Laparoscopic Repair of Incisional and Parastomal Hernias after Major Genitourinary or Abdominal Surgery
|
|
- Gregory Bradley
- 6 years ago
- Views:
Transcription
1 JOURNAL OF ENDOUROLOGY Volume 15, Number 2, March 2001 Mary Ann Liebert, Inc. Laparoscopic Repair of Incisional and Parastomal Hernias after Major Genitourinary or Abdominal Surgery PAUL M. KOZLOWSKI, M.D., 1 PETER C. WANG, M.D., 2 and HOWARD N. WINFIELD, M.D. 1 ABSTRACT Background and Purpose: Abdominal wall or parastomal hernias following major genitourinary or abdominal surgery are a significant surgical problem. Open surgical repair is difficult because of adhesion formation and poor definition of the hernia fascial edges. Laparoscopic intervention has allowed effective correction of these abdominal wall hernias. Patients and Methods: From November 1997 to June 2000, 14 male and 3 female patients underwent laparoscopic abdominal wall herniorrhaphy at our institution. Of these, 13 patients received incisional and 4 parastomal hernia repair. All hernia defects were repaired using a measured piece of Gore-Tex DualMesh. A retrospective review of each patient s history and operative characteristics was undertaken. Results: All repairs were successful. No patient required conversion to an open procedure, and there were no intraoperative complications. The average operative time was 4 (range ) and 4.3 (range ) hours in the incisional and parastomal group, respectively. The average hospital stay was 4.9 days (range 2 12) for the incisional group and 3.8 (range 3 4) days for the parastomal group. To date, two patients experienced a recurrence of incisional hernias, at 5 and 8 months postoperatively. No recurrences have developed in the parastomal hernia repairs at 2 to 33 months. Conclusion: Laparoscopic repair of abdominal wall incisional or parastomal hernias provides an excellent anatomic correction of such defects. Adhesions are lysed under magnified laparoscopic vision, and the true limits of the fascial defects are clearly identified. The DualMesh is easy to work with and has yielded excellent results. A comparison with open repair with respect to perioperative factors and long-term success is currently under way. INTRODUCTION ABDOMINAL WALL HERNIAS following major genitourinary or abdominal surgery are a significant surgical problem. It has been reported that as many as 26% of patients who undergo major abdominal surgery can develop an abdominal wall hernia. 1 3 Factors that may predispose a patient to the formation of such hernias include multiple abdominal operations, infection, obesity, poor nutritional status, and chronic medical problems, especially pulmonary, all of which interfere with normal healing. Traditionally, the repair of abdominal wall hernias has been approached via an open technique. A wide variety of methods have been developed, such as those described by Stoppa 4 and Wantz. 5 However, the recurrence rate after open incisional hernia repair has been reported to be as high as 54%. 6,7 Although the introduction of prosthetic material in incisional hernia repair has decreased the recurrence rates, the risk of wound infections and local wound complications may be increased Because of the high recurrence rates and subsequent attempts at correction followed by increasingly higher recurrence rates, an alternative to open surgery is needed. 14 With the advent of laparoscopic surgery, a new form of hernia repair became available to surgeons. The goal of the laparoscopic approach to abdominal hernia repair should be a decrease in recurrence rates and wound complications, while offering the patient the advantages of a minimally invasive procedure. The first laparoscopic incisional hernia repair was reported in Since that time, studies comparing open and laparoscopic abdominal wall hernia repair have suggested that 1 Department of Urology, Stanford University, Stanford, California. 2 Department of Surgery, VA Health Care System, Palo Alto, California. 175
2 176 KOZLOWSKI ET AL. patients who undergo laparoscopic hernia repair experience the predicted advantages of less pain and shorter hospitalization, while the recurrence rate and infection complication are lower. 16,17 The purpose of this study was to review all patients who underwent incisional and parastomal hernia repair related to previous genitourinary and abdominal surgery at a single institution over a 2-year period. Patients PATIENTS AND METHODS We retrospectively reviewed the records of 14 male and 3 female patients ages 44 to 79 who underwent a laparoscopic incisional or parastomal hernia repair performed between November 1997 and June 2000 (Table 1). Patient age, sex, significant surgical and medical history, type of hernia repair, average operative time, surface area of mesh repair, time to return to full diet, hospital stay, complications, and recurrences were reviewed. Of the patients reviewed, 13 had incisional and 4 had parastomal hernia repairs. Defects of any size were included in this study. All repairs were performed laparoscopically, and no patient required open conversion. Surgical Technique TABLE 1. CHARACTERISTICS OF PATIENTS Patient Age Sex Hernia Type Previous Surgery Relevant Medical History a 1 44 M Incisional Ventral hernia repair None 2 48 M Incisional Cystoprostatectomy Renal Insuff F Incisional Splenectomy None 4 55 F Incisional Simple cystectomy w ileal loop None 5 57 F Incisional Nephrolithotomy, Open COPD 6 62 M Incisional AAA repair b CAD, HTN 7 64 M Incisional Exploratory laparotomy HTN 8 67 M Incisional AAA repair CAD, COPD, HTN 9 67 M Incisional Hiatal hernia HTN M Incisional Collectomy CAD, HTN M Incisional AAA repair COPD, C5 quad M Incisional Cystoprostatectomy HTN, PVD M Incisional Cystoprostatectomy HTN, COPD, DM M Parastomal Cystoprostatectomy HTN, COPD, DM M Parastomal Colectomy HTN, COPD, DM M Parastomal Cystroprostatectomy DM, CAD M Parastomal Cystroprostatectomy HTN, PVD a COPD 5 chronic obstructive pulmonary disease, CAD 5 coronary artery disease, HTN 5 hypertension, C-5 quad 5 C5 quadraplegia, PVD 5 peripheral vascular disease, DM 5 diabetes mellitus. b AAA 5 abdominal aortic aneurysm. 16F Foley catheter is placed in the bladder or stoma of the urinary diversion for a parastomal hernia repair. With the patient under general anesthesia, the Hasson cannula technique is used to obtain a pneumoperitoneum. The initial entry port is in a site farthest away from the hernia defect and original surgical incision, so as to minimize the risk of entry into an area of adhesions or bowel. In other words, if the hernia is in the right mid or lower abdomen, the Hasson cannula entry would be in the left upper quadrant. The working port size, number, and placement is dependent on the location, type, and size of the hernia. Generally, three or four ports (5 11 mm) are required. The basic objective is to space the ports in a triangular fan-shape configuration with the apex of the triangle directed to the hernia. All patients undergo preoperative CT scanning, with a loopogram performed in the case of parastomal hernias, to determine the contents of the hernia and define the extent of the fascial defect (Fig. 1). All patients received oral antibiotics and a full mechanical bowel preparation with Golytely and are typed and screened for blood products. Patients are routinely given one dose of broad-spectrum antibiotic on call to the operating room. An orogastric tube is placed for gastric decompression, and a FIG. 1. hernia. Preoperative CT scan demonstrating ileal parastomal
3 LAPAROSCOPIC INCISIONAL HERNIA REPAIR 177 FIG. 2. Laparoscopic view of ileal loop with mesenteric blood supply and parastomal fascial defect. Adhesiolysis is achieved with both blunt and sharp dissection. The hernia is emptied, and the fascial edges are freed of overlying tissue circumferentially beyond 3 cm. The mesentery supplying the ileal or colonic conduit is carefully identified and preserved with separation from surrounding herniated bowel in the case of parastomal hernia repairs (Fig. 2). The circumferential dimensions of the hernia defect are measured by percutaneously placing an 18-gauge spinal needle under laparoscopic guidance through the edge of the fascial defect. Once the size of the defect is determined, a piece of Gore-Tex DualMesh (W.L. Gortex) is cut 2 to 3 cm larger. Four quadrant stitches of 2-0 Gor-Tex are placed on the mesh, which is then inserted into the abdominal cavity through a 10/11-mm port site. The DualMesh has a smooth side, which diminishes adhesion formation, and a rough side, which causes more ingrowth of fibroblasts and collagen. The smooth side is oriented toward the bowel contents and the rough side toward the abdominal wall. The mesh is positioned and the quadrant stitches brought out percutaneously using the Carter Tomlinson (Inlet Medical, Eden Praire, MN) device. The ProTack (Autosuture Inc., Norwalk, CT) secures the Gore-Tex mesh to the fascia edge beyond the defect. Tacks are placed every 1.5 cm around the outer edge of the defect (Fig. 3). Final hemostasis is obtained, and the port sites are closed in the usual fashion. An abdominal wall binder is placed at the termination of the procedure, and the patient is encouraged to wear this binder as much FIG. 3. Laparoscopic view of position of Gore-Tex mesh in completed parastomal hernia repair. as possible over the ensuing 6 weeks. Strenuous or lifting activities are discouraged during this time. RESULTS All 17 patients tolerated the procedure well. The average operative time was 4 (range ) hours for incisional repairs and 4.3 (range ) hours for parastomal hernias. The average surface area of the DualMesh employed was 510 (range ) cm 2 for incisional and 424 (range ) cm 2 for parastomal hernias. It should be noted that the mesh was 2 to 3 cm circumferentially larger than the hernia defect. The other postoperative characteristics, hospital stay, complications, and success rate for the various types of hernia repairs are reflected in Table 2. No intraoperative complications occurred, and no patient required conversion to an open repair. Postoperative complications included prolonged ileus necessitating placement of a nasogastric tube for 2 or 3 days in three patients and postoperative angina in one patient. Most patients reported moderate discomfort in the areas where the mesh was secured with the tacks, but this generally resolved within 48 hours. Follow-up has ranged from 2 to 33 months. Patients have been followed with routine clinic visits and phone interviews. To our knowledge, there have been two recurrences to date in TABLE 2. RESULTS OF LAPAROSCOPIC REPAIR Av OR Av Av return Av hosp time surface to diet stay Hernia (h) area (cm 2 ) (days) (days) Success type No. (range) (range) (range) (range) Compl. (%) Incisional a 85 ( ) ( ) (1 10) (2 12) Para-stomal a 100 ( ) ( ) (1 3) (3 4) a Three patients with prolonged ileus; one patient with angina.
4 178 patients who underwent repair of incisional hernias. The first patient was a 57-year-old obese woman who had a history of a right nephrolithotomy through a flank incision. The mesh used in her repair was cm (surface area 285 cm 2 ). The patient s recurrence was first noted on a return clinic visit 5 months after her laparoscopic repair. The patient has not undergone a repair of the recurrence to date. The second patient was a 68-year-old man who had previously undergone cardiac surgery, after which he developed an epigastric hernia in the lower 4 cm of the chest incision that extended into the abdomen. The patient had undergone a prior open repair, not involving prosthetic material, which had failed. The mesh used was cm (surface area 418 cm 2 ). The recurrence was noted 8 months after the laparoscopic repair. To date, the patient has not undergone a repair for the recurrence. No recurrences have been seen in the parastomal group to date. DISCUSSION Recurrences after open incisional hernia repair have been associated with several causes, but infection and the size of the defect remain the most predominant. 18,19 The recurrence rate has been reported to be as high as 54%, with even higher rates for repeat open hernia repairs. 6,7 The addition of prosthetic materials such as Marlex mesh and polytetrafluoroethylene (PTFE) to open repairs has decreased these recurrence rates, but the results are still less than optimal With the advent of minimally invasive surgery in the early 1990s, laparoscopic intervention has been demonstrated to be a good alternative for the management of incisional hernias. Any new approaches to the repair of incisional or parastomal hernias should not only strive to reduce complications and recurrences but afford the patient a quicker and more comfortable recovery from surgery. The advantages of shorter hospitalization, faster recovery, and less postoperative pain have been observed in comparing laparoscopic and open inguinal hernia repair Furthermore, a study by Ramshaw and associates 16 has shown advantages of decreased wound complications and recurrence rates when comparing open and laparoscopic repair for large or recurrent ventral hernias. This retrospective study from a single medical center reviews the results of laparoscopic repair of incisional and parastomal hernias following major genitourinary or abdominal surgery. Our operative time and length of hospitalization are somewhat longer than in previously published studies. 16,17 However, it appears that the size of the hernia defect and measured mesh surface area were much larger than in the other series. In addition, our learning curve certainly affected the initial five cases. The most dangerous and time-consuming portion of the procedure is the lysis of bowel and omental adhesions from the abdominal wall and the reduction of the hernia contents. Adhesiolysis should be performed with judicious use of electrocautery or the Harmonic Shears (Ethicon Endosurgery, Cincinnati, OH), especially in proximity to the bowel. Careful inspection of the abdominal cavity for bleeding or bowel injury after placement of the mesh is mandatory. In the event of an enterotomy, the standard of care would be repair of the injury by laparoscopic means or laparotomy and removal of the mesh. Maintenance of the mesh (i.e., foreign body) in this situation would be discouraged. However, some authors have reported placing the mesh laparoscopically in the face of only an isolated smallbowel injury in a patient who has undergone a very thorough bowel preparation. 24 Mesh placement in the face of a largebowel injury is strictly contraindicated. Fortunately, no patient in our series sustained a bowel injury. The majority of complications reported in the literature are a result of infection or bowel injury. 16,17 In our group of patients, complications occurred only in the postoperative period and may be considered minor. In the 13 patients who underwent a laparoscopic repair of an incisional hernia, 2 (15%) have developed recurrences, at 5 and 8 months. Previously reported recurrence rates for incisional and ventral hernias after laparoscopic repair with prosthetic material have been 2% to 11%. 16,17 We believe that these two recurrences were attributable to the location of the hernias, as described in Results, thus making the securing of the mesh more difficult because of the adjacent diaphragm. In addition, it is also believed that because of our inexperience, an insufficient number of laparoscopic securing tacks were used in the area of the hernia, resulting in recurrence. No recurrences have been demonstrated to date in the four parastomal repairs. Of the currently available prosthetic materials, Gore-Tex mesh has been shown to cause a lesser foreign-body reaction, lower rate of adhesion formation, and decreased infection rate compared with other commonly used materials. 25,26 The smooth side of this material has a pore size of,3 mm, which diminishes tissue attachment, making this side optimally suited for contact with bowel. The rough side has a pore size of 22 mm that encourages fibroblast and collagen ingrowth and attachment to the mesh. This larger pore side is oriented for contact with the body wall so as to increase mesh adherence and support for the abdominal wall. All patients in our study group were repaired using Gore-Tex mesh. No patient in our group experienced mesh infection, bowel erosion, or fistula formation. Whereas conventional open hernia repairs require a large incision and wide dissection to define adequate facial edges, the laparoscopic approach facilitates the necessary adhesiolysis and definition of the hernia defect using minimally invasive access. Once the hernia sac has been cleared of the adherent bowel and omental adhesions, the DualMesh is positioned over the defect, maintaining a 2- to 3-cm circumferential margin. This laparoscopic technique has allowed us to clearly define and correct these troublesome abdominal hernias in patients who have already undergone major genitourinary or abdominal surgery. A contemporary comparison of this technique with a matched group of patients undergoing open surgical repair is ongoing. It is expected that our results will complement those in the literature showing that laparoscopic hernia repair is associated not only with a better postoperative course but with lower recurrence rates. CONCLUSION KOZLOWSKI ET AL. Laparoscopic incisional and parastomal herniorrhaphy in our hands proved to be a highly effective procedure. In this small series, all patients tolerated the procedure well with no intraoperative complications and only minor postoperative compli-
5 LAPAROSCOPIC INCISIONAL HERNIA REPAIR 179 cations. A comparison with open repair of similar types of hernias at our institution is currently under way. As with all laparoscopic techniques, proper training and surgical experience is essential before attempting these procedures. REFERENCES 1. Mudge M, Hughes LE. Incisional hernia: A 10-year prospective study of incidence and attitudes. Br J Surg 1985;72: George CD, Ellis H. The results of incisional hernia repair in a 12- year review. Ann R Coll Surg 1986;68: Iraelson LA. The surgeon as a risk factor for complications of midline incisions. Eur J Surg 1998;164: Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg 1989;13: Wantz G. Incisional hernioplasty with Mersilene. Surg Gynecol Obstet 1991;172: Paul A, Korenkov M, Peters S, et al. Unacceptable results of the Mayo procedure for repair of abdominal incisional hernias. Eur J Surg 1998;164: Luijendijk RW, Lemmen MH, Hop WC, et al. Incisional hernia recurrence following vest over pants or vertical Mayo repair of primary hernias of the midline. World J Surg 1997;21: McLanahan D, King LT, Weems C, et al. Retrorectus prosthetic mesh repair of midline abdominal hernia. Am J Surg 1997;173: Temudom T, Siadati M, Sarr M. Repair of complex giant recurrent ventral hernias by using tension free intraperitoneal prosthetic mesh (Stoppa technique): Lessons learned from our initial experience (fifty patients). Surgery 1996;120: Koller R, Miholic J, Jakl RJ. Repair of incisional hernias with expanded polytetrafluoroethylene. Eur J Surg 1997;163: Amid PK, Shulman AG, Lichtenstein L. A simple stapling technique for prosthetic repair of massive incisional hernias. Am Surgeon 1995;60: Leber GE, Garb JL, Alexander AL, et al. Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 1998;133: White TJ, Santos MC, Thompson JS. Factors affecting wound complications in repair of ventral hernias. Am Surgeon 1998;64: George CD, Ellis H. The results of incisional hernia repair: A twelve year review. Ann R Coll Surg Engl 1986;68: Leblanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: Preliminary findings. Surg Laparosc Endosc 1992;3: Ramshaw BJ, Esartia P, Schwab J, et al. Comparison of laparoscopic and open ventral herniorrhaphy. Am Surgeon 1999;65: Park A, Birch DW, Lovrics P. Laparoscopic and open incisional hernia repair: A comparison study. Surgery 1998;124: Hesselink VJ, Luijendijk RW, de Wilt JHW, et al. An evaluation of risk factors in incisional hernia recurrence. Gynecol Obstet 1993;176; Bucknall TE, Cox PJ, Ellis H. Burst abdomen & incisional hernia: A prospective study of 1129 major laparotomies. Br Med J 1982; 284: Wilson MS, Deans GT, Brough WA. Prospective trial comparing Lichenstein with laparoscopic tension-free mesh repair of inguinal hernia. Br J Surg 1995;82: Liem MSL, van der Graaf Y, Steensel CJ, et al. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med 1997;336: Stoker DL, Spiegelhalter DJ, Singh R, et al. Laparoscopic versus open inguinal hernia repair: Randomized prospective trial. Lancet 1994;343: Kozol R, Lange PM, Kosir M, et al. A prospective, randomized study of open vs laparoscopic inguinal hernia repair: An assessment of postoperative pain. Arch Surg 1997;132: Koehler RH, Voeller G. Recurrences in laparoscopic incisional hernias repairs: A personal series and review of the literature. J Soc Laparosc Surgeons 1999;3: Bauer JJ, Salky BA, Gelernt IM, et al. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE). Ann Surg 1987;206: Law NW. A comparison of polypropylene mesh, expanded polytetrafluoro patch and polyglycolic acid mesh for the repair of experimental abdominal wall defects. Acta Chir Scand 1990;156:759. Address reprint requests to: Howard N. Winfield, M.D. Dept. of Urology, S-287 Stanford University School of Medicine 300 Pasteur Drive Stanford, CA hnw@stanford.edu
7/2/2015. Incidence. *Mudge M et al, Br. J. Surg, 1985, 72:70-71
Ventral Hernia Repair: Revisonal Surgery Natan Zundel MD FACS Professor of Surgery Vice-Chairman Department of Surgery FIU Herbert Wertheim College of Medicine. Miami Florida DISCLOSURE Ethicon Endosurgery
More informationCase Report. XCM Biologic Tissue Matrix. Components separation using sandwich technique for reconstruction of abdominal wall defect.
Case Report XCM Biologic Tissue Matrix. Components separation using sandwich technique for reconstruction of abdominal wall defect. XCM Biologic Tissue Matrix. Components separation using sandwich technique
More informationPAPER. Long-term Complications Associated With Prosthetic Repair of Incisional Hernias
PAPER Long-term Complications Associated With Prosthetic Repair of Incisional Hernias Geoffrey E. Leber, MD; Jane L. Garb, MS; Albert I. Alexander, MD; William P. Reed, MD Objective: To determine whether
More informationSCIENTIFIC PAPER ABSTRACT INTRODUCTION METHODS
SCIENTIFIC PAPER Adhesion Formation After Laparoscopic Ventral Incisional Hernia Repair With Polypropylene Mesh: A Study Using Abdominal Ultrasound Juliane Bingener, MD, George B. Kazantsev, MD, Shailendra
More informationInadvertent Enterotomy in Minimally Invasive Abdominal Surgery
SCIENTIFIC PAPER Inadvertent Enterotomy in Minimally Invasive Abdominal Surgery Steven J. Binenbaum, MD, Michael A. Goldfarb, MD ABSTRACT Background: Inadvertent enterotomy (IE) in laparoscopic abdominal
More informationORIGINAL ARTICLE. Short-term Outcomes of Laparoscopic and Open Ventral Hernia Repair
Short-term Outcomes of and Ventral Hernia A Meta-analysis ORIGINAL ARTICLE Philip P. Goodney, MD; Christian M. Birkmeyer, MS; John D. Birkmeyer, MD Background: Although laparoscopic repair of ventral hernia
More informationTitle at a Single Institution. Issue Date Right.
NAOSITE: Nagasaki University's Ac Title Author(s) Laparoscopic Repair of a Ventral He at a Single Institution. Ono, Shinichiro; Kawashita, Yujo; K Citation Acta medica Nagasakiensia, 57(2), p Issue Date
More informationPerhaps the most controversial of new laparoscopic operations is the repair of the inguinal hernia. The
JOURNAL OF LAPAROENDOSCOPIC SURGERY Volume 2, Number 6, 1992 Mary Ann Liebert, Inc., Publishers Extraperitoneal Endoscopie Inguinal Hernia Repair GEORGE S. FERZLI, M.D., F.A.C.S., AZIZ MASSAD, M.D., and
More informationHernias Umbilical Hernia When to See a Surgeon? What Are Symptoms of an Umbilical Hernia? How is Repair Performed?
Hernias Umbilical Hernia An umbilical hernia occurs when part of the intestine protrudes through the umbilical opening in the abdominal muscles. Umbilical hernias are common and typically harmless. They
More informationTechnique Guide. Bard MK Hernia Repair. Featuring Modified Onflex Mesh SOFT TISSUE REPAIR. Anterior Approach to a Preperitoneal Inguinal Hernia Repair
Bard MK Hernia Repair Featuring Modified Onflex Mesh Technique Guide Anterior Approach to a Preperitoneal Inguinal Hernia Repair SOFT TISSUE REPAIR Right Procedure. Right Product. Right Outcome. The opinions
More informationDifficult Abdominal Closure. Mark A. Carlson, MD
Difficult Abdominal Closure Mark A. Carlson, MD Illustrative case 14 yo boy with delayed diagnosis of appendicitis POD9 Appendectomy 2 wk after onset of symptoms POD4: return to OR for midline laparotomy
More informationPAPER. Open Incisional Hernia Repair at an Academic Tertiary Care Medical Center
PAPER Open Incisional Hernia Repair at an Academic Tertiary Care Medical Center Khashayar Mohebali, MD; David M. Young, MD; Scott L. Hansen, MD; Alexandra Shawo, BS; Christopher E. Freise, MD; David S.
More informationHernia. emoryhealthcare.org
Hernia Have you noticed a bulge or pain in your abdominal wall or groin? If so you may have a hernia. You may be in the process of confirming this diagnosis with your Primary Care Physician or already
More information3/21/2011. Advances in laparoscopic ventral hernia repair. Laparoscopic approach well-suited for simple hernias:
Advances in laparoscopic ventral hernia repair Topics Technique of laparoscopic ventral hernia repair Patient selection Is laparoscopic any better than open? Recent advances (or, should we say, advances?)
More informationThis information is intended as an overview only
This information is intended as an overview only Please refer to the INSTRUCTIONS FOR USE included with this device for indications, contraindications, warnings, precautions and other important information
More information2015 General Surgery Survival Guide
2015 General Surgery Survival Guide Chapter 10: Hernia Repair Know What to Look for When Coding Hernia Repair Reporting hernia repair can be tricky. But if you know what to look for then half the work
More informationA Clinical Study on Incisional Hernia: Anatomical Repair V/S Mesh Repair
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/1 A Clinical Study on Incisional Hernia: Anatomical Repair V/S Mesh Repair Gandla Anil Kumar 1, Bejjamshetty Nagendar
More informationLAPAROCELI: LAPAROSCOPY LIVE SURGERY PARASTOMAL HERNIA: WHAT TO DO? OSPEDALE DI PORTOGRUARO U.O.C. CHIRURGIA GENERALE FRANCESCO FIDANZA
LAPAROCELI: LAPAROSCOPY LIVE SURGERY PARASTOMAL HERNIA: WHAT TO DO? OSPEDALE DI PORTOGRUARO U.O.C. CHIRURGIA GENERALE FRANCESCO FIDANZA PARASTOMAL HERNIA Some degree of herniation around a colostomy is
More informationSTOMA SITING & PARASTOMAL HERNIA MANAGEMENT
STOMA SITING & PARASTOMAL HERNIA MANAGEMENT Professor Hany S. Tawfik Head of the Department of Surgery & Chairman of Colorectal Surgery Unit Benha University Disclosure No financial affiliation to disclose
More informationJMSCR Vol 04 Issue 04 Page April 2016
www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 5.88 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: http://dx.doi.org/10.18535/jmscr/v4i4.44 Clinical study of Incisional Hernia Authors
More informationINGUINAL HERNIA REPAIR PROCEDURE GUIDE
ROOM CONFIGURATION The following figure shows an overhead view of the recommended OR configuration for a da Vinci Inguinal Hernia Repair (Figure 1). NOTE: Configuration of the operating room suite is dependent
More informationEarly View Article: Online published version of an accepted article before publication in the final form.
: Online published version of an accepted article before publication in the final form. Journal Name: Journal of Case Reports and Images in Surgery doi: To be assigned Early view version published: November
More informationParastomal Hernia Repair: a Single Center Experience
SCIENTIFIC PAPER Parastomal Hernia Repair: a Single Center Experience Danielle M. Pastor, DO, Eric M. Pauli, MD, Walter A. Koltun, MD, Randy S. Haluck, MD, Timothy R. Shope, MD, Lisa S. Poritz, MD ABSTRACT
More informationDefinitive Surgical Treatment of Infected or Exposed Ventral Hernia Mesh
ANNALS OF SURGERY Vol. 237, No. 3, 437 441 2003 Lippincott Williams & Wilkins, Inc. Definitive Surgical Treatment of Infected or Exposed Ventral Hernia Mesh Steven R. Szczerba, MD,* and Gregory A. Dumanian,
More informationComparison of Laparoscopic vs Open Modified Shouldice Technique in Inguinal Hernia Repair. Thomas Nicholson, MD, V. Tiruchelvam, MD METHODS
Comparison of vs Modified Shouldice Technique in Inguinal Hernia Repair JSLS Thomas Nicholson, MD, V. Tiruchelvam, MD ABSTRACT Inguinal hernia repair has been a common procedure performed by general surgeo.
More informationThe use of synthetic mesh in patients undergoing ventral hernia repair during colorectal resection: Risk of infection and recurrence
Asian Journal of Surgery (2012) 35, 149e153 Available online at www.sciencedirect.com journal homepage: www.e-asianjournalsurgery.com ORIGINAL ARTICLE The use of synthetic mesh in patients undergoing ventral
More informationA Prospective Study of Incisional Hernia with An Evaluation of Factors In Developing Post-Operative Complications
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 3 Ver. I (March. 2017), PP 25-29 www.iosrjournals.org A Prospective Study of Incisional Hernia
More information34 yo M presented in ER of KCH at 7/06/10 Painful lump lt groin + vomiting Pain started 2 hrs before presentation. PMH known left inguinal hernia PSH
Case Presentation 34 yo M presented in ER of KCH at 7/06/10 Painful lump lt groin + vomiting Pain started 2 hrs before presentation. PMH known left inguinal hernia PSH negative NKDA Case Presentation VS:
More informationSetting The study setting was tertiary care. The economic study was carried out in the USA.
Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia: prospective comparison to open prefascial polypropylene mesh repair DeMaria E J, Moss J M, Sugerman
More informationPostoperative Surgical Site Infection after Incisional Hernia Repair: Link to Previous Surgical Site Infection? Zulfiqar Ali, AG Rehan
Original Article Postoperative Surgical Site Infection after Incisional Hernia Repair: Link to Previous Surgical Site Infection? Zulfiqar Ali, AG Rehan ABSTRACT Objective: Aim of the study was to determine
More informationInternational Journal of Current Research and Academic Review ISSN: Volume 3 Number 1 (January-2015) pp
International Journal of Current Research and Academic Review ISSN: 2347-3215 Volume 3 Number 1 (January-2015) pp. 348-354 www.ijcrar.com Study of Operative Procedures and their Indications in Management
More informationLaparoscopic Treatment of Subxiphoid Incisional Hernias in Cardiac Transplant Patients
SCIENTIFIC PAPER Laparoscopic Treatment of Subxiphoid Incisional Hernias in Cardiac Transplant Patients Dan Eisenberg, MD, MS, Wanda M. Popescu, MD, Andrew J. Duffy, MD, Robert L. Bell, MD, MA ABSTRACT
More informationVentral Hernia Repair
Ventral Hernia Repair Ventrio ST Hernia Patch Ventrio Hernia Patch Technique Guide Open and Laparoscopic Ventral Hernia Repair SOFT TISSUE REPAIR Right Procedure. Right Product. Right Outcome. This Technique
More informationRECTAL INJURY IN UROLOGIC SURGERY. Inadvertent rectal injury from a urologic procedure is often subtle but has serious postoperative consequences.
RECTAL INJURY IN 27 UROLOGIC SURGERY Inadvertent rectal injury from a urologic procedure is often subtle but has serious postoperative consequences. With good mechanical bowel preparation plus antibiotic
More informationA comparative study of open versus laparoscopic incisional hernia repair
International Surgery Journal Bathalapalli JMR et al. Int Surg J. 2017 Mar;4(3):916-920 http://www.ijsurgery.com pissn 2349-3305 eissn 2349-2902 Original Research Article DOI: http://dx.doi.org/10.18203/2349-2902.isj20170428
More informationAbdominal Wall Modification for the Difficult Ostomy
Abdominal Wall Modification for the Difficult Ostomy David E. Beck, M.D. 1 ABSTRACT A select group of patients with major stomal problems may benefit from operative modification of the abdominal wall.
More informationColorectal procedure guide
Colorectal procedure guide Illustrations by Lisa Clark Biodesign ADVANCED TISSUE REPAIR cookmedical.com 2 INDEX Anal fistula repair Using the Biodesign plug with no button.... 4 Anal fistula repair Using
More informationAbdominal Aortic Aneurysms. A Surgeons Perspective Dr. Derek D. Muehrcke
Abdominal Aortic Aneurysms A Surgeons Perspective Dr. Derek D. Muehrcke Aneurysm Definition The abnormal enlargement or bulging of an artery caused by an injury or weakness in the blood vessel wall A localized
More informationLAPAROSCOPIC HERNIA REPAIR
LAPAROSCOPIC HERNIA REPAIR Treating Your Hernia with Laparoscopy When You Have a Hernia Anyone can have a hernia. This is a weakness or tear in the wall of the abdomen. It often results from years of wear
More informationOpen Tension-Free Mesh Repair for Adult Inguinal Hernia: Eight Years of Experience in a Community Hospital
Original Articles Asian Journal of Surgery Excerpta Medica Asia Ltd Open Tension-Free Mesh Repair for Adult Inguinal Hernia: Eight Years of Experience in a Community Hospital Shunji Yamamoto, Toshiki Maeda,
More informationAbdominal Wound Dehiscence. Presenter: T Mohammed Moderator: Dr H Pienaar
Abdominal Wound Dehiscence Presenter: T Mohammed Moderator: Dr H Pienaar Introduction Wound Dehiscence is the premature "bursting" open of a wound along surgical suture. It is a surgical complication that
More information4/30/2010. Options for abdominal wall reconstruction. Scott L. Hansen, MD
Components Separation Scott L. Hansen, MD University of California, San Francisco Chief, Plastic and Reconstructive Surgery San Francisco General Hospital Overview Options for abdominal wall reconstruction
More informationSurgical treatment of urinary stress incontinence with tension free vaginal tape
Surgical treatment of urinary stress incontinence with tension free vaginal tape Gynaecology department 01935 384 385 yeovilhospital.nhs.uk Many surgical operations are available for the treatment of
More informationCOMPLICATIONS OF HERNIA REPAIR
COMPLICATIONS OF HERNIA REPAIR Stanley Rogers, MD Associate Clinical Professor of Surgery University of Califronia, San Francisco Paré was respected as a hernia specialist, and was known to have elevated
More informationThe pillars defining our quality care. We Care!
The pillars defining our quality care We Care! 1 An umbilical hernia occurs when a tissue bulges out through an opening in time muscles on the abdomen near the navel or belly button (umbilicus). About
More informationSTUDY OF PROLENE HERNIA MESH SYSTEM IN MANAGEMENT OF PRIMARY INGUINAL HERNIA REPAIR Vishal Nandagawali 1, Amit Bellurkar 2
STUDY OF PROLENE HERNIA MESH SYSTEM IN MANAGEMENT OF PRIMARY INGUINAL HERNIA REPAIR Vishal Nandagawali 1, Amit Bellurkar 2 HOW TO CITE THIS ARTICLE: Vishal Nandagawali, Amit Bellurkar. Study of Prolene
More informationTECHNICAL INNOVATION. A technique for repairing massive ventral incisional hernias without the use of a mesh
British Journal of Plastic Surgery (1999), 52, 399 403 1999 The British Association of Plastic Surgeons TECHNICAL INNOVATION A technique for repairing massive ventral incisional hernias without the use
More informationStop Coping. Start Living. Talk to your doctor about pelvic organ prolapse and sacrocolpopexy
Stop Coping. Start Living Talk to your doctor about pelvic organ prolapse and sacrocolpopexy Did you know? One in three women will suffer from a pelvic health condition in her lifetime. Four of the most
More informationOne hundred percent fascial approximation with sequential abdominal closure of the open abdomen
The American Journal of Surgery 192 (2006) 238 242 HowIdoit One hundred percent fascial approximation with sequential abdominal closure of the open abdomen C. Clay Cothren, M.D. a,b, *, Ernest E. Moore,
More informationMeshes. Meshes. Non-absorbable meshes. Absorbable meshes
Meshes Meshes Non-absorbable meshes Absorbable meshes Non-absorbable meshes hernia Premilene Mesh Premilene Mesh Plug Optilene Mesh Optilene Mesh LP Optilene Mesh Elastic Omyra Mesh Non-absorbable meshes
More informationSuture Versus Tack Fixation of Mesh in Laparoscopic Umbilical Hernia Repair
SCIENTIFIC PAPER Suture Versus Tack Fixation of Mesh in Laparoscopic Umbilical Hernia Repair Riley K. Kitamura, BS, Jacqueline Choi, MD, Elizabeth Lynn, MD, Celia M. Divino, MD, FACS ABSTRACT Background
More informationLaparoscopic Hernia Repair, Indications, Superiority and Outcome
Laparoscopic Hernia Repair, Indications, Superiority and Outcome Mr. Amir Morgan MBBCh; MSc; MD; FICS; JAG; FRCS Consultant Laparoscopic Colorectal & General Surgeon Lead of medical education and surgical
More informationPelvic Prolapse. A Patient Guide to Pelvic Floor Reconstruction
Pelvic Prolapse A Patient Guide to Pelvic Floor Reconstruction Pelvic Prolapse When an organ becomes displaced, or slips down in the body, it is referred to as a prolapse. Your physician has diagnosed
More informationFirst Transumbilical Transabdominal Preperitoneal Inguinal Hernia Repair in the Middle East
ISPUB.COM The Internet Journal of Surgery Volume 25 Number 1 First Transumbilical Transabdominal Preperitoneal Inguinal Hernia Repair in the Middle East A Al-Dowais Citation A Al-Dowais. First Transumbilical
More informationResidency Teaching Conference March 19, 2010
Residency Teaching Conference March 19, 2010 Add Biologic basis of disease (mmp, etc) Anatomy Inguinal hernias Open vs Laparoscopic Incisional Ventral Open vs Laparoscopic Iliohypogastric nerve
More informationMedieval times in surgery Still no solution for:
Medieval times in surgery Still no solution for: The most frequent complications of the abdominal surgeon: Adhesions Postoperative ileus Incisional hernia Anastomotic leakage Wound infection Incidence
More information-primarily by apposition of the anterior rectus
2 Component separation Cop HARVEY CHIM, KAREN KIM EVANS, AND SAMIR MARDINI Mater al Introduction 7 Preoperative markings 7 Intraoperative details 9 Technique modification: Component separation with preservation
More informationComparative Study Of Laparoscopic Versus Open Peptic Perforation Closure
ISPUB.COM The Internet Journal of Surgery Volume 17 Number 2 Comparative Study Of Laparoscopic Versus Open Peptic Perforation Closure M Porecha, S Mehta, D Udani, P Mehta, K Patel, S Nagre Citation M Porecha,
More informationLaparoscopic Incisional and Ventral Hernia Repair (LIVH): An Evolving Outpatient Technique
SCIENTIFIC PAPER Laparoscopic Incisional and Ventral Hernia Repair (LIVH): An Evolving Outpatient Technique G. Kevin Gillian, MD, W. Peter Geis, MD, Gary Grover, MD ABSTRACT Background and Objectives:
More informationLaparoscopic Inguinal Hernia Repair
1 Laparoscopic Inguinal Hernia Repair Hernia is a medical condition where a part of the intestine bulges out of the weak abdominal muscles. Inguinal hernia is a type of hernia which occurs in the groin
More informationObjectives. Hesselbach s Triangle 11/30/2009. Myopectineal Orifice of Fruchaud. Hernias: Who, What, When, Where, Why?
Objectives Hernias: Who, What, When, Where, Why? J. Scott Roth, MD Chief, Gastrointestinal Surgery Director, Minimally Invasive Surgery University of Kentucky June 16, 2009 Identify patients at risk for
More informationThe use of peritoneal flaps in the repair of large incisional hernia
The use of peritoneal flaps in the repair of large incisional hernia Marc Huyghe MD GZA St Augustinus Hospital (Antwerp) Mesh 2017 - Paris Peritoneal flap in the repair of incisional hernia - definition
More informationLaparoscopic umbilical herniorrhaphy: a novel technique of hernia neck closure and outcomes in the first 19 cases
Original Article Page 1 of 7 Laparoscopic umbilical herniorrhaphy: a novel technique of hernia neck closure and outcomes in the first 19 cases Cheyenne Vetter 1, Yagan Pillay 2 1 Department of Family Medicine,
More informationKaiser Oakland Urology
Kaiser Oakland Urology What is Laparoscopy? Minimally invasive surgical alternative to standard surgery How is Laparoscopy Performed? A laparoscope and video camera are used to visualize internal organs
More informationA Case Report of a Repair of a Ruptured Incisional Hernia Using Polypropylene Mesh and Component Separation Technique A Rambhajan, T Bernard ABSTRACT
A Case Report of a Repair of a Ruptured Incisional Hernia Using Polypropylene Mesh and Component Separation Technique A Rambhajan, T Bernard ABSTRACT Incisional hernias are a common complication of laparotomies
More informationSPIGELIAN HERNIA Anastasia Ussia
SPIGELIAN HERNIA Anastasia Ussia 34 years old woman 2010 : Operated for endometriosis and afterwards severe pain mainly in the right fossa ; extending up to umbilicus and radiating to upper right thigh
More informationKeyhole Laparoscopic Hernia Repairs: What s the Benefit for Your Patients?
InTouch ARTICLE Keyhole Laparoscopic Hernia Repairs: What s the Benefit for Your Patients? Author: Mr Steve Warren Date: Mary 2015 17 19 View Road, Highgate, London, N6 4DJ Tel. 020 8341 4182 Email. enquiries@highgatehospital.co.uk
More informationREINFORCED BIOSCAFFOLDS
REINFORCED BIOSCAFFOLDS Midline Incisional Open OviTex 1S Resorbable Clinical Case Study: Open Abdomen Incisional Herniorrhaphy in Contaminated (CDC Class IV) Operative Field Performed by Dr. Michael Sawyer,
More informationABSITE Review: Hernias
ABSITE Review: Inguinal and Femoral Hernias Sybile Val M.D. SUNY Downstate Medical Center Department of Surgery June 27, 2008 Objectives www.downstatesurgery.org Correctly identify anatomical landmarks
More informationA comparative study between laparoscopic intraperitoneal onlay mesh hernioplasty and open underlay mesh hernioplasty for ventral hernias
International Surgery Journal Rao ASN et al. Int Surg J. 2015 Aug;2(3):352-360 http://www.ijsurgery.com pissn 2349-3305 eissn 2349-2902 Research Article DOI: http://dx.doi.org/10.18203/2349-2902.isj20150498
More informationColostomy & Ileostomy
Colostomy & Ileostomy Indications, problems and preference By Waleed Omar Professor of Colorectal surgery, Mansoura University. Disclosure I have no disclosures. Presentation outline Stoma: Definition
More informationOptiFix Absorbable Fixation System
OptiFix Absorbable Fixation System Absorbable Fixation Redefined Advancing the Fixation Experience. SOFT TISSUE REPAIR Right Procedure. Right Product. Right Outcome. Hernia Repair Fixation Challenges and
More informationVentralex ST Hernia Patch featuring Sepra Technology
Ventralex ST Hernia Patch featuring Sepra Technology Proven Sepra Technology in a Low Profile, Lightweight Mesh Sepra Technology An extensively studied barrier with more than 10 publications and used clinically
More informationThe Emergency Hernia or The call you don t want at 2:00 a.m.*
or The call you don t want at 2:00 a.m.* *Or even at 8:00 a.m. Michael G. Sarr, MD Professor of Surgery Mayo Clinic South Canada WEST CANADA EAST CANADA Clinical talk Hernias Inguinal Umbilical Incisional
More informationMr John Groom The Complete Guide to Hernia
Mr John Groom The Complete Guide to Hernia What Do They Have in Common? AA Both Subjects Controversial! Debate 1. Laparoscopic verses Open Hernia Repair Beautiful Big splash Debate 2. Use of Mesh in Hernia
More informationTechnical points of the laparoscopic transabdominal preperitoneal (TAPP) approach in inguinal hernia repair
Surgical Technique Page 1 of 5 Technical points of the laparoscopic transabdominal preperitoneal (TAPP) approach in inguinal hernia repair Qiwei Shen, Qiyuan Yao Department of General Surgery, Huashan
More informationLAPAROSCOPIC AORTO-ILIAC SURGERY
LAPAROSCOPIC AORTOILIAC SURGERY J QUANIERS UNIVERSITY HOSPITAL OF LIEGE OCCLUSIVE AORTIC DISEASE Purpose : This article describes an original laparoscopic technique that allows performance of aortobifemoral
More informationSurgical management of the undescended testis is performed
Undescended Testes/Orchiopexy James C.Y. Dunn, MD, PhD, 1 Akemi L. Kawaguchi, MD, 2 and Eric W. Fonkalsrud, MD 1 Surgical management of the undescended testis is performed to prevent the potential complications
More informationA prospective comparison of ambulatory endoscopic totally extraperitoneal inguinal hernioplasty versus open mesh hernioplasty
J. of Ambulatory Surgery 137 (2003) 137/141 www.elsevier.com/locate/ambsur A prospective comparison of ambulatory endoscopic totally extraperitoneal inguinal hernioplasty versus open mesh hernioplasty
More informationPrevention and Surgical management of Parastomal hernias; When to treat?
Prevention and Surgical management of Parastomal hernias; When to treat? Sabry A. Mahmoud (MD) Prof of General & Colorectal Surgery Mansoura University It is an incisional hernia that develops at the site
More informationIn two cases, fundamentally: - Bilateral inguinal hernia recurrent groin hernia, already treated with open surgery
3.- What cases the hernia? It is unknown. Sometimes it is related to violent exercise or some trauma; you begin feeling discomfort and later the lump appears in the groin. It is also related to chronic
More informationConsecutive, Bilateral Obturator Hernia in a Single Case HO Aydın¹, EHA Soy¹, T Avcı¹, T Tezcaner¹, S Yıldırım ABSTRACT
Consecutive, Bilateral Obturator Hernia in a Single Case HO Aydın¹, EHA Soy¹, T Avcı¹, T Tezcaner¹, S Yıldırım ABSTRACT Obturator hernia (OH) is a rare pelvic hernia. It is diffucult to make an early diagnosis
More informationMore than 150 consecutive open umbilical hernia repairs in a major Veterans Administration Medical Center
The American Journal of Surgery (2008) 196, 647 651 The Association of VA Surgeons More than 150 consecutive open umbilical hernia repairs in a major Veterans Administration Medical Center Buckminster
More informationAbout your hernia repair
Other formats What is a hernia? About your hernia repair If you need this information in another format such as audio tape or computer disk, Braille, large print, high contrast, British Sign Language or
More informationPort Site Hernia after Laparoscopic Cholecystectomy
Human Journals Research Article November 2018 Vol.:13, Issue:4 All rights are reserved by Ridha Turki Jasim et al. Port Site Hernia after Laparoscopic Cholecystectomy Keywords: Port site hernia, port closure,
More informationINCISIONAL HERNIA REPAIR A CLINICAL STUDY OF 30 PATIENTS
IJCRR Vol 05 issue 15 Section: Healthcare Category: Research Received on: 09/07/13 Revised on: 28/07/13 Accepted on: 11/08/13 INCISIONAL HERNIA REPAIR A CLINICAL STUDY OF 30 PATIENTS Nikhil Nanjappa B.
More informationAnorectal malformations include a wide spectrum of
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES Volume 20, Number 1, 2010 ª Mary Ann Liebert, Inc. DOI: 10.1089=lap.2008.0343 Laparoscopic-Assisted Pull-Through for Congenital Rectal Stenosis
More informationA New Open Minimal Access Approach for Mesh Repair of Inguinal Hernia
Advances in Surgical Sciences 2015; 3(4): 27-31 Published online September 21, 2015 (http://www.sciencepublishinggroup.com/j/ass) doi: 10.11648/j.ass.20150304.11 ISSN: 2376-6174 (Print); ISSN: 2376-6182
More informationINFORMED CONSENT FOR LAPAROSCOPIC ADJUSTABLE GASTRIC BAND. Please read this form carefully and ask about anything you may not understand.
Please read this form carefully and ask about anything you may not understand. I consent to undergo laparoscopic placement of a laparoscopic Adjustable Gastric Band for the purposes of weight loss. I met
More informationInteresting Case Series. Omental Flap for Thoracic Aortic Graft Infection
Interesting Case Series Omental Flap for Thoracic Aortic Graft Infection Andrew A. Marano, BA, Adam M. Feintisch, MD, and Mark S. Granick, MD Division of Plastic Surgery, Department of Surgery, Rutgers
More informationIs Laparoscopic Groin Hernia Repair Better Than Open Mesh Repair?
ISPUB.COM The Internet Journal of Surgery Volume 8 Number 2 Is Laparoscopic Groin Hernia Repair Better Than Open Mesh Repair? S Jain, C Norbu Citation S Jain, C Norbu. Is Laparoscopic Groin Hernia Repair
More informationThe lateral incisional hernia: anatomical considerations for a standardized retromuscular sublay repair
Hernia (2009) 13:293 297 DOI 10.1007/s10029-009-0479-0 ORIGINAL ARTICLE The lateral incisional hernia: anatomical considerations for a standardized retromuscular sublay repair M. Stumpf J. Conze A. Prescher
More informationCIC Edizioni Internazionali. original article
G Chir Vol. 39 - n. 4 - pp. 208-214 July-August 2018 summary: A new modified Mayo technique: should the surgeons need a new open technique for hernia repair in their armamentarium? a. toro, G. stella,
More informationLaparoscopic reversal of Hartmann's procedure
J Korean Surg Soc 2012;82:256-260 http://dx.doi.org/10.4174/jkss.2012.82.4.256 CASE REPORT JKSS Journal of the Korean Surgical Society pissn 2233-7903 ㆍ eissn 2093-0488 Laparoscopic reversal of Hartmann's
More informationEndovascular Repair o Abdominal. Aortic Aneurysms. Cesar E. Mendoza, M.D. Jackson Memorial Hospital Miami, Florida
Endovascular Repair o Abdominal Aortic Aneurysms Cesar E. Mendoza, M.D. Jackson Memorial Hospital Miami, Florida Disclosure Nothing to disclose. 2 Mr. X AAA Mr. X. Is a 70 year old male who presented to
More informationOperative Management of Small Bowel Fistulae Associated with Open Abdomen
Original Article Operative Management of Small Bowel Fistulae Associated with Open Abdomen Suvit Sriussadaporn, Sukanya Sriussadaporn, Kritaya Kritayakirana and Rattaplee Pak-art, Department of Surgery,
More informationFarah S, Kiyingi A, Leinkram C. The Melbourne Hernia Clinic Masada Hospital 26 Balaclava Road St Kilda East Victoria, Australia 3168.
Medium to Long term results following open intra-abdominal repair of large incisional hernias with a new composite polypropylene and silicone mesh, without components separation. Farah S, Kiyingi A, Leinkram
More informationHostile Abdomen Index Risk Stratification and Laparoscopic Complications
SCIENTIFIC PAPER Hostile Abdomen Index Risk Stratification and Laparoscopic Complications Michael A. Goldfarb, MD, Bogdan Protyniak, MD, Molly Schultheis, MD ABSTRACT Background: Common life-threatening
More informationRobotics in General Surgery. Objectives
Robotics in General Surgery Jennifer S. Schwartz, MD Assistant Professor of Surgery Department of Surgery Division of General & Gastrointestinal Surgery The Ohio State University Wexner Medical Center
More informationDesara TV and Desara Blue TV
Desara TV and Desara Blue TV Sling for Female Stress Urinary Incontinence Instructions For Use D I Prescription Use only Do not reuse Sterilized using ethylene oxide Available Electronically M Manufactured
More information