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

Morgagni-Larrey hernia is a rare type of diaphragmatic hernia, the diagnosis of which is made incidentally by routine chest X-ray film. We describe a technique for the laparoscopic repair of Morgagni-Larrey hernia which was successfully performed in three adult patients; two women and one man. Two of the patients were asymptomatic and had herniation of only omentum into the right hemithorax; however, one was symptomatic and had herniation of the omentum and large bowel. Tension-free closure of the defects was done using Prolene mesh with a hernia stapler, helical fastener, and Endostitch. There were no early complications and the patients were discharged on the fourth postoperative day. The mean follow-up period was 41 months, and there has been no late morbidity or mortality related to this procedure. Using a laparoscopic approach to repair a Morgagni-Larrey hernia provides an excellent view of the surgical field and allows easy manipulation with minimal surgical trauma, followed by rapid recovery of the patient.
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PMID:Laparoscopic repair of a Morgagni-Larrey hernia: report of three cases. 1237 90

Since the early 19th century different prostheses have been tried and tested to prevent recurrences after hernia repairs. This article reviews the evolution of prostheses and their use in hernia surgery. Tension-free mesh hernia repairs using polypropylene fibre seems to be associated with very low recurrence rates and minimal complications.
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PMID:The use of prosthetics in hernia repair. 1257 33

Tension-free repair using the Prolene Hernia System (PHS) has been widely adopted for inguinal hernias with excellent results. In our department, a new technique for umbilical hernia repair, using the PHS, has been developed. Between 2000 and 2002, 48 patients underwent tension-free umbilical hernia repair, using the PHS. There were 20 male and 28 female patients, with a mean age of 54 years. The preperitoneal space was dissected to accumulate the underlay patch of the PHS. The onlay patch was placed on the anterior rectus sheath and the connector in the umbilical ring. The median operating time was 35 min (range, 28-40). Postoperative pain was minimal, and there were no complications associated with the mesh, except a seroma, which required needle aspiration. There were no recurrences after a median follow-up of 13 months (1-24). Our early results indicate that the described tension-free technique could become the standard treatment for umbilical hernia repair, but long-term results are required to establish the efficacy of the procedure.
Hernia 2003 Dec
PMID:A new tension-free technique for the repair of umbilical hernia, using the Prolene Hernia System--early results from 48 cases. 1295 92

Hernia (know breuk in Dutch, rompure in French, keal in Greek and rupture in English) has plagued humans throughout recorded history and descriptions of hernia reduction date back to the Ebers papyrus in Egypt. In medicine it is difficult to find historical periods, but we found two eras of uneven time: pre-technique and technique. The first was distinguished by a blend of empiricism and magic, and the second for greater comprehension of the human body; however much of modern surgical techniques result from contributions of early surgeons. Nonetheless, it was not until the late 19th century that hernia surgeon Eduardo Bassini published his work Nuovo Metodo per la Cura Radiacale dell"Ernia Inguinale (in 1889). Among the most notable contemporany classic hernia repairs are the Bassini, Halsted, Shouldice, and Tension-free repair techniques.
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PMID:[Historical evolution of inguinal hernia treatment]. 1461 14

Tension-free and sutureless hernioplasty by plug and mesh of nonreabsorbable material is one of the most common techniques for inguinal hernia repair. It's a simple and quick procedure with a low cost and allows for a short hospital stay. It shows a low reoccurrence rate, but it can result, in very few cases, in complications strictly related to prosthetic material. The literature describes some cases of plug migration from its proper position, for example, to the scrotum, preperitoneal adipose tissue, and abdominal cavity. We report on a case of sigmoid colon perforation due to a plug of Trabucco hernioplasty performed 2 years previously.
Hernia 2005 Mar
PMID:Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report. 1623 85

Tension-free hernioplasty is performed using prosthetic material in one-half of hernia repair procedures in Poland but in 85% of those in the region of Pomerania. This questionnaire study of surgeons in Pomerania examined their sources of knowledge about and the factors influencing their choice of groin hernia surgery. The questionnaire was sent to surgeons from 19 hospitals and was answered by 109 (83% of hernia surgeons in the region). We analyzed their reported knowledge of particular operative techniques, factors important in selecting the technique (personal experience, trends in surgical center), and the available sources of information (e.g., medical literature, internet, information from teachers, sales representatives). All respondents reported being familiar with and able to perform tension-free techniques, but only 44% are influenced by their individual professional skills in selecting the technique. Another 44% base their decision on trends in their hospital, and only 22% consider the patient's preferences. The most frequently quoted sources of scientific information are articles in the medical literature and conference reports (90%). Only 8% of the respondents are governed in their professional work by information from pharmaceutical company representatives. Most surgeons (70%) would prefer to make a decision about using a new surgical technique after practical training sessions or workshops led by experienced colleagues. In contrast to common opinion, the information from sales representatives are of only minor importance compared to that of evidence-based data and attendance at workshops and courses.
Hernia 2005 Mar
PMID:Factors influencing surgeons' choice of method for hernia repair technique. 1536 82

Surgery of the groin hernia has become more a question of the applied tension-free, mesh technique. Whereas studies on laparascopic versus open tension-free hernia repair or open-mesh versus open-nonmesh repair have been performed sufficiently, data regarding the open tension-free plug-and-patch technique are rather poor. During the period from January 2001 to October 2003, we followed and filed 766 hernia repairs in the plug-and-patch technique of Rutkow. Follow up was during the hospital stay, 4 weeks, and minimally 12 months after operation. The main follow-up variables were complications, recurrence rate, and pain. The mean operating time was 37.8 +/- 15.85 (12-135) minutes. In 141 (19.3%) patients (n=730), the ilioinguinal nerve was resected. The 1 intraoperative complication that occurred was a severed small intestine. Length of hospital stay was 2.09 +/- 1.35 (0-17) days, work leave lasted for 15.3 +/- 12.42 (0-60) days, and return to normal daily activities was possible within 6.54 +/- 6.86 (0-35) days. Twenty-two (2.9%) patients (n=766) developed a postoperative hematoma as the most common complication, and a reoperation was required 17 (2.2%) times during the hospital stay. Early complications included hematoma (3.7%), seroma (3.5%), infection (0.2%), necrosis of 1 testicle (0.2%), persisting scrotal swelling (1.5%), persisting pain (0.9%), and hypoesthesia (2.4%). Within 4 weeks, 4 (0.9%) patients were reoperated for 1 seroma, hematoma, infection, and testicle necrosis. After 605.4 +/- 154.5 (365-1018) days, the following 19 (5.7%) patient complaints were noted: persisting pain (2.1%), hypoesthesia (1.8%), foreign-body feeling (0.6%), scrotal swelling (0.6%), and 1 (0.3%) mesh dislocation. Six (1.8%) reoperations have been performed. The overall recurrence rate was 1.8% (n=6), for primary 1.5% (n=4), and 3.3% (n=2) for recurrent hernias; 96.3% of the patients would agree to undergo the same operation a second time. Tension-free repair of the inguinal hernia by the plug-and-patch technique is a quick and secure method that simplifies hernia surgery without compromising the high-quality standards such as a low recurrence rate and low pain load of the patient. Patients had a fast recovery with a subsequent short work leave. The method is a simple, effective, and economical operation, suitable as a standard performed in local anesthesia on an out-patient basis.
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PMID:Rutkow PerFix-plug repair for primary and recurrent inguinal hernias--a prospective study. 1545 17

Peritoneal dialysis is becoming more and more common as a method of treating patients at the final stage of renal failure. In the year 2002 the number of patients treated with this method in Poland amounted to 1324. Studies have demonstrated that inguinal and abdominal hernias develop more frequently in chronic renal failure patients. The percentage of patients with hernia diagnosed within the first five years of dialysis is about 10%. Continuation of dialysis with the hernia condition left untreated may result in severe complications which are the third most frequent cause of converting treatment method into hemodialysis in PD patients. Currently in Poland there is no national standard in existence as to the management of hernias, and the only British standard from 1998 does not reflect the present expertise of either surgical treatment or dialysis methods. The aim of the current questionnaire based study investigating Polish peritoneal dialysis centers was to assess the treatment when hernia had been diagnosed in the PD patient. Of 49 dialysis centers in Poland, 39 do have protocols on managing the patient before and after the operation. A considerable diversity has been found as to surgical techniques used and the ways the patients are managed in hospital. Following the need expressed by 33 dialysis centers in Poland for some standard for relevant procedures, the authors formulated principles of modern hernia treatment in PD patients. Accordingly, the main principles include: 1) consulting a surgeon collaborating with the center before qualifying for peritoneal dialysis and when hernia symptoms have manifested; 2) Tension-free methods used in a treatment of choice (recommended by PHS); 3) Application of antibiotic prophylaxis (preferably first generation cephalosporin); 4) Induction of local or epidural anesthesia; 5) Peritoneal dialysis programme does not need to be discontinued but low volume dwells or preferably intermittent APD is recommended immediately after surgery.
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PMID:Management of inguinal hernia on peritoneal dialysis: an audit of current Polish practice and call for a standard. 1684 Dec 85

Midline ventral hernias are common. Tension-free mesh repair of ventral hernias is becoming popular due to the high recurrence rate with conventional techniques. We have used an open intraperitoneal technique using the Bard Ventralex hernia patch in midline ventral hernias (<or=3 cm). Fifty-one patients were treated (34 males and 17 females) with a mean age of 52.4 years (range 18-82). Forty-three patients were day cases. Operative times, analgesic use, overnight hospital stay and postoperative complications were recorded prospectively. The mean operative time was 30 min (range 10-68). Thirty-six patients required mild/moderate postoperative analgesia. Two patients had minor wound infections and one had seroma. There was one recurrence. Our early experience suggests that Ventralex hernia patch repair of small midline ventral hernias can be performed as a day case with minimal postoperative complications.
Hernia 2006 Oct
PMID:Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients. 1693 46

Today, plastic surgeons are increasingly faced with the problem of complex abdominal wall reconstruction. Obesity, bariatric surgery, and failed prior herniorrhaphy contribute to high rates of hernia recurrence in these difficult tertiary cases. We reviewed 50 consecutive complex abdominal wall reconstructions to identify the roles of 3 technical variables in successful outcomes: use of mesh, use of a flap buttress to reinforce the fascial repair, and the use of concomitant body-contouring techniques. Six groups were identified based on the presence or absence of each of these variables. Incidence of hernia recurrence and incidence of complications were compared for each group. Patient satisfaction with reconstructive outcome was assessed at follow-up using a 5-point scale. At a mean follow-up of 24 months, we observed an overall hernia recurrence rate of 4.0%, and an overall complication rate of 34%. Tension-free primary fascial repair and mesh repair of tension defects had equivalent recurrence rates (3.3% vs. 5%) and complication rates (40% vs. 25%). Repairs buttressed with flaps and repairs without buttressing had equivalent recurrence rates (3% vs. 6%) and complication rates (38% vs 28%). Repairs with and without body contouring techniques as part of the reconstructive plan had equivalent recurrence rates (7.7% vs. 0%) and complication rates (31.7% vs. 53%). Mean patient satisfaction was 4.8 of 5. Reconstruction of complex and recurrent hernias can be successfully performed. When tension-free primary fascial closure is not possible, an inlay mesh with a soft-tissue buttress leads to a 10-fold reduction in hernia recurrence as compared to historical norms. Concomitant body contouring surgery does not impact recurrence or complication rates and may contribute to reconstructive success.
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PMID:A "buttressed mesh" technique for fascial closure in complex abdominal wall reconstruction. 1924 May 26


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