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

The Spigelian hernia occurs where the vertical linea semilunaris, along the lateral border of the rectus muscle, joins the linea semicircularis. The hernia lies in the soft tissue under the aponeurosis of the oblique abdominis muscle; incision of that layer can be avoided by laparoscopic techniques. In this case the hernial canal was closed, firstly with single titanium staples, and secondly with a continuous laparoscopic suture using resorbable material. In suspicious cases laparoscopy should be performed to confirm the diagnosis of a Spigelian hernia. Laparoscopic hernial repair should be evaluated by further usage of this technique.
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PMID:[Laparoscopic management of a Spigelian hernia]. 782 Oct 54

A 40-year-old man developed a lumbar hernia through an iliac bone graft donor site. The defect was repaired using an autologous bone graft reinforced by titanium mesh.
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PMID:Iliolumbar hernia following bone grafting. 787 49

Recently, titanium staples have been designed to stabilize a small prosthetic mesh used for laparoscopic herniorrhaphy. Unlike the giant prosthesis employed by Stoppa, the small mesh must be fixed to the surrounding musculo-aponeurotic defect. The strength of these titanium staples has never been evaluated and was compared to 0-Prolene sutures. In an ex vivo study, we evaluated the maximal stress (bursting strength [BS]) a repair performed with 0-Prolene sutures or staples can bear. Bilateral abdominal-wall defects were created in 16 piglets. A Prolene mesh was fixed preperitoneally on one side of the abdomen with 0-Prolene sutures and on the other side with the Endopath EMS stapler or the Endo Hernia stapler. The mean BS of meshes attached with 0-Prolene was 1,461.7 mmHg. The mean BS of meshes fixed with Endopath EMS staples was 885.5 mmHg and that of meshes fixed with Endo Hernia staples was 665.2 mmHg. A repair with 0-Prolene sutures is stronger (P < 0.05) than one with staples (Endopath EMS or Endo Hernia). Also, repair with an Endopath EMS stapler has a significantly higher BS (P < 0.05) than one with the Endo Hernia stapler. In the second part of the study, evaluation of the longitudinal tensile strength also showed that 0-Prolene sutures are stronger (P < 0.05) than staples. Endopath EMS staples are stronger (P < 0.05) than Endo Hernia staples.
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PMID:Bursting strength evaluation. Comparison of 0-Prolene sutures and endoscopic staples in an experimental prosthetic patch repair of abdominal wall defect. 797 15

A laparoscopic colposuspension technique for the correction of urinary stress incontinence has been described in the recent literature. Herein we describe a laparoscopic adaptation of the Burch procedure, used in the treatment of urinary stress incontinence since 1958. The use of titanium hernia staples and Prolene mesh in place of traditional suture material eliminates the need for laparoscopic suturing in the confined pelvic space, a practice that often poses difficulty for inexperienced surgeons. Of 40 female patients treated, with a mean 6-month follow-up, there has been no relapse of stress incontinence. Complications in this modest population have been minor and self-limiting. As with any laparoscopic procedure, the results obtained here may be influenced by the extensive experience of the laparoscopist.
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PMID:Laparoscopic bladder neck suspension using hernia mesh and surgical staples. 811 Nov 8

Recent developments in laparoscopic hernia repair techniques have led to the design of titanium staples. In a laparoscopic hernia repair, a polypropylene mesh is stapled over the direct and indirect hernia sites in the inguinal region. The effectiveness of these staples in holding the prosthetic mesh, and therefore providing adequate strength to the abdominal wall, has not been yet investigated. We have characterized the bursting strength (BS) of an experimental hernia mesh repair fixed with Prolene suture, which is used extensively for this procedure, and the BS of repairs fixed with two currently available staplers, the Endopath EMS endoscopic multifeed stapler and the Endo Hernia stapler. We first simulated abdominal wall hernias in 16 piglets by creating incisions on both sides of the abdomen of each animal. Each defect was then covered with a polypropylene mesh, which was fixed on one side with Prolene sutures and on the other side using either the Endopath EMS (Group 1) or the Endo Hernia stapler (Group 2). The abdominal tissue with the mesh covering the defect was then excised and the BS evaluated using an Instron machine. Since many mechanical characteristics contribute to the BS of a repair, we investigated these characteristics in vitro, including tensile properties of the staples and the prosthetic mesh as well as the suture-tearing resistance of the mesh. Polypropylene mesh exhibits the same elongation in the three directions, i.e. 0 degrees , 45 degrees and 90 degrees . This elongation was estimated at 136% (SD = 130).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mechanical characterization of endoscopic surgical staples during an experimental hernia repair. 1014 27

A case of central carcinoma of the mandible arising from a recurrent odontogenic keratocyst is reported. A 38-year-old man was admitted to the Tokai University Hospital due to postoperative infection of a recurrent odontogenic keratocyst of the left mandible. He had had a cystectomy for an odontogenic keratocyst 4 years ago. The lesion revealed bony destruction of the mandible with worm-eating shaped margins with extension to the facial skin. A biopsy specimen revealed squamous cell carcinoma. The mandible was resected with facial skin and the sublingual space was dissected to preserve the lingual nerve. The oral and the facial resections were reconstructed with a titanium plate and bilateral rectus abdominis myocutaneous free flaps. The plate was removed due to infection around the margins and readjustment of the flaps was conducted 5 months after the surgery. He has not had a local relapse, metastasis, or incisional hernia for 8 months following surgery. Good occlusion has been attained by the residual mandible, and he is able to eat without any problems.
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PMID:A case of central carcinoma of the mandible arising from a recurrent odontogenic keratocyst: delineation of surgical margins and reconstruction with bilateral rectus abdominis myocutaneous free flaps. 1035 4

The Lichtenstein hernia repair has become a popular technique for most inguinal hernias performed in the United States. One attempt to improve on this technique includes the use of a tacker instead of suturing the mesh. This study compared the feasibility and time saving for placement of mesh for open inguinal hernias with a tacker versus polypropylene suture.Thirty-four patients were prospectively randomized to undergo open hernia repair using either running 2-0 polypropylene suture or a tacker device that contained spiral titanium tacks. Patients were examined after 1 week and followed for a mean of 8 months (range 1-26 months) to record postoperative complications and technical failure rate. Mesh placement times were significantly shorter in the tacker group (9.0+/-3.5 min) than the suture group (30.9+/-9.9 min). No technical complications or recurrences were found in the follow-up period in either group.Securing mesh with the tacker is safe, and repair appears durable at short-term follow-up. Using the tacker on open inguinal hernia repairs shortens the time for mesh placement compared to suture fixation. Decreased operative time may reduce overall cost.
Hernia 2002 Sep
PMID:Lichtenstein inguinal herniorrhaphy using sutures versus tacks. 1220 96

The authors report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM) in 56 patients. 34 patients had a bilateral hernia, 6 of which were recurrent and 22 had a monolateral hernia, of which 9 had recurrent hernia. Overall, a total of 90 hernias were treated. The hernia repair was performed utilizing "GORE-TEX DualMesh Plus biomaterial with holes" in the first 32 cases and the latest "...Corduroy" type in the remaining 24 cases. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Five minor post-operative complications (5.5%), 2 seromas and 3 transient paresthesias, were observed. Four patients (7.1%) needed analgesics after the first 24 hours. Mean hospital stay was 36 hours, with a minimum of 24 and a maximum of 48. Mean resumption of normal activity was 8 days with return to work within two weeks. At an average 18 months follow-up, 3 recurrences were recorded (3.3%). The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.
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PMID:[Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh]. 1287 Feb 82

Congenital diaphragmatic hernia (CDH) has a mortality rate of up to 77% despite optimal pre- and postnatal care. Fetuses with liver herniation, a low lung-to-head ratio, and an early diagnosis before 24 weeks have a particularly poor prognosis. In utero open repair of these fetuses does not improve patient survival. The PLUG (Plug the Lung Until it Grows) technique was reported to be able to reverse pulmonary hypoplasia in CDH. A foam plug or a titanium clip is used and the trachea can be unplugged using Ex Utero Intrapartum Tracheoplasty (EXIT) at birth. Since hysterotomy causes premature labour, a video-fetoscopic intrauterine technique of tracheal occlusion called Fetendo-PLUG was developed. Compared to those who receive standard postnatal care or fetal tracheal occlusion via open hysterotomy, patients who undergo Fetendo-PLUG are reported to have a higher survival rate of 75% and fewer fetal and maternal complications. A recent refinement is to use a detachable balloon for intratracheal occlusion through a single 5 mm port under real-time ultrasound guidance. Without the need for neck dissection, injury to the recurrent laryngeal nerves and trachea and vocal cord paresis can be minimized. The result of this form of treatment for CDH is promising, but further refinement of fetal instrumentation and development of effective tocolytic drugs are still required.
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PMID:Prenatal surgery for congenital diaphragmatic hernia. 1453 Jan 15

Laparoscopic repair of ventral incisional hernia is a relatively new procedure. Recent studies have confirmed that this technique is associated with minimal postoperative morbidity, a short hospital stay, and a low recurrence rate. Spiral tackers made of titanium are usually used for the safe and secure fixation of the mesh. We report the case of a small bowel perforation due to protruding spiral tackers that occurred 17 days after an initially uneventful clinical course.
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PMID:Small bowel perforation due to protruding spiral tackers: a rare complication in laparoscopic incisional hernia repair. 1509 76


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