Paul Shuttleworth, Shariq Sabri, Andrei Mihailescu
{"title":"The Utility of Minimally Invasive Surgery in the Emergency Management of Femoral Hernias: A Systematic Review.","authors":"Paul Shuttleworth, Shariq Sabri, Andrei Mihailescu","doi":"10.3389/jaws.2023.11217","DOIUrl":"10.3389/jaws.2023.11217","url":null,"abstract":"<p><p><b>Background:</b> Femoral hernias are a relatively rare type of hernia but have a high complication rate, with a high proportion either presenting as an emergency or requiring emergency management. Minimal access surgery has been shown to be safe, with good results, in an elective setting, but there is little published evidence of its utility in an emergency. <b>Methods:</b> A systematic review was conducted searching PubMed, OVID, Embase, and Cochrane reviews for ((Femoral hernia) AND (laparoscop* OR minimal access OR robotic)) AND (strangulat* OR obstruct* OR incarcerat*). <b>Results:</b> 286 manuscripts were identified of which 33 were relevant. 24 were individual case reports, 3 case series, 4 cohort studies or case control series, and 2 high level reviews of National registers. <b>Conclusion:</b> Minimal access surgery can avoid an unnecessary laparotomy for the assessment of hernial contents, especially <i>via</i> a TAPP approach. Minimal access repair of femoral hernias as an emergency is feasible and can be done safely with results similar to open surgery but good quality evidence is lacking.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84398478","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":"Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials.","authors":"Can Deniz Deveci, Stina Öberg, Jacob Rosenberg","doi":"10.3389/jaws.2023.11179","DOIUrl":"10.3389/jaws.2023.11179","url":null,"abstract":"<p><p><b>Introduction:</b> Groin hernia literature often uses the terms light- and heavyweight and small or large pores to describe meshes. There is no universal definition of these terms, and the aim of this scoping review was to assess how mesh weight and pore sizes are defined in the groin hernia literature. <b>Methods:</b> In this systematic scoping review, we searched PubMed, Embase, and Cochrane CENTRAL. We included randomised controlled trials with adults undergoing groin hernia repair with the Lichtenstein or laparoscopic techniques using a flat permanent polypropylene or polyester mesh. Studies had to use the terms lightweight, mediumweight, or heavyweight to be included, and the outcome was to report how researchers defined these terms as well as pore sizes. <b>Results:</b> We included 48 studies with unique populations. The weight of lightweight meshes ranged from 28 to 60 g/m<sup>2</sup> with a median of 39 g/m<sup>2</sup>, and the pore size ranged from 1.0 to 4.0 mm with a median of 1.6 mm. The weight of heavyweight meshes ranged from 72 to 116 g/m<sup>2</sup> with a median of 88 g/m<sup>2</sup>, and the pore size ranged from 0.08 to 1.8 mm with a median of 1.0 mm. Only one mediumweight mesh was used weighing 55 g/m<sup>2</sup> with a pore size of 0.75 mm. <b>Conclusion:</b> There seems to be a consensus that meshes weighing less than 60 g/m<sup>2</sup> are defined as lightweight and meshes weighing more than 70 g/m<sup>2</sup> are defined as heavyweight. The weight terms were used independently of pore sizes, which slightly overlapped between lightweight and heavyweight meshes.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82795060","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}
Helena Subirana, Jaume Comas, Oriol Crusellas, Joaquim Robres, Joan Barri, Ana Domenech, Cristina Borlado, Jordi Castellví
{"title":"Preoperative Progressive Pneumoperitoneum in the Treatment of Hernias With Loss of Domain. Our Experience in 50 Cases.","authors":"Helena Subirana, Jaume Comas, Oriol Crusellas, Joaquim Robres, Joan Barri, Ana Domenech, Cristina Borlado, Jordi Castellví","doi":"10.3389/jaws.2023.11230","DOIUrl":"10.3389/jaws.2023.11230","url":null,"abstract":"<p><p><b>Introduction:</b> Surgical planning for repair of giant hernias with loss of domain needs to consider patient comorbidities, potential risks and possible postoperative complications. Some postoperative complications are related to the increase in intra-abdominal pressure caused by the reintroduction of abdominal contents into the peritoneal space. Preoperative progressive pneumoperitoneum (PPP) increases the capacity of abdominal cavity prior to hernia repair and allows for better physiological postoperative adaptation. The aim of this study is to analyze perioperative and intraoperative characteristics as well as outcomes of a cohort of patients treated with PPP prior to giant hernia repair at a single, high volume center. <b>Methods:</b> Prospective, descriptive, observational single-center study including 50 patients undergoing PPP prior to hernia with loss of domain repair between January 2005 and June 2022. We analysed epidemiological, surgical and safety variables. <b>Results:</b> Fifty patients were included: 43 incisional hernias, 6 inguinal hernias and 1 umbilical hernia. Mean age was 66 years (36-85). Median insufflation time was 12 days (4-20) and median insufflated volume of ambient air was 10,036 cc. There were complications during PPP in nine patients: 2 decompensation of chronic respiratory disease and 7 subcutaneous emphysema. PPP was prematurely suspended in patients with respiratory decompensation. All patients with incisional and umbilical hernias underwent open repair with mesh placement. Preperitoneal repair was performed in inguinal hernias. Three cases of hernia recurrence were reported during the follow up. <b>Conclusion:</b> PPP is a safe and effective tool in the preoperative management of patients with giant hernias. It helps to achieve the decrease or absence of abdominal wall tension and can favour the results of complex eventroplasty techniques.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84856152","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":"Robot-assisted repair of primary uncomplicated inguinal hernia: comparisons to conventional laparoendoscopic repair","authors":"Bernhard Limper, Lukas Kamrath","doi":"10.4103/ijawhs.ijawhs_60_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_60_22","url":null,"abstract":"BACKGROUND AND METHOD: Robotic hernia surgery is progressing more and more, so that the robotic procedure is also used in the groin. We compared our patients who were operated on laparoscopically using the TEP technique with patients who were operated on robotically using the TAPP technique. RESULTS: The rTAPP can be safely performed without any problems and has many advantages, but the operating time is significantly longer than the laparoscopic TEPP. CONCLUSION: Inguinal hernia surgery can certainly be learned quickly and effectively as an introduction to robotics. It remains to be seen whether it will prevail in terms of surgical time and economics.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85477327","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}
J. Eckhoff, D. Müller, S. Brunner, H. Fuchs, O. Meireles
{"title":"Do the costs of robotic surgery present an insurmountable obstacle? A narrative review","authors":"J. Eckhoff, D. Müller, S. Brunner, H. Fuchs, O. Meireles","doi":"10.4103/ijawhs.ijawhs_62_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_62_22","url":null,"abstract":"With increasing market size and rising demand, the question arises whether the high cost impedes accessibility to robotic surgery. Despite all the apparent advantages robotic surgery offers to surgeons and patients, it is imperative for healthcare providers to weigh the insufficiently documented evidence for robotics against the exorbitant price. Aside from the high acquisition cost of robotic systems, the cost of instruments and accessories, maintenance, as well as the need for training, and the impact on procedural dynamics in the operating room factor into any cost–utility analysis. However, current perspectives provide an insufficient overview of available systems and their cost. And the lack of transparency and incomplete information provided by manufacturers impose a significant challenge to informed decision-making. This article gives a short overview of the cost of robotic surgery, what additional costs to consider, where to obtain information, and attempts to elaborate on the question of whether cost impedes the worldwide establishment of robotic surgery.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89136039","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":"Editorial commentary for a special issue of the International Journal of Abdominal Wall and Hernia Surgery “robot-assisted hernia surgery”","authors":"R. Bittner","doi":"10.4103/ijawhs.ijawhs_46_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_46_23","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78952747","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":"The first robotic STORRM: A case report","authors":"H. Hakmi, T. Pacheco, D. Halpern","doi":"10.4103/ijawhs.ijawhs_59_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_59_22","url":null,"abstract":"Parastomal hernias present a continued challenge to the general surgeon. There are a myriad of techniques available, with hernia recurrence rates varying between 10 to greater than 50%. Mesh reinforcement and underlay or sublay placement are associated with lower hernia recurrence rates. Many patients with parastomal hernia have associated comorbidities which increase their risk for perioperative wound complications. Robotic and minimally invasive techniques offer decreased rate of wound complications, but can be challenging to perform if the stoma needs to be relocated. For patients with complex parastomal hernias requiring abdominal wall reconstruction with transversus abdominis release and retromuscular mesh placement, it can be difficult to align the layers of the abdominal wall and create an aperture in the mesh to allow for a straight passage of the conduit and prevent subsequent angulation of the bowel. Stapled Transabdominal Ostomy Reinforcement with retromuscular mesh, or STORRM technique, has been previously described elsewhere as a technique whereby a circular EEA (End-to-End Anastomoses) stapler is used to create a straight tunnel through the mesh and abdominal wall layers, standardize sizing, fixate the mesh, and substitute traditional cruciate incisions with a stapled reinforcement of the aperture in the mesh/tissues.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73464669","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":"Robot-assisted repair of incisional hernia of the abdominal wall: Which access is better—endoscopic totally extraperitoneal preperitoneal plasty (eTEP) or mini- or less-open sublay (e)(MILOS), some first considerations","authors":"R. Vogel, F. Heinzelmann, P. Büchler, Bjoern Mück","doi":"10.4103/ijawhs.ijawhs_57_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_57_22","url":null,"abstract":"Numerous metanalyses have shown that the retromuscular mesh placement is superior to other positions in terms of recurrence and complication rate. As a result, there has been a surge in novel minimally invasive retromuscular surgical techniques. We compared total extraperitoneal plasty (eTEP) and hybrid Mini/Less-open-Sublay [(e)MILOS] with respect to their adaptability to a surgical robotic system. Unfortunately, there is little to no literature regarding robotic adaptation of the (e)MILOS procedure, which made it rather difficult to juxtapose, but then again also implies that it is not commonly performed. As many benefits as the robot brings to endoscopic surgery, however, there is one major constraint when it comes to directionality. In eTEP dissection is performed in one direction and the trocars are positioned at the edge of the dissection field. The centripetal preparation of the (e)MILOS procedure is less suitable for the currently available systems and would naturally require multiple un- and re-dockings of the robot. Alternatively, the robot could only be used for a minor part of the operation. Looking at the published data concerning laparoendoscopic (e)MILOS and eTEP, there appears to be no significant difference in terms of major complications as well as reoperation and infection rates. However, a comparison to a robot-assisted eTEP cannot be done due to lack of publications. Judging from our own experience, we believe the eTEP technique to harness the advantages of the robot in addition to those of minimally invasive surgery more effectively. Within the last two decades, we have been experiencing a constant increment of endoscopic procedures in hernia surgery. This surge is nonetheless thanks to the availability of robotics in a continuously increasing number of hospitals in Europe and the United States. The combination of the advantages of minimally invasive surgery and robotic systems has been discussed and elaborated on many occasions and platforms. Hence, the goal of this analysis is to compare two broadly established minimally invasive (or less open) retromuscular methods in hernia repair surgery with regard to their adaptability to a surgical robot.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76569472","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":"Prospects and challenges of robotic hernia surgery in China: A narrative review","authors":"Shaochun Li, Shaojie Li, Dongsheng Hou, Jianxiong Tang","doi":"10.4103/ijawhs.ijawhs_54_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_54_22","url":null,"abstract":"The Da Vinci surgical robotic system has revolutionized the field of robotic surgery and has become one of the most ubiquitous and recognized systems in the robotic surgery era. The rapid rise in China’s economy will provide crucial support for the promotion and application of robotic surgical systems in the country’s surgical field. At present, approximately 1.2 million inguinal hernia repairs are performed annually in China. However, many of these surgeries are performed via traditional open repair or laparoscopy methods. Using the purported benefits of robotic surgery system to benefit hernia patients should become a future direction for Chinese hernia surgeons.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76017802","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":"Commentary special issue “Robotics in Hernia Surgery”","authors":"D. Mueller, H. Fuchs","doi":"10.4103/ijawhs.ijawhs_12_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_12_23","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82254494","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}