International Journal of Abdominal Wall and Hernia Surgery最新文献

{"title":"Robotic transabdominal preperitoneal morgagni hernia repair technique: A case report","authors":"C. Janowski, N. Sioda, Siwen Liu, A. Sabatino, C. Ballecer","doi":"10.4103/ijawhs.ijawhs_71_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_71_21","url":null,"abstract":"Robotic transabdominal preperitoneal Morgagni hernia repair: A step-wise approach. Morgagni hernia (MH) is an atypical and rare type of diaphragmatic hernia that presents surgical challenges given its location and proximity to vital structures. Classically, these hernias have been repaired either open or laparoscopically with the use of an intraperitoneal onlay mesh without defect closure. Borrowing from the groups’ excellent experience in robotic transabdominal preperitoneal hernia repair (rTAPP) ventral and atypically located hernias, this approach has shown promise in repairing MHs in albeit a small cohort of patients. The rTAPP technique in our opinion overcomes many of the challenges and pitfalls associated with atypical hernias, including those of the diaphragm, providing excellent visualization and facilitating wide preperitoneal dissection with a complete reduction of the hernia sac located in the anterior mediastinum. The wide preperitoneal exposure allows for directed diaphragmatic closure, minimizing the risk of injury to mediastinal structures, placement of a large uncoated mesh sandwiched in between layers of the abdominal wall, and safely targeted fixation at cardinal points. Preperitoneal mesh allows for the use of a more cost-effective uncoated mesh that is not exposed to the viscera. It also allows for minimal and targeted fixation without the use of tacks, leading to decreased postoperative pain and complications. In this article, we are detailing the rTAPP approach in managing MHs.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"70 1","pages":"135 - 139"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86272890","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":"Repair of giant incisional hernias: Comparison of separation technique with and without mesh","authors":"S. Benek, Şevki Pedük, Yasin Duran","doi":"10.4103/IJAWhs.ijawhs_74_21","DOIUrl":"https://doi.org/10.4103/IJAWhs.ijawhs_74_21","url":null,"abstract":"BACKGROUND: Incisional hernias are one of the most common postoperative complications encountered by surgeons in daily practice. In our study, we compared the component separation technique (CST) with and without synthetic mesh in large incisional hernia surgery. MATERIALS AND METHODS: The files of 79 patients who underwent surgery for giant incisional hernia between January 2016 and November 2020 were reviewed retrospectively. The patients were divided into two groups: CST with mesh reinforcement (mesh+ group) and CST without mesh reinforcement (non-mesh group). The groups were compared in terms of recurrence, complications, and other clinical features. RESULTS: There were 36 patients in the mesh+ group and 38 patients in the non-mesh group. There was no significant difference between the two groups in terms of demographic parameters and clinical features. There was a statistically significant difference between the groups in terms of recurrence rate (P = 0.007, OR = 0.17). In addition, there was a significant difference between the two groups in terms of mean operation times (2.8 h and 1.9 h for mesh+ and non-mesh, respectively) (P = 0.000, 95% CI). Regardless of the use of mesh, recurrence was significantly higher in the presence of high body mass index (BMI) (P = 0.003, 95% CI) and comorbidity (P = 0.031, OR = 3.4). CONCLUSION: Repair of giant incisional hernias with mesh-reinforced CST is superior to the non-mesh technique in terms of hernia recurrence. Although CST without mesh reinforcement seems advantageous in terms of complications and operation time, we believe that the mesh-reinforced CST should be applied in suitable patients when the total cost, recurrence, and patient satisfaction are taken into account.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"25 1","pages":"110 - 115"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88374126","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":"A combined laparoscopic and open delayed repair of a rare traumatic abdominal wall hernia: A case report","authors":"D. Dorpmans, A. Dams","doi":"10.4103/IJAWhs.ijawhs_84_21","DOIUrl":"https://doi.org/10.4103/IJAWhs.ijawhs_84_21","url":null,"abstract":"Introduction: Traumatic abdominal wall hernias (TAWHs) are uncommon and result from a high-energetic blunt trauma to the abdomen. These hernias are not always apparent in initial trauma evaluation. No consensus exists regarding optimal timing and surgical approach. Case Presentation: A 68-year-old Caucasian woman was involved as a passenger in a high-energetic head-on collision motor vehicle accident. In the initial assessment a sternal fracture, four rib fractures, a small pneumothorax, and a medial malleolus fracture were found. A small abdominal wall hernia was missed. Six months later she presents with a painful mass in her left flank. Computed tomography (CT) showed a large hernia containing colon. An elective hybrid repair was done. Laparoscopically, a preperitoneal mesh was placed. Afterward, using open access, the abdominal wall musculature was re-fixated on the iliac crest. Discussion: Emergent surgical management of TAWH is often preferred due to high incidence of associated intra-abdominal lacerations. These settings are not always favorable for mesh placement. Some data suggest a higher recurrence rate for hernias without mesh augmentation and repair within the acute posttraumatic period. Conservative management poses the risk of incarceration and hernia defect enlargement. A delayed repair can be considered if the patient is hemodynamically stable, no associated visceral lacerations are present and the defect is large enough to reduce the risk of incarceration. It has the advantage of mesh placement in healthy tissue.Conclusions: A delayed laparoscopic repair seems a safe and valid option allowing larger mesh placement. Additional fascia closure of muscle fixation can be done granting more reinforcement and smaller incision needs and thus less postoperative pain.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"1 1","pages":"145 - 149"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86992317","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":"A rare complication of giant pseudocyst after femoral hernia repair with mesh: A case report","authors":"Jasmine Bhinder, Boris Borges, W. Guo","doi":"10.4103/ijawhs.ijawhs_67_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_67_21","url":null,"abstract":"Hernia repair is one of the most common procedures performed by general surgeons worldwide. Rates of recurrence have significantly decreased with the use of mesh; however, this foreign material has its own inherent complications. We present a rare and unusual complication of giant pseudocyst formation after femoral hernia repair. Pseudocysts have mostly been described after incisional hernia repairs and there are only a handful of cases reported after groin hernia repair in the literature. To the best of our knowledge, this is the first reported case of pseudocyst after femoral hernia repair.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"5 1","pages":"100 - 102"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81490745","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":"Obstructed inguinal hernia in an adult male: A rare presentation of persistent Müllerian duct syndrome (internal male pseudohermaphroditism): A case report","authors":"M. Husain, Sabina Khan, Sanika Deshpande, Kartavya Yadav","doi":"10.4103/IJAWhs.ijawhs_47_21","DOIUrl":"https://doi.org/10.4103/IJAWhs.ijawhs_47_21","url":null,"abstract":"Persistent Müllerian duct syndrome (PMDS) is an unusual form of internal male pseudohermaphroditism in which Müllerian duct derivatives are seen in phenotypically normal males, with 46, XY karyotype. PMDS is an outcome of defective functioning of the Müllerian inhibiting factor (MIF) or its receptor. MIF causes degeneration of the Müllerian duct in the fetus. PMDS clinically manifests as cryptorchidism or inguinal hernia, although it is mostly undetected until puberty. We report a rare case of PMDS in a 45-year-old male patient with right-sided cryptorchidism and contralateral inguinal hernia. Upon exploration of the hernial sac, it contained a uterus-like mass with attached left testis. Biopsy and subsequent histopathological examination of the mass confirmed the presence of endometrial glands.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"10 1","pages":"91 - 94"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74716028","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":"A case report on late-onset congenital diaphragmatic hernia in adolescence","authors":"Pawan Sharma, S. Rehsi, A. Das, V. Nair","doi":"10.4103/IJAWhs.ijawhs_34_21","DOIUrl":"https://doi.org/10.4103/IJAWhs.ijawhs_34_21","url":null,"abstract":"Congenital diaphragmatic hernia is a life-threatening anomaly with the high mortality rate in infancy. Very rarely they remain silent and manifest in the adult life. Once they manifest, the symptoms vary and are not easy to diagnose. The entity also has associated problems in the form of hypoplastic lungs and loss of domain of the abdomen. In such cases, the diagnosis is most often based on clinical suspicion and radiological confirmation. The treatment options are open abdominothoracic procedures or laparoscopic procedures. Once hernia is reduced, the defect is closed and should be reinforced with prosthetic mesh. Here we present a case of congenital diaphragmatic hernia in a teenager presenting with cardiac symptoms. The challenges faced in managing the case are discussed.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"119 1","pages":"86 - 88"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73928309","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":"Surgical repair of abdominal wall hernias in rural southeast Nigeria: Barriers, outcomes, and opportunities for change","authors":"A. Ogbuanya, N. Ugwu","doi":"10.4103/ijawhs.ijawhs_79_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_79_21","url":null,"abstract":"Background: Abdominal wall hernias constitute a significant cause of morbidity and mortality globally, but more importantly, they present a more pathetic situation in rural areas of sub-Saharan Africa and other developing nations. In our setting, the rate of elective repair is still too low and many cases present late, often with complications. This study aimed at documenting the spectrum, barriers to early repair, and factors that influence the outcomes of repair. Materials and Methods: A prospective study of adult patients surgically treated for abdominal wall hernia in rural southeast Nigeria between January 2014 and December 2019. Results: Overall, 975 patients were recruited: 706 (72.4%) had simple uncomplicated hernias, whereas the rest (269, 27.6%) presented in the emergency. Inguinal hernias comprised 74.1% of the cases followed by primary midline hernias (14.5%). Delayed presentation was common, with only 2.3% presenting within three months and the main reason being financial constraint (31.0%) followed by ignorance (12.2%). A third (324, 33.2%) of the patients harbored complete inguinoscrotal/inguinolabial hernias. Nearly a quarter (240, 24.6%) had comorbid illnesses, 14.9% harbored recurrent hernias, and more than a third (43.4%) had hernias with defect sizes >5 cm. Wound infection rates were 34.6% in the emergency group, 26.2% in the elderly, 20.7% for those with recurrent hernias, and 17.1% in those with comorbidities. Morbidity rates were greater in patients with hernia defects >10 cm (37.8%), inguinoscrotal/inguinolabial hernias (18.5%), and those who received bowel resection (56.7%). Generally, elevated wound infection and high overall morbidity rates were associated with emergency presentation (P = 0.000), advancing age (P = 0.030), procedures performed by a nonspecialist surgeon (P = 0.014), and large hernia variants (P = 0.000). Overall, mortality rate was 2.9%, but it was 9.7% in those with emergency repair. The main independent predictors of mortality were intestinal resection (P = 0.000), delayed presentation (0.003), advanced age (0.020), and comorbidities (P = 0.002). Conclusion: Delayed presentation, often in an emergency setup, is common among patients with abdominal wall hernias in our rural practice. Financial impediments and ignorance were the main barriers to early presentation and elective repair. Consequently, morbidity and mortality rates were high, especially in the setting of advancing age, delayed presentation, coexisting medical conditions, and bowel resection.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"71 1","pages":"59 - 68"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78747483","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":"Diaphragmatic hernia repair using uniportal video-assisted thoracoscopic surgery: A case report","authors":"B. Patel, S. Provenzano","doi":"10.4103/ijawhs.ijawhs_39_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_39_21","url":null,"abstract":"The objective of this case study is the management of small necked diaphragmatic hernia in a patient with hostile abdomen. Case study describes the technique of uniportal video-assisted thoracoscopic surgery (U-VATS) for management of diaphragmatic hernia. This is a novel case for the management of diaphragmatic hernia using a patch utilizing minimally invasive cardiac surgical instrumentation via U-VATS approach. U-VATS is a feasible option for the management of diaphragmatic hernia in a patient with hostile abdomen.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"24 57","pages":"89 - 90"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72396386","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":"Hernia uterine inguinale in adolescence: A rare presentation","authors":"A. Samy, Dasarathan Shanmugam","doi":"10.4103/ijawhs.ijawhs_31_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_31_21","url":null,"abstract":"A 14-year-old girl presented with a swelling over the right groin for 2 years associated with amenorrhea. She also had cyclical pain over the swelling every month. On further evaluation, she had a right inguinal hernia with right ovary and uterus in the hernia sac. She underwent inguinal exploration and hernial sac was identified. She underwent hernioplasty and was discharged uneventfully. The presence of uterus in a hernial sac is a rare entity. The risk of complications and chances of untoward injury during the unprecedented surgical procedure warrants a careful evaluation before surgery.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"20 1","pages":"83 - 85"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83355398","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":"Innovative technique for the abdominal wall reconstruction of complex enteroatmospheric fistula: A case report","authors":"V. Kollias, B. Cribb, Timothy Ganguly, Christopher Bierton, D. Tonkin","doi":"10.4103/IJAWhs.ijawhs_48_21","DOIUrl":"https://doi.org/10.4103/IJAWhs.ijawhs_48_21","url":null,"abstract":"Enteroatmospheric fistula (EAF) is a rare and devastating surgical complication with significant management challenges. Abdominal wall reconstruction (AWR) at the time of definitive repair represents the major challenge in patients with large abdominal wall defects with associated loss of abdominal domain. Herein, we describe a case of EAF with significant loss of domain for which AWR was achieved using an innovative combined approach of preoperative botulinum toxin A (BTA), extensive transversus abdominal release (TAR), and abdominal reinforcement with biosynthetic mesh. This approach achieves primary abdominal closure, providing the option of a single definitive reconstructive procedure for EAF. Further studies with long-term follow-up are required to assess the long-term durability of this approach.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"37 1","pages":"95 - 99"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81460124","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}