International Journal of Abdominal Wall and Hernia Surgery最新文献

{"title":"Mesh infection of Mycobacterium fortuitum after inguinal hernia repair: A rare case report and literature review","authors":"Lucheng Chen, Gengwen Huang","doi":"10.4103/ijawhs.ijawhs_39_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_39_22","url":null,"abstract":"PURPOSE: Inguinal hernia repair is one of the most common operations worldwide. The standard procedure now is tension-free hernioplasty with mesh implantation. Mesh repairs obviously reduce the rate of hernia recurrence and alleviate the pain. However, mesh infection is one of the most serious complications, which usually causes secondary operation. At present, no standard treatment measures of mesh infections, especially for rare pathogens such as nontuberculous mycobacteria (NTM), are available. MATERIALS AND METHODS: We present an unusual case of Mycobacterium fortuitum infection of implanted mesh after inguinal hernia repair. Medline and PubMed databases were searched using the keywords mentioned subsequently, and the literature on treatment measures of mesh infection of M. fortuitum and other subtypes of NTM after inguinal hernia repair is reviewed. RESULTS: Mesh infections of M. fortuitum are very rare after inguinal hernia repair. The infection is hard to diagnose and complex to treat. However, it has characteristic clinical manifestations. With early recognition and specific tests, clinicians can still confirm the infection. Treatments include antibiotics and surgical intervention. Mesh displantation is considered to be necessary and needs to be conducted as soon as possible. CONCLUSION: When a mesh infection is present, it is important to check the wound before obtaining bacteriological evidence. Once the mycobacteria infection is suspected, corresponding tests should be taken immediately. With appropriate treatment, patients will likely make a full recovery.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80907510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of diaphragmatic omental hernias by radiology: A prevalence study","authors":"F. Çankal, B. Demir, Ali Köksal","doi":"10.4103/ijawhs.ijawhs_44_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_44_22","url":null,"abstract":"INTRODUCTION: This study aimed to describe the radiological features of omental hernias originating from the diaphragm and their localization on the diaphragm, examine their relationship with the thoracic and abdominal organs, and present guiding data to clinicians in operational planning. MATERIALS AND METHODS: This study was obtained as a result of retrospective scanning of the images of 824 patients aged 18–65 who applied for thorax and/or upper abdomen computerized tomography (CT). The patients’ thorax and upper abdomen regions were examined in detail and divided into two groups of individuals with and without hernias. Hernia types, content, localization, and effect types of patients with hernia were recorded and analyzed separately. RESULTS: Diaphragmatic hernia was detected in 197 (23.9%) of 824 patients. While 50.8% of these patients were female, 49.2% were male. Of the patients diagnosed with diaphragmatic hernia, 49.2% (n = 97) had Morgagni hernia, 30.5% (n = 60) had Bochdalek hernia, and 17.8% had hiatal hernia. While Morgagni hernia had anterior localization in 82.5%, Bochdalek hernia was generally localized on the left side (75.8%), and hiatal hernias were sliding type with a rate of 84.2%. The highest effect was observed in Bochdalek hernias (71.1%). Omental tissue (59.4%) was observed most frequently in Morgagni hernias, while stomach content (91.9%) was found to be the highest in hiatal hernias (P < 0.05). DISCUSSION–CONCLUSION: Diaphragmatic omental hernias are rare. The rarity, as well as the uncertain and nonspecific presentations, contributes to the retard in diagnosis. Commonly, the presentation in the adult age group is that of recurrent chest infection and rarely with gastroesophageal reflux and esophagitis. Physicians caring for these patients should be aware of this, and a high index of suspicion is recommended to obviate delay in diagnosis with its associated morbidity. We think the radiological features of diaphragmatic hernias should be detailed in determining and applying the optimal treatment approach. In addition, contrary to what was thought, we found that the prevalence of diaphragmatic hernia in our population is higher than that reported in the literature.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75145607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of inguinal hernia management: A review","authors":"Patrick J. McBee, R. Walters, R. Fitzgibbons","doi":"10.4103/ijawhs.ijawhs_36_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_36_22","url":null,"abstract":"Groin hernias are the most common reason for primary care physicians to refer patients for surgical management. Patients often present with a bulge in the groin that is associated with pain in two-thirds of cases. Diagnosis is usually clinical, with physical exam and history being sufficient enough to confirm diagnosis without imaging. Groin hernias may be associated with morbidity and can become complicated by incarceration or strangulation, requiring emergent surgical repair. However, the risk of strangulation is sufficiently low in asymptomatic or minimally symptomatic patients with inguinal hernias that an initial approach of watchful waiting is safe and appropriate. Chronic pain and hernia recurrence are other potential complications that support a watchful waiting approach in asymptomatic patients. Patients with symptomatic hernias should be offered surgical repair. The objective of this paper is to review the current status of the clinical diagnosis and management of patients with inguinal hernias.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81879267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Tensiometry: A New Modality for Per-Operative Measurement of Medialization and Tension During Laparoscopic Hernia Surgery.","authors":"F P J Den Hartog, E F Van Koten, J J Van Den Dobbelsteen, P J Tanis, M Van Der Elst, A L A Bloemendaal","doi":"10.3389/jaws.2022.10850","DOIUrl":"10.3389/jaws.2022.10850","url":null,"abstract":"<p><p><b>Background:</b> Newly developed techniques for minimally invasive abdominal wall reconstruction (AWR) for complex ventral hernia are continuously evolving. In order to achieve hernia defect closure, the aponeurotic edges of the hernia defect need to be approximated. Currently, surgeons have no way to objectively measure and quantify the traction required to approximate these edges. This study presents minimally invasive tensiometry (MINT), a novel technology for measuring fascial tension, as well as initial experiences and results using it. <b>Methods:</b> The MINT device was designed using rapid prototyping principles. It was designed as an add-on tool for any existing laparoscopic instrument, enabling objective assessment of abdominal wall tension by the use of a manually operated linear spring. Pre-clinical measurements of medialization at 10 and 20 N of tension during AWR were performed on fresh-frozen Post-Mortem Human Specimens (PMHS). <b>Results:</b> Three specimens were included, and a total number of 36 measurements of medialization at three different levels of the abdominal wall were performed under structured and similar circumstances. Median total medialization with 20 Newton (N) of applied tension was 25 mm (mm) cranially, 37.5 mm at the umbilicus and 27.5 mm at the caudal level. The highest rate of medialization was seen at the umbilical level (2.25 mm/N). <b>Conclusion:</b> MINT is a novel non-invasive technique, which allows surgeons to intraoperatively measure fascial tension when performing AWR. The MINT device is easy to use and reproduce. The next step is to start performing clinical measurements applying MINT during AWR.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82597619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factor-Driven Prehabilitation Prior to Abdominal Wall Reconstruction to Improve Postoperative Outcome. A Narrative Review.","authors":"Allard S Timmer, Jeroen J M Claessen, Marja A Boermeester","doi":"10.3389/jaws.2022.10722","DOIUrl":"10.3389/jaws.2022.10722","url":null,"abstract":"<p><p>All abdominal wall reconstructions find themselves on a scale, varying between simple to highly complex procedures. The level of complexity depends on many factors that are divided into patient comorbidities, hernia characteristics, and wound characteristics. Preoperative identification of modifiable risk factors provides the opportunity for patient optimization. Because this so called prehabilitation greatly improves postoperative outcome, reconstructive surgery should not be scheduled before all modifiable risk factors are optimized to a point where no further improvement can be expected. In this review, we discuss the importance of preoperative risk factor recognition, identify modifiable risk factors, and utilize options for patient prehabilitation, all aiming to improve postoperative outcome and therewith long-term success of the reconstruction.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89425377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Emergent Groin Hernia Repair: Anterior or Posterior Approach?","authors":"V Rodrigues-Gonçalves, M Verdaguer, M Moratal, R Blanco, A Bravo-Salva, J A Pereira-Rodíguez, M López-Cano","doi":"10.3389/jaws.2022.10586","DOIUrl":"10.3389/jaws.2022.10586","url":null,"abstract":"<p><p><b>Introduction:</b> The current literature has not yet provided a definitive conclusion on the best emergency groin hernia repair. The aim of this study was first to compare the short and long-term outcomes between open preperitoneal and anterior approach in emergency groin hernia repair and second to identify risk factors for postoperative complications, mortality, and recurrence. <b>Materials and Methods:</b> This retrospective cohort study included patients who underwent emergency groin hernia repair between January 2010 and December 2018. Short and long-term outcomes were analyzed comparing approach and repair techniques. The predictors of complications and mortality were investigated using multivariate logistic regression. Cox regression multivariate analysis were used to explore risk factors of recurrence. <b>Results:</b> A total of 316 patients met the inclusion criteria. The most widely used surgical techniques were open preperitoneal mesh repair (34%) and mesh plug (34%), followed by Lichtenstein (19%), plug and patch (7%) and tissue repair (6%). Open preperitoneal mesh repair was associated with lower rates of recurrence (<i>p</i> = 0.02) and associated laparotomies (<i>p</i> < 0.001). Complication and 90-day mortality rate was similar between the techniques. Multivariable analysis identified patients aged 75 years or older (OR, 2.08; 95% CI, 1.14-3.80; <i>p</i> = 0.016) and preoperative bowel obstruction (OR, 2.11; 95% CI, 1.20-3.70; <i>p</i> = 0.010) as risk factors for complications and Comprehensive Complication Index ≥26.2 as risk factor for 90-day mortality (OR, 44.76; 95% CI, 4.51-444.59; <i>p</i> = 0.01). Female gender was the only risk factor for recurrence. <b>Conclusion:</b> Open preperitoneal mesh repair may be superior to other techniques in the emergency setting, because it can avoid the morbidity of associated laparotomies, with a lower long-term recurrence rate.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75164135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Textbook Outcome After Implementation of Transversus Abdominis Release in a Regional Hospital.","authors":"Johannes A Wegdam, Dite L C de Jong, Tammo S de Vries Reilingh, Ellis E Schipper, Nicole D Bouvy, Simon W Nienhuijs","doi":"10.3389/jaws.2022.10517","DOIUrl":"10.3389/jaws.2022.10517","url":null,"abstract":"<p><p><b>Background:</b> The posterior component separation technique with transversus abdominis release (TAR) was introduced in 2012 as an alternative to the classic anterior component separation technique (Ramirez). This study describes outcome and learning curve of TAR, five years after implementation of this new technique in a regional hospital in the Netherlands. <b>Methods:</b> A standardized work up protocol, based on the Plan-Do-Check-Act cycle, was used to implement the TAR. The TAR technique as described by Novitsky was performed. After each 20 procedures, outcome parameters were evaluated and new quality measurements implemented. Primary outcome measure was Textbook Outcome, the rate of patients with an uneventful clinical postoperative course after TAR. Textbook Outcome is defined by a maximum of 7 days hospitalization without any complication (wound or systemic), reoperation or readmittance, within the first 90 postoperative days, and without a recurrence during follow up. The number of patients with a Textbook Outcome compared to the total number of consecutively performed TARs is depicted as the institutional learning curve. Secondary outcome measures were the details and incidences of the surgical site and systemic complications within 90 days, as well as long-term recurrences. <b>Results:</b> From 2016, sixty-nine consecutive patients underwent a TAR. Textbook Outcome was 35% and the institutional learning curve did not flatten after 69 procedures. Systemic complications occurred in 48%, wound complications in 41%, and recurrences in 4%. Separate analyses of three successive cohorts of each 20 TARs demonstrated that both Textbook Outcome (10%, 30% and 55%, respectively) and the rate of surgical site events (45%, 15%, and 10%) significantly (<i>p</i> < 0.05) improved with more experience. <b>Conclusion:</b> Implementation of the open transversus abdominis release demonstrated that outcome was positively correlated to an increasing number of TARs performed. TAR has a long learning curve, only partially determined by the technical aspects of the operation. Implementation of the TAR requires a solid plan. Building, and maintaining, an adequate setting for patients with complex ventral hernias is the real challenge and driving force to improve outcome.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74487727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of robotic repair of parastomal hernias","authors":"Kyle Schmitt, Vance L. Albaugh, K. LeBlanc","doi":"10.4103/ijawhs.ijawhs_87_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_87_21","url":null,"abstract":"BACKGROUND: Parastomal hernias present a common complex surgical problem that has a severe clinical impact on quality of life. Several techniques for repair have been described with open or minimally invasive techniques, although recurrence and reoperation continue to be common problems. In the following, a case series utilizing a technique for a minimally invasive repair using the Di Vinci robotic platform for a mesh-reinforced, modified Sugarbaker repair is described. STUDY DESIGN: This study is a retrospective review of 24 cases of robotic-assisted parastomal hernia repairs performed by a single surgeon from 2014 to 2020. Primary endpoints of interest were operative times and length of stay, as well as postoperative complications. RESULTS: Twenty-four patients were included in the study. The average operative time was 194.8 min (range: 95–378 min) and the average console time was 149.5 min (range: 72–319 min). The average length of stay was 3.9 days. No patients required conversion to either a laparoscopic or an open procedure, although two complications required reoperation. Twelve patients developed minor complications, including four who developed a postoperative seroma, but none of them required surgical intervention. CONCLUSIONS: This is the first and largest series describing a technique for a robotic-assisted parastomal hernia repair. This shows that this procedure can be reliably undertaken with the robotic platform with consistent and reproducible results and few complications. Further long-term research will be needed as new robotic techniques evolve and patients will need follow-up regarding recurrence rates and any late complications evaluated.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81667222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When hernia mesh erodes into the bowel: A “bezoar” case","authors":"I. Nair, Kellee Slater","doi":"10.4103/ijawhs.ijawhs_88_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_88_21","url":null,"abstract":"Incisional hernia repair surgery is commonly performed by using a synthetic mesh; due to its low complication rate. This article describes the management of a patient with mesh erosion into the small bowel, a rare complication of mesh-based ventral hernia repair. Fatigue secondary to iron-deficiency anemia and disfigurement from his hernia were his only symptoms. The patient was conservatively managed for several years due to the risks associated with restorative surgery. Eventually, due to deterioration of his health as well as advances in the techniques of abdominal wall reconstruction, the patient underwent surgery. The patient made excellent recovery. The complications associated with the synthetic mesh are likely to be very underreported. This article discusses the factors leading to mesh erosion, including mesh type, fixation methods, mesh migration, and mesh position, and it emphasizes the importance of reporting and following up hernia patients to advance the science behind mesh technology and surgical techniques surrounding ventral hernia repair.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76273414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing safety in ventral patch repair for umbilical hernia by utilizing a hybrid technique","authors":"R. Jhaveri, Vishakha Kalikar, R. Modi, R. Patankar","doi":"10.4103/ijawhs.ijawhs_26_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_26_22","url":null,"abstract":"BACKGROUND: Both suture and mesh repairs are used for smaller (1-3 cm) umbilical hernias. But primary repair has a higher recurrence rate in literature. The use of mesh repairs has become the way to go for small and medium sized ventral hernias. Ventral patch placement is a simple and effective procedure for the repair of umbilical hernias of 1–3 cm size. We demonstrate the safety and efficacy of the ventral patch for the same with our modification of the technique in 100 consecutive patients. We would initially insert the patch as described by the company, but had one patient presenting with intestinal obstruction, who on diagnostic laparoscopy had a small bowel loop entrapped between the patch and the anterior abdominal wall. This brought about a change in the original technique at our institute, which we adopted for all patients thereafter. MATERIALS AND METHODS: A single centre retrospective analysis of prospectively collected data was done. Our modified technique was done in 100 consecutive patients with umbilical hernia defect size ranging from 1 cm to 2.5 cm, from January 2017 to January 2021. Demographics, post-operative pain, duration of hospital stay, surgical site occurrences (early and late), post-operative complications and recurrences were noted. RESULTS: A total of 100 patients were included in the study. Two patients had superficial surgical site infection which was managed conservatively. We did not record any other major complications or recurrence. Visual analogue scale for pain was recorded at 24 hours. Majority (95%) of the patients had none to mild pain and were discharged at 24 hours. Five patients experienced moderate pain and were discharged at 36–48 hours. No patient experienced chronic pain at follow up. CONCLUSION: The hybrid technique of the ventral patch placement is a safe way for optimum visualization for the correct mesh placement and may improve results, decrease complications and recurrences.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81535159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}