Pub Date : 2024-08-08DOI: 10.4103/ijawhs.ijawhs_34_24
H. Kulacoglu, Alp Alptekin, H. Celasin
Botulinum toxin has been used for the treatment of numerous medical conditions. Recently, preoperative botulinum toxin A (BTA) injections into the lateral abdominal wall muscles are beneficial for facilitating ventral hernia repairs and improving surgical outcomes. Early and late, local and systemic adverse effects of BTA application have been described, some of them are flu-like symptoms (FLS). However, no case of FLS following botulinum toxin injections before ventral hernia repair has been described. In this report, we present a 58-year-old female patient who developed FLS episodes throughout preoperative and postoperative periods following BTA injections.
{"title":"Flu-like symptoms following botulinum toxin A application before incisional hernia repair: A case report","authors":"H. Kulacoglu, Alp Alptekin, H. Celasin","doi":"10.4103/ijawhs.ijawhs_34_24","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_34_24","url":null,"abstract":"\u0000 Botulinum toxin has been used for the treatment of numerous medical conditions. Recently, preoperative botulinum toxin A (BTA) injections into the lateral abdominal wall muscles are beneficial for facilitating ventral hernia repairs and improving surgical outcomes. Early and late, local and systemic adverse effects of BTA application have been described, some of them are flu-like symptoms (FLS). However, no case of FLS following botulinum toxin injections before ventral hernia repair has been described. In this report, we present a 58-year-old female patient who developed FLS episodes throughout preoperative and postoperative periods following BTA injections.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926715","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}
Pub Date : 2024-07-24DOI: 10.4103/ijawhs.ijawhs_19_24
Mathew Philip Pallikamattom, Murali T.V., Sheima R. Das, John Thomas
When a swelling arising in the gluteal region herniates into the pelvic cavity through the sciatic foramen, it is referred to as inverse or reverse sciatic hernia and is a rare occurrence. We present the case of a 62-year-old female who presented with swelling in the left gluteal region with features of sciatica and abdominal pain. Magnetic resonance imaging showed 27 cm × 22 cm × 9 cm soft tissue swelling arising from the gluteal region and inversely herniating into the pelvic cavity through the sciatic foramen. We were successful in delivering the tumor through a gluteal approach. Lipomatous tumors presenting as inverse sciatic hernia are a rare event.
{"title":"A rare case report of inverse sciatic hernia unveiling as a lipoma","authors":"Mathew Philip Pallikamattom, Murali T.V., Sheima R. Das, John Thomas","doi":"10.4103/ijawhs.ijawhs_19_24","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_19_24","url":null,"abstract":"\u0000 When a swelling arising in the gluteal region herniates into the pelvic cavity through the sciatic foramen, it is referred to as inverse or reverse sciatic hernia and is a rare occurrence. We present the case of a 62-year-old female who presented with swelling in the left gluteal region with features of sciatica and abdominal pain. Magnetic resonance imaging showed 27 cm × 22 cm × 9 cm soft tissue swelling arising from the gluteal region and inversely herniating into the pelvic cavity through the sciatic foramen. We were successful in delivering the tumor through a gluteal approach. Lipomatous tumors presenting as inverse sciatic hernia are a rare event.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141809215","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}
Pub Date : 2024-07-04DOI: 10.4103/ijawhs.ijawhs_13_24
Varsha Chinta, Sunil Krishna M, Vivek Ramesh Udupi
Internal hernia is the protrusion of a viscus through a normal or abnormal peritoneal or mesenteric aperture within the confines of the peritoneal cavity. They can be congenital or acquired after abdominal surgery. We report a case of a 58-year-old woman who presented with complaints of abdominal pain and nonbilious vomiting for 2 days. She underwent an abdominal hysterectomy 15 years ago. After baseline blood investigations and imaging, a diagnosis of subacute intestinal obstruction was made. As she clinically worsened over 24 h, CT imaging was done, which suggested acute small bowel obstruction secondary to adhesions. Surgery revealed herniation with incarceration of distal ileal loops through a defect in the sigmoid mesocolon. Bowel resection was done, and the defect was closed. The clinical presentation of internal hernias, especially transmesosigmoid hernia, is nonspecific, and they rapidly progress to bowel ischemia. Early intervention and surgical correction are prudent for good clinical outcomes.
{"title":"Closed-loop obstruction due to internal hernia: An atypical clinical presentation of acute abdomen - A case report","authors":"Varsha Chinta, Sunil Krishna M, Vivek Ramesh Udupi","doi":"10.4103/ijawhs.ijawhs_13_24","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_13_24","url":null,"abstract":"\u0000 Internal hernia is the protrusion of a viscus through a normal or abnormal peritoneal or mesenteric aperture within the confines of the peritoneal cavity. They can be congenital or acquired after abdominal surgery. We report a case of a 58-year-old woman who presented with complaints of abdominal pain and nonbilious vomiting for 2 days. She underwent an abdominal hysterectomy 15 years ago. After baseline blood investigations and imaging, a diagnosis of subacute intestinal obstruction was made. As she clinically worsened over 24 h, CT imaging was done, which suggested acute small bowel obstruction secondary to adhesions. Surgery revealed herniation with incarceration of distal ileal loops through a defect in the sigmoid mesocolon. Bowel resection was done, and the defect was closed. The clinical presentation of internal hernias, especially transmesosigmoid hernia, is nonspecific, and they rapidly progress to bowel ischemia. Early intervention and surgical correction are prudent for good clinical outcomes.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141837471","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}
Pub Date : 2024-06-08DOI: 10.4103/ijawhs.ijawhs_68_23
Ganesh Shenoy, Marina Thomas, Ramesh Shamburao, Nawab Jan
Occult traumatic diaphragmatic hernias (DHs) are relatively rare and may present years after the trauma. Clinical presentations range from asymptomatic incidental findings on imaging to life-threatening incarceration of abdominal organs. Traumatic migration of the kidney into the thorax is a very uncommon event. We herein report a rare case of a 34-year-old male patient with a symptomatic DH secondary to a motor vehicle accident and a history of laparotomy for liver laceration 10 years back who underwent laparoscopic reduction and intraabdominal reposition of left kidney from thorax, suture repair of the defect with mesh reinforcement. Thoracoscopic visualization was performed to assess the efficiency and completeness of the repair and to rule out any iatrogenic pericardial injury after mesh fixation. The operative technique, difficulties encountered, and tips to overcome these challenges were discussed. With adequate expertise, reduction, and repositioning of migrated kidney, suture closure of the defect with mesh reinforcement is safe and feasible by laparoscopic approach.
{"title":"Laparoscopic management of delayed traumatic left diaphragmatic hernia with intrathoracic kidney: A rare case report and technical aspects","authors":"Ganesh Shenoy, Marina Thomas, Ramesh Shamburao, Nawab Jan","doi":"10.4103/ijawhs.ijawhs_68_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_68_23","url":null,"abstract":"\u0000 Occult traumatic diaphragmatic hernias (DHs) are relatively rare and may present years after the trauma. Clinical presentations range from asymptomatic incidental findings on imaging to life-threatening incarceration of abdominal organs. Traumatic migration of the kidney into the thorax is a very uncommon event. We herein report a rare case of a 34-year-old male patient with a symptomatic DH secondary to a motor vehicle accident and a history of laparotomy for liver laceration 10 years back who underwent laparoscopic reduction and intraabdominal reposition of left kidney from thorax, suture repair of the defect with mesh reinforcement. Thoracoscopic visualization was performed to assess the efficiency and completeness of the repair and to rule out any iatrogenic pericardial injury after mesh fixation. The operative technique, difficulties encountered, and tips to overcome these challenges were discussed. With adequate expertise, reduction, and repositioning of migrated kidney, suture closure of the defect with mesh reinforcement is safe and feasible by laparoscopic approach.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141368811","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}
Pub Date : 2024-02-28DOI: 10.4103/ijawhs.ijawhs_81_23
A. Aljuhani, Ghaith Al Saied, Arjmand Reyaz, Mohammed A Alkahlan, Ibrahim M Aljohani, Muhammed M Abukhater
Traumatic abdominal wall hernia (TAWH) is a rare clinical occurrence, with only limited cases published since 1906. This type of hernia is primarily caused by low- or high-energy blunt force trauma, resulting in damage to abdominal wall musculature while the skin is intact. The diagnosis and management of TAWH poses a lot of challenges and complexities. Herein, we present a case of a 32-year-old male Saudi patient who sustained significant abdominal trauma as a driver involved in a front collision while wearing a seat belt. Upon arrival at the trauma center, the patient was hemodynamically stable and exhibited clinical signs of left flank bulge, seat belt sign, and abdominal bruising. First, a focused assessment with sonography for trauma (FAST) was performed, which revealed minimal free fluid in the abdomen. Subsequent contrast-enhanced IV computed tomography (CT) scan confirmed a 3.6-cm left lateral abdominal wall defect with herniation of short segments of the large and small bowel loops and adjacent subcutaneous fluid. Following initial observation, the patient developed signs of bowel obstruction. A repeat CT scan showed interval progression of the hernia, partial small bowel obstruction, and other concerning findings. An emergency laparoscopic exploration revealed a large defect at the left lumber region containing omentum and long segments of the small bowel with mild distension. The bowel and omentum were reduced. The surgical repair included herniorrhaphy and mesh placement. The patient recovered well and was discharged on the third postoperative day. This case underscores the importance of thorough evaluation and timely intervention in TAWHs. Rapid surgical management, aided by advanced imaging techniques, can lead to favorable outcomes even in complex cases involving bowel herniation and associated complications.
{"title":"Unique laparoscopic emergency management of traumatic obstructed abdominal wall hernia: A case report and review of literature","authors":"A. Aljuhani, Ghaith Al Saied, Arjmand Reyaz, Mohammed A Alkahlan, Ibrahim M Aljohani, Muhammed M Abukhater","doi":"10.4103/ijawhs.ijawhs_81_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_81_23","url":null,"abstract":"\u0000 Traumatic abdominal wall hernia (TAWH) is a rare clinical occurrence, with only limited cases published since 1906. This type of hernia is primarily caused by low- or high-energy blunt force trauma, resulting in damage to abdominal wall musculature while the skin is intact. The diagnosis and management of TAWH poses a lot of challenges and complexities. Herein, we present a case of a 32-year-old male Saudi patient who sustained significant abdominal trauma as a driver involved in a front collision while wearing a seat belt. Upon arrival at the trauma center, the patient was hemodynamically stable and exhibited clinical signs of left flank bulge, seat belt sign, and abdominal bruising. First, a focused assessment with sonography for trauma (FAST) was performed, which revealed minimal free fluid in the abdomen. Subsequent contrast-enhanced IV computed tomography (CT) scan confirmed a 3.6-cm left lateral abdominal wall defect with herniation of short segments of the large and small bowel loops and adjacent subcutaneous fluid. Following initial observation, the patient developed signs of bowel obstruction. A repeat CT scan showed interval progression of the hernia, partial small bowel obstruction, and other concerning findings. An emergency laparoscopic exploration revealed a large defect at the left lumber region containing omentum and long segments of the small bowel with mild distension. The bowel and omentum were reduced. The surgical repair included herniorrhaphy and mesh placement. The patient recovered well and was discharged on the third postoperative day. This case underscores the importance of thorough evaluation and timely intervention in TAWHs. Rapid surgical management, aided by advanced imaging techniques, can lead to favorable outcomes even in complex cases involving bowel herniation and associated complications.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140419443","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}
Pub Date : 2024-02-03DOI: 10.4103/ijawhs.ijawhs_69_23
Saeed Aldarwish, Paula Guda, M. Philipp, Clemens Schafmayer, S. Hinz
Open liver surgery is one of the most common abdominal surgeries, which is associated with a higher risk of developing an incisional hernia (IH). This is mainly because of the extent and type of the surgical incisions in this type of surgery. Of course, many other risk factors may interfere with wound healing and can increase the risk of developing IH after this type of surgery. In this study, we analyzed several perioperative risk factors, particularly the type of surgical incision and the technical suture aspects. Retrospectively, we analyzed the development of incisional hernia within the first 36 postoperative months clinically and image-morphologically among 155 patients who had undergone an open liver resection or liver transplantation and met the inclusion criteria between 2015 and 2020 in our institution. Most of the incisional hernias occurred during the first 16 postoperative months, with a peak incidence in the eighth postoperative month. The most important preoperative risk factors were the positive past medical history of other hernias (P = 0.05) and overweight/ obesity (P = 0.018). From the operative course, many risk factors were detected, like an intraoperative blood loss of > 1,000 ml (P = 0.043) and an intraoperative blood transfusion of > 10 PRBCs (P = 0.001), a Mercedes-star incision (P = 0.007), the use of Vicryl (polyglactin 910) sutures and interrupted suture techniques for the fascial reconstruction (P = 0.045) and (P = 0.006), and a long operative time of > 240 min (P = 0.033). Postoperative ascites formation as well as the need for revision operation due to a postoperative complication were associated with higher incidence rates of developing IH (P = 0.02) and (P = 0.014). The development of IH cannot be avoided. But the leading risk factors can be modified or optimized. From our experience and according to this analysis, we recommend the careful selection of the surgical approach for each patient and promotion of the use of the minimally invasive approaches, avoiding the angulated incisions as much as possible, applying the running suture technique with (polydioxanone) PDS-loops for the fascial reconstruction, minimizing the intraoperative blood loss and need for blood transfusion, shortening the operative time as much as possible, early detection of postoperative formation of ascites, and managing it properly. In the event of need for a revision operation due to a postoperative complication, a reinforced reconstruction of the fascia can be considered.
{"title":"Developing incisional hernia after open liver resection and liver transplantation: A single-center risk factor analysis","authors":"Saeed Aldarwish, Paula Guda, M. Philipp, Clemens Schafmayer, S. Hinz","doi":"10.4103/ijawhs.ijawhs_69_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_69_23","url":null,"abstract":"\u0000 \u0000 \u0000 Open liver surgery is one of the most common abdominal surgeries, which is associated with a higher risk of developing an incisional hernia (IH). This is mainly because of the extent and type of the surgical incisions in this type of surgery. Of course, many other risk factors may interfere with wound healing and can increase the risk of developing IH after this type of surgery. In this study, we analyzed several perioperative risk factors, particularly the type of surgical incision and the technical suture aspects.\u0000 \u0000 \u0000 \u0000 Retrospectively, we analyzed the development of incisional hernia within the first 36 postoperative months clinically and image-morphologically among 155 patients who had undergone an open liver resection or liver transplantation and met the inclusion criteria between 2015 and 2020 in our institution.\u0000 \u0000 \u0000 \u0000 Most of the incisional hernias occurred during the first 16 postoperative months, with a peak incidence in the eighth postoperative month. The most important preoperative risk factors were the positive past medical history of other hernias (P = 0.05) and overweight/ obesity (P = 0.018). From the operative course, many risk factors were detected, like an intraoperative blood loss of > 1,000 ml (P = 0.043) and an intraoperative blood transfusion of > 10 PRBCs (P = 0.001), a Mercedes-star incision (P = 0.007), the use of Vicryl (polyglactin 910) sutures and interrupted suture techniques for the fascial reconstruction (P = 0.045) and (P = 0.006), and a long operative time of > 240 min (P = 0.033). Postoperative ascites formation as well as the need for revision operation due to a postoperative complication were associated with higher incidence rates of developing IH (P = 0.02) and (P = 0.014).\u0000 \u0000 \u0000 \u0000 The development of IH cannot be avoided. But the leading risk factors can be modified or optimized. From our experience and according to this analysis, we recommend the careful selection of the surgical approach for each patient and promotion of the use of the minimally invasive approaches, avoiding the angulated incisions as much as possible, applying the running suture technique with (polydioxanone) PDS-loops for the fascial reconstruction, minimizing the intraoperative blood loss and need for blood transfusion, shortening the operative time as much as possible, early detection of postoperative formation of ascites, and managing it properly. In the event of need for a revision operation due to a postoperative complication, a reinforced reconstruction of the fascia can be considered.\u0000","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139808486","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}
Pub Date : 2024-02-03DOI: 10.4103/ijawhs.ijawhs_69_23
Saeed Aldarwish, Paula Guda, M. Philipp, Clemens Schafmayer, S. Hinz
Open liver surgery is one of the most common abdominal surgeries, which is associated with a higher risk of developing an incisional hernia (IH). This is mainly because of the extent and type of the surgical incisions in this type of surgery. Of course, many other risk factors may interfere with wound healing and can increase the risk of developing IH after this type of surgery. In this study, we analyzed several perioperative risk factors, particularly the type of surgical incision and the technical suture aspects. Retrospectively, we analyzed the development of incisional hernia within the first 36 postoperative months clinically and image-morphologically among 155 patients who had undergone an open liver resection or liver transplantation and met the inclusion criteria between 2015 and 2020 in our institution. Most of the incisional hernias occurred during the first 16 postoperative months, with a peak incidence in the eighth postoperative month. The most important preoperative risk factors were the positive past medical history of other hernias (P = 0.05) and overweight/ obesity (P = 0.018). From the operative course, many risk factors were detected, like an intraoperative blood loss of > 1,000 ml (P = 0.043) and an intraoperative blood transfusion of > 10 PRBCs (P = 0.001), a Mercedes-star incision (P = 0.007), the use of Vicryl (polyglactin 910) sutures and interrupted suture techniques for the fascial reconstruction (P = 0.045) and (P = 0.006), and a long operative time of > 240 min (P = 0.033). Postoperative ascites formation as well as the need for revision operation due to a postoperative complication were associated with higher incidence rates of developing IH (P = 0.02) and (P = 0.014). The development of IH cannot be avoided. But the leading risk factors can be modified or optimized. From our experience and according to this analysis, we recommend the careful selection of the surgical approach for each patient and promotion of the use of the minimally invasive approaches, avoiding the angulated incisions as much as possible, applying the running suture technique with (polydioxanone) PDS-loops for the fascial reconstruction, minimizing the intraoperative blood loss and need for blood transfusion, shortening the operative time as much as possible, early detection of postoperative formation of ascites, and managing it properly. In the event of need for a revision operation due to a postoperative complication, a reinforced reconstruction of the fascia can be considered.
{"title":"Developing incisional hernia after open liver resection and liver transplantation: A single-center risk factor analysis","authors":"Saeed Aldarwish, Paula Guda, M. Philipp, Clemens Schafmayer, S. Hinz","doi":"10.4103/ijawhs.ijawhs_69_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_69_23","url":null,"abstract":"\u0000 \u0000 \u0000 Open liver surgery is one of the most common abdominal surgeries, which is associated with a higher risk of developing an incisional hernia (IH). This is mainly because of the extent and type of the surgical incisions in this type of surgery. Of course, many other risk factors may interfere with wound healing and can increase the risk of developing IH after this type of surgery. In this study, we analyzed several perioperative risk factors, particularly the type of surgical incision and the technical suture aspects.\u0000 \u0000 \u0000 \u0000 Retrospectively, we analyzed the development of incisional hernia within the first 36 postoperative months clinically and image-morphologically among 155 patients who had undergone an open liver resection or liver transplantation and met the inclusion criteria between 2015 and 2020 in our institution.\u0000 \u0000 \u0000 \u0000 Most of the incisional hernias occurred during the first 16 postoperative months, with a peak incidence in the eighth postoperative month. The most important preoperative risk factors were the positive past medical history of other hernias (P = 0.05) and overweight/ obesity (P = 0.018). From the operative course, many risk factors were detected, like an intraoperative blood loss of > 1,000 ml (P = 0.043) and an intraoperative blood transfusion of > 10 PRBCs (P = 0.001), a Mercedes-star incision (P = 0.007), the use of Vicryl (polyglactin 910) sutures and interrupted suture techniques for the fascial reconstruction (P = 0.045) and (P = 0.006), and a long operative time of > 240 min (P = 0.033). Postoperative ascites formation as well as the need for revision operation due to a postoperative complication were associated with higher incidence rates of developing IH (P = 0.02) and (P = 0.014).\u0000 \u0000 \u0000 \u0000 The development of IH cannot be avoided. But the leading risk factors can be modified or optimized. From our experience and according to this analysis, we recommend the careful selection of the surgical approach for each patient and promotion of the use of the minimally invasive approaches, avoiding the angulated incisions as much as possible, applying the running suture technique with (polydioxanone) PDS-loops for the fascial reconstruction, minimizing the intraoperative blood loss and need for blood transfusion, shortening the operative time as much as possible, early detection of postoperative formation of ascites, and managing it properly. In the event of need for a revision operation due to a postoperative complication, a reinforced reconstruction of the fascia can be considered.\u0000","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139868455","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}
Pub Date : 2024-02-02DOI: 10.4103/ijawhs.ijawhs_59_23
Germán A Giacosa, Martín Rodríguez, Álvaro Juárez, Santiago S Begnis, Álvaro Tabares
Lumbar incisional hernias are a defect of the posterolateral region on the abdominal wall that originated from previous surgical incisions in the area. A surgical approach is challenging due to low incidence and the lack of enough publications on the topic, which generates controversies among surgeons. The purpose of this paper is to show our laparoscopic approach experience using the intraperitoneal onlay mesh (IPOM) and IPOM Plus procedures for the treatment of lumbar incisional hernias. This was a retrospective descriptive study, including 10 patients with lumbar/posterolateral incisional hernias, diagnosed by computerized tomography scan and surgically treated with the IPOM laparoscopic technique in one case and IPOM Plus in nine cases from 2014 to 2021. Demographic data and baseline characteristics of enrolled patients were assessed, as well as perioperative data, surgical time, length of hospital stay, and recurrence during an average 38.6-month follow-up. In the series assessed, the defect size ranged between 24 and 72 cm2, with mean longitudinal and transversal diameters of 7.9 and 5.8 cm, respectively. The surgery lasted 120–180 min. There were no cases of conversion or intraoperative visceral lesions. Nine patients were discharged on an average of 37.8 ± 8.9 h after admission, and one patient stayed for 64 h due to extra analgesic demand. Postoperative morbidity was a case of hematoma. There was one case of recurrence. The results of our experience have shown the benefits of the laparoscopic approach with the IPOM Plus method for the treatment of lumbar incisional hernias, including short hospital stays and low incidence of postoperative complications. Accordingly, this mainstream technique, which has shown good outcomes both in the short and the long term, appears to be a simple and safe procedure.
{"title":"Incisional lumbar hernias: Current role of laparoscopic approach with intraperitoneal onlay mesh procedure","authors":"Germán A Giacosa, Martín Rodríguez, Álvaro Juárez, Santiago S Begnis, Álvaro Tabares","doi":"10.4103/ijawhs.ijawhs_59_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_59_23","url":null,"abstract":"\u0000 \u0000 \u0000 Lumbar incisional hernias are a defect of the posterolateral region on the abdominal wall that originated from previous surgical incisions in the area. A surgical approach is challenging due to low incidence and the lack of enough publications on the topic, which generates controversies among surgeons. The purpose of this paper is to show our laparoscopic approach experience using the intraperitoneal onlay mesh (IPOM) and IPOM Plus procedures for the treatment of lumbar incisional hernias. \u0000 \u0000 \u0000 \u0000 This was a retrospective descriptive study, including 10 patients with lumbar/posterolateral incisional hernias, diagnosed by computerized tomography scan and surgically treated with the IPOM laparoscopic technique in one case and IPOM Plus in nine cases from 2014 to 2021. Demographic data and baseline characteristics of enrolled patients were assessed, as well as perioperative data, surgical time, length of hospital stay, and recurrence during an average 38.6-month follow-up.\u0000 \u0000 \u0000 \u0000 In the series assessed, the defect size ranged between 24 and 72 cm2, with mean longitudinal and transversal diameters of 7.9 and 5.8 cm, respectively. The surgery lasted 120–180 min. There were no cases of conversion or intraoperative visceral lesions. Nine patients were discharged on an average of 37.8 ± 8.9 h after admission, and one patient stayed for 64 h due to extra analgesic demand. Postoperative morbidity was a case of hematoma. There was one case of recurrence.\u0000 \u0000 \u0000 \u0000 The results of our experience have shown the benefits of the laparoscopic approach with the IPOM Plus method for the treatment of lumbar incisional hernias, including short hospital stays and low incidence of postoperative complications. Accordingly, this mainstream technique, which has shown good outcomes both in the short and the long term, appears to be a simple and safe procedure.\u0000","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139810901","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}
Pub Date : 2024-02-02DOI: 10.4103/ijawhs.ijawhs_59_23
Germán A Giacosa, Martín Rodríguez, Álvaro Juárez, Santiago S Begnis, Álvaro Tabares
Lumbar incisional hernias are a defect of the posterolateral region on the abdominal wall that originated from previous surgical incisions in the area. A surgical approach is challenging due to low incidence and the lack of enough publications on the topic, which generates controversies among surgeons. The purpose of this paper is to show our laparoscopic approach experience using the intraperitoneal onlay mesh (IPOM) and IPOM Plus procedures for the treatment of lumbar incisional hernias. This was a retrospective descriptive study, including 10 patients with lumbar/posterolateral incisional hernias, diagnosed by computerized tomography scan and surgically treated with the IPOM laparoscopic technique in one case and IPOM Plus in nine cases from 2014 to 2021. Demographic data and baseline characteristics of enrolled patients were assessed, as well as perioperative data, surgical time, length of hospital stay, and recurrence during an average 38.6-month follow-up. In the series assessed, the defect size ranged between 24 and 72 cm2, with mean longitudinal and transversal diameters of 7.9 and 5.8 cm, respectively. The surgery lasted 120–180 min. There were no cases of conversion or intraoperative visceral lesions. Nine patients were discharged on an average of 37.8 ± 8.9 h after admission, and one patient stayed for 64 h due to extra analgesic demand. Postoperative morbidity was a case of hematoma. There was one case of recurrence. The results of our experience have shown the benefits of the laparoscopic approach with the IPOM Plus method for the treatment of lumbar incisional hernias, including short hospital stays and low incidence of postoperative complications. Accordingly, this mainstream technique, which has shown good outcomes both in the short and the long term, appears to be a simple and safe procedure.
{"title":"Incisional lumbar hernias: Current role of laparoscopic approach with intraperitoneal onlay mesh procedure","authors":"Germán A Giacosa, Martín Rodríguez, Álvaro Juárez, Santiago S Begnis, Álvaro Tabares","doi":"10.4103/ijawhs.ijawhs_59_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_59_23","url":null,"abstract":"\u0000 \u0000 \u0000 Lumbar incisional hernias are a defect of the posterolateral region on the abdominal wall that originated from previous surgical incisions in the area. A surgical approach is challenging due to low incidence and the lack of enough publications on the topic, which generates controversies among surgeons. The purpose of this paper is to show our laparoscopic approach experience using the intraperitoneal onlay mesh (IPOM) and IPOM Plus procedures for the treatment of lumbar incisional hernias. \u0000 \u0000 \u0000 \u0000 This was a retrospective descriptive study, including 10 patients with lumbar/posterolateral incisional hernias, diagnosed by computerized tomography scan and surgically treated with the IPOM laparoscopic technique in one case and IPOM Plus in nine cases from 2014 to 2021. Demographic data and baseline characteristics of enrolled patients were assessed, as well as perioperative data, surgical time, length of hospital stay, and recurrence during an average 38.6-month follow-up.\u0000 \u0000 \u0000 \u0000 In the series assessed, the defect size ranged between 24 and 72 cm2, with mean longitudinal and transversal diameters of 7.9 and 5.8 cm, respectively. The surgery lasted 120–180 min. There were no cases of conversion or intraoperative visceral lesions. Nine patients were discharged on an average of 37.8 ± 8.9 h after admission, and one patient stayed for 64 h due to extra analgesic demand. Postoperative morbidity was a case of hematoma. There was one case of recurrence.\u0000 \u0000 \u0000 \u0000 The results of our experience have shown the benefits of the laparoscopic approach with the IPOM Plus method for the treatment of lumbar incisional hernias, including short hospital stays and low incidence of postoperative complications. Accordingly, this mainstream technique, which has shown good outcomes both in the short and the long term, appears to be a simple and safe procedure.\u0000","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139870617","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 Importance of Shared Decision Making in the Decision to Prevent a Parastomal Hernia With Prosthetic Mesh","authors":"M. López-Cano, J. M. García-Alamino","doi":"10.3389/jaws.2023.12316","DOIUrl":"https://doi.org/10.3389/jaws.2023.12316","url":null,"abstract":"EDITORIAL J. Abdom. Wall Surg., 10 November 2023 https://doi.org/10.3389/jaws.2023.12316","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136781","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}
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