Surgical treatment of intercostal hernia with implantation of polypropylene mesh (original) (raw)
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Repair of recurrent hernia after biologic mesh failure in abdominal wall reconstruction
The American Journal of Surgery, 2014
BACKGROUND: Biologic mesh is commonly used in abdominal wall reconstruction but may result in increased hernia recurrence. There are minimal data on repair of these recurrent hernias. METHODS: We conducted a retrospective chart review of 24 patients presenting to a single surgeon with recurrent ventral hernia, previously repaired with biologic mesh. RESULTS: Seventeen of 24 study patients underwent open repair, including 5 revisions of incomplete external oblique release. Mesh was polypropylene in 11 patients and fenestrated condensed polytetrafluoroethylene in 3 patients. In 1 patient, no mesh was used. In 2 patients, bridged biologic mesh was used because of risk of exposure. All biologic repairs have since recurred. Complications occurred in 3 of 15 prosthetic mesh patients and in all biologic mesh patients. CONCLUSIONS: Prior components release can be repeated if computed tomography scan reveals incomplete release. Recurrence is common after bridged biologic mesh repair. Conventional mesh can be used safely in many recurrent abdominal hernias after biologic mesh failure.
ROLE OF MESH IN ABDOMINAL WALL HERNIAS REPAIR
A prospective study of patients with abdominal wall hernias, who were admitted and operated upon at Al-Fallouja teaching hospital ,Al-Anbar, Iraq, in the period between April 2009 and November 2013. A total of 54 cases, 40 males and 14 females were included in the study sample. Inguinal hernia formed 68.5%, incisional hernia 22.25% and umbilical hernia 9.25% of the study sample. Patients were all adults between 15-75 years (mean age: 46.6). The duration of their complaints ranged from few months to several years.Hernioplasty was performed using polypropylene mesh (open andlaparoscopic technique) to have a tension free repair. Postoperatively the patients were followed up to one year. The incidence of postoperative complications was 18.5%, seroma was the most frequent 9.2%, followed by wound infection 3.7%. A single case of recurrence was reported.
Prosthetic mesh repair of large and recurrent diaphragmatic hernias
Surgical Endoscopy, 2007
Background: Laparoscopic repair of large paraesophageal hernias (PEH) is associated with significant recurrence rates. Use of prosthetic mesh to complete tension-free repair of the hiatus has been suggested to decrease the recurrence rate. Methods: Fifty-nine patients with large (n = 44) or recurrent (n = 15) PEH were operated on via the laparoscopic approach with the use of prosthetic mesh. Patients were followed with office visits and phone interviews. All patients were referred for barium studies. Data analysis included all patients, including conversions, on an intention-to-treat basis. Results: Followup was completed in 56 (95%) patients. Mean followup time was 28.4 months. Forty patients (74%) had significant relief of all symptoms. Barium studies were performed in 45 patients (80.3%), including all symptomatic patients. Fifteen patients (33%) had a small sliding hernia, six (13.3%) had recurrent PEH, and four (8.8%) had narrowing of the gastroesophageal junction. Most patients with small hiatal hernias were symptomatic (60%). All responded to medical treatment. Conclusions: Laparoscopic repair of large PEH with reinforcement mesh is feasible and safe with excellent short-term results. Long-term followup shows a low PEH recurrence requiring reoperation, but a significant number of patients develop symptomatic recurrent small hiatal hernias that can be managed nonoperatively.
Surgery, 2016
Our objective was to determine outcomes for complex ventral hernia repairs in a large cohort of patients utilizing an operative construct employing retrorectus placement of a narrow, macroporous polypropylene mesh with up to 45 suture fixation points for force distribution. No consensus exists on the optimal technique for repair of complex ventral hernias. Current trends emphasize large meshes with wide overlaps and minimal suture fixation, though reported complications and recurrence remain problematic. A retrospective review was performed for all patients undergoing ventral hernia repair with retrorectus placement of midweight, uncoated, soft polypropylene mesh by a single surgeon (GAD) between the years of 2010 and 2015. Patient characteristics, operative history, operative data, and postoperative course were reviewed. A total of 101 patients with a mean age of 56 years and a mean body mass index of 29 m/kg(2) (range 18-51 m/kg(2)) underwent hernia repair. Patients had a median o...
Feasibility of mesh repair for strangulated abdominal wall hernias
International Journal of Surgery, 2012
Background: Prosthetic mesh reduces the risk of hernia recurrence. The use of mesh in patients with strangulated hernias requiring bowel resection is controversial. Patients and methods: Patients with acutely incarcerated hernias (with small intestine contents) who underwent polypropylene mesh hernioplasty were included in this prospective study from June 2005 to Jan. 2011. Results: 163 patients were included; 48 required intestinal resection and anastomosis (Group I) and 115 did not (Group II). Operative times and hospital stay were longer in Group I (P ¼ 0.001). No significant difference was noted between both groups in terms of postoperative morbidities (16.6% vs 13% P ¼ 0.5), wound infection (6% vs 4% P ¼ 0.6), and recurrence rate (2% vs 2.8% P ¼ 0.8), All cases of wound infection were successfully managed with drainage and local wound care and no mesh had to be removed. One patient in Group I and five patients in Group II died of concomitant diseases in the follow-up period (P ¼ 0.5). Conclusion: Mesh hernioplasty is crucial to prevent recurrence, and it is safe to utilize it in repair of acutely incarcerated hernias even if associated with intestinal resection.
Management of Irreducible Hernia Using Polypropylene Mesh
al-azhar medical journal, 2020
Background: Incarceration of abdominal wall hernia is a frequent problem. Moreover, using polypropylene mesh in management of acute hernia is infrequently performed. Objective: To detect the relation between postoperative surgical site infections (SSI) in patients with irreducible abdominal wall hernia using polypropylene mesh in their hernia repair. Patients and methods: Our study included 30 irreducible abdominal hernia patients even with strangulation and/or obstruction who were managed by polypropylene meshes. This prospective interventional study was conducted at the Department of General Surgery, Al-Zahraa University Hospital from November 2018 to November 2019. All patients, who presented with irreducible, obstructed or strangulated abdominal wall hernias, were included in this study. Results: Preoperative hernia complications were 66.7% irreducibility only, 3.3% hematoma, 3.3% obstructed, 6.7% strangulated, 20% strangulated obstructed. Presence of toxic fluid in the hernia s...
Simplified technique for incisional hernia repair with mesh prosthesis
Hernia, 2003
This paper describes a simplified technique for the repair of incisional hernias. The previous scar is resected, and the peritoneal sac is carefully dissected until it is completely exposed. The sac is opened to liberate structures adherent to the sac or to the area immediately surrounding the defect. The peritoneum is closed and invaginated to form a sac bed underlying the entire extent of the defect, and the mesh is laid on this sac bed. The mesh is then fixed with "U" stitches, reinforcing these by inserting a second line from the edge of the defect to the mesh. Suture material used is polypropylene 1/0 or 2/0. This procedure has been carried out on 15 patients, and after 1 year of follow-up, there has been no recurrence of the hernia. Operating time was reduced, and the surgical technique was found to be easier. Placing a mesh prosthesis inside the hernia sac and fixing it to the abdominal wall with two lines of suturing simplifies the repair procedure, reduces operating time, and is effective in the repair of all incisional hernias. A study is required to compare this outcome with the different mesh repair techniques.
The Use of Self Fixating Mesh in Open Inguinal Hernia Repair
Madridge Journal of Surgery, 2018
Introduction: Lichtenstein technique of inguinal hernia repair, which is performed with tension-free approach by mesh placing and fixation to the surrounding tissues, is currently the treatment of choice for open surgery repair of inguinal hernia. The fixation of the mesh is estimated to be the cause of post-operative complications such as chronic pain, surgical site granuloma, nerve entrapment and hernia recurrence. Aim: The aim of this research is to retrospectively determine the efficacy and the clinical implications underlying the use of self-adhesive mesh compared to a non-adhesive mesh in open surgery repair of inguinal hernia. Methods: This study is a retrospective study that included 248 Patients. These patients underwent open surgery repair for inguinal hernia with Liechtenstein technique at Assuta Hospital, Israel, by using a Progrip adhesive mesh (by Covidien), while fixation was made only with a few Vicryl sutures (2 - 3 stitches only).The Patients were requested to scale pain intensity by using Numerical Rating Scale (NRS) method. For post-operative Clinical evaluation, participants were questioned for periods of one month, three months and six months after surgery while carefully identifying post-operative complications that included chronic pain, surgical wound granuloma, seroma, nerve entrapment and hernia recurrence. Results: The average pain intensity was 3.16 (± 2.3) after one month, 1.14 (± 1.6) after 3 months and 0.43 (± 1.2) after 6 months of surgery. Four patients (2.7%) reported pain intensity over grade 3 on the NRS scale during six months after surgeryand only six patients (4%) reported pain or any discomfort after two years of surgery while the NRS scale was less than 3 during this time. Sixteen patients reported chronic complaints and two patients (0.8%) reported hernia recurrence that led to a second surgery. Conclusion: In conclusion, the use of an adhesive mesh compared to a non-adhesive mesh reduces chronic pain complaints and reduces its severity. In addition, this surgical approach leads to a fewer common post-surgical complications. Nevertheless, there was no change in the incidence of hernia recurrence compared to a non-adhesive mesh.