One in two ventral and incisional hernia repair (VIHR) patients had preoperative opioid prescriptions. The study found that preoperative opioid tolerance, superficial wound infection, current smoking status, and opioid dispensation within 45 days of admission were significant predictors of increased postoperative opioid use. Preoperative opioid use 45 days prior to admission strongly correlated with postoperative […]
Category: Hernia
Optimizing Abdominal Wall Reconstruction: The Complex Hernia Bundle
A “Getting It Right First Time” approach to abdominal wall reconstruction (AWR) involves developing a comprehensive management pathway. The study outlines a detailed AWR pathway, integrating literature review and experiential knowledge, facilitating better patient outcomes. Referred to as the “complex hernia bundle,” this approach guides AWR teams, offering valuable insights for managing challenging hernia cases […]
Disappointing Results of SMART Technique for Parastomal Hernia Repair
The study assesses the Modified Stapled Mesh Stoma Reinforcement Technique (mSMART) for parastomal hernia repair, revealing a high recurrence rate of 57.1% during follow-up. Despite low rates of surgical site occurrence and infection, disappointing outcomes indicate the need for alternative approaches in addressing parastomal hernias to improve patient outcomes and reduce recurrence. Journal Article by […]
Comparing Robotic Hernia Repair Techniques: Perioperative Differences but Comparable Costs
Robotic incisional hernia repairs using intraperitoneal onlay mesh (ipom) showed more perioperative complications, higher postoperative pain, and readmission rates than retromuscular (rm) repairs. However, rm repairs had higher defect closure rates and lower postoperative complications. Despite higher postoperative complication costs in ipom, total costs were comparable between the techniques. Recurrence rates and hospital costs did […]
High Recurrence Rates and Comorbidities Post-Transversus Abdominis Release
Abdominal surgeries following transversus abdominis release are linked to substantial comorbidities and heightened hernia recurrence rates. Efforts to minimize reoperations post-tar procedure are crucial. Results reveal a 36.1% hernia recurrence rate in 1137 patients, with 4.7% undergoing non-hernia abdominal surgeries, primarily due to small bowel obstructions. Urgent or emergent surgeries predominated, highlighting the need for […]
Reinforcing Hiatal Hernia Repair to Reduce Recurrence Rates
Revision procedures for recurrent hiatal hernia revealed that most recurrences occurred in the left-anterior quadrant of the hiatus. Posterior recurrences were also notable. Both anterior and posterior hiatal reinforcement may be necessary to decrease recurrence rates. A randomized controlled trial using a circular, bio-absorbable mesh is underway to validate this hypothesis. Review by Geerts JH, […]
Mesh Repair Reduces Ventral Hernia Recurrence Rates Over Time
The study revealed that the 5-year recurrence rate after ventral hernia repair was greater than 40% and 70% in patients with and without mesh, respectively. Ventral hernia recurrence rates increased over time, emphasizing the need for close, long-term follow-up. Risk factors associated with higher odds of recurrence include higher body mass index, immunosuppressants, incisional and […]
Advances in Hernia Care: Moving Towards Individualized Treatment
Recent advances in hernia surgery have allowed surgeons to accurately predict risk, diagnose hernias based on individual characteristics, and utilize new technology and techniques in the operating room. While outcomes have modestly improved, further progress is still needed, with emphasis on continued research, use of registries, education, and training. Hernia prevention strategies focusing on minimally […]
Obesity and Adiposity Distribution: Causal Factors for Ventral Hernia
Obesity measures and abdominal adiposity indicators were evaluated using Mendelian randomization to determine their causal relationship with ventral hernia (VH) risk. Increased BMI, body fat percentage, body fat mass, visceral adiposity tissue, waist circumference, and hip circumference were found to be causally associated with a higher risk of VH. Body fat percentage remained a significant […]
Preventing Metachronous Contralateral Hernia with Laparoscopic IPTR
Laparoscopic iliopubic tract repair effectively reduces the risk of metachronous contralateral inguinal hernia (MCIH) by treating contralateral occult inguinal hernia. The study found a lower incidence of indirect MCIH in patients with treated occult inguinal hernia compared to those without treatment. Postoperative complications, pain scores, and recovery times were similar between the groups, emphasizing the […]