{"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":"111 21","pages":"0"},"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}
A. de Beaux, S. Becker, T. Parent, G. Temporal, R. Kummer, C. Allouard, B. East
Introduction: Hernia Basecamp is an online learning platform hosted within the WebSurg website. One of the drivers of its development was to cover the syllabus of the UEMS AWS examination, but it is a learning resource in its own right. There are currently 205 video lectures, with a number of them selected to create 10 modules of 3 h each with UEMS CME accreditation. The aim of this study was to review the Hernia Basecamp usage since launch in June 2021. Methods: The Hernia Basecamp WebSurg platform was interrogated using Matomo Analytics in January 2023 (19 month period since launch). Data on the number of visits, pages looked at and time spent on the platform per visit, along with the number of CME modules taken and passed were collected. Results: Users from 146 countries visited the Hernia Basecamp site 17,171 times (6,586 times, 38.4% in first 9 months). The top 5 countries by visitors were the United Kingdom, Mexico, Spain, United States and Germany (accounting for 29.4% of the visits). The average time spent per visit was 11 min 37 s (range: 47 s–49 min 4 s), and the number of pages/videos viewed per visit was 8.1 (range: 2–21). The number of UEMS CME modules taken was 675, and 326 (48%) of these tests were passed. Conclusion: In the first 19 months from launch, Hernia Basecamp provided over 3,000 h of hernia education. The UEMS approved CME accreditation tests were commonly used.
{"title":"Hernia Basecamp—A Free to Use, Online Hernia Learning Platform. Analysis of Its Use Since Launch in June 2021","authors":"A. de Beaux, S. Becker, T. Parent, G. Temporal, R. Kummer, C. Allouard, B. East","doi":"10.3389/jaws.2023.11803","DOIUrl":"https://doi.org/10.3389/jaws.2023.11803","url":null,"abstract":"Introduction: Hernia Basecamp is an online learning platform hosted within the WebSurg website. One of the drivers of its development was to cover the syllabus of the UEMS AWS examination, but it is a learning resource in its own right. There are currently 205 video lectures, with a number of them selected to create 10 modules of 3 h each with UEMS CME accreditation. The aim of this study was to review the Hernia Basecamp usage since launch in June 2021. Methods: The Hernia Basecamp WebSurg platform was interrogated using Matomo Analytics in January 2023 (19 month period since launch). Data on the number of visits, pages looked at and time spent on the platform per visit, along with the number of CME modules taken and passed were collected. Results: Users from 146 countries visited the Hernia Basecamp site 17,171 times (6,586 times, 38.4% in first 9 months). The top 5 countries by visitors were the United Kingdom, Mexico, Spain, United States and Germany (accounting for 29.4% of the visits). The average time spent per visit was 11 min 37 s (range: 47 s–49 min 4 s), and the number of pages/videos viewed per visit was 8.1 (range: 2–21). The number of UEMS CME modules taken was 675, and 326 (48%) of these tests were passed. Conclusion: In the first 19 months from launch, Hernia Basecamp provided over 3,000 h of hernia education. The UEMS approved CME accreditation tests were commonly used.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135200218","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}
Ursula Dahlstrand, Maria Melkemichel, Johanna Österberg, Agneta Montgomery, Hanna de la Croix
Introduction: Groin hernias in women is much less common than in men; it constitutes only 9% of all groin hernia operations. Historically, studies have been performed on men and the results applied to both genders. However, prospectively registered operations within national registers have contributed to new knowledge regarding groin hernias in women. The aim of this paper was to investigate and present a body of literature based upon the Swedish Hernia Register together with recent data from the register’s annual report. Patients and Methods: PubMed and Embase were searched for studies based on the Swedish Hernia Register between 1992 and 2023. Based on the initial reading of abstracts, studies that presented results separately for women were selected and read. Recent data were acquired from the 2022 annual report of the Swedish Hernia Register. Results: A total of 73 studies of interest were identified. Of these, 52 included women, but only 19 presented separate results for women. Four themes emerged and were analysed further: emergency surgery and mortality, femoral hernias, the risk of reoperation for recurrence, and chronic pain following female groin hernia repairs. Discussion: Studies from the Swedish Hernia Register clearly describe that both the presentation of hernias and outcomes after repair differ significantly between the two genders. The differences that have been identified over the years have been incorporated into the national guidelines. Register data indicates that the guidelines have been implemented and are fairly well adhered to. As a result, significant improvements in outcomes regarding recurrences have been made for women with groin hernias in Sweden.
{"title":"Female Groin Hernia Repairs in the Swedish Hernia Register 1992–2022: A Review With Updates","authors":"Ursula Dahlstrand, Maria Melkemichel, Johanna Österberg, Agneta Montgomery, Hanna de la Croix","doi":"10.3389/jaws.2023.11759","DOIUrl":"https://doi.org/10.3389/jaws.2023.11759","url":null,"abstract":"Introduction: Groin hernias in women is much less common than in men; it constitutes only 9% of all groin hernia operations. Historically, studies have been performed on men and the results applied to both genders. However, prospectively registered operations within national registers have contributed to new knowledge regarding groin hernias in women. The aim of this paper was to investigate and present a body of literature based upon the Swedish Hernia Register together with recent data from the register’s annual report. Patients and Methods: PubMed and Embase were searched for studies based on the Swedish Hernia Register between 1992 and 2023. Based on the initial reading of abstracts, studies that presented results separately for women were selected and read. Recent data were acquired from the 2022 annual report of the Swedish Hernia Register. Results: A total of 73 studies of interest were identified. Of these, 52 included women, but only 19 presented separate results for women. Four themes emerged and were analysed further: emergency surgery and mortality, femoral hernias, the risk of reoperation for recurrence, and chronic pain following female groin hernia repairs. Discussion: Studies from the Swedish Hernia Register clearly describe that both the presentation of hernias and outcomes after repair differ significantly between the two genders. The differences that have been identified over the years have been incorporated into the national guidelines. Register data indicates that the guidelines have been implemented and are fairly well adhered to. As a result, significant improvements in outcomes regarding recurrences have been made for women with groin hernias in Sweden.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135536367","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}
Aim: Women have the highest prevalence of epigastric hernia repair. Outcomes after epigastric hernia repair are rarely reported independently, although pathology and surgical techniques may be different than for other primary ventral hernias. The aim of this study was to evaluate long-term outcomes after epigastric hernia repairs in women on a nationwide basis. Methods: Nationwide cohort study from the Danish Hernia Database. Complete data from women undergoing elective epigastric hernia repair during a 12 years period (2007–2018) was extracted. A 100% follow-up was obtained by combining data from the National Civil Register. The primary outcome was operation for recurrence, secondary outcomes were readmission and operation for complications. Outcomes for open sutured repair, open mesh repair mesh, and laparoscopic repairs were compared. Results: In total, 3,031 women underwent elective epigastric hernia repair during the study period. Some 1,671 (55.1%) women underwent open sutured repair, 796 (26.3%) underwent open mesh repair, and 564 (18.6%) underwent laparoscopic repair. Follow-up was median 4.8 years. Operation for recurrence was higher after sutured repairs than after open mesh and laparoscopic repairs (7.7% vs. 3.3%, vs. 6.2%, p < 0.001). The risk of operation for complications was slightly higher after open mesh repair compared with sutured repair and laparoscopic repair (2.6% vs. 1.2%, vs. 2.0%, p = 0.032), with more operations for wound complications in the open mesh group (2.0%, p = 0.006). Conclusion: More than half of the women underwent a suture-based repair, although mesh repair reduces risk of recurrence. Open mesh repair had the lowest risk of recurrence, but on the expense of slightly increased risk of wound-related complications.
目的:女性腹上疝修补率最高。尽管病理和手术技术可能与其他原发性腹疝不同，但腹壁疝修复后的结果很少独立报道。本研究的目的是在全国范围内评估女性腹壁疝修补术后的长期预后。方法:来自丹麦疝数据库的全国队列研究。提取了12年(2007-2018)期间接受择期腹壁疝修补术的妇女的完整数据。通过结合国家民事登记处的数据，获得了100%的随访。主要结局是手术治疗复发，次要结局是再入院和手术治疗并发症。比较开放式缝合修复、开放式补片修复和腹腔镜修复的结果。结果:在研究期间，总共有3031名妇女接受了择期腹壁疝修补术。约1671例(55.1%)女性接受了开放式缝合修复，796例(26.3%)接受了开放式补片修复，564例(18.6%)接受了腹腔镜修复。随访时间中位数为4.8年。缝合修复后的复发率高于开放补片和腹腔镜修复后的复发率(7.7% vs. 3.3% vs. 6.2%， p <0.001)。开放式补片修复术后并发症的手术风险略高于缝合修复和腹腔镜修复(2.6% vs. 1.2% vs. 2.0%， p = 0.032)，开放式补片组因伤口并发症的手术风险更高(2.0%，p = 0.006)。结论:超过一半的女性接受了基于缝线的修复，尽管补片修复降低了复发的风险。开放式补片修复有最低的复发风险，但代价是伤口相关并发症的风险略有增加。
{"title":"Long-Term Outcomes After Epigastric Hernia Repair in Women—A Nationwide Database Study","authors":"M. W. Christoffersen, N. A. Henriksen","doi":"10.3389/jaws.2023.11626","DOIUrl":"https://doi.org/10.3389/jaws.2023.11626","url":null,"abstract":"Aim: Women have the highest prevalence of epigastric hernia repair. Outcomes after epigastric hernia repair are rarely reported independently, although pathology and surgical techniques may be different than for other primary ventral hernias. The aim of this study was to evaluate long-term outcomes after epigastric hernia repairs in women on a nationwide basis. Methods: Nationwide cohort study from the Danish Hernia Database. Complete data from women undergoing elective epigastric hernia repair during a 12 years period (2007–2018) was extracted. A 100% follow-up was obtained by combining data from the National Civil Register. The primary outcome was operation for recurrence, secondary outcomes were readmission and operation for complications. Outcomes for open sutured repair, open mesh repair mesh, and laparoscopic repairs were compared. Results: In total, 3,031 women underwent elective epigastric hernia repair during the study period. Some 1,671 (55.1%) women underwent open sutured repair, 796 (26.3%) underwent open mesh repair, and 564 (18.6%) underwent laparoscopic repair. Follow-up was median 4.8 years. Operation for recurrence was higher after sutured repairs than after open mesh and laparoscopic repairs (7.7% vs. 3.3%, vs. 6.2%, p &lt; 0.001). The risk of operation for complications was slightly higher after open mesh repair compared with sutured repair and laparoscopic repair (2.6% vs. 1.2%, vs. 2.0%, p = 0.032), with more operations for wound complications in the open mesh group (2.0%, p = 0.006). Conclusion: More than half of the women underwent a suture-based repair, although mesh repair reduces risk of recurrence. Open mesh repair had the lowest risk of recurrence, but on the expense of slightly increased risk of wound-related complications.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135866552","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}
Cesare Stabilini, Filip E. Muysoms, Alexander A. Tzanis, Lisa Rossi, Ourania Koutsiouroumpa, Dimitris Mavridis, Michel Adamina, Umberto Bracale, Henk-Thijs Brandsma, Stéphanie O. Breukink, Manuel López Cano, Samantha Cole, Suzanne Doré, Kristian Kiim Jensen, Marianne Krogsgaard, Neil J. Smart, Christoffer Odensten, Chantal Tielemans, Stavros A. Antoniou
Background: Growing evidence on the use of mesh as a prophylactic measure to prevent parastomal hernia and advances in guideline development methods prompted an update of a previous guideline on parastomal hernia prevention. Objective: To develop evidence-based, trustworthy recommendations, informed by an interdisciplinary panel of stakeholders. Methods: We updated a previous systematic review on the use of a prophylactic mesh for end colostomy, and we synthesized evidence using pairwise meta-analysis. A European panel of surgeons, stoma care nurses, and patients developed an evidence-to-decision framework in line with GRADE and Guidelines International Network standards, moderated by a certified guideline methodologist. The framework considered benefits and harms, the certainty of the evidence, patients’ preferences and values, cost and resources considerations, acceptability, equity and feasibility. Results: The certainty of the evidence was moderate for parastomal hernia and low for major morbidity, surgery for parastomal hernia, and quality of life. There was unanimous consensus among panel members for a conditional recommendation for the use of a prophylactic mesh in patients with an end colostomy and fair life expectancy, and a strong recommendation for the use of a prophylactic mesh in patients at high risk to develop a parastomal hernia. Conclusion: This rapid guideline provides evidence-informed, interdisciplinary recommendations on the use of prophylactic mesh in patients with an end colostomy. Further, it identifies research gaps, and discusses implications for stakeholders, including overcoming barriers to implementation and specific considerations regarding validity.
{"title":"EHS Rapid Guideline: Evidence-Informed European Recommendations on Parastomal Hernia Prevention—With ESCP and EAES Participation","authors":"Cesare Stabilini, Filip E. Muysoms, Alexander A. Tzanis, Lisa Rossi, Ourania Koutsiouroumpa, Dimitris Mavridis, Michel Adamina, Umberto Bracale, Henk-Thijs Brandsma, Stéphanie O. Breukink, Manuel López Cano, Samantha Cole, Suzanne Doré, Kristian Kiim Jensen, Marianne Krogsgaard, Neil J. Smart, Christoffer Odensten, Chantal Tielemans, Stavros A. Antoniou","doi":"10.3389/jaws.2023.11549","DOIUrl":"https://doi.org/10.3389/jaws.2023.11549","url":null,"abstract":"Background: Growing evidence on the use of mesh as a prophylactic measure to prevent parastomal hernia and advances in guideline development methods prompted an update of a previous guideline on parastomal hernia prevention. Objective: To develop evidence-based, trustworthy recommendations, informed by an interdisciplinary panel of stakeholders. Methods: We updated a previous systematic review on the use of a prophylactic mesh for end colostomy, and we synthesized evidence using pairwise meta-analysis. A European panel of surgeons, stoma care nurses, and patients developed an evidence-to-decision framework in line with GRADE and Guidelines International Network standards, moderated by a certified guideline methodologist. The framework considered benefits and harms, the certainty of the evidence, patients’ preferences and values, cost and resources considerations, acceptability, equity and feasibility. Results: The certainty of the evidence was moderate for parastomal hernia and low for major morbidity, surgery for parastomal hernia, and quality of life. There was unanimous consensus among panel members for a conditional recommendation for the use of a prophylactic mesh in patients with an end colostomy and fair life expectancy, and a strong recommendation for the use of a prophylactic mesh in patients at high risk to develop a parastomal hernia. Conclusion: This rapid guideline provides evidence-informed, interdisciplinary recommendations on the use of prophylactic mesh in patients with an end colostomy. Further, it identifies research gaps, and discusses implications for stakeholders, including overcoming barriers to implementation and specific considerations regarding validity.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135488173","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}
Thiago Souza Silva, Mario Rino Martins, Thales Lima Batista, Euclides Dias Martins, Marcelo Henrique Fernandes, Eduarda Araujo Hinrichsen
Introduction: A high risk patient with evisceration underwent to abdominal wall reconstruction without mesh or drains. We present a case of a 62 years-old female patient with a significant medical history of Wilson’s disease-related hepatopathy Child-Pugh class B classification, sequelae of a stroke, and relevant surgical background including total hysterectomy, oophorectomy, and Hartmann’s procedure for ovarian neoplasm stage 3. The patient developed a large incisional hernia in the midline incision while undergoing Bevacizumab (Avastin) treatment for clinical oncology. During an attempt at skin closure due to erosion and necrosis, there was progressive deterioration leading to evisceration. We opted for abdominal wall reconstruction by transposing the hernia sac without using mesh and employing hemostatic powder (Arista) to mitigate the risk of bleeding in a high-risk patient due to recent bevacizumab use and hepatopathy. The patient had a favorable postoperative course without any other intervention in abdominal wall. Patient developed worsening hepatic function with the presence of ascites, constipation, and disorientation. On the 6th day postoperative, a tomography was performed, which showed colonic distension without obstructive factors and a slight amount of supra-aponeurotic fluid. The patient was discharged on the 10th day postoperative after improvement of the condition with clinical treatment. The patient has been progressing under outpatient follow-up for 5 months, with a resumption of chemotherapy cycles and no evidence of hernia recurrence. Conclusion: Further studies and long-term follow-up are necessary to evaluate the efficacy and safety of hernia sac transposition as a mesh-free technique and the use of hemostatic powder without drains in high-risk patients. However, our case highlights the potential feasibility of these approaches in carefully selected cases.
{"title":"Case Report: Abdominal Wall Reconstruction in a High-Risk Patient With Incisional Hernia and Complications From Oncological Treatment","authors":"Thiago Souza Silva, Mario Rino Martins, Thales Lima Batista, Euclides Dias Martins, Marcelo Henrique Fernandes, Eduarda Araujo Hinrichsen","doi":"10.3389/jaws.2023.11767","DOIUrl":"https://doi.org/10.3389/jaws.2023.11767","url":null,"abstract":"Introduction: A high risk patient with evisceration underwent to abdominal wall reconstruction without mesh or drains. We present a case of a 62 years-old female patient with a significant medical history of Wilson’s disease-related hepatopathy Child-Pugh class B classification, sequelae of a stroke, and relevant surgical background including total hysterectomy, oophorectomy, and Hartmann’s procedure for ovarian neoplasm stage 3. The patient developed a large incisional hernia in the midline incision while undergoing Bevacizumab (Avastin) treatment for clinical oncology. During an attempt at skin closure due to erosion and necrosis, there was progressive deterioration leading to evisceration. We opted for abdominal wall reconstruction by transposing the hernia sac without using mesh and employing hemostatic powder (Arista) to mitigate the risk of bleeding in a high-risk patient due to recent bevacizumab use and hepatopathy. The patient had a favorable postoperative course without any other intervention in abdominal wall. Patient developed worsening hepatic function with the presence of ascites, constipation, and disorientation. On the 6th day postoperative, a tomography was performed, which showed colonic distension without obstructive factors and a slight amount of supra-aponeurotic fluid. The patient was discharged on the 10th day postoperative after improvement of the condition with clinical treatment. The patient has been progressing under outpatient follow-up for 5 months, with a resumption of chemotherapy cycles and no evidence of hernia recurrence. Conclusion: Further studies and long-term follow-up are necessary to evaluate the efficacy and safety of hernia sac transposition as a mesh-free technique and the use of hemostatic powder without drains in high-risk patients. However, our case highlights the potential feasibility of these approaches in carefully selected cases.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135981424","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 : 2023-07-01DOI: 10.4103/ijawhs.ijawhs_10_23
B. Mandal, Abhijeet Kumar, S. Agrawal, S. Sah, Rakesh Gupta
BACKGROUND: Ventral hernia (primary and incisional) is one of the most frequently encountered problems by the General Surgeon. The enhanced view totally extraperitoneal (eTEP) technique for inguinal hernia was first described by J Daes, which was later used in ventral hernia repair for the first time by Belyansky et al. We applied the same technique for ventral hernia repair to see its feasibility in the context of our country. MATERIALS AND METHODS: It is a single-center prospective observational study of a patient who underwent eTEP (with or without TAR) by a single surgeon between September 2019 and May 2020 and followed up for 12 months. Patient demographics, hernia characteristics, operative details, perioperative complications, and satisfaction scores using the Likert scale were collected for data analysis. RESULTS: The study included 42 patients with 66% of female among them. The mean age was 51 ± 12.97 years, the mean BMI was 29.88 ± 2.16 kg/m2, and the mean ASA of patients was 1.5. Incisional hernia (74%) was the most common diagnosis. The mean operative time was less for the primary hernia (125.45 min) than for the incisional hernia (138.35 min). Intraoperative complications were seen in three (7%) of all the patients. Postoperative length of hospital stay was 1.8 days on average. Postoperative pain was low with only one of the patients having chronic pain while none had a recurrence on follow-up. All the patients were satisfied. CONCLUSION: eTEP is a feasible, cheap, and safe alternative MIS option as it has less morbidity and does not carry an extra cost of mesh in comparison to conventional procedures.
{"title":"Short-term outcomes of eTEP repair of ventral hernia in university hospital of Nepal","authors":"B. Mandal, Abhijeet Kumar, S. Agrawal, S. Sah, Rakesh Gupta","doi":"10.4103/ijawhs.ijawhs_10_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_10_23","url":null,"abstract":"BACKGROUND: Ventral hernia (primary and incisional) is one of the most frequently encountered problems by the General Surgeon. The enhanced view totally extraperitoneal (eTEP) technique for inguinal hernia was first described by J Daes, which was later used in ventral hernia repair for the first time by Belyansky et al. We applied the same technique for ventral hernia repair to see its feasibility in the context of our country. MATERIALS AND METHODS: It is a single-center prospective observational study of a patient who underwent eTEP (with or without TAR) by a single surgeon between September 2019 and May 2020 and followed up for 12 months. Patient demographics, hernia characteristics, operative details, perioperative complications, and satisfaction scores using the Likert scale were collected for data analysis. RESULTS: The study included 42 patients with 66% of female among them. The mean age was 51 ± 12.97 years, the mean BMI was 29.88 ± 2.16 kg/m2, and the mean ASA of patients was 1.5. Incisional hernia (74%) was the most common diagnosis. The mean operative time was less for the primary hernia (125.45 min) than for the incisional hernia (138.35 min). Intraoperative complications were seen in three (7%) of all the patients. Postoperative length of hospital stay was 1.8 days on average. Postoperative pain was low with only one of the patients having chronic pain while none had a recurrence on follow-up. All the patients were satisfied. CONCLUSION: eTEP is a feasible, cheap, and safe alternative MIS option as it has less morbidity and does not carry an extra cost of mesh in comparison to conventional procedures.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"60 1","pages":"159 - 165"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78883336","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 : 2023-07-01DOI: 10.4103/ijawhs.ijawhs_60_23
William Hope
{"title":"Commentary on “Conflict of interest—A serious malady in hernia research publications”","authors":"William Hope","doi":"10.4103/ijawhs.ijawhs_60_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_60_23","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"35 1","pages":"214 - 214"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79795982","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 : 2023-07-01DOI: 10.4103/ijawhs.ijawhs_17_23
J. Gorjanc, Christiane Dreschl, Sigrid Trieb, M. Greiner, Andreas Grün, Pero Zanchi, Manfred Kuschnig, May Müller, Alexander Engels, J. Tschmelitsch
In the modern era of tension-free hernia repairs, any tissue tension seems to be counterproductive. It was believed to cause tissue damage, hemorrhage, and chronic pain, and lead to higher early or late recurrence rates. Surprisingly, recently published data on intraoperative fascial traction do not confirm this harmful effect of tissue tension in the cases of sufficiently wide mesh augmentation. On the contrary, the traction was reported to be beneficial in order to approximate large hernia defects and at the same time avoid the wide tissue preparation of component separation (CS) techniques. Below is presented our initial and positive experience regarding this after intraoperative fascial traction was used in two patients, each of them with a large incisional hernia (W3). Without intraoperative traction, the linea alba could not have been approximated in patient 1 without CS, and a large bridging of the linea alba would have been necessary in patient 2. The duration of hospitalization in both patients was short and there were no negative long-term results. It seems that intraoperative fascial traction facilitates the closure of hernia defects. It can serve as a useful adjunct tool in the surgery of large midline incisional hernias (W3) in the future. However, more data are needed to better evaluate this method.
{"title":"The use of intraoperative fascial traction in W3-incisional hernia repair: A revolution or an emergency exit (two case reports)","authors":"J. Gorjanc, Christiane Dreschl, Sigrid Trieb, M. Greiner, Andreas Grün, Pero Zanchi, Manfred Kuschnig, May Müller, Alexander Engels, J. Tschmelitsch","doi":"10.4103/ijawhs.ijawhs_17_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_17_23","url":null,"abstract":"In the modern era of tension-free hernia repairs, any tissue tension seems to be counterproductive. It was believed to cause tissue damage, hemorrhage, and chronic pain, and lead to higher early or late recurrence rates. Surprisingly, recently published data on intraoperative fascial traction do not confirm this harmful effect of tissue tension in the cases of sufficiently wide mesh augmentation. On the contrary, the traction was reported to be beneficial in order to approximate large hernia defects and at the same time avoid the wide tissue preparation of component separation (CS) techniques. Below is presented our initial and positive experience regarding this after intraoperative fascial traction was used in two patients, each of them with a large incisional hernia (W3). Without intraoperative traction, the linea alba could not have been approximated in patient 1 without CS, and a large bridging of the linea alba would have been necessary in patient 2. The duration of hospitalization in both patients was short and there were no negative long-term results. It seems that intraoperative fascial traction facilitates the closure of hernia defects. It can serve as a useful adjunct tool in the surgery of large midline incisional hernias (W3) in the future. However, more data are needed to better evaluate this method.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"1 1","pages":"186 - 192"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87984153","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 : 2023-07-01DOI: 10.4103/ijawhs.ijawhs_35_23
Marcel Andriessen, Alexander Bloemendaal
We present a case of a small-bowel obstruction due to herniation through a peritoneal defect after TransREctus sheath PrePeritoneal (TREPP) mesh repair for an inguinal hernia.
我们报告一例腹股沟疝经经直肌鞘腹膜前(TREPP)补片修复后因腹膜缺损疝引起的小肠梗阻。
{"title":"Small-bowel obstruction complicating TransREctus sheath PrePeritoneal (TREPP) mesh repair of an inguinal hernia: A case report","authors":"Marcel Andriessen, Alexander Bloemendaal","doi":"10.4103/ijawhs.ijawhs_35_23","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_35_23","url":null,"abstract":"We present a case of a small-bowel obstruction due to herniation through a peritoneal defect after TransREctus sheath PrePeritoneal (TREPP) mesh repair for an inguinal hernia.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"7 1","pages":"200 - 202"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90286060","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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