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K. K. Jensen - One of the best experts on this subject based on the ideXlab platform.
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Should simultaneous stoma closure and incisional Hernia Repair be avoided?
Hernia, 2020Co-Authors: E. Oma, N. N. Baastrup, K. K. JensenAbstract:Purpose Patients scheduled for stoma closure may also have an incisional Hernia. Studies have reported acceptable outcomes after contaminated ventral Hernia Repair, but whether stoma closure and incisional Hernia Repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional Hernia Repair compared with incisional Hernia Repair only. Methods This was a nationwide propensity-score matched study. Patients who underwent elective incisional Hernia Repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional Hernia Repair only. The primary outcome was reoperation for Hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. Results In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional Hernia Repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional Hernia Repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional Hernia Repair only (median 8 versus 3 days, p
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Should simultaneous stoma closure and incisional Hernia Repair be avoided
Hernia, 2020Co-Authors: E. Oma, N. N. Baastrup, K. K. JensenAbstract:Patients scheduled for stoma closure may also have an incisional Hernia. Studies have reported acceptable outcomes after contaminated ventral Hernia Repair, but whether stoma closure and incisional Hernia Repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional Hernia Repair compared with incisional Hernia Repair only. This was a nationwide propensity-score matched study. Patients who underwent elective incisional Hernia Repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional Hernia Repair only. The primary outcome was reoperation for Hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional Hernia Repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional Hernia Repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional Hernia Repair only (median 8 versus 3 days, p
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Recovery after laparoscopic parastomal Hernia Repair
Surgical Endoscopy, 2020Co-Authors: Anders L. Ebbehøj, Peter Sparre, K. K. JensenAbstract:Background The perioperative care and postoperative period after laparoscopic Hernia Repair have not been well described. The aim of this study was to describe the postoperative course after laparoscopic parastomal Hernia Repair. Methods This was a prospective cohort study including consecutive patients undergoing laparoscopic parastomal Hernia Repair. The outcomes of interest were patient-reported pain, nausea and fatigue, time to stoma function, length of stay (LOS), use of transversus abdominis plane (TAP) block and epidural analgesia, the cumulative dose of morphine equivalent analgesics during the first 5 postoperative days, and postoperative complications. Results Forty patients were included, 20% had ileostomy and 80% colostomy. The mesh was placed according to Sugarbaker (87.5%) and keyhole (12.5%) technique. Twenty-two patients (55%) required peripheral nervous blockades postoperatively. The median number of days to stoma function was 3 days (range 2–3.8). The mean cumulative dose of morphine equivalent analgesics was 21.9 mg on the day of surgery, 27.8 mg on the first postoperative day (POD1), 23.9 on POD2, 17.3 mg on POD3, 15.3 mg on POD4, 8.9 mg on POD5, and 115.2 mg in total. The median LOS was 4 days (range 3–6). The incidence of postoperative complications was 25%. Conclusion Laparoscopic parastomal Hernia Repair carried a high risk of complications. Further, analgesic treatment after surgery was insufficient, with high opioid requirements postoperatively, and more than half of the patients required peripheral nervous blockades, indicating that postoperative pain is a major issue in this patient group. Improved postoperative care for these patients is required.
E. Oma - One of the best experts on this subject based on the ideXlab platform.
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Should simultaneous stoma closure and incisional Hernia Repair be avoided?
Hernia, 2020Co-Authors: E. Oma, N. N. Baastrup, K. K. JensenAbstract:Purpose Patients scheduled for stoma closure may also have an incisional Hernia. Studies have reported acceptable outcomes after contaminated ventral Hernia Repair, but whether stoma closure and incisional Hernia Repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional Hernia Repair compared with incisional Hernia Repair only. Methods This was a nationwide propensity-score matched study. Patients who underwent elective incisional Hernia Repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional Hernia Repair only. The primary outcome was reoperation for Hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. Results In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional Hernia Repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional Hernia Repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional Hernia Repair only (median 8 versus 3 days, p
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Should simultaneous stoma closure and incisional Hernia Repair be avoided
Hernia, 2020Co-Authors: E. Oma, N. N. Baastrup, K. K. JensenAbstract:Patients scheduled for stoma closure may also have an incisional Hernia. Studies have reported acceptable outcomes after contaminated ventral Hernia Repair, but whether stoma closure and incisional Hernia Repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional Hernia Repair compared with incisional Hernia Repair only. This was a nationwide propensity-score matched study. Patients who underwent elective incisional Hernia Repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional Hernia Repair only. The primary outcome was reoperation for Hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional Hernia Repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional Hernia Repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional Hernia Repair only (median 8 versus 3 days, p
Anthony Gonzalez - One of the best experts on this subject based on the ideXlab platform.
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Current perspectives in robotic Hernia Repair.
Robotic surgery (Auckland), 2017Co-Authors: Charan Donkor, Anthony Gonzalez, Michelle Gallas, Michael W. Helbig, Corey Weinstein, Jaime A. RodriguezAbstract:The surgical treatment of Hernias has developed throughout the evolution of surgery. The fascination with Hernia surgery is in part driven by its prevalence and by the variety of treatment options. Minimally invasive Hernia surgery has a goal of a robust Repair with minimal complications, and new robotic techniques are being developed in complex abdominal wall Hernias with promising results. This review focuses on inguinal, ventral, and incisional Hernias and their outcomes with a discussion on the traditional open, laparoscopic, and robotic techniques. The prevalence of minimally invasive Hernia surgery and its advantages are also outlined. We highlight our experience in these procedures, specifically robotic herniorrhaphy, as it pertains to ventral incisional and inguinal Hernia Repair. We conclude that the robotic platform is proving to be a benefit to Hernia Repair. Many studies are showing its feasibility and comparable results to standard laparoscopy, and some have shown improved results, including shorter hospital stay without significant increases in cost. The robotic option of Hernia Repair has resulted in an increase in minimally invasive Hernia Repair, a number that has remained stagnant for the last decade. With more surgeons gaining training and experience and greater availability of the robotic platform, we expect to see greater numbers of minimally invasive Hernia Repair.
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feasibility of robotic inguinal Hernia Repair a single institution experience
Surgical Endoscopy and Other Interventional Techniques, 2016Co-Authors: Jose E. Escobar Dominguez, Charan Donkor, Michael Gonzalez Ramos, Rupa Seetharamaiah, Jorge Rabaza, Anthony GonzalezAbstract:Background With the growth of the discipline of laparoscopic surgery, technology has been further developed to facilitate the performance of minimally invasive Hernia Repair. Most of the published literature regarding robotic inguinal Hernia Repair has been performed by urologists who have dealt with this entity in a concomitant way during radical prostatectomies. General surgeons, who perform the vast majority of inguinal herniorrhaphies worldwide, have yet to describe the role of robotic inguinal Hernia Repair. Here, we describe our initial experience and create the foundation for future research questions regarding robotic inguinal Hernia Repair.
N. N. Baastrup - One of the best experts on this subject based on the ideXlab platform.
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Should simultaneous stoma closure and incisional Hernia Repair be avoided?
Hernia, 2020Co-Authors: E. Oma, N. N. Baastrup, K. K. JensenAbstract:Purpose Patients scheduled for stoma closure may also have an incisional Hernia. Studies have reported acceptable outcomes after contaminated ventral Hernia Repair, but whether stoma closure and incisional Hernia Repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional Hernia Repair compared with incisional Hernia Repair only. Methods This was a nationwide propensity-score matched study. Patients who underwent elective incisional Hernia Repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional Hernia Repair only. The primary outcome was reoperation for Hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. Results In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional Hernia Repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional Hernia Repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional Hernia Repair only (median 8 versus 3 days, p
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Should simultaneous stoma closure and incisional Hernia Repair be avoided
Hernia, 2020Co-Authors: E. Oma, N. N. Baastrup, K. K. JensenAbstract:Patients scheduled for stoma closure may also have an incisional Hernia. Studies have reported acceptable outcomes after contaminated ventral Hernia Repair, but whether stoma closure and incisional Hernia Repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional Hernia Repair compared with incisional Hernia Repair only. This was a nationwide propensity-score matched study. Patients who underwent elective incisional Hernia Repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional Hernia Repair only. The primary outcome was reoperation for Hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional Hernia Repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional Hernia Repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional Hernia Repair only (median 8 versus 3 days, p
Jose E. Escobar Dominguez - One of the best experts on this subject based on the ideXlab platform.
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feasibility of robotic inguinal Hernia Repair a single institution experience
Surgical Endoscopy and Other Interventional Techniques, 2016Co-Authors: Jose E. Escobar Dominguez, Charan Donkor, Michael Gonzalez Ramos, Rupa Seetharamaiah, Jorge Rabaza, Anthony GonzalezAbstract:Background With the growth of the discipline of laparoscopic surgery, technology has been further developed to facilitate the performance of minimally invasive Hernia Repair. Most of the published literature regarding robotic inguinal Hernia Repair has been performed by urologists who have dealt with this entity in a concomitant way during radical prostatectomies. General surgeons, who perform the vast majority of inguinal herniorrhaphies worldwide, have yet to describe the role of robotic inguinal Hernia Repair. Here, we describe our initial experience and create the foundation for future research questions regarding robotic inguinal Hernia Repair.
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Robotic inguinal Hernia Repair
Journal of Surgical Oncology, 2015Co-Authors: Jose E. Escobar Dominguez, Anthony M. Gonzalez, Charan DonkorAbstract:Inguinal Hernias have been described throughout the history of medicine with many efforts to achieve the cure. Currently, with the advantages of minimally invasive surgery, new questions arise: what is going to be the best approach for inguinal Hernia Repair? Is there a real benefit with the robotic approach? Should minimally invasive Hernia surgery be the standard of care? In this report we address these questions by describing our experience with robotic inguinal Hernia Repair. J. Surg. Oncol. 2015; 112:310–314. © 2015 Wiley Periodicals, Inc.