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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Marlex mesh (polypropylene) is an excellent prosthetic material for closure of major defects in the abdominal wall. It helps to overcome many technical difficulties, making possible the repair of virtually every hernia. We describe two methods of ventral hernia repair, using Marlex mesh. In 20 operations in which one of the two methods was used, the results were uniformly satisfactory with acceptably low morbidity and no deaths.
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PMID:Marlex mesh in giant ventral hernia repair. 742 14

We herein report three pediatric cases of spigelian hernia involving a 6-month-old girl, an 8-month-old girl, and a 3-year-old boy. This is a rare condition with only 20 children (12 boys and 8 girls) younger than 15 years of age previously reported in the literature. Their ages ranged from 6 days to 15 years. The hernia was situated on the right side in six cases, on the left side in nine, and was bilateral in four (with one case unreported). Among these, four cases were caused by trauma and one case by a postoperative complication. Our first and third cases were spontaneous, while the second case was a postoperative lateral ventral hernia. The first and second cases were associated with ipsilateral mediastinal neuroblastoma. No previous report of spigelian hernia has been associated with mediastinal neuroblastoma. We suspected that muscle atrophy caused by the neuropathy of the ninth to twelfth intercostal nerves may have been the cause of the hernia. These two cases are thus believed to be the first such cases to be reported.
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PMID:Pediatric spigelian hernia: reports of three cases. 778 Feb 31

Spigelian hernia, an uncommon but well-recognized ventral hernia, is rare in children. Two such cases are reported, both on the left side in female infants under 1 year of age. The first hernia, which was repaired when the infant was 7 months old, contained an ovary. Repair of the second hernia, which was diagnosed in the neonatal period, was delayed because of a congenital diaphragmatic hernia requiring urgent repair. The hernia reduced spontaneously and is no longer palpable, suggesting spontaneous closure. A literature review revealed only eight other cases of spigelian hernias occurring in infants less than 1 year of age. Spontaneous closure has not been recorded before.
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PMID:Spigelian hernias in infants: report of two cases. 788 22

From October 1993 to April 1994, laparoscopic ventral hernia repair was performed on 10 patients, all of whom had a history of failed ventral hernia repair and at least two prior ventral hernia repair procedures. Patients presented with complaints of abdominal discomfort, painful mass at the hernia site, or vague abdominal discomfort. No operative deaths occurred. Two patients had minor complications: a seroma at the repair site, which resolved spontaneously, and a superficial wound infection at a trochar site, which responded to an oral cephalosporin. Six patients were discharged within 24 hours of surgery and one patient was operated on as an outpatient and discharged the same day. Follow-up of all patients ranged from 10 to 17 months. No evidence of hernia recurrence has been noted. Some recurrent ventral hernias are amenable to laparoscopic repair, and this technique may be preferable in some patients, especially those who have had an earlier failed open repair with mesh. We do not advocate use of our technique for the first repair of a ventral hernia. Long-term follow-up is still needed to determine recurrence rates compared with conventional open techniques.
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PMID:Laparoscopic ventral hernia repair: a community hospital experience. 912 40

The repair of a ventral hernia in an obese patient presents an interesting clinical challenge. We retrospectively reviewed the charts of 55 patients who, over a 12-year period from 1983 to 1995, concomitantly underwent both ventral herniorrhaphy and panniculectomy or abdominoplasty. In six of 55 patients, the hernia was recurrent. Forty-six patients had primary abdominal wall hernias or diastasis recti. Nineteen of 55 patients had weight greater than 200 lbs. This last subset of patients had a significantly higher incidence of complications, such as seroma, cellulitis, and persistent wound drainage. In our 55 patients, we experienced only two hernia recurrences (3.6%) during an average patient follow-up of 53 weeks. From this experience, we believe that simultaneous ventral hernia repair and panniculectomy is a safe and efficacious approach to these two problems so commonly found in the obese patient. Patients with a preoperative weight greater than 200 lbs can be expected to have a greater risk of wound complications. In all cases, the wounds eventually healed with no long-term sequelae.
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PMID:Ventral hernia repair with simultaneous panniculectomy. 871 68

A new method of laparoscopy have been designed: a laparoscope is introduced through a ventral hernia. The method can be used in patients with contraindications for a regular laparoscopy. Umbilical hernia with the hernia orifice less than 3 cm is a contraindication for "herniolaparoscopy". The method was used in 32 patients, including 17 patients with the acute cholecystitis. In 12 patients besides of umbilical hernia there were other contraindications, including postoperative scarring, obesity etc. There were no any complications with the use of the new method. In all cases pneumoperitoneum was preserved till the end of a procedure.
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PMID:[Method of laparoscopy in ventral hernia]. 875 20

With the increasing frequency of minimally invasive surgical procedures, we have begun to see descriptions of new and unforseen complications. One such complication is the formation of a ventral hernia through an unclosed or poorly closed fascial defect created by trocar insertion. The necessity to perform fascial closure of trocar insertion sites, particularly those greater than 5 mm, has been established and is routinely practiced by the majority of laparoscopists. Standard suture techniques can be difficult and frustrating, and often involve blind closure of the fascial defect. A number of instruments have been developed to facilitate this fascial closure. We are currently using a self-contained disposable fascial closure device (Endo-JudgeTM--Synergistic Medical Technologies, Inc., Orlando, Florida), which is quick and relatively simple to use. It enables secure fascial closure under direct vision with the pneumoperitoneum intact. Initial results reveal consistent fascial and peritoneal closure and no postoperative hernia formation.
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PMID:Effective peritoneal and fascial closure of abdominal trocar sites utilizing the Endo-Judge. 889 44

The authors present an account of their experience with surgery of inguinal and ventral hernias using synthetic material and Lichtenstein's or Gallie's method. The group of 133 patients comprises 108 patients with hernia in the area of the inguinal canal operated by Lichtenstein's plastic operation and 25 patients with a ventral hernia operated by Gallie's method. The author mentions the number of complications and relapses in the group. The advantage of these methods is according to the author the small number of relapses, relatively easy surgical technique and easy postoperative course which in inguinal hernias makes it possible to use local anaesthesia and perform the operation in the out-patient department.
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PMID:[Hernia operations using synthetic materials]. 899 58

The purpose of this paper is to describe the subjective results after operation for ventral hernia. Patients operated for ventral hernia in the period from January 1, 1988 to December 31, 1992 were sent a questionnaire with a response rate of 87%. Forty-five percent had lasting discomfort, 30% were absent due to illness more than eight weeks after the operation and 22% were not able to go to work. These factors increase with the number of hernia operations. Regardless of the number of operations, about 70% of the patients wanted a new operation should the hernia recur. It is therefore important to give the patient an objective and detailed information to prevent from unrealistic expectations of the results of ventral hernia operation.
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PMID:[Results after surgery of incisional hernias]. 947 48

Necrotizing abdominal wall infections, enteric fistulae, or exposed prosthetic material after ventral hernia repair often results in a loss of abdominal wall integrity. Further surgical reconstruction with prosthetic material is usually contraindicated in the contaminated wound because of the high infection rate necessitating prosthetic removal and further abdominal wall debridement. Consequently, for the past 9 years, we have been using free grafts of autologous fascia lata to replace deficient abdominal wall fascia and muscle in situations where prosthetic material is contraindicated and local tissue rearrangement (i.e., component separation) would be inadequate. Thirty-two patients (mean age 59 years) underwent abdominal wall reconstruction with autologous fascia lata grafts. Indications included exposed mesh (31 percent), enteric fistulae (28 percent), enteric contamination (22 percent), wound infection (13 percent), and immunosuppression alone (6 percent); 31 percent of all patients were immunosuppressed secondary to either a solid organ transplant or a systemic inflammatory disorder. Fascia grafts (mean size 10 x 17 cm) were sutured to the surrounding abdominal wall and covered by local skin flap advancement and/or myocutaneous flap rotation. All abdominal reconstructions were initially successful. Subsequent local abdominal wall complications included cellulitis (n = 3), seroma (n = 2), and skin dehiscence with exposed fascia grafts (n = 7). Five of seven patients with skin dehiscence healed by secondary intention, whereas two had split-thickness skin grafts successfully applied to the granulating fascia. Thigh donor site complications included hematoma (n = 1), skin dehiscence (n = 1), and seroma (n = 2). There have been no cases of lateral knee instability. The average follow-up period is 27 months (range 3 to 106 months). Recurrent hernia has been seen in three patients (9 percent). Interestingly, laparotomy has been performed through an intact fascia lata patch in three patients for unrelated intra-abdominal conditions. In each case, the graft was intact and revascularized, confirming experimental animal data performed in our laboratory. Recurrent hernia has not been observed through the laparotomy site. Our 9-year experience has demonstrated that in the face of large, contaminated abdominal wounds where prosthetic material is contraindicated and local tissue rearrangement would be inadequate, fascia lata autografts are a reliable adjuvant to abdominal wall reconstruction.
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PMID:Restoring abdominal wall integrity in contaminated tissue-deficient wounds using autologous fascia grafts. 1475 35


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