A Minimally Invasive Approach to a ‘ Seatbelt Hernia’
A MINIMALLY INVASIVE APPROACH TO A ‘ SEATBELT HERNIA’.Elyssa Feinberg MD, Aksim Rivera MD, Suttatip Vechvitvarakul MD , Ajay K Chopra MD.Jacobi Medical Center, Albert Einstein College of Medicine, Bronx NYIntroduction: Traumatic abdominal wall hernias are often the result of improperly worn lap and shoulder seat belts. Most cases of traumatic lumbar/flank hernias described have… Continue Reading
A Paradigm Shift in Ventral Hernia Repair. Laparoscopic Component Separation During Laparoscopic Ventral Hernia Repair.
Component separation is an important technique in the repair of ventral hernias because it allows restoration of the normal anatomic relationship of the rectus muscles while maintaining a tension-free repair. Our group has previously reported on fully laparoscopic component separation as an important tool in the repair of ventral hernias. This technique allows for protection… Continue Reading
“Clinically Significant Reason for TAPPS over TEPPS?”
Introduction: Would the ability to diagnose unexpected secondary findings be a crucial factor to choose TAPPS over TEPPS? The primary surgeon of this abstract incidentally diagnosed a liver malignancy that prompted this question. Over the years, debate between the two approaches has been an on-going issue. Neither surgery has demonstrated definitive superiority over the other.… Continue Reading
CT Mapping of Anterior Abdominal Wall Defects.
INTRODUCTION: Ventral hernia is a challenging surgical problem. Occult ventral hernia defects contribute to the relatively high recurrence rate after open surgical repair.METHODS: 44 patients underwent comprehensive physical examination, CT scan, and laparoscopy for ventral hernia. Hernia defects were mapped using all three methods and the results were compared. Descriptive statistics were used to analyze… Continue Reading
Endoscopic Totally Extraperitoneal Repair for Bilateral Inguinal Hernias
INTRODUCTION: The benefits of the laparoscopic approach in inguinal hernia surgery are most evident when performed for bilateral cases. A single surgery to address bilateral pathologies would be practical and cost efficient. MATERIALS & METHODS: Our single centre series involves a retrospective review of 74 consecutive patients who underwent endoscopic totally extraperitoneal (TEP) repair for… Continue Reading
Fibrin Sealant (Tissucol) Enhances Tissue Integration of cPTFE Meshes and Reduces Early Adhesion Formation in Experimental IPOM Repair
AbstractBackground: The laparoscopic intraabdominal peritoneal onlay mesh repair (IPOM) is a common technique for the reinforcement of multiple ventral hernias or defined defects after laparotomies. However, the placement of synthetic meshes in the intraabdominal cavity can be associated with severe complications. Adhesions frequently originate from the implant and protruding parts of fixation devices, presenting a… Continue Reading
Human fibrin sealant (Tisseel) for hiatal mesh fixation in an experimental model in pigs
Introduction The fixation of hiatal meshes with perforating devices, such as tacks or sutures, can be associated with potentially life threatening complications1. Fibrin sealant (FS, Tissucol, Baxter Biosciences, Vienna, Austria) is successfully used for atraumatic mesh fixation in inguinal and incisional hernia repair2,3. The rationale of this study was to test the potential of FS… Continue Reading
Laparoscopic Completely Extraperitoneal Repair of Inguinal Hernia in Children; A Single Institute Experiences with 1,257 Repairs in Comparison with Cut-down Herniorrhaphy.
Aim of the study: Conventional open herniorrhaphy in children has been reported to have 2~3% recurrence and 10~20% postoperative contralateral hernia rates. We developed a unique technique to achieve completely extraperitoneal ligation of patent processus vaginalis (PPV) without any skip areas, sparing the spermatic cord and vessels under laparoscopic control. Our technique should be theoretically… Continue Reading
Laparoscopic Inguinal Hernia Repair in Children with Transperitoneal Division of the Hernia Sac.
INTRODUCTION: This case series reviews the results of our new, modified technique for repair of inguinal hernias (IH) in children.METHODS: This is a retrospective case series of one surgeon during the period of January to August 2007. A total of 32 IH were repaired laparoscopically in 28 patients (5 girls, 23 boys, median age 3… Continue Reading
Laparoscopic Suprapubic Hernia Repair in the Overweight Population
Background: Laparoscopic suprapubic hernia repair (LSHR) is technically challenging, requiring difficult, dissection in the superior pelvis. Obesity creates an added complexity to the repair itself, and to the complications and recurrences that may develop.Methods: We retrospectively reviewed 22 overweight and obese patients who underwent LSHR by one surgeon between the years of 2005 to 2007.… Continue Reading
Laparoscopic Transperitoneal Incisional Lumbar Hernia Repair
Introduction: Incisional lumbar hernia is an uncommon hernia type associated with lumbar incisions for nefrectomy, aortic aneurysm repair, bone resection on the iliac crest, or latissimus dorsi myocutaneous flaps. Open surgical procedures have significant postoperative morbidity and patient dissatisfaction.Patients and Methods: From May 2003 to August 2005, 7 patients (5 female, 2 male) with lumbar… Continue Reading
Mechanisms of Ventral Hernia Recurrence Following Laparoscopic Repair
Objective: To determine mechanisms of ventral hernia recurrence following laparoscopic repair.Background: Laparoscopic ventral hernia repair techniques have demonstrated low recurrence rates in recent years. Mechanisms of recurrence following open repair are well-documented, but there is less data defining how laparoscopically-repaired hernias recur.Methods: We performed a retrospective analysis of 25 patients who had previously undergone at… Continue Reading
Minimally traumatic suture transfixation can decrease Suture Site Pain (SSP) and inflammation (SSI) in Laparoscopic Ventral Hernia Repair (LVHR) – a Randomized Controlled Study.
Objectives of study :SSP and SSI have been attributed to tying of sutures & trauma due to suture passer. Aim of this study was to evaluate the benefit of passing transfixating sutures with the help of disposable thin Spinal Needles versus reusable Suture Passes which is much thicker & gets blunted with repeatd use.Methods and… Continue Reading
Morbidly Obese Patients Do Not Have Increased Incidence of Early Recurrence After Laparoscopic Ventral Hernia Repair
INTRODUCTION: Previous studies have raised concern that morbid obesity is associated with a markedly increased risk of recurrence after repair of ventral hernias. This study compared the incidence of early post-operative recurrence after laparoscopic ventral hernia repair in morbidly obese patients and non-morbidly obese patients.METHODS: Case notes were reviewed for consecutive patients who underwent laparoscopic… Continue Reading
Obesity Contributes to Recurrence after Laparoscopic Incisional Hernia Repair
Objective: Obesity is a known risk factor for the development of incisional hernias. Despite the widespread use of prosthetic mesh, recurrence rates for open repair in obesity remain high. The magnitude of mechanical force exerted on the abdominal wall in obese individuals may contribute to a higher than expected recurrent incisional hernia rate. Laparoscopic ventral… Continue Reading