Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Reports on the ambulatory open repair of umbilical trocal hernias are missing. Patients with trocar, primary and recurrent umbilical hernia open suture and open suture–mesh repair with prospective follow-up were retrospectively evaluated. Patients received perioperative antibiotic prophylaxis, preemptive analgesia and modified anesthesia. In total, 171 patients with umbilical hernia (51 years, female 14%; male 86%) were treated with open suture (n = 29; 17%) and suture–mesh (n = 142; 83%) repair. In total, 10% of patients were treated for trocar hernia (late onset), 5% for recurrent hernia and 85% for a primary umbilical hernia. In total, 29% of trocar hernia repairs had minor complications associated with obesity (40%) and comorbidity (80%). Age, suture and suture–mesh repair were not associated with complications. According to guidelines for umbilical hernia repair open flat mesh may be useful in the treatment of trocar hernia.

СУЩЕСТВУЮЩИЕ ВОЗМОЖНОСТИ И ПЕРСПЕКТИВЫ ЛАПАРОСКОПИЧЕСКОЙ ГЕРНИОРАФИИ

Over the past quarter century, the number of operations for an umbilical hernia among gracenotea increased from 5 to 14%. The article considers the author's method of a laparoscopic hernioraphy as an independent method of a hernioplasty and presents its possibilities as a way to improve the cosmetic effect in a minimally invasive surgical treatment of an umbilical hernia. The clinical example is described in which the proposed hernioraphy was used in a combination with a mesh implant in IPOM-plasty in the patient with the presence of a combined (umbilical and trocar) hernia. A laparoscopic hernioraphy is a relatively easily reproducible technique, economically attractive and quite effective in terms of "fast track" surgery and hospital-preserving technologies that allow to restore the ability to work of the operated patient in the shortest possible time.

The Role of the Composite and Biologic Meshes in the Trocar Site Hernia Repair Following Laparoscopic Surgery

The increasing proportion of laparoscopic interventions in the surgical centers has, also, determined an increased incidence of specific complications, such as trocar hernia. Nowadays, there is no unanimously agreed concensus regarding the optimal closure technique of the trocar incision, wether it should include the suture of the aponeurosis or not at the 10 mm ports. There is, also, no consensus regarding the proper surgical technique for the trocar hernia repair- alloplastic or tissue repair technique.The purpose of the study is to present our experience on the alloplastic repair of the trocar hernias. It is a retrospective study that analyzes the results obtained by our clinicalteam regarding the alloplastic repair of the trocar hernias, over a five-year period, between January 2011 and December 2015. The recurrence and the occurrence rates of different complications (seroma, neuroma with postoperative pain, parietal infiltration, infections and mesh rejection), depending on the type of mesh used for the surgical repair,are studied.

Abdominal Mass After Robotic Assisted Laparoscopic Prostatectomy: Spigelian Type Trocar Hernia

Prostate cancer is the most common cancer in men. Men are diagnosed at early stages of prostate cancer with the use of prostate specific antigen. Surgical removal of the prostate is the standard treatment in localized prostate cancer. Complications after surgical procedures are inevitable. Although robotic prostatectomy has resulted in decreased complications compared to open surgery, complications occur. After an uneventful robotic assisted laparoscopic prostatectomy in a 71-year-old gentleman, with history of chronic cough and continued low dose glucocorticoid use, the patient returned to hospital with complain of a tender abdominal mass in right lower quadrant. After performing a computed tomography of the contrast, a Spigelian type trocar hernia was noted. The patient underwent a laparoscopic diagnostic surgery followed by small bowel resection and abdominal wall defect repair. The patient was discharged home with no other complains.