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Hernia Recurrence (hernia + recurrence)
Selected AbstractsLAPAROSCOPIC VERSUS OPEN VENTRAL HERNIA REPAIR: A RANDOMIZED CONTROLLED TRIALANZ JOURNAL OF SURGERY, Issue 10 2008Chris M. Pring Laparoscopic and open techniques are both recognized treatment options for ventral hernias. We conducted a prospective randomized trial of both methods, to assess hernia recurrence, postoperative recovery and complications. Fifty-eight patients with ventral hernias were enrolled into the trial between August 2003 and December 2005. Of these, 31 underwent laparoscopic repair and 27 underwent open repair. Clinical parameters were documented on all patients during a median follow-up period of 27.5 months. The demographics of the two groups were similar. There was one recurrence in each of the laparoscopic and open groups. There was an equivalent rate of operative time, length of stay, postoperative pain scores, return to normal activities, wound infection and seroma formation between the two groups. Laparoscopic and open ventral hernia repair are comparable and offer low recurrence rates. [source] Laparoscopic repair of ventral incisional herniaANZ JOURNAL OF SURGERY, Issue 4 2002Keith B. Kua Background: Laparoscopic repair of ventral incisional hernias was first reported in 1993. Since then, there have been sporadic case reports and small series published about this procedure, but it has not been widely adopted. Newer types of composite prosthetic mesh may reduce the potential problem of bowel adhesion. Methods: Thirty cases of laparoscopic ventral incisional hernia repairs (carried out by two surgeons or their senior registrars) have been retrospectively reviewed and reported in this article. The data were obtained from patient records and subsequent phone surveys. Results: Thirty patients between 29 and 82 years (mean: 58 years) underwent this procedure. There were 14 men and 16 women. The average weight of the patients was 81 kg. The hernias were up to 6 or 7 cm in diameter. Mesh was used in 28 cases (polypropylene in 25 cases, expanded polytetrafluoroethylene in two cases and composite mesh in one case). Most meshes were laid intraperitoneally and fixed into position with laparoscopic spiral tacks. Twenty-nine cases were completed laparoscopically. One operation (3.3%) was converted to an open procedure because of severe bowel adherence to the hernia sac. The mean operating time was 52 min for laparoscopic ventral incisional hernia repairs only. All but two patients tolerated an oral diet within 24 h. The postoperative hospital stay ranged from 0 to 11 days, with 17 patients (57%) staying overnight and eight patients (27%) staying another day. Over 80% of the patients returned to house duties within a week. There was no mortality, and minor complications occurred in four patients (14%). One patient had a small bowel obstruction treated successfully by repeat laparoscopy with division of fibrinous adhesions to polypropylene mesh on day four. Follow up ranged from 1 to 69 months (mean: 12 months). One patient did not attend follow-up appointments. There were three cases of hernia recurrence (10%). Conclusion: The results suggest that laparoscopic repair of ventral incisional hernias is a safe, effective and technically feasible operation for small- to medium-sized hernias allowing shorter hospital stay, early recovery and resumption of normal activities. However, recurrence rates are comparable to open mesh hernioplasty especially for larger hernias. [source] Comparison between anatomical polyester (Parietex) mesh and polypropylene (Prolene) mesh with fixation in total extraperitoneal repair for inguinal herniaASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2010EG Cu Abstract Introduction: Laparoscopic inguinal hernia surgery has been gaining in worldwide popularity, with the total extraperitoneal (TEP) repair gaining greater acceptance than the transabdominal pre-peritoneal repair. Most techniques using TEP advocate some form of fixation of the prosthesis, but newer meshes avoid the use of fixation. Methods: We compared the use of the polyester mesh (Parietex; Tyco, Princeton, USA) without fixation and polypropylene (Prolene; Ethicon, USA) mesh with fixation using either ProTack (Tyco, USA) or EndoAnchor (Ethicon, Cincinnati, USA) in a consecutive series of patients who underwent total TEP endoscopic inguinal hernia repair. Results: Of 127 patients who underwent TEP repairs, 60 had Parietex mesh while 67 had Prolene mesh with fixation. The mean age was 50 years old and 97% were men. There was no difference in patient demographics or complication rate. The most common complication was small seroma or hematoma formation in 14% of patients and none required re-operation. There was no hernia recurrence in either group with a mean follow-up period of 13 months. Conclusion: This study shows that in laparoscopic TEP inguinal hernia repair, early results indicate comparable results between the use of polyester (Parietex) mesh without fixation and polypropylene (Prolene) mesh with fixation. [source] Laparoscopic-assisted onlay meshplasty to treat umbilical hernias in patients with severe cirrhosisASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2010M Tomikawa Abstract We used laparoscopic-assisted onlay meshplasty to treat umbilical hernias in four patients with severe cirrhosis. A skin incision was made just above the hernia and the circumferential abdominal wall was exposed. Under laparoscopic vision, transabdominal-wall mattress sutures were placed circumferentially around the hernia without leaving a gap between the sutures, and the mesh was placed over the hernia sac and fixed by ligation. Neither postoperative peritonitis nor rupture with ascites was found. None of the patients experienced hernia recurrence or mesh infection after a mean follow-up of 563 d. There was no relevant mortality. Laparoscopic-assisted onlay meshplasty to treat umbilical hernias in patients with severe cirrhosis seems to be technically feasible and offers good results without complications and early recurrence. [source] Laparoscopic inguinal hernia repair during laparoscopic radical prostatectomyBJU INTERNATIONAL, Issue 3 2007Benjamin C. Lee OBJECTIVE To describe our experience of simultaneous laparoscopic radical prostatectomy (LRP) and inguinal hernia repair (LIHR) with a non-absorbable mesh, as there are few reports of simultaneous herniorrhaphy during LRP. PATIENTS AND METHODS Forty patients who had simultaneous LIHR and LRP were retrospectively reviewed. All operations were completed via antegrade techniques using a non-absorbable mesh for the LIHR, as the results with absorbable mesh were disappointing. RESULTS In all, 48 clinically apparent hernias were repaired in 40 patients (mean age 60 years). Of these, 13 were left-sided, 23 right-sided, and six bilateral; 19 were direct, 14 indirect, two pantaloon, three femoral, and in 10 the type was not recorded. The mean operative duration was 172 min and the mean hospital stay was 1.5 days. Two patients had a urine leak after surgery, which resolved with no further intervention, and two developed a pelvic lymphocele, one at 4 months and the other at 2 months after surgery. Two patients required urinary catheter re-insertion for retention after surgical catheter removal at 9 and 10 days after surgery, respectively. One patient developed a deep venous thrombosis 19 days after surgery. Of the 40 patients, 36 (90%) were followed for a mean of 10 months; none had a hernia recurrence on the repaired side, while two developed a new symptomatic contralateral hernia. CONCLUSIONS LIHR is a successful and reliable way to treat symptomatic patients who are treated surgically for prostate cancer. [source] Influence of implantation interval on the long-term biocompatibility of surgical meshBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2002Dr B. Klosterhalfen Background: The aim was to study the long-term tissue response to polypropylene mesh. Methods: This was a retrieval study that investigated 76 polypropylene meshes with a median implantation interval of 18 (range 2,180) months. Mesh was explanted following hernia recurrence, infection or pain. The median implantation interval was 20 (range 4,180) months in the recurrence group, 30 (range 5,48) months in the pain group and 10 (range 2,56) months in the infection group (P < 0·05, infection versus pain or recurrence). The inflammatory response was determined by immunohistochemistry of macrophages (CD68), polymorphonuclear granulocytes (CD15) and T and B lymphocytes (CD3 and CD20). The cell turnover within the interface mesh fibre,recipient tissue was measured by TUNEL for apoptosis or DNA strand breaks, Ki67 for cell proliferation and heat-shock protein (HSP) 70 for cell stress. Results: With the exception of HSP-70, levels of all variables decreased over time. Sex, age, type of previous operation or location of the mesh did not have a significant influence. Conclusion: Long-term incorporated polypropylene mesh in humans has a more favourable tissue response with increasing implantation interval. © 2002 British Journal of Surgery Society Ltd [source] Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2002W. W. Vrijland Background: The optimum method for inguinal hernia repair has not yet been determined. The recurrence rate for non-mesh methods varies between 0·2 and 33 per cent. The value of tension-free repair with prosthetic mesh remains to be confirmed. The aim of this study was to compare mesh and non-mesh suture repair of primary inguinal hernias with respect to clinical outcome, quality of life and cost in a multicentre randomized trial in general hospitals. Methods: Between September 1993 and January 1996, all patients scheduled for repair of a unilateral primary inguinal hernia were randomized to non-mesh or mesh repair. The patients were followed up at 1 week and at 1, 6, 12, 18, 24 and 36 months. Clinical outcome, quality of life and costs were registered. Results: Three hundred patients were randomized of whom 11 were excluded. Three-year recurrence rates differed significantly: 7 per cent for non-mesh repair (n = 143) and 1 per cent for mesh repair (n = 146) (P = 0·009). There were no differences in clinical variables, quality of life and costs. Conclusion: Mesh repair of primary inguinal hernia repair is superior to non-mesh repair with regard to hernia recurrence and is cost-effective. Postoperative complications, pain and quality of life did not differ between groups. © 2002 British Journal of Surgery Society Ltd [source] Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional herniaBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2002Dr M. Korenkov Background: Since conventional suture repair for incisional hernia is associated with high recurrence rates, alloplastic and autoplastic prosthetic techniques have been suggested. Methods: In a randomized trial, 160 patients with simple or complex hernias underwent either suture repair, autodermal skin graft or onlay polypropylene mesh repair. Suture repair was not done in complex hernias. This report concerns a planned interim analysis. Results: At mean follow-up of 16 months, there were 17 hernia recurrences that were distributed similarly between the surgical techniques. There were fewer infectious complications after suture repair (three of 33 patients) than after skin graft or mesh repair (seven of 39 and five of 28 for simple hernias; seven of 31 and ten of 29 respectively for complex hernias) (P not significant). The severity of infections after polypropylene mesh implantation prompted the trial committee to discontinue the study. No differences were noted in duration of stay in hospital and quality of life. However, pain was significantly more frequent after polypropylene mesh repair (pooled risk ratio 2·9 and 1·8 at 6 weeks and 1 year respectively). Conclusion: Suture repair was safe for small incisional hernias. Both autoplastic and alloplastic hernia repair yielded comparably low recurrence rates, but led to a high rate of wound infection. © 2002 British Journal of Surgery Society Ltd [source] | ||||||||||