all 20 patients. Intraoperatively, 14 hernia sacs contained both ovaries and fallopian tubes and 6 contained only ovaries. There were 12 cases on the right side, 7 cases on the left side and 1 case on both sides. All underwent successful hernia reduction and sac repair without any recurrences. Follow-up periods ranged from 12 to 20 years, averaging 15.5 years. During follow-up, 13 patients had normal pregnancy, 7 patients had normal secondary sexual characteristics.</p><p><strong>Conclusion: </strong>Preoperative B-ultrasonography and careful discerning of the hernia contents during herniotomy may help avoid incision or excision of the ovary and/or fallopian tube.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"44"},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}