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Hatewar A, Mahakalkar C, Kshirsagar S, Ram Sohan P, Dixit S, Bikkumalla S. From Meshes to Minimally Invasive Techniques: A Comprehensive Review of Modern Hernia Repair Approaches. Cureus 2024; 16:e66206. [PMID: 39233930 PMCID: PMC11374351 DOI: 10.7759/cureus.66206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
Hernias are a common medical condition characterized by the protrusion of organs or tissues through weakened muscle walls, affecting millions worldwide annually. Historically, from being treated with open surgeries using tension-free mesh repairs, the landscape of hernia repair has evolved significantly. This evolution has been marked by the advent and refinement of minimally invasive techniques, including laparoscopic and robotic-assisted approaches, which offer reduced postoperative pain, shorter recovery times, and improved patient outcomes compared to traditional methods. This comprehensive review aims to elucidate the evolution of hernia repair techniques, emphasizing the transition from conventional mesh repairs to advanced minimally invasive methodologies. By examining the historical progression and current state of hernia surgery, this review thoroughly analyzes the advancements in surgical techniques, materials, and technologies. Furthermore, it explores emerging trends such as biological meshes, ultrasound-guided procedures, and 3D printing applications in hernia repair. The clinical significance of these advancements lies in their potential to enhance the patient's quality of life, minimize complications, and optimize healthcare resource utilization. Insights gained from this review will inform clinicians and researchers about the efficacy, safety, and comparative effectiveness of various hernia repair approaches, guiding future directions in hernia management and fostering innovation in surgical practice.
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Affiliation(s)
- Akansha Hatewar
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Chanrashekhar Mahakalkar
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shivani Kshirsagar
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Poosarla Ram Sohan
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sparsh Dixit
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shruthi Bikkumalla
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kurian J, Winant AJ, Hull NC, Lee EY. Pediatric Acute Abdomen: Bread-and-Butter Diagnoses. Semin Roentgenol 2024; 59:312-331. [PMID: 38997184 DOI: 10.1053/j.ro.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 07/14/2024]
Affiliation(s)
- Jessica Kurian
- Department of Radiology, Westchester Medical Center, Valhalla, NY.
| | - Abbey J Winant
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
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Lorenz R, Paasch C, Stechemesser B, Reinpold W, Niebuhr H, Fortelny RH, Mayer F, Köckerling F, Mantke R. Long-term evaluation of the Hernia Compact course of the German Hernia School. Hernia 2024; 28:621-628. [PMID: 38393496 DOI: 10.1007/s10029-024-02966-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/11/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Since 2011, the German Hernia Society has developed the German Hernia School (GHS) as a standardized hernia surgery training program for younger surgeons, consisting of the Hernia Compact basic module. It is a standardized three day training program (cadaver workshop, ultrasound simulation training, and hands-on training). After 12 years of experience, a survey was conducted to evaluate the long term effect of this training. METHOD Using an anonymous online-questionnaire, we contacted from September 2023 to October 2023 the Hernia Compact course participants via the congress organizer "Weitmeer" and the German Hernia Society. This online questionnaire contains 18 multiple choice questions regarding participants' age, gender, professional experience, participation in other modules of the German Hernia School, the effect of the course on their daily practice and their specific interest in hernia and abdominal wall surgery. RESULTS A total of 146 participants responded to the anonymous online questionnaire. A majority of 132 of 146 participants (90.42%) responded that this course improved the quality of surgical and hernia training (n = 146, no missing data). 141 of 146 individuals (96.58%) recommended the course to surgical colleagues (n = 146, no missing data). There were 89.73% of participants, (n = 146, no missing data) that developed a specific interest in hernia and abdominal wall surgery after the course. For 78.08% (n = 146, no missing data) of participants hernia and abdominal wall surgery was one of the most important activities in their daily surgical practice. CONCLUSION The standardized Hernia Compact basic course of the German Hernia School appears to have a huge impact on the quality of hernia surgery training in Germany and Austria. It might also help generate a specific interest in hernia surgery among participants.
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Affiliation(s)
- R Lorenz
- 3+CHIRURGEN Hernia Center, Klosterstrasse 34/35, 13581, Berlin, Germany.
- Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany.
| | - C Paasch
- Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany
| | - B Stechemesser
- Hernia Center Cologne, PAN-Klinik, Zeppelinstrasse 1, 50667, Cologne, Germany
| | - W Reinpold
- Hamburger Hernien Centrum, Harburg (an der Helios Mariahilf Klinik), Stader Str. 203c, 21075, Hamburg, Germany
| | - H Niebuhr
- Hamburger Hernien Centrum, Eppendorf, Eppendorfer Baum 8, 20249, Hamburg, Germany
| | - R H Fortelny
- Department of General Surgery, Klinik Ottakring, Montleartstraße 37, 1160, Vienna, Austria
- Medical Faculty, Sigmund Freud University, Freudplatz 3, 1020, Vienna, Austria
| | - F Mayer
- Department of Surgery, Paracelsus Medical University, University Hospital, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - F Köckerling
- Vivantes Humboldt Hospital Berlin, Academic Teaching Hospital of Charite' University Medicine, Am Nordgraben 2, 13509, Berlin, Germany
| | - R Mantke
- Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany
- Faculty of Medicine, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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Karatay E, Eren A, Javadov M. Diagnostic impact of using the semi-erect position in the evaluation of inguinal hernia with superficial sonography. POLISH JOURNAL OF SURGERY 2024; 96:9-14. [PMID: 39138991 DOI: 10.5604/01.3001.0054.2676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
<b>Introduction:</b> The main cause of groin pain is inguinal hernia (IH). The most commonly used imaging test for diagnosis is sonography, which is also useful in distinguishing between indirect and direct hernias.<b>Aim:</b> In this study, measurements were made with sonography in the semi-erect position (45) in addition to the supine position and the effectiveness of this position in detecting the defect was investigated.<b>Material and methods:</b> The IH cases diagnosed by ultrasound between March 2019 and October 2023 were evaluated retrospectively. According to the diameter of the defect in the supine position, the cases were divided into three groups: Group A (≤1.5 cm), Group B (1.5-3 cm), and Group C (≥3 cm). A total of 252 patients with unilateral IH were identified.<b>Results:</b> For Group A, the mean value was 1.09 0.23 (0.64-1.48) cm in the supine position and 1.28 0.26 (0.67) cm in the semi- -erect position (p<0.001). For Group B, the mean value was 2.29 0.29 (1.57-2.82) cm in the supine position and 2.41 0.31 (1.65-2.94) cm in the semi-erect position (p<0.001). For Group C, the mean value was 3.57 0.23 (3.28-4.05) cm in the supine position and 3.62 0.24 (3.32-4.10) cm in the semi-erect position (p<0.05).<b>Conclusions:</b> Superficial ultrasound, which provides reliable results in the diagnosis of IH, is an easily accessible modality. Unlike previous studies, this study was the first to examine the semi-erect position in IH patients. It showed that it is effective in determining the optimal diameter of the defect.
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Affiliation(s)
- Emrah Karatay
- Department of Radiology, Ministry of Health Tuzla State Hospital, Istanbul, Turkey
| | - Abdulkadir Eren
- Department of Radiology, Istanbul Medipol University Mega Hospital, Istanbul, Turkey
| | - Mirkhalig Javadov
- Department of General Surgery, Medicana International Atasehir Hospital, Istanbul, Turkey
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Szasz P, Mainprize M, Spencer Netto FAC. Muscular groin hernias: an anatomical variation as a cause of recurrence. Hernia 2023; 27:1483-1489. [PMID: 37480501 DOI: 10.1007/s10029-023-02840-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/09/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The objective of this study was to understand our center's experience with the rare entity of muscular groin hernias. Specifically, to determine this hernia's incidence and characteristics and provide valuable information to surgeons that can be utilized at the time of a hernia repair regardless of modality used. METHODS This was a retrospective chart review between 2005 and 2019. Patients who had a primary or recurrent groin hernia operation for an atypically located hernia (other than direct, indirect, or femoral) were included. Descriptive statistics were utilized to present the hernia and patient data as median (interquartile range, range). RESULTS There were 152 patients with 155 muscular hernias identified in primary operations and 41 patients with 41 muscular hernias identified in recurrent operations. In both primary and recurrent groups there were more males, and the males were on average younger with a higher body mass index (BMI) than females. Most muscular hernias were located lateral (76) or lateral/superior (33) to the internal ring with a median distance between 2 and 3 cm (1, 0.3-5; 2.8,2-5) from the internal ring. A concurrent ipsilateral inguinal hernia was found and repaired in 42.3% of left and 46.8% of right sided primary muscular hernia operations. A concurrent ipsilateral inguinal hernia was noted in 5% of left and 14.3% of right sided recurrent muscular operations. In left sided recurrent operations for a muscular hernia, 68.9% had a previous ipsilateral inguinal hernia repair and in right sided recurrent operations, 67.7% had a previous ipsilateral inguinal hernia repair. CONCLUSION This study describes a previously unidentified groin muscular hernia in both primary and recurrent hernia operations as a potential cause of hernia recurrence and identifies muscular hernia locations. This information can be utilized at the time of surgery to identify and subsequently repair these defects, leading to improved patient and hernia outcomes.
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Affiliation(s)
- Peter Szasz
- Department of Surgery, Queen's University, Kingston Health Sciences Center, Kingston, ON, Canada
| | - Marguerite Mainprize
- Department of Surgery, Shouldice Hospital, 7750 Bayview Ave, Thornhill, ON, L3T 7N2, Canada.
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Weidman B, Callahan J, Newell J. Amyand’s Hernia: A Case Study. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2023. [DOI: 10.1177/87564793231162631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Amyand’s hernia is a rare inguinal hernia where the appendix is trapped in the hernia sac. This uncommon hernia is most often revealed as an incidental finding, and the demonstration of this disease process is variable. This case study presents a scrotal sonogram of a 48-year-old male complaining of pain and swelling, without history of trauma. Sonographic images of the right inguinal region identified Amyand’s hernia that contained fat, free fluid, and the appendix. Treatment of Amyand’s hernia is highly debatable, but most cases are treated based upon classification that includes the state of the appendix, the patient’s age, septic state, and if any peritoneal involvement was identified.
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