• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

The Coming of Age of Complex Laparoscopy in a Community Teaching Hospital: Practice Patterns Learned From a Laparoscpic Ventral Hernia Repair Model

Ashwin A Kurian, MD, Sidhbh Gallagher, MD, Robert Josloff, MD. Abington Memorial Hospital

Objective: Assess practice patterns in the incorporation of complex laparoscopy by general surgeons in a community teaching hospital using a laparoscopic ventral hernia repair (LVHR) model.
Methods: Univariate and multivariate regression analysis of patient and intraoperative variables was conducted on a prospectively acquired database of LVHRs performed between April 2001 to July 2010. Patients were divided into, Group 1 (patients operated on by seven surgeons without advanced laparoscopic fellowship training) and Group 2 (patients operated on by three surgeons trained in advanced laparoscopic fellowships). A multivariate logistic regression model was created, to determine independent variables that correlate with length of procedure, (LOP: surrogate for the incorporation of advanced laparoscopic skills in the surgeons practice). P value <0.05 was considered significant.
Results:
Descriptive Analysis: 324 patients underwent elective LVHR with a mean age of 56.6 years. There were 230 patients in Group 1, and 94 patients in Group 2. The average BMI was 32.5 (range: 17 – 64). The overall conversion rate to open operation was 4.9%. The mean LOP was 96 minutes (range: 28 -418 minutes).
Univariate Analysis: The mean age was significantly higher in Group 2 (55 vs 59 years, p=0.03). There were a higher percentage of females (45% vs 67%, p=0.0006) and patients with incisional hernias (48% vs 76%, p=0.0001) in Group 2. The mean BMI and ASA grade distribution was not statistically dissimilar between the two groups. There was a significantly higher percentage of patients with recurrent hernias (19% vs 27%, p = 0.042) and complex hernias (21% vs 31%, p = 0.003) in Group 2. The mean size of mesh used in the repair (surrogate for hernia size) was significantly higher in Group 2 (175 vs 230 cm², p = 0.008), as was the mean number of trans-fascial sutures used (2.3 vs 4.5 sutures, p < 0.0001). The mean length of procedure was significantly longer in Group 2 (90 vs 112 minutes, p = 0.0008).
Logistic Regression: A multivariaite logistic regression model was created with LOP being the dependent variable. Five factors were independently associated with a significant longer LOP on mutivariate logistic regression analysis (p<0.05): mesh size (p<0.0001), complex hernias (p=0.0002), incisional hernia (p=0.0003), lysis of adhesions (p=0.001) and patient age (p=0.02). Significantly, an advanced laparoscopic fellowship was not independently associated with LOP.

Conclusions: Practice patterns suggest incorporation of laparoscopic techniques in the management of ventral hernias among general surgeons. Surgeons with advanced laparoscopic training tend to operate on larger and more complicated ventral hernias. Advanced laparoscopic training does not significantly decrease the length of this particular procedure, suggesting that general surgeons have incorporated the skills required to approach the laparoscopic management of ventral hernias into their skill set. Mesh size, complex hernias, incisional hernias, need for lysis of adhesions and patient age independently predict a longer length of procedure when a patient undergoes a laparoscopic ventral hernia repair.


Session: SS13
Program Number: S083

Post Views: 26

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2011 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc