Concomitant Laparoscopic Hiatal Hernia Repair with Cholecystectomy: A Multicentric Study (original) (raw)
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Diseases
Introduction: Concomitant surgeries have been performed previously in several centers with experience in laparoscopic surgeries. These surgeries are performed in one patient under one operation with anesthesia. Methods: We performed a retrospective unicenter study from October 2021 to December 2021 analyzing patients who underwent laparoscopic hiatal hernia repair with cholecystectomy. We extracted data from 20 patients who underwent hiatal hernia repair together with cholecystectomy. Grouping of data by hiatal hernia type showed 6 type IV hernias (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed, 19 were patients suffering from chronic cholecystitis and 1 patient presented with acute cholecystitis. The average operating time was 179 min. Minimum blood loss was achieved. Cruroraphy was performed in all cases, mesh reinforcement was added in five cases, and fundoplication was performed in all cases, with 3 Toupet, 2 ...
Journal of Babol University of Medical Sciences, 2016
BACKGROUND AND OBJECTIVE: One of the complications of laparoscopic cholecystectomy is trocar incision hernia (TSIH: Trocar Site Incisional Hernia), which occurs almost exclusively in the navel area and could cause significant problems. The aim of this study was to evaluate the prevalence of hiatal hernia in laparoscopic cholecystectomy and identify the associated risk factors. METHODS: This cross sectional study was done on patients who underwent laparoscopic cholecystectomy during one year in different hospitals of Babol. Information including age, gender, BMI, diagnosis prior to surgery, duration of hospitalization, duration of surgery, the thickness of the lining of the gallbladder, surgical site infection and umbilical hernia during 12 months follow-up for patients were confirmed and examined. FINDINGS: Among 270 studied patients, there were 236 women (87.4%) and 34 men (12.59 %). Eleven patients (4.07%) during the 12-month follow-up; they had a hiatal hernia surgical site infection in the navel area (223.82-4.33: CI-95%, OR: 31.14) and BMI (60.18-1.72 CI-95%; OR: 10.21) were associated with increased incidence of inguinal hernias. There was no relationship between other variables and umbilical hernia. CONCLUSION: According to the results of this study obesity and surgical site infections have been linked with an increased incidence of inguinal hernias.
Open versus Laparoscopic Hiatal Hernia Repair
JSLS, Journal of the Society of Laparoendoscopic Surgeons, 2013
The literature reports the efficacy of the laparoscopic approach to paraesophageal hiatal hernia repair. However, its adoption as the preferred surgical approach and the risks associated with paraesophageal hiatal hernia repair have not been reviewed in a large database.
Laparoscopic hiatal hernia repair
Surgical Endoscopy, 2006
Background: The recurrence rate after laparoscopic repair of hiatal hernias with paraesophageal involvement (LRHP) is reported to be high. Mesh reinforcement has been proposed with the objective of solving this problem. This study aimed to compare the outcome of LRHP before and after the introduction of mesh reinforcement. Methods: Between 1992 and 2003, 56 consecutive patients received LRHP including posterior crurorrhaphy and additional fundoplication. Of these 56 patients, 17 underwent a mesh-reinforced hiatoplasty. Perioperative outcome was assessed retrospectively, and follow-up assessment was performed according to protocol including a barium contrast swallow. Results: The follow-up period averaged 52 ± 31 months (range, 9-117 months). The recurrence rate for hiatal hernia without mesh reinforcement was 19% (7/36). No recurrence (0/16) was observed in patients with mesh reinforcement. The intraoperative complication rate was 9%, and the perioperative morbidity rate was 14%. There were neither mesh-related complications nor operation-related deaths. Conclusions: Although challenging, LRPH is a successful procedure. The high recurrence rate reported in the literature can be reduced by additional mesh reinforcement.
Surgery, 2001
The evidence for the final outcomes was derived from a single study. Link between effectiveness and cost data The costing was undertaken prospectively on the same patient sample as that used in the effectiveness study. Study sample A specific sample size was preliminarily determined to assure a certain power. All adult low-risk patients requiring elective surgical treatment for both symptomatic chronic calculous cholecystitis and synchronous unilateral primary inguinal hernia, who were hospitalised at the authors' institution between January 1994 and February 1997 were included in the sample. The exclusion criteria were pregnancy, high risk for anaesthesia, coagulation disorders, prior complicated operations, irreducible or congenital hernia, and massive scrotal or sliding hernia. Only those patients who allowed the surgeon to
Journal of Clinical and Investigative Surgery, 2021
The aim of this study was to compare the frequency of umbilical hernia repair during open and laparoscopic cholecystectomies. Consecutive patients who underwent laparoscopic and open cholecystectomy between January 1993 and June 2005 were retrospectively reviewed. Among those, cases of patients who underwent simultaneous cholecystectomy and umbilical hernia repair were included in the study, and the distribution of hernia repairs via laparoscopic and open cholecystectomy were investigated. In addition, patients who underwent umbilical hernia repair only during the study period were also screened and the type of repair was noted in order to be compared to the types of hernia repair in the patients who underwent cholecystectomy. In total, there were 3,028 patients who underwent cholecystectomy, out of which 2,281 were performed via laparoscopy. In total, 46 patients underwent cholecystectomy and simultaneous umbilical hernia repair; 44 underwent laparoscopic cholecystectomy and umbili...
Journal of the American College of Surgeons, 2013
BACKGROUND: Minimally invasive techniques have become an integral part of general surgery with recent investigation into single-incision laparoscopic cholecystectomy (SILC). This study presents the final 1-year results of a prospective, randomized, multicenter, single-blinded trial of SILC vs multiport cholecystectomy (4PLC). STUDY DESIGN: Patients with biliary colic and documented gallstones or polyps or with biliary dyskinesia were randomized to SILC vs 4PLC. Data measures included operative details, adverse events, and conversion to 4PLC or laparotomy. Patients were followed for 12 months. RESULTS: Two hundred patients underwent randomization to SILC (n ¼ 119) or 4PLC (n ¼ 81). Enrollment ranged from 1 to 50 patients with 4 sites enrolling >25 patients. Total adverse events were not significantly different between groups (36% 4PLC vs 45% SILC; p ¼ 0.24), as were severe adverse events (4% 4PLC vs 10% SILC; p ¼ 0.11). Incision-related adverse events were higher after SILC (11.7% vs 4.9%; p ¼ 0.13), but all of these were listed as mild or moderate. Total hernia rates were 1.2% (1 of 81) in 4PLC patients vs 8.4% (10 of 119) in SILC patients (p ¼ 0.03). At 1-year follow-up, cosmesis scores continued to favor SILC (p < 0.0001). CONCLUSIONS: Results of this trial show SILC to be a safe and feasible procedure when compared with 4PLC, with similar total adverse events but with an identified significant increase in hernia formation. Cosmesis scoring and patient preference at 12 months continue to favor SILC, and more than half of the patients were willing to pay more for a single-site surgery over a standard laparoscopic procedure. Additional longer-term population-based studies are needed to clarify if this increased rate of hernia formation as compared with 4PLC will continue to hold true. (J Am Coll Surg 2013;216:1037e1048. Ó 2013 by the American College of Surgeons) Disclosure Information: This study was sponsored by Covidien (Norwalk, CT). Dr Rivas has received an honorarium as a speaker for Covidien. All other authors have nothing to disclose.
International Surgery
Background: High rates of recurrence after laparoscopic hiatal hernia repair have been published. Most of these recurrences are asymptomatic and only diagnosed by endoscopic or radiologic studies. The definition of hiatal hernia recurrence is still under discussion. Objective: This study aimed to define a true hiatal hernia recurrence using a score and classification criteria considering the presence of symptoms and size of the recurrence. Patients and Methods: A total of 153 patients with giant hiatal hernia larger than 10 cm in diameter underwent an operation using a laparoscopic approach. Of these patients, 129 had a complete follow-up (3–5 years) after surgery, and they were the only ones included in this study. The IT system of our hospital was our database for data registration. A score and classification were designed for definition of a “true” hiatal hernia recurrence, based on postoperative symptoms and the presence or not of a hiatal hernia in both radiologic and endoscopi...
Laparoscopic management of giant hiatal hernia: factors influencing long-term outcome
Surgical Endoscopy and Other Interventional Techniques, 2006
Background The laparoscopic management of large hiatal hernias still is controversial. Recent studies have presented a high recurrence rate. Methods In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal defect was performed in 14 cases. “Tension-free” repair using a mesh was performed in 37 cases, and 14 patients underwent a Collis–Nissen gastroplasty. For the last 38 patients in the series, an intraoperative endoscopy was performed to identify the esophagogastric junction. Results There was no mortality, no conversions to open surgery, and no intraoperative complications. A recurrent hernia was present in 23 of the 77 patients (30%). The recurrence rate was 77% when a direct suture was used and 35% when a mesh was used (p < 0.05). No recurrences were observed in the patients treated with the Collis–Nissen technique, but in one case, perforation of the distal esophagus developed 3 weeks after surgery. The multivariate analysis showed that recurrences are statistically correlated with the type of hiatal hernia and surgical technique. Conclusions To reduce recurrences after laparoscopic management of large hiatal hernias, it is essential to identify all cases of short esophagus using intraoperative endoscopy and to perform a Collis–Nissen procedure in such cases.
Comparison Between Incidence of Incisional Hernia in Laparoscopic Cholecystectomy and by Single Port
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2018
Surgeries with single port access have been gaining ground among surgeons who seek minimally invasive procedures. Although this technique uses only one access, the incision is larger when compared to laparoscopic cholecystectomy and this fact can lead to a higher incidence of incisional hernias. To compare the incidence of incisional hernia after laparoscopic cholecystectomy and by single port. A total of 57 patients were randomly divided into two groups and submitted to conventional laparoscopic cholecystectomy (n=29) and laparoscopic cholecystectomy by single access (n=28). The patients were followed up and reviewed in a 40.4 month follow-up for identification of incisional hernias. Follow-up showed 21,4% of incisional hernia in single port group and 3.57% in conventional technique. There was a higher incidence of late incisional hernia in patients submitted to single port access cholecystectomy compared to conventional laparoscopic cholecystectomy.