China
Africa
Explore chapters and articles related to this topic
Questions 1–20
Published in Anna Kowalewski, SBAs and EMQs in Surgery for Medical Students, 2021
An incisional hernia is a hernia that occurs through a previously made incision in the abdominal wall. If pain is felt, it is felt over the defect and is greatest at the fascial margins. The presence of an irreducible hernia requires a prompt surgical referral, and if there is sharp pain or signs of peritonitis, urgent surgical referral is necessary. Most incisional defects are repaired with mesh.
Specimen Retrieval after Laparoscopic Colectomy and NOSE
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Deep Goel, Ravindra Vats, Luv Gupta, Vipin Pal Singh, Virandera Pal Bhalla
Incisional Hernia: Incidence of incisional hernia is highest in midline (periumbilical) and least in supra-pubic (Pfannensteil incision) [8,9]. Tho order is midline > stomal > transverse > suprapubic.
Abdominal surgery
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
Incisional hernias occur as a result of a previous surgical incision. Following a surgical incision in the abdominal wall the structures are approximated. Traditionally, this approximation has been with a non-absorbable suture material. Absorbable suture materials with a predictable rate of degradation, i.e. six weeks or more, are being used increasingly. An incisional hernia represents a failure of the initial repair. Following the surgical repair of an abdominal wound, healing takes place. The healing involves the laying down of fibroblasts, which then mature and organize, giving strength to the wound. This process can be inhibited by severe infection, uraemia or other conditions known to reduce the healing process. In a patient with a severe wound infection there is a very high incidence of incisional hernia occurring within the first year following surgery. An incisional hernia represents a delayed would dehiscence, i.e. the wound gives way slowly such that the skin remains intact but the underlying structures have given way.
Two Polyurethane Adhesives for PVDF Fixation Show Superior Biocompatibility in a Rat Model
Published in Journal of Investigative Surgery, 2022
Daniel Heise, Yelyzaveta Mirlas, Marius Helmedag, Roman Eickhoff, Andreas Kroh, Andreas Lambertz, Christian Daniel Klink, Ulf Peter Neumann, Uwe Klinge, Rene Tolba
The development of an incisional hernia is one of the most common complications after abdominal surgery. The current standard for both, open and laparoscopic approach, consist of an abdominal wall repair with mesh.1 However, especially during laparoscopic repair, the ideal fixation method of prosthetic material is still under discussion. Conventional fixation methods such as spiral tacking or suturing show biomechanical stability, but potentially generate a number of complications. In particular, using spiral tacks can lead to chronic abdominal pain due to nerve entrapment, intestinal obstruction or, though rarely, fistula development or small bowel perforation.2–4 An option of growing interest is the use of adhesive based mesh fixation with potential less complications due to avoidance of tissue penetration.5 Ideally, the surgical adhesive should meet some essential criteria, such as biocompatibility with a low foreign body reaction.6 Furthermore, the mechanical properties of not only the mesh but especially the combination of mesh and fixation play a key role. The aim of prosthesis is to reinforce the compromised abdominal wall, imitating autologous tissue without diminishing compliance.7 Therefore, we also focused on mechanical stability in addition to foreign body reaction and biocompatibility.
Incisional Hernia Repair of Medium- and Large-Sized Defects: Laparoscopic IPOM Versus Open SUBLAY Technique
Published in Acta Chirurgica Belgica, 2019
Patrick Hamid Alizai, Eric Lelaona, Anne Andert, Ulf Peter Neumann, Christian Daniel Klink, Marc Jansen
Incisional hernia repair is among the most frequently performed surgical procedures. Although the use of new prosthetic mesh materials and operative techniques has improved abdominal wall hernia repair outcomes, postoperative complications remain an intractable problem. Over the past two decades, laparoscopic approach has become widely used for the repair of incisional hernias. Laparoscopic repair seems to provide acceptable outcomes in terms of morbidity, length of hospital stay, postoperative pain and recurrence rate [8]. However, most of the published studies include very heterogeneous type of hernias, varying from small, primary fascial defects to large incisional hernias. Small hernias can be repaired without substantial morbidity, but larger defect sizes are associated with increased postoperative complications [14]. The aim of this study was to evaluate if morbidity rates of laparoscopic repair compared to open surgery when larger defects are repaired. We therefore analyzed prospectively collected data of patients with medium- and large-sized incisional hernias according to the EHS classification [11]. Morbidity rate in patients who underwent SUBLAY was twice as high as in the IPOM group. Comparable to laparoscopic repair of small fascial defects, laparoscopic repair reduced the postoperative complications when applied to medium and large-sized defects. This is in line with a Cochrane collaboration report by Sauerland and colleagues, which found significantly less postoperative complications after laparoscopic hernia repair [8].
Incidence and predictors of incisional hernia after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy*
Published in International Journal of Hyperthermia, 2019
Todd M. Tuttle, Jing Li Huang, Scott Kizy, Ariella M. Altman, Harika Nalluri, Schelomo Marmor, Wolfgang B. Gaertner, Eric H. Jensen, Jane Y.C. Hui
Incisional hernia is one of the most common postoperative complications after abdominal surgery for cancer. In this retrospective single-center study, the incidence of IH after CRS/HIPEC was 17% with a minimum follow-up time of two years. Independent predictors of IH were older age, female gender, and obesity. To the authors’ knowledge, only one other study has reported IH rates after CRS/HIPEC. In a German study of patients undergoing CRS/HIPEC, Struller et al reported that the IH rate was 7%; factors associated with IH were older age, cardiopulmonary morbidity, pseudomyxoma peritonei, mesothelioma, and abdominal wall rupture [11]. Notably, the use and frequency of surveillance CT were not described in this study from Germany, which may account for the lower incidence of IH compared to the current study.