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Robotic Hernia Repair

Mathew A Kozman, Darren Tonkin, Jimmy Eteuati, Alex Karatassas, Christopher R McDonald
BACKGROUND: Laparoscopic ventral hernia repair provides several benefits over the open approach. Intraperitoneal surgical mesh placement without fascial defect closure is associated with increased seroma formation and other adverse hernia-site outcomes. Transfascial sutures and tacs for fascial closure and surgical mesh fixation are associated with greater post-operative pain. Robotic-assisted ventral hernia repair (rVHR) may afford benefits of the laparoscopic approach while facilitating a more robust and less painful repair...
February 18, 2019: ANZ Journal of Surgery
F Gokcal, S Morrison, O Y Kudsi
BACKGROUND: Retromuscular ventral hernia repairs have become increasingly popular, both with and without transversus abdominis release. We aim to describe our 90-day outcomes in patients who underwent robotic retromuscular ventral hernia repair (RRVHR). METHODS: All patients were subcategorized into those who underwent a TAR (TAR+) as part of their repair, and those who did not (TAR-). Patient demographics, comorbidities, hernia characteristics, and LOS were studied...
February 15, 2019: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Angelica Beatriz Hernandez, Luis G Medina, Pierre A Hueber, Felipe Placco Araujo Glina, Hannah Landsberger, Daniel Oberlin, Giovanni Cacciamani, Byron Lopez, Ketan Patel, Rene J Sotelo
INTRODUCTION: Simple prostatectomy is the gold standard for prostates >80 grams, robotic system has proven to help into speed the recovery of the patient and in morbid obesity the advantages of the robotic system can help to perform a suc¬cessful surgery. CASE: 80 years old male with morbid obesity (BMI 45) and several other comorbidities, with history of an umbilical hernia and obstructive lower urinary tract symptoms in acute urinary retention. PSA was 7 ng/dl, DRE demonstrates a >100gr prostate gland...
January 30, 2019: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Robin Schmitz, Frank Willeke, Justin Barr, Michael Scheidt, Heike Saelzer, Ibrahim Darwich, Sabino Zani, Dietmar Stephan
INTRODUCTION: This retrospective study was performed to evaluate the safety and feasibility of the new Senhance™ Robotic System (TransEnterix Inc., Morrisville, North Carolina) for inguinal hernia repairs using the transabdominal preperitoneal approach. MATERIALS AND METHODS: From March to September 2017, 76 inguinal hernia repairs in 64 patients were performed using the Senhance™ Robotic System. Patients were between 18 and 90 years of age, eligible for a laparoscopic procedure with general anesthesia, had no life-threatening disease with a life expectancy of less than 12 months, and a body mass index (BMI) < 35...
February 1, 2019: Surgical Technology International
H B Cunningham, J J Weis, L R Taveras, S Huerta
PURPOSE: This study reviewed the literature regarding mesh migration in abdominal hernia repair. The aim of this study is to interrogate incidence, common type of abdominal hernia repair leading to migration, patterns of mesh migration, and materials associated with migration. METHODS: A comprehensive literature review was conducted. PubMed and MEDLINE were searched for relevant articles in the English literature. We employed Ovid syntax from 1949 to January 2010, the Cochrane Library, Google and Google Scholar...
January 30, 2019: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Vernissia Tam, Devin E Rogers, Amr Al-Abbas, Jeffrey Borrebach, Stefanie A Dunn, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Over the past 5 y, robotic surgery has expanded within general surgery, especially in regard to hernia repairs. We aimed to evaluate the outcomes of the early experience of over 300 consecutive robotic inguinal hernia repairs performed in an academic multihospital system. METHODS: Consecutive robotic inguinal hernia repairs performed between December 2015 and June 2017 were analyzed. Retrospective chart review was performed, and hospital records were queried...
March 2019: Journal of Surgical Research
Pooya Rajabaleyan, Allan Dorfelt, Peiman Poornoroozy, Per Vadgaard Andersen
INTRODUCTION: Perineal hernia is a protrusion of the pelvic floor containing intra-abdominal viscera. The occurrence of postoperative perineal hernia after abdominoperineal resection (APR) is rare, but reports have indicated a recent increase in occurrence following surgical treatment for rectal cancer. This has been attributed to a shift towards extralevator abdominoperineal resection, together with more frequent and long-term use of neoadjuvant therapy. PRESENTATION OF CASE: Here, we report the case of a patient who underwent APR for cancer...
January 17, 2019: International Journal of Surgery Case Reports
Leslie M Okorji, Kevin R Kasten
A 63-year-old woman with history of stage II rectal adenocarcinoma status postneoadjuvant chemoradiation and subsequent abdominoperineal resection presented with worsening bulge and inability to pouch stoma. CT scan revealed a 4-cm parastomal hernia. After discussion with the patient regarding management options, she elected to undergo repair of hernia defect. A robot-assisted laparoscopic parastomal hernia repair with synthetic mesh via the Sugarbaker technique was performed. After a short stay in the hospital, the patient recovered well and reported no recurrent symptoms...
February 2019: Diseases of the Colon and Rectum
Massimo Arcerito, Eric Changchien, Monica Falcon, Mauricio A Parga, Oscar Bernal, John T Moon
Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). The mean age of the patients was 58 years. Biosynthetic mesh was used in 28 patients with paraesophageal hernia. The mean operative time was 115 minutes (90-132) in the sliding hiatal hernia group, whereas it was 200 minutes (180-210) in the paraesophageal hiatal hernia group...
December 1, 2018: American Surgeon
Efi Georgiou, Elina Schoina, Sophia-Liberty Markantonis, Vangelis Karalis, Panagiotis G Athanasopoulos, Periklis Chrysoheris, Fotis Antonakopoulos, Konstantinos Konstantinidis
Laparoscopic inguinal hernia repair is one of the most frequently performed operations. However, the search for the most appropriate prosthetic materials continues to occupy the surgical community. The purpose of this study was to evaluate the postoperative short- and mid-term effects (like duration of stay, number and type of complications, and inguinal pain) of laparoscopic inguinal hernia repair using the total extraperitoneal (TEP) approach. The evaluation encompassed different types of mesh and fixation devices, as well as medications prescribed during hospitalization...
December 2018: Medicine (Baltimore)
Daniel C Edwards, David B Cahn, Madhu Reddy, Dana Kivlin, Aseem Malhotra, Tianyu Li, David Y T Chen, Rosalia Viterbo, Robert G Uzzo, Richard E Greenberg, Marc C Smaldone, Paul Curcillo, Alexander Kutikov
INTRODUCTION: Postoperative incisional hernias (PIH) are an established complication of abdominal surgery with rates after radical cystectomy (RC) poorly defined. The objective of this analysis is to compare rates and risk factors of PIH after open (ORC) and robotic-assisted (RARC) cystectomy at a tertiary-care referral center. MATERIALS AND METHODS: We performed a retrospective review of patients undergoing ORC and RARC from 2000-2015 with pre and postoperative cross-sectional imaging available...
December 2018: Canadian Journal of Urology
Eduardo Henrique Pirolla, Gabriel Pavani Patriota, Fernanda Junqueira Cesar Pirolla, Felipe Piccarone Gonçalves Ribeiro, Marina Guitton Rodrigues, Layla Riva Ismail, Raquel Mezzalira Ruano
INTRODUCTION: Inguinal hernia is one of the most frequent surgical diseases. Currently, with the advantages of minimally invasive surgery, new questions arise: what will be the best approach for correction of inguinal hernia? Is there real benefit to the robotic approach? OBJECTIVE: To compile results of the published studies that used the robot-assisted technique in the repair of inguinal hernia, analyzing its limitations, complications and comparing it with those of the pre-existing techniques...
December 6, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Walaa F Abdelmoaty, Christy M Dunst, Chris Neighorn, Lee L Swanstrom, Chet W Hammill
BACKGROUND: Cost-effectiveness of robotic-assisted surgery is still debatable. Robotic-assisted inguinal hernia repair has no clear clinical benefit over laparoscopic repair. We performed a comprehensive cost-analysis comparison between the two approaches for evaluation of their cost-effectiveness in a large healthcare system in the Western United States. METHODS: Health records in 32 hospitals were queried for procedural costs of inguinal hernia repairs between January 2015 and March 2017...
December 7, 2018: Surgical Endoscopy
N A Henriksen, K K Jensen, F Muysoms
PURPOSE: The number of robot-assisted hernia repairs is increasing, but the potential benefits have not been well described. The aim of this study was to evaluate the available literature reporting on outcomes after robot-assisted hernia repairs. METHODS: This is a qualitative review and meta-analysis of papers evaluating short-term outcomes after inguinal or ventral robot-assisted hernia repair compared with either open or laparoscopic approach. The primary outcome was postoperative complications and secondary outcomes were duration of surgery, postoperative length of stay and financial costs...
December 6, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Benjamin Wei, Bruce C Pittman
Morgagni hernia (MH) is a rare, congenital diaphragmatic hernia (CDH). The use of robotic surgery to repair MH in adults has recently been described in the literature, but only on two previous occasions. The objective of this report is to describe four cases of robotic repair of MH in adults performed by a single surgeon to better delineate an emerging approach to this rare condition. A retrospective review of patients who underwent robotic repair of MH by a single surgeon was performed. Four consecutive patients were identified and included...
November 21, 2018: Journal of Robotic Surgery
J T Halka, A Vasyluk, A Demare, A Iacco, R Janczyk
BACKGROUND: Although the open transversus abdominis release (oTAR) is an effective operation for large ventral hernias, it is historically associated with a relatively long length of stay. Robotic retromuscular transversus abdominis release (rTAR) allows minimally invasive repair of complex ventral hernias with shorter length of stay (LOS) compared to open repairs (TAR), but hybrid robotic TAR (hrTAR), partial open intervention via incision through the overlying hernia sac for fascial closure, may be required to accomplish effective repair of large defects...
November 19, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Muhammad Qais Luqman, Afzaal Mughal, Ronan Waldron, Iqbal Z Khan
Acquired abdominal intercostal hernia (AAIH) is an infrequent occurrence whereby intra-abdominal contents herniate into intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. These hernias are difficult to diagnose and should always be suspected when a chest wall swelling occur after major or minor trauma. Surgical repair is warranted in symptomatic patients. The majority of AAIHs are repaired through an open approach using tension-free mesh, with significant recurrence risk...
November 3, 2018: BMJ Case Reports
R Sharma, N Fadaee, E Zarrinkhoo, S Towfigh
PURPOSE: As more mesh is implanted for hernia repairs, mesh-related complications may increase, with some requiring mesh removal. We describe our experience as to indications and perioperative factors that surround hernia mesh removal. METHODS: All patients who underwent hernia mesh removal from the abdomen (ventral, flank) and pelvis (inguinal, femoral, obturator, perineal) were captured from a single hernia center database. RESULTS: Over 4...
December 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Adam Truong, Badr Saad Al-Aufey, Shirin Towfigh
BACKGROUND: Inguinal hernia repairs are among the most common operations performed worldwide. An increasing number is performed minimally invasively with mesh placed pre-peritoneally. Some situations may require mesh removal. This can be complex and challenging. We share our technique to remove pre-peritoneal mesh using a minimally invasive approach. METHODS: The multiple steps involved in robotic-assisted pre-peritoneal mesh removal are reviewed in detail, including preoperative planning, intraoperative positioning, review of anatomic landmarks, and systematic approach with technical tips to reduce complications...
October 24, 2018: Surgical Endoscopy
Alexander C Mertens, Rob C Tolboom, Hana Zavrtanik, Werner A Draaisma, Ivo A M J Broeders
INTRODUCTION: Published data regarding robot-assisted hiatal hernia repair are mainly limited to small cohorts. This study aimed to provide information on the morbidity and mortality of robot-assisted complex hiatal hernia repair and redo anti-reflux surgery in a high-volume center. MATERIALS AND METHODS: All patients that underwent robot-assisted hiatal hernia repair, redo hiatal hernia repair, and anti-reflux surgery between 2011 and 2017 at the Meander Medical Centre, Amersfoort, the Netherlands were evaluated...
October 22, 2018: Surgical Endoscopy
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