International Journal of Abdominal Wall and Hernia Surgery最新文献

{"title":"Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic","authors":"H. Adamou, I. Amadou Magagi, O. Habou, A. Magagi, R. Sani","doi":"10.4103/ijawhs.ijawhs_66_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_66_22","url":null,"abstract":"OBJECTIVE: To describe epidemiological, therapeutic, and prognostic aspects of groin and ventral hernia in adults at Zinder National Hospital. MATERIALS AND METHODS: This was a retrospective data collected over a period of 10 years (January 2012–December 2021). All patients aged at least 18 years operated for abdominal wall hernia were included. A value of P < 0.05 was considered significant. RESULTS: A total of 921 patients were included. In these patients, groin hernia was present in 78.8% (n = 726), umbilical hernia in 13.25% (n = 122), linea alba hernia in 7.3% (n = 67), and Spiegel’s hernia in 6 cases (0.65%). The mean age was 48 ± 17.2 years. Men accounted for 80.9% (n = 745). Rural origin was 67% (n = 623) and poor 63.8% (n = 588). The stage of hernia strangulation represents 32% (n = 295). The median time to surgical consultation was 8 years. This delay was associated with rural origin (odds ratio [OR] = 1.42; P = 0.0142), poverty status (OR = 1.67; P = 0.0001), and inguinal location (OR = 1.75; 0.0371). General anesthesia was used in 58.7% (n = 541). Bowel necrosis was seen in 9.33% (n = 86). For all groin hernias (n = 783), 96.2% (n = 753) underwent herniorrhaphy and 3.8% (n = 30) underwent a Lichtenstein procedure. For all ventral hernias herniorrhaphy was performed in 95% (n = 245) and mesh repair in 5% (n = 13). Morbidity was 15.4% (n = 142) and mortality 1.74% (n = 16). This was associated with age over 60 years (OR = 3.06; P = 0.0341), ASAIII and ASAIV classes (OR = 5.21; P = 0.015), complicated clinical forms (OR = 4.87; P = 0.023), emergency surgery (OR = 4.51; P = 0.003), and the occurrence of bowel necrosis (OR = 4.11; P = 0.001). The median follow-up was 6 months (range: 3–36 months). Overall, hernia recurrence was recorded in 69 cases or 7.6%. This was associated with emergency surgery (OR = 6.26; P = 0.000) and age over 60 years (OR = 3.02; P = 0.000). CONCLUSION: In our context, the management of groin and ventral hernias is an important activity for the surgeon. Inguinal hernias predominate and hernia strangulation is an element of poor prognosis.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87521207","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":"Herniation and incarceration of the gallbladder through the abdominal drain site: A case report","authors":"D. Garbuzenko, D. Belov","doi":"10.4103/ijawhs.ijawhs_3_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_3_23","url":null,"abstract":"A rare case of herniation and incarceration of the gallbladder through the abdominal drain site in an 86-year-old woman with degenerative aortic valve disease, a severe aortic stenosis, and an aortic insufficiency grade 2 hospitalized for transcatheter aortic valve implantation is described. An incarcerated incisional hernia through the abdominal drain site was confirmed by contrast-enhanced multislice computed tomography (MSCT) scan of the abdomen. Given the short duration of incarceration and the absence of MSCT findings of the gallbladder wall necrosis, the patient was dynamically monitored. There were no indications for emergency surgery. The presented case recalls the possibility of the formation of incisional hernias containing the gallbladder through the abdominal drain site. Literature data indicate that the diagnostic errors when they are incarcerated can lead to fatal consequences.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85551362","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":"Low back pain and motor control dysfunction after pregnancy: The possible role of rectus diastasis","authors":"R. Tuominen, T. Jahkola, Jani Mikkonen, H. Luomajoki, J. Arokoski, J. Vironen","doi":"10.4103/ijawhs.ijawhs_71_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_71_22","url":null,"abstract":"Purpose: Pregnancy-related low back pain is a common condition. Persistent postpartum diastasis recti may cause back pain and motor control dysfunction. The role of diastasis in pregnancy-related back pain remains debatable. This study aimed to compare participants with increased symptoms after index pregnancy with those reporting no change in back pain or subjective movement control and to analyze inter-rectus distance. Materials and Methods: This case-control study included a cohort of women who delivered 1 year earlier. We recruited participants with increased symptoms (n = 14) after index pregnancy and controls (n = 41) and recorded their inter-rectus distance using ultrasound. A questionnaire was completed, and an ultrasound performed twice for each study group. Results: At the baseline, there was no significant difference in inter-rectus distance between cases and controls (mean 2.45 ± 1.01 cm and 2.09 ± 1.03 cm, respectively). A year after index pregnancy symptomatic cases had significantly wider inter-rectus distance than controls (mean 3.45 ± 0.90 cm and 2.40 ± 0.79 cm, respectively). Motor control dysfunction test results were not associated with core stability problems or back pain in this cohort. There was a difference in the sit-up test between cases and controls (mean 4.7 ± 4.2 and 8.2 ± 3.9, respectively). Conclusion: Women who reported increased back pain and core instability after index pregnancy had wider inter-rectus diameter than controls. In the case group with more symptoms after pregnancy, the classification of rectus diastasis (RD) changed from mild abdominal RD (2–3 cm) to moderate (>3–5 cm). RD may contribute to persistent pregnancy-related lumbopelvic pain.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79417750","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":"Outcomes in the surgical management of giant inguinal hernias: A systematic review","authors":"S. Oyewale, Azeezat Ariwoola","doi":"10.4103/ijawhs.ijawhs_4_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_4_23","url":null,"abstract":"Giant inguinal hernia presents a range of unique challenges in its treatment. Detailing the potential complications and outcomes of treatment can motivate patients with giant inguinal hernias (GIH) to seek an early surgical intervention and raise awareness of the risks of neglecting the condition. The aim of this review is to identify the rates of complications, especially the abdominal compartment syndrome, and the causes of mortality encountered in the treatment of GIH. Furthermore, a new classification system for GIH is proposed. The search resulted in 1,926 papers, and 10 papers were included in the study. The majority of the studies were conducted on subjects living in sub-Saharan Africa. The most frequently performed procedure was Nylon Darning, accounting for 46.5% and only 53 (12.5%) were laparoscopic repair. There were four deaths reported in two studies. Two were caused by pulmonary embolism, whereas renal failure and abdominal compartment syndrome were the causes of one death each. After a proportional meta-analysis, the pooled complication rate of the surgical interventions was 39% (95% confidence interval: 0.18–0.59) with a random effect model I2 = 82.6%. There was no recurrence in any of the studies. The complication rate for treating giant inguinal hernia is high but mortality is low. There was zero recurrence despite some subjects undergoing modified Bassini repair. Further research is needed to identify predictors of abdominal compartment syndrome and intra-abdominal hypertension. The proposed classification also requires further study on a large scale.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72476756","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":"Thoughts on Trocar Site Hernia Prevention. A Narrative Review.","authors":"A C de Beaux, B East","doi":"10.3389/jaws.2022.11034","DOIUrl":"10.3389/jaws.2022.11034","url":null,"abstract":"<p><p><b>Background:</b> Laparoscopic and robot-assisted surgery is now common place, and each trocar site is a potential incisional hernia site. A number of factors increase the risk of trocar site hernia (TSH) at any given trocar site. The aim of this paper is to explore the literature and identify the patients and the trocar sites at risk, which may allow target prevention strategies to minimise TSH. <b>Methods:</b> A pub med literature review was undertaken using the MeSH terms of \"trocar\" OR \"port-site\" AND \"hernia.\" No qualifying criteria were applied to this initial search. All abstracts were reviewed by the two authors to identify papers for full text review to inform this narrative review. <b>Results:</b> 961 abstracts were identified by the search. A reasonable quality systematic review was published in 2012, and 44 additional more recent publications were identified as informative. A number of patient factors, pre-operative, intra-operative and post-operative factors were identified as possibly or likely increasing the risk of TSH. Their careful management alone and more likely in combination may help reduce the incidence of TSH. <b>Conclusion:</b> Clinically symptomatic TSH is uncommon, in relation to the many trocars inserted every day for \"keyhole\" surgery, although it is a not uncommon hernia to repair in general surgical practice. There are patients inherently at risk of TSH, especially at the umbilical location. It is likely, that a multi-factored approach to surgery, will have a cumulative effect at reducing the overall risk of TSH at any trocar site, including choice of trocar type and size, method of insertion, events during the operation, and decisions around the need for fascial closure and how this is performed following trocar removal.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87006216","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":"Educating Men-Compulsory Reading in the Enlightenment of Gender Diversity.","authors":"Andrew de Beaux","doi":"10.3389/jaws.2022.11063","DOIUrl":"10.3389/jaws.2022.11063","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84670626","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":"The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure.","authors":"René H Fortelny","doi":"10.3389/jaws.2022.10962","DOIUrl":"10.3389/jaws.2022.10962","url":null,"abstract":"<p><p><b>Introduction:</b> The risk of developing an incisional hernia after primary elective median laparotomy is reported in the literature as being between 5 and 20 percent. The basic of an optimal outcome after midline incision is the appropriate closure technique with or without a prophylactic mesh. The objective of this paper is to critically examine the various closure techniques and, in particular, to present a detailed comparison of the long stitch and short stitch techniques. <b>Method:</b> Based on the available literature, the characteristics of the different closure techniques are described in detail, advantages and disadvantages are compared, and the current status of a practicable recommendation is discussed. Special attention is paid to the criteria of the short stitch technique, such as the suture to incision length ratio, number of stitches and distances, as well as suture material. <b>Results:</b> For elective midline closures, the use of a continuous closure using a slowly absorbable suture material in the small-bites technique with suture to wound ratio of at least 5:1 result in significantly lower risk of complications such as bursting abdomen and less incisional hernia rates compared to the large-bites technique. <b>Conclusion:</b> Based on the present evidence in midline closure after elective laparotomy the small bites technique can be recommended to significantly reduce the rate of incisional hernia.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87191390","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":"An Algorithmic Approach for the MIS Repair of Ventral Midline Hernias Associated With Diastasis of the Rectus Abdominis Muscle.","authors":"Cosman Camilo Mandujano, Diego L Lima, Jason Xia, Prashanth Sreeramoju, Flavio Malcher","doi":"10.3389/jaws.2022.10864","DOIUrl":"10.3389/jaws.2022.10864","url":null,"abstract":"<p><p><b>Purpose:</b> We present our algorithmic approach for symptomatic ventral hernias with Diastasis of the Rectus Abdominis Muscle (DRAM). <b>Methods:</b> Retrospective analysis of patients with symptomatic ventral hernias and DRAM undergoing hernia repair and plication of DRAM from July 2018-March 2021 was conducted. Based on our algorithm, patients were selected for an Endoscopic Onlay Repair (ENDOR) or a Robotic Extended Totally Extraperitoneal Ventral Repair (R-eTEP). <b>Results:</b> We performed a R-eTEP in fifty-seven patients and an ENDOR in twenty-four patients. In the R-eTEP group, thirty-seven (65%) patients were female, the mean age was 54.8 (±10.6), and the mean BMI was 32 (±4.8). Fifty patients (87.7%) had multiple defects, of which 19 (38%) were recurrent hernias and 31 (62%) were incisional hernias. The mean operative time was 200 (±62.4) minutes, with two cases requiring a hybrid approach. The median length of stay was 1 day (0-12), and the median follow-up was 103 days. Twenty-four patients underwent an ENDOR, 19 females (79.2%), the mean age was 45.7 years (±11.7) and the mean BMI was 28 (±3.6). 13 patients had isolated umbilical or epigastric hernias. The mean operative time was 146.2 min (±51.1). Fibrin sealant and suture was the predominant method for mesh fixation, and most cases were performed in an ambulatory setting. Four patients developed post-operative seromas; one requiring drainage due to infection. The Median follow-up was 48.5 days (10-523), with two reported hernia recurrences. <b>Conclusion:</b> An algorithmic approach for adequate patient selection was shown to be safe for treating ventral hernias with DRAM.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77286966","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":"Association Between Inter-Recti Distance and Impaired Abdominal Core Function in Post-Partum Women With Diastasis Recti Abdominis.","authors":"L Bixo, G Sandblom, J Österberg, O Stackelberg, K Bewö, A Olsson","doi":"10.3389/jaws.2022.10909","DOIUrl":"10.3389/jaws.2022.10909","url":null,"abstract":"<p><p><b>Background and Aim:</b> The definition and management of Diastasis Recti Abdominis (DRA) is under debate. This study aimed to understand the correlation between the post-partum inter-recti distance (IRD) and functional impairments associated with core instability, with the hypothesis that IRD could serve as a proxy for core instability symptoms and constitute a tool in decision-making for DRA treatment. <b>Material and Methods:</b> A cohort of post-partum women with abdominal core instability symptoms combined with DRA were studied. The size of IRD was measured with ultrasonography and cross-sectionally analysed against functional impairments registered with the self-report Disability Rating Index (DRI), which grades the ability to perform 12 different daily activities. <b>Results:</b> A total of 224 women were included in the study. In univariable analysis, IRD was associated with impairment of the activities running (<i>p</i> = 0.007), heavy work (<i>p</i> = 0.036) and exercise/sports (<i>p</i> = 0.047), but not with dressing, walking, sitting for long periods, standing bent over a sink, carrying a suitcase, making a bed, light manual labour or heavy lifting. No significant correlations were seen in the multivariable analysis when adjustments were made for BMI and parity. <b>Conclusion:</b> IRD and post-partum functional impairments had no significant correlation in multivariable analysis. The post-partum core instability condition is complex and probably associated with more factors than solely the IRD. The IRD alone does not seem to be a sufficient proxy for decision-making regarding optimal treatment. A more complete instrument to assess the post-partum abdominal core is warranted.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81345496","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":"Description of the Current Da Vinci^® Training Pathway for Robotic Abdominal Wall Surgery by the European Hernia Society.","authors":"Maaike Vierstraete, Maarten Simons, Knut Borch, Andrew de Beaux, Barbora East, Wolfgang Reinpold, Cesare Stabilini, Filip Muysoms","doi":"10.3389/jaws.2022.10914","DOIUrl":"10.3389/jaws.2022.10914","url":null,"abstract":"<p><p><b>Background:</b> Robot assisted laparoscopic abdominal wall surgery (RAWS) has seen a rapid adoption in recent years. The safe introduction of the robot platform in the treatment of abdominal wall hernias is important to safeguard the patient from harm during the learning curve. The scope of this paper is to describe the current European training curriculum in RAWS. <b>Methods and Analysis:</b> The pathway to competence in RAWS will depend on the robot platform, experience in other abdominal procedures (novice to expert) and experience in the abdominal wall repair techniques. An overview of the learning curve effect in the initial case series of several early adopters in RAWS was reviewed. In European centres, current training for surgeons wanting to adopt RAWS is managed by the specific technology-based training organized by the company providing the robot. It consists of four phases where phases I and II are preclinical, while phases III and IV focus on the introduction of the robotic platform into surgical practice. <b>Conclusion:</b> On behalf of the Robotic Surgery Task Force of the European Hernia Society (EHS) we believe that the EHS should play an important role in the clinical phases III and IV training. Courses organized in collaboration with the robot provider on relevant surgical anatomy of the abdominal wall and procedural steps in complex abdominal wall reconstruction like transversus abdominis release are essential. Whereas the robot provider should be responsible for the preclinical phases I and II to gain familiarity in the specific robot platform.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85319115","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}