首页 > 最新文献

International Journal of Abdominal Wall and Hernia Surgery最新文献

英文 中文
A novel hybrid approach to the repair of flank hernias 一种新的混合入路修复侧腹疝
Q4 SURGERY Pub Date : 2022-04-01 DOI: 10.4103/ijawhs.ijawhs_76_21
Brendan P. Chou, Karalyn Bentley, K. LeBlanc
Background: Flank hernias are uncommon and challenging to repair. Discussion of flank hernia repair is scarce in the literature. We present a novel approach to repair flank incisional, traumatic, and denervation hernias with a “hybrid” approach using an open repair in conjunction with the robotic platform for laparoscopic intraperitoneal mesh fixation. Materials and Methods: A retrospective analysis was conducted on all patients who received a “hybrid” repair from April 2014 through January 2020 by a single surgeon. Patient and hernia characteristics, operative techniques, and outcomes were evaluated. Each patient underwent a similar operation with an intraperitoneal mesh as well as an onlay mesh. Minor technique changes including quilting and wound vac placement were developed and compared. Results: Twenty-five patients were included in the study. Outcomes analyzed included wound infection (8.0%), seroma formation (16.0%), hematoma formation (12.0%), mesh infection (0.0%), weight gain (16.0%), hernia recurrence (4.0%), reoperation (12.0%), and chronic pain (25.0%). Compared to the drain placement group, quilting of the subcutaneous tissue was more likely to result in seroma (17.6% vs. 12.5%, P = 0.618) and hematoma (17.6% vs. 0.0%, P = 0.296). Use of negative pressure incisional wound vac did not impact the incidence of wound infection (12.5% vs. 6.2%, P = 0.565), seroma (12.5% vs. 17.6%, P = 0.618), or hematoma formation (12.5% vs. 11.8%, P = 0.704). Conclusion: The “hybrid” repair represents a novel approach to flank hernias. Improved visualization of the intraperitoneal portions of the operation using the robotic platform allows for accurate mesh fixation. In experienced hands, this approach provides safe and satisfactory outcomes similar to a purely open repair.
背景:腹侧疝是一种罕见且具有挑战性的手术。关于腹侧疝修补的讨论在文献中很少。我们提出了一种新的方法来修复侧腹切口、外伤性和去神经疝,采用开放式修复结合机器人平台进行腹腔镜腹膜内网固定的“混合”方法。材料和方法:回顾性分析2014年4月至2020年1月由同一名外科医生接受“混合”修复的所有患者。评估患者和疝的特征、手术技术和结果。每位患者都接受了类似的手术,使用了腹膜内补片和衬垫补片。小的技术变化包括绗缝和伤口真空放置的发展和比较。结果:25例患者纳入研究。结果分析包括伤口感染(8.0%)、血肿形成(16.0%)、血肿形成(12.0%)、补片感染(0.0%)、体重增加(16.0%)、疝气复发(4.0%)、再手术(12.0%)和慢性疼痛(25.0%)。与置管组相比,皮下组织缝合更容易导致血肿(17.6%比12.5%,P = 0.618)和血肿(17.6%比0.0%,P = 0.296)。使用负压切口真空对伤口感染(12.5%比6.2%,P = 0.565)、血肿(12.5%比17.6%,P = 0.618)或血肿形成(12.5%比11.8%,P = 0.704)的发生率没有影响。结论:“混合式”修复是一种治疗侧腹疝的新方法。使用机器人平台改善手术腹膜内部分的可视化,允许精确的网状固定。在经验丰富的人员中,这种方法提供了安全而令人满意的结果,类似于纯粹的开放式修复。
{"title":"A novel hybrid approach to the repair of flank hernias","authors":"Brendan P. Chou, Karalyn Bentley, K. LeBlanc","doi":"10.4103/ijawhs.ijawhs_76_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_76_21","url":null,"abstract":"Background: Flank hernias are uncommon and challenging to repair. Discussion of flank hernia repair is scarce in the literature. We present a novel approach to repair flank incisional, traumatic, and denervation hernias with a “hybrid” approach using an open repair in conjunction with the robotic platform for laparoscopic intraperitoneal mesh fixation. Materials and Methods: A retrospective analysis was conducted on all patients who received a “hybrid” repair from April 2014 through January 2020 by a single surgeon. Patient and hernia characteristics, operative techniques, and outcomes were evaluated. Each patient underwent a similar operation with an intraperitoneal mesh as well as an onlay mesh. Minor technique changes including quilting and wound vac placement were developed and compared. Results: Twenty-five patients were included in the study. Outcomes analyzed included wound infection (8.0%), seroma formation (16.0%), hematoma formation (12.0%), mesh infection (0.0%), weight gain (16.0%), hernia recurrence (4.0%), reoperation (12.0%), and chronic pain (25.0%). Compared to the drain placement group, quilting of the subcutaneous tissue was more likely to result in seroma (17.6% vs. 12.5%, P = 0.618) and hematoma (17.6% vs. 0.0%, P = 0.296). Use of negative pressure incisional wound vac did not impact the incidence of wound infection (12.5% vs. 6.2%, P = 0.565), seroma (12.5% vs. 17.6%, P = 0.618), or hematoma formation (12.5% vs. 11.8%, P = 0.704). Conclusion: The “hybrid” repair represents a novel approach to flank hernias. Improved visualization of the intraperitoneal portions of the operation using the robotic platform allows for accurate mesh fixation. In experienced hands, this approach provides safe and satisfactory outcomes similar to a purely open repair.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"15 4","pages":"53 - 58"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72609939","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}
引用次数: 0
Outcomes after laparoscopic transabdominal preperitoneal (TAPP) hernia repair in the emergency: A matched case-control study 急诊腹腔镜经腹腹膜前疝修补术的结果:一项匹配的病例对照研究
Q4 SURGERY Pub Date : 2022-04-01 DOI: 10.4103/ijawhs.ijawhs_3_22
A. Olivero, M. Casas, C. Angeramo, F. Schlottmann, E. Sadava
Introduction: Laparoscopic repair of groin hernia (LRGH) is widely accepted for elective cases, but its use in emergency cases remains controversial. We aimed to compare postoperative outcomes between elective and emergent transabdominal preperitoneal (TAPP) repairs. Materials and Methods: Patients undergoing emergent LRGH (EM-LR) using a TAPP technique between June 2014 and December 2019 were included for analysis. A case-control cohort of patients undergoing elective LRGH (EL-LR) in the same period was identified and matched (1:3) on gender, age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, active smoking, and hypertension. Preoperative variables and postoperative outcomes were compared between both groups. Results: A total of 15 EM-LR were matched with 45 EL-LR. In patients undergoing EM-LR, the median time from onset of symptoms to surgery was 12 (1–168) h. No differences were found regarding the operative time (EM-LR: 107 min vs. EL-LR: 117 min, P = 0.37) and hernia defect size (EM-LR: 3.6 cm vs. EL-LR: 4.1 cm, P = 0.48). Although small bowel obstruction was observed in all emergent cases, no patients required enterectomy. Emergent cases were performed more frequently by specialist surgeons (EM-LR: 87% vs. EL-LR: 24%, P < 0.001). Mean hospital stay was 3.1 and 0.3 days after EM-LR and EL-LR, respectively (P < 0.001). Overall 30-day morbidity was similar between groups (EM-LR: 6.6% vs. EL-LR: 4.4%, P = 0.43). After a mean follow-up of 28.2 months, no recurrence was observed. Conclusion: EM-LR had similar overall morbidity and recurrence rates than elective repairs. Prompted surgical exploration and use of laparoscopy should be encouraged for the management of complicated inguinal hernias.
腹腔镜腹股沟疝修补术(LRGH)在选择性病例中被广泛接受,但在急诊病例中的应用仍存在争议。我们的目的是比较择期和紧急经腹腹膜前(TAPP)修复的术后结果。材料和方法:纳入2014年6月至2019年12月期间使用TAPP技术接受急诊LRGH (EM-LR)的患者进行分析。在同一时期进行选择性LRGH (EL-LR)的患者进行病例对照队列识别,并在性别、年龄、体重指数(BMI)、美国麻醉医师协会(ASA)评分、主动吸烟和高血压方面进行1:3匹配。比较两组术前变量和术后结果。结果:15例EM-LR与45例EL-LR匹配。在接受EM-LR的患者中,从出现症状到手术的中位时间为12(1-168)小时。在手术时间(EM-LR: 107分钟vs EL-LR: 117分钟,P = 0.37)和疝缺损大小(EM-LR: 3.6 cm vs EL-LR: 4.1 cm, P = 0.48)方面没有发现差异。虽然在所有紧急病例中都观察到小肠梗阻,但没有患者需要肠切除术。急诊病例更常由专科外科医生进行手术(EM-LR: 87% vs. EL-LR: 24%, P < 0.001)。EM-LR和EL-LR的平均住院时间分别为3.1天和0.3天(P < 0.001)。总体30天发病率组间相似(EM-LR: 6.6% vs. EL-LR: 4.4%, P = 0.43)。平均随访28.2个月,无复发。结论:EM-LR的总体发病率和复发率与选择性修复相似。对于复杂的腹股沟疝,应鼓励手术探查和腹腔镜检查。
{"title":"Outcomes after laparoscopic transabdominal preperitoneal (TAPP) hernia repair in the emergency: A matched case-control study","authors":"A. Olivero, M. Casas, C. Angeramo, F. Schlottmann, E. Sadava","doi":"10.4103/ijawhs.ijawhs_3_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_3_22","url":null,"abstract":"Introduction: Laparoscopic repair of groin hernia (LRGH) is widely accepted for elective cases, but its use in emergency cases remains controversial. We aimed to compare postoperative outcomes between elective and emergent transabdominal preperitoneal (TAPP) repairs. Materials and Methods: Patients undergoing emergent LRGH (EM-LR) using a TAPP technique between June 2014 and December 2019 were included for analysis. A case-control cohort of patients undergoing elective LRGH (EL-LR) in the same period was identified and matched (1:3) on gender, age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, active smoking, and hypertension. Preoperative variables and postoperative outcomes were compared between both groups. Results: A total of 15 EM-LR were matched with 45 EL-LR. In patients undergoing EM-LR, the median time from onset of symptoms to surgery was 12 (1–168) h. No differences were found regarding the operative time (EM-LR: 107 min vs. EL-LR: 117 min, P = 0.37) and hernia defect size (EM-LR: 3.6 cm vs. EL-LR: 4.1 cm, P = 0.48). Although small bowel obstruction was observed in all emergent cases, no patients required enterectomy. Emergent cases were performed more frequently by specialist surgeons (EM-LR: 87% vs. EL-LR: 24%, P < 0.001). Mean hospital stay was 3.1 and 0.3 days after EM-LR and EL-LR, respectively (P < 0.001). Overall 30-day morbidity was similar between groups (EM-LR: 6.6% vs. EL-LR: 4.4%, P = 0.43). After a mean follow-up of 28.2 months, no recurrence was observed. Conclusion: EM-LR had similar overall morbidity and recurrence rates than elective repairs. Prompted surgical exploration and use of laparoscopy should be encouraged for the management of complicated inguinal hernias.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"4 1","pages":"77 - 82"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86942840","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}
引用次数: 3
A single surgeon’s experience of 1000 consecutive transabdominal preperitoneal repair cases and measures to prevent recurrence 一位外科医生连续1000例经腹腹膜前修复的经验及预防复发的措施
Q4 SURGERY Pub Date : 2022-04-01 DOI: 10.4103/IJAWhs.IJAWHS_80_21
Tatsuya Tazaki, M. Sasaki, M. Kohyama, Y. Sugiyama, T. Yamaguchi, Shinya Takahashi, A. Nakamitsu
PURPOSE: In laparoscopic transabdominal preperitoneal repair (TAPP), the use of a larger mesh has been shown to reduce the rate of recurrence of hernia. However, recurrence may still be observed occasionally, especially in procedures performed by inexperienced surgeons. The purpose of this study was to clarify the learning curve of TAPP and to establish a procedure that precluded the possibility of recurrence. MATERIALS AND METHODS: We analyzed the learning curve based on operative time, recurrence, and complication in a single surgeon’s experience of 1,000 consecutive TAPP. In addition, by examining cases showing recurrence, techniques necessary to prevent recurrence were clarified. RESULTS: The operative time stabilized after 60 cases and continued to reduce thereafter. Recurrence of nine hernias in eight patients within 1 year of surgery was observed up to the 482nd case. Recurrence or intraoperative complication was not confirmed since then. Recurrence after primary inguinal hernia repair presented as indirect hernia-type recurrence. The causes of recurrence were incomplete parietalization in indirect sliding hernia, insufficient dissection of the lateral dorsal side, and up-rolling mesh placement with the lateral dorsal side. CONCLUSION: Recurrence can be prevented by sufficiently dissecting the preperitoneal space on the lateral dorsal side and taking care to avoid up-rolling of the mesh while it is being placed.
目的:在腹腔镜经腹腹膜前修复(TAPP)中,使用较大的补片已被证明可以降低疝的复发率。然而,偶尔仍可观察到复发,特别是在没有经验的外科医生进行的手术中。本研究的目的是阐明TAPP的学习曲线,并建立一种排除复发可能性的手术方法。材料和方法:我们分析了一位外科医生连续1000例TAPP的手术时间、复发和并发症的学习曲线。此外,通过检查复发病例,明确了预防复发的必要技术。结果:60例术后手术时间稳定,术后持续缩短。截至482例,8例患者手术1年内9例疝气复发。此后未见复发或术中并发症。原发性腹股沟疝修补术后复发表现为间接疝型复发。复发的原因是间接性滑脱疝顶骨不全、外侧背侧解剖不充分、外侧背侧上滚网片放置。结论:充分解剖腹侧背侧腹膜前间隙,放置补片时注意避免上卷,可预防复发。
{"title":"A single surgeon’s experience of 1000 consecutive transabdominal preperitoneal repair cases and measures to prevent recurrence","authors":"Tatsuya Tazaki, M. Sasaki, M. Kohyama, Y. Sugiyama, T. Yamaguchi, Shinya Takahashi, A. Nakamitsu","doi":"10.4103/IJAWhs.IJAWHS_80_21","DOIUrl":"https://doi.org/10.4103/IJAWhs.IJAWHS_80_21","url":null,"abstract":"PURPOSE: In laparoscopic transabdominal preperitoneal repair (TAPP), the use of a larger mesh has been shown to reduce the rate of recurrence of hernia. However, recurrence may still be observed occasionally, especially in procedures performed by inexperienced surgeons. The purpose of this study was to clarify the learning curve of TAPP and to establish a procedure that precluded the possibility of recurrence. MATERIALS AND METHODS: We analyzed the learning curve based on operative time, recurrence, and complication in a single surgeon’s experience of 1,000 consecutive TAPP. In addition, by examining cases showing recurrence, techniques necessary to prevent recurrence were clarified. RESULTS: The operative time stabilized after 60 cases and continued to reduce thereafter. Recurrence of nine hernias in eight patients within 1 year of surgery was observed up to the 482nd case. Recurrence or intraoperative complication was not confirmed since then. Recurrence after primary inguinal hernia repair presented as indirect hernia-type recurrence. The causes of recurrence were incomplete parietalization in indirect sliding hernia, insufficient dissection of the lateral dorsal side, and up-rolling mesh placement with the lateral dorsal side. CONCLUSION: Recurrence can be prevented by sufficiently dissecting the preperitoneal space on the lateral dorsal side and taking care to avoid up-rolling of the mesh while it is being placed.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"38 1","pages":"69 - 76"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91295395","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}
引用次数: 0
The open perforator sparing anterior component separation 开放的穿支保留前构件分离
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/ijawhs.ijawhs_52_21
M. Mughal, D. Ross, D. Ross
Hernia surgery, and intra-abdominal surgery in general, have been accompanied by an increased risk of complications, largely due to a combination of operative complexity and obesity. Advances in care following major abdominal trauma, infections and complex abdominal procedures has led to the advent of several techniques that can allow dependable closure of these wider, more difficult defects. Anterior component separation (ACS) is a well-established technique used to achieve fascial closure in complex abdominal wall reconstruction (AWR). Wound related complications in the traditional ACS procedure have been reported to occur in 24%-50% of cases. In a quest to reduce complications and improve wound healing rates, methods have evolved in order to limit the anatomical injury caused by lateral elevation of flaps in the conventional techniques. These techniques involve preservation of the abdominal wall perforators. Thus ensuring appropriate perfusion of the overlying skin flaps. Perforator-sparing techniques have become increasingly important as they reflect greater understanding of how pre-operative planning can aid reduction of surgical risk, wound infection and improve wound healing in patients with complex abdominal wall hernias.
疝气手术和一般的腹腔手术都伴随着并发症的风险增加,这主要是由于手术复杂性和肥胖的结合。重大腹部创伤、感染和复杂腹部手术后护理的进步导致了几种技术的出现,这些技术可以可靠地关闭这些更宽、更困难的缺陷。前成分分离(ACS)是一种成熟的技术,用于实现复杂腹壁重建(AWR)的筋膜关闭。据报道,传统ACS手术中伤口相关并发症发生率为24%-50%。为了减少并发症和提高伤口愈合率,在传统技术中,各种方法不断发展,以限制皮瓣外侧抬高引起的解剖损伤。这些技术包括保留腹壁穿支。从而确保适当的灌注覆盖的皮瓣。保留穿孔技术变得越来越重要,因为它们反映了对术前计划如何帮助降低手术风险、伤口感染和改善复杂腹壁疝患者伤口愈合的更好理解。
{"title":"The open perforator sparing anterior component separation","authors":"M. Mughal, D. Ross, D. Ross","doi":"10.4103/ijawhs.ijawhs_52_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_52_21","url":null,"abstract":"Hernia surgery, and intra-abdominal surgery in general, have been accompanied by an increased risk of complications, largely due to a combination of operative complexity and obesity. Advances in care following major abdominal trauma, infections and complex abdominal procedures has led to the advent of several techniques that can allow dependable closure of these wider, more difficult defects. Anterior component separation (ACS) is a well-established technique used to achieve fascial closure in complex abdominal wall reconstruction (AWR). Wound related complications in the traditional ACS procedure have been reported to occur in 24%-50% of cases. In a quest to reduce complications and improve wound healing rates, methods have evolved in order to limit the anatomical injury caused by lateral elevation of flaps in the conventional techniques. These techniques involve preservation of the abdominal wall perforators. Thus ensuring appropriate perfusion of the overlying skin flaps. Perforator-sparing techniques have become increasingly important as they reflect greater understanding of how pre-operative planning can aid reduction of surgical risk, wound infection and improve wound healing in patients with complex abdominal wall hernias.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"58 1","pages":"21 - 25"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73664482","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}
引用次数: 0
Progressive pneumoperitoneum: Where do we stand in 2021? 进行性气腹:我们在2021年处于什么位置?
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/ijawhs.ijawhs_56_21
M. Allaeys, G. V. van Ramshorst, F. Berrevoet
Progressive pneumoperitoneum (PPP) is a technique in which the abdomen is artificially and gradually insufflated over a period of time. The technique was first applied in hernia repair in the 1940s and is now regarded as a useful adjunct in the treatment of complex or giant hernias and those associated with “loss of domain” (LOD). With gradual insufflation, the abdomen becomes progressively distended, promoting soft tissue elongation and preparing it for the post-repair surplus volume of the herniated content. PPP also helps with preoperative pulmonary stabilization and preparation, and it induces pneumatic lysis of intestinal adhesions. In contrast to the longevity of the technique, the heterogeneity in indications and technical variations is remarkable. Indications vary greatly in literature, being either based on clinical judgment or different volumetric cut-off values. Neither is there any consensus on which gas should be used, what volume should be injected, in what frequency, and for how long the pneumoperitoneum should be maintained. There is a clear need for an international consensus concerning LOD hernias and how they are defined. As setting up randomized controlled trials on PPP is not feasible, further research should rely on high-quality observational studies. For reviews and meta-analysis to have any meaningful conclusions, these studies should follow, and adhere to, clear guidelines on the manner of reporting. However, PPP remains a very powerful adjunct in the treatment of large and complex hernias with LOD and has proven its value over time.
渐进式气腹(PPP)是一种在一段时间内对腹部进行人工逐渐充气的技术。该技术于20世纪40年代首次应用于疝修补,现在被认为是治疗复杂或巨大疝以及与“区域丧失”(LOD)相关的疝的有用辅助手段。随着逐渐充气,腹部逐渐膨胀,促进软组织伸长,为修复后疝内容物的剩余体积做好准备。PPP也有助于术前肺稳定和准备,并诱导肠粘连的气动溶解。与该技术的寿命相比,适应症和技术变化的异质性是显著的。文献中的适应症差异很大,要么是基于临床判断,要么是不同的体积临界值。对于应该使用哪种气体,应该注射多少体积,以什么频率,以及气腹应该维持多长时间,也没有任何共识。对于LOD疝及其如何定义,显然需要达成国际共识。由于建立PPP的随机对照试验是不可行的,进一步的研究应依赖于高质量的观察性研究。为了使综述和荟萃分析得出有意义的结论,这些研究应该遵循并坚持明确的报告方式指导方针。然而,PPP仍然是治疗大而复杂的LOD疝的一种非常有效的辅助手段,并随着时间的推移证明了它的价值。
{"title":"Progressive pneumoperitoneum: Where do we stand in 2021?","authors":"M. Allaeys, G. V. van Ramshorst, F. Berrevoet","doi":"10.4103/ijawhs.ijawhs_56_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_56_21","url":null,"abstract":"Progressive pneumoperitoneum (PPP) is a technique in which the abdomen is artificially and gradually insufflated over a period of time. The technique was first applied in hernia repair in the 1940s and is now regarded as a useful adjunct in the treatment of complex or giant hernias and those associated with “loss of domain” (LOD). With gradual insufflation, the abdomen becomes progressively distended, promoting soft tissue elongation and preparing it for the post-repair surplus volume of the herniated content. PPP also helps with preoperative pulmonary stabilization and preparation, and it induces pneumatic lysis of intestinal adhesions. In contrast to the longevity of the technique, the heterogeneity in indications and technical variations is remarkable. Indications vary greatly in literature, being either based on clinical judgment or different volumetric cut-off values. Neither is there any consensus on which gas should be used, what volume should be injected, in what frequency, and for how long the pneumoperitoneum should be maintained. There is a clear need for an international consensus concerning LOD hernias and how they are defined. As setting up randomized controlled trials on PPP is not feasible, further research should rely on high-quality observational studies. For reviews and meta-analysis to have any meaningful conclusions, these studies should follow, and adhere to, clear guidelines on the manner of reporting. However, PPP remains a very powerful adjunct in the treatment of large and complex hernias with LOD and has proven its value over time.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"19 1","pages":"36 - 41"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80089577","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}
引用次数: 1
Erratum: Laparoscopic transversus abdominis release for the treatment of complex ventral hernia 更正:腹腔镜腹侧松解术治疗复杂腹疝
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/2589-8736.338066
{"title":"Erratum: Laparoscopic transversus abdominis release for the treatment of complex ventral hernia","authors":"","doi":"10.4103/2589-8736.338066","DOIUrl":"https://doi.org/10.4103/2589-8736.338066","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"35 1","pages":"51 - 51"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82043243","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}
引用次数: 0
Open transversus abdominis release
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/ijawhs.ijawhs_45_21
K. Tunder, Y. Novitsky
The management of most complex abdominal wall hernias remains a significant challenge and the approaches to repair them have evolved. To address these challenges, the posterior component separation using the transversus abdominis muscle release (TAR) was developed. Through cadaveric research and better understanding of the anatomy of the transversus abdominis muscle, the first TAR transversus abdominis release was performed in 2006. In the numerous studies performed since, TAR continues to show low recurrence rates, limited significant wound morbidity, rare mesh complications, and low incidence of mesh explantation. The TAR approach has now been definitively proven to be a valuable technique for abdominal wall reconstruction and can address a wide variety of defects. Moreover, a proper performed TAR has been shown to have no deleterious effects on the abdominal trunk musculature and trunk/core function. A deep understanding of the anatomy, preoperative optimization and precise surgical technique is imperative to performing a TAR and ensuring the best outcome for the patient.
大多数复杂腹壁疝的治疗仍然是一个重大挑战,修复方法也在不断发展。为了解决这些挑战,使用腹横肌释放(TAR)的后构件分离被开发出来。通过尸体研究和更好地了解腹横肌解剖结构,2006年进行了第一次TAR腹横肌松解术。在此后进行的大量研究中,TAR仍然显示出低复发率、有限的重大伤口发病率、罕见的补片并发症和低补片外植的发生率。TAR入路目前已被明确证明是一种有价值的腹壁重建技术,可以解决各种缺陷。此外,适当进行的TAR已被证明对腹部躯干肌肉组织和躯干/核心功能没有有害影响。深入了解解剖结构、术前优化和精确的手术技术是进行TAR和确保患者获得最佳结果的必要条件。
{"title":"Open transversus abdominis release","authors":"K. Tunder, Y. Novitsky","doi":"10.4103/ijawhs.ijawhs_45_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_45_21","url":null,"abstract":"The management of most complex abdominal wall hernias remains a significant challenge and the approaches to repair them have evolved. To address these challenges, the posterior component separation using the transversus abdominis muscle release (TAR) was developed. Through cadaveric research and better understanding of the anatomy of the transversus abdominis muscle, the first TAR transversus abdominis release was performed in 2006. In the numerous studies performed since, TAR continues to show low recurrence rates, limited significant wound morbidity, rare mesh complications, and low incidence of mesh explantation. The TAR approach has now been definitively proven to be a valuable technique for abdominal wall reconstruction and can address a wide variety of defects. Moreover, a proper performed TAR has been shown to have no deleterious effects on the abdominal trunk musculature and trunk/core function. A deep understanding of the anatomy, preoperative optimization and precise surgical technique is imperative to performing a TAR and ensuring the best outcome for the patient.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"36 1","pages":"26 - 29"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85795067","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}
引用次数: 1
Erratum: Prevention of seroma formation after laparoscopic inguinoscrotal indirect hernia repair by a new surgical technique: A preliminary report 一种新的手术技术预防腹腔镜腹股沟-阴囊间接疝修补术后血清肿的形成:初步报告
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/2589-8736.338065
{"title":"Erratum: Prevention of seroma formation after laparoscopic inguinoscrotal indirect hernia repair by a new surgical technique: A preliminary report","authors":"","doi":"10.4103/2589-8736.338065","DOIUrl":"https://doi.org/10.4103/2589-8736.338065","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"10 1","pages":"50 - 50"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80470295","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}
引用次数: 0
Endoscopic anterior component separation: How we do it? 内镜前组件分离:我们如何做?
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/ijawhs.ijawhs_51_21
L. Jørgensen, K. Jensen
The repair of large incisional hernia is challenging and has evolved at a high pace in recent decades, since Ramirez described the open anterior component separation, dividing the external oblique aponeurosis. Endoscopic anterior component separation is a minimally invasive approach to this technique, which also serves as an adjunct to open repair of large incisional hernia. Popularized by Michael Rosen’s group in 2007, this technique has become one of the many important tools every abdominal wall surgeon should master. In the current paper, we review the technique, from preoperative considerations and patient placement to specific technical details, and discuss pitfalls and potential limitations.
自从Ramirez描述了切开前成分分离,分离外斜腱膜以来,大切口疝的修复是具有挑战性的,并且在近几十年中发展得很快。内镜前组件分离是一种微创入路,也可作为开放性修复大切口疝的辅助手段。2007年由Michael Rosen的团队推广,这项技术已经成为每个腹壁外科医生应该掌握的许多重要工具之一。在本文中,我们回顾了这项技术,从术前考虑和患者安置到具体的技术细节,并讨论了陷阱和潜在的局限性。
{"title":"Endoscopic anterior component separation: How we do it?","authors":"L. Jørgensen, K. Jensen","doi":"10.4103/ijawhs.ijawhs_51_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_51_21","url":null,"abstract":"The repair of large incisional hernia is challenging and has evolved at a high pace in recent decades, since Ramirez described the open anterior component separation, dividing the external oblique aponeurosis. Endoscopic anterior component separation is a minimally invasive approach to this technique, which also serves as an adjunct to open repair of large incisional hernia. Popularized by Michael Rosen’s group in 2007, this technique has become one of the many important tools every abdominal wall surgeon should master. In the current paper, we review the technique, from preoperative considerations and patient placement to specific technical details, and discuss pitfalls and potential limitations.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"10 1","pages":"8 - 12"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83436639","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}
引用次数: 0
Expanding your surgical tools for large ventral and incisonal hernias 扩大你的手术工具为大腹疝和切口疝
Q4 SURGERY Pub Date : 2022-01-01 DOI: 10.4103/ijawhs.ijawhs_4_22
F. Berrevoet
{"title":"Expanding your surgical tools for large ventral and incisonal hernias","authors":"F. Berrevoet","doi":"10.4103/ijawhs.ijawhs_4_22","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_4_22","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"81 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87480909","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}
引用次数: 0
期刊
International Journal of Abdominal Wall and Hernia Surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1