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Incisional Hernia (incisional + hernia)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Robotic assisted radical cystectomy: short to medium-term oncologic and functional outcomes

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2008
P. Dasgupta
Summary Purpose:, To report short- and medium-term oncological and functional outcomes of the first robotic-assisted laparoscopic radical cystectomy (RARC) series from the UK. Materials and methods:, Thirty patients underwent RARC between 2004 and 2007 at our unit. We report oncological and functional outcomes of this procedure in 20 patients (17 ileal conduit and three Studer Pouches), who have completed at least 6 months of follow up. Results:, There were 17 men and three women, median age 66 years (range 38,77 years). Median operating time was 330 min (range 295,510 min), and median blood loss 150 ml (range 100,1150 ml). There were two major complications (10%); a port site bleed and a rectal injury. The median follow up of this cohort is 23 months (range 7,44 months). One patient died of distant metastases at 8 months, and another developed a right ureteric tumour at 7 months. None of the patients had local pelvic or port site recurrence. The overall and disease-free survival are 95% and 90% respectively. Functional complications included a neovesico-urethral stricture at 3 months, a left upper ureteric stricture at 6 months and an incisional hernia at 12 months. Conclusion:, Robotic-assisted laparoscopic radical cystectomy is an emerging minimally invasive procedure which at short- to medium-term follow up, in our experience, is oncologically and functionally equivalent to open radical cystectomy. [source]

Giant incisional hernia: a case study

ANZ JOURNAL OF SURGERY, Issue 10 2009
Raed Tayyem MB BS
No abstract is available for this article. [source]

GS26P ABDOMINAL WALL ENDOMETRIOMA FOLLOWING CAESAREAN SECTION

ANZ JOURNAL OF SURGERY, Issue 2007
R. J. Whitfield
Purpose Endometriosis is defined as the presence of aberrant endometrial tissue outside of the uterus that responds to stimulation by ovarian hormones. A large, circumscribed mass of such tissue is commonly termed an endometrioma. Abdominal wall endometriomas in association with caesarean section scars have been reported repeatedly in the obstetrics and gynaecology literature, but rarely in general surgical journals. Methodology In this paper, six patients are reviewed who presented between 2001 and 2006 with painful, tender nodules in and around caesarean section scars. Of these, four reported exacerbation of symptoms during, or just prior to menstruation. One patient had experienced 12 years of symptoms, previously attributed to intra-abdominal adhesions. Results All patients had their scar nodules excised. Five procedures were performed electively. One patient underwent emergency exploration of her caesarean scar for possible incarcerated incisional hernia. Ectopic endometrial tissue was seen in the histological specimens of all patients. Four patients reported resolution of their symptoms following surgery. One patient had ongoing symptoms post-operatively, with an additional mass lesion seen on ultrasound consistent with a second endometrioma. One patient did not attend follow-up. Conclusion General surgeons are commonly required to assess and manage abdominal wall masses, and should have an awareness of endometrioma in the differential diagnosis when such a lesion is seen in association with a caesarean section scar. Wide excision is usually very effective at alleviating symptoms of abdominal wall endometrioma. [source]

Vermiform appendix in right upper quadrant incisional hernia

ANZ JOURNAL OF SURGERY, Issue 8 2005
BComm, Daniel W. McKay MB BS(Hons)
No abstract is available for this article. [source]

Laparoscopic repair of ventral incisional hernia

ANZ JOURNAL OF SURGERY, Issue 4 2002
Keith 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]

Original Article: Randomised prospective study of abdominal wall closure in patients with gynaecological cancer

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010
Roberto BERRETTA
Background:, Median laparotomy is the most common approach to the abdominopelvic cavity in patients with gynaecological tumours. Aims:, The primary endpoint of the study was to evaluate the onset of incisional hernia. The secondary endpoint was to evaluate the onset of infection, wound dehiscence, wound infection, and scar pain during the post-operative period. Methods:, A total of 191 patients were eligible for the study. They were divided into three groups. Group A underwent en bloc closure of the peritoneum and fascia with Premilene® suture, Group B en bloc closure of the peritoneum and fascia with Polydioxanone suture, and Group C separate closure of the peritoneum and fascia with single stitches of Ethibond suture. Statistical analysis was performed using the Statistical Software Package for Social Sciences 12.0. Results:, Group A and Group B comprised 63 patients, and Group C included 65 patients. The three groups proved homogeneous on statistical analysis (P > 0.05). The statistical analysis did not reveal significant differences between the different suture types and techniques with respect to the incidence of incisional hernia (P > 0.05). Conclusion:, In our study, the incidence of incisional hernia was 8%. Randomised patients were homogeneous for sample size and risk factors. No significant differences were found between suture types or techniques. Currently, there is no suture material or technique that can be considered superior to others. When possible, we believe that the best way to prevent incisional hernia is to preserve the integrity of the abdominal wall using minimally invasive techniques. [source]

Laparoscopic reintervention for anastomotic leakage after primary laparoscopic colorectal surgery,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2007
J. Wind
Background: Anastomotic leakage is associated with high morbidity and mortality rates. The aim of this study was to assess the potential benefits of a laparoscopic reintervention for anastomotic leakage after primary laparoscopic surgery. Methods: Between January 2003 and January 2006, ten patients who had laparoscopic colorectal resection and later developed anastomotic leakage had a laparoscopic reintervention. A second group included 15 patients who had relaparotomy after primary open surgery. Results: Patient characteristics were comparable in the two groups. The median time from first operation to reintervention was 6 days in both groups. There were no conversions. The intensive care stay was shorter in the laparoscopic group (1 versus 3 days; P = 0·002). Resumption of a normal diet (median 3 versus 6 days; P = 0·031) and first stoma output (2 versus 3 days; P = 0·041) occurred earlier in the laparoscopic group. The postoperative 30-day morbidity rate was lower (four of ten patients versus 12 of 15; P = 0·087) and hospital stay was shorter (median 9 versus 13 days; P = 0·058) in the laparoscopic group. No patient developed incisional hernia in the laparoscopic group compared with five of 15 in the open group (P = 0·061). Conclusion: These data suggest that laparoscopic reintervention for anastomotic leakage after primary laparoscopic surgery is associated with less morbidity, faster recovery and fewer abdominal wall complications than relaparotomy. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Causative factors, surgical treatment and outcome of incisional hernia after liver transplantation

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2002
Dr H. Janßen
Background: Little is known about the incidence and causes of herniation, and the results of hernia repair in patients undergoing liver transplantation. Likewise, nothing is known about the best surgical approach for hernia repair. Methods: A retrospective analysis was conducted of the occurrence of incisional hernia in 290 patients who had liver transplantation between 1990 and 2000, and survived more than 6 months. Follow-up data were obtained from medical records and the outpatient service. Patients were evaluated for various clinical and surgical factors. Hernias were analysed with respect to localization, type of surgical repair and recurrence rate. Results: Some 17 per cent of the transplanted patients experienced an incisional hernia. Risk factors were acute rejection with affiliated steroid bolus therapy (P = 0·025), a low platelet count after transplantation (P = 0·048), and a transverse abdominal incision with upper midline approach (P = 0·04). Hernias were mainly located at the junction of the transverse and midline incision (P < 0·001) and the recurrence rate was highest here (P = 0·007). Prosthetic hernia repair achieved the lowest rate of recurrence and did not increase the incidence of infectious complications. Conclusion: Improved immunosuppression should avoid early steroid bolus therapy after transplantation. A low platelet count promotes herniation. Transverse abdominal incision seems to be the best approach for liver transplantation. Prosthetic hernia repair does not increase the complication rate. © 2002 British Journal of Surgery Society Ltd [source]

Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2002
Dr 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]

Mesh hernioplasty for repair of incisional hernias of the ventral body wall in large horses

EQUINE VETERINARY EDUCATION, Issue 5 2005
Y. A. Elce
First page of article [source]

Late surgical complications following liver transplantation

LIVER TRANSPLANTATION, Issue S2 2009
Paige M. Porrett
Key Points 1. Biliary strictures and incisional hernias are the most common surgical complications encountered late after liver transplantation. 2. Anastomotic biliary strictures are amenable to endoscopic intervention and rarely need surgical intervention. 3. The presence of a biliary stricture mandates an evaluation of the patency of the hepatic artery. 4. Ischemic-type intrahepatic strictures are common indications for retransplantation. 5. Recipients of living related liver transplantation and donation after cardiac death allografts are at the highest risk for biliary and vascular complications late after transplantation. Liver Transpl 15:S12,S18, 2009. © 2009 AASLD. [source]