24-Month results of the BRAVO study: A prospective, multi-center study evaluating the clinical outcomes of a ventral hernia cohort treated with OviTex® 1S permanent reinforced tissue matrix.

Background: This study evaluated the performance of OviTex® 1S (TELA Bio Inc., Malvern, PA, USA) over 24 months when used for ventral hernia repair.

Methods: This was a prospective, single-arm, multi-center clinical trial (ClinicalTrials.

Bridged repair of large ventral hernia defects using an ovine reinforced biologic: A case series.

Introduction: Of all hernia types, large ventral hernias have the most impact on patient quality of life, however they are also the most difficult type of hernia to repair and are associated with high rates of complications. This case series describes repair of large ventral hernias with an ovine reinforced biologic in a complex patient cohort with comorbidities and concomitant procedures.

Methods: The author performed bridged repair with an ovine reinforced biologic in 19 consecutive high-risk patients over a 5-year period.

A Prospective, Single Arm, Multi-Center Study Evaluating the Clinical Outcomes of Ventral Hernias Treated with OviTex 1S Permanent Reinforced Tissue Matrix: The BRAVO Study 12-Month Analysis.

Background: Conflicting results from previous studies have led to dissent over whether surgical mesh is safe and effective in ventral hernia repair. A newer class of mesh known as a reinforced tissue matrix, combining a biologic scaffold and minimal polymer reinforcement, offers promise in reducing inflammatory response and increasing abdominal wall support. This study sought to assess the clinical utility of a reinforced tissue matrix (OviTex) in ventral hernia repair 12 months after implantation.

A Polymer-Biologic Hybrid Hernia Construct: Review of Data and Early Experiences.

Surgical mesh reinforcement of the human abdominal wall has been found to reduce the chance of recurrence in hernia repairs. While traditionally polymer meshes have been used in hernia repair, alternative mesh options have been engineered to prevent the inflammatory foreign body response invoked by polymers. A reinforced tissue matrix (RTM) mesh has been developed by embedding a polymer within a decellularized extracellular matrix.

Laparoscopic Repair of Foramen of Winslow Hernia.

Foramen of Winslow hernia is a rare surgical entity with very few reported cases in literature. Preoperative diagnosis used to be difficult but with emerging computed tomography technology, diagnosing this internal abdominal hernia has become easier. We present an unusual case report of foramen of Winslow hernia in a 77-year-old patient who presented with severe abdominal pain.

Competence acquisition for single-incision laparoscopic cholecystectomy.

Background And Objectives: Within the past few years, there has been a push for an even more minimally invasive approach to biliary disease with the adoption of single-incision laparoscopic cholecystectomy. We sought to compare 4 individual surgeon experiences to define whether there exists a learning curve for performing single-incision laparoscopic cholecystectomy.

Methods: We performed a retrospective review 290 single-incision laparoscopic cholecystectomies performed by a group of general surgeons, with varying levels of experience and training, at 3 institutions between May 2008 and September 2010.

Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy.

Background: Minimally invasive techniques have become an integral part of general surgery with recent investigation into single-incision laparoscopic cholecystectomy (SILC). This study presents the final 1-year results of a prospective, randomized, multicenter, single-blinded trial of SILC vs multiport cholecystectomy (4PLC).

Study Design: Patients with biliary colic and documented gallstones or polyps or with biliary dyskinesia were randomized to SILC vs 4PLC.

Prospective study of single-stage repair of contaminated hernias using a biologic porcine tissue matrix: the RICH Study.

Background: In the presence of contamination, the repair of a ventral incisional hernia (VIH) is challenging. The presence of comorbidities poses an additional risk for postoperative wound events and hernia recurrence. To date, very few studies describe the outcomes of VIH repair in this high-risk population.

Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy.

Background: Minimally invasive techniques have become an integral part of general surgery, with recent investigation into single-incision laparoscopic cholecystectomy (SILC). This study presents a prospective, randomized, multicenter, single-blind trial of SILC compared with four-port cholecystectomy (4PLC) with the goal of assessing safety, feasibility, and factors predicting outcomes.

Methods: Patients with biliary colic and documented gallstones or polyps or with biliary dyskinesia were randomized to SILC or 4PLC.

Robotic vs. laparoscopic colorectal surgery: an institutional experience.

Background: Robotic colorectal surgery is gaining interest in general and colorectal surgery. The use of the da Vinci(®) Robotic system has been postulated to improve outcomes, primarily by increasing the dexterity and facility with which complex dissections can be performed. We report a large, single institution, comparative study of laparoscopic and robotic colectomies, attempting to better elucidate the benefits of robotic surgery in patients with colorectal disease.

Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data.

Background: This study presents preliminary data from a prospective randomized multicenter, single-blinded trial of single-incision laparoscopic cholecystectomy (SILC) versus standard laparoscopic cholecystectomy (4PLC).

Methods: Patients with symptomatic gallstones, polyps, or biliary dyskinesia (ejection fraction <30%) were randomized to SILC or 4PLC. Data included operative time, estimated blood loss, length of skin and fascial incisions, complications, pain, satisfaction and cosmetic scoring, and conversion.

Concurrent robotic trans-abdominal pre-peritoneal (TAP) herniorrhaphy during robotic-assisted radical prostatectomy.

Background: Robotic prostatectomy (RP) is now increasingly performed because it allows for precise dissection of neurovascular structures with better outcomes. It is estimated that 5-12% of candidates for radical prostatectomy have detectable inguinal hernias, and simultaneous mesh hernioplasty is now well supported. A disadvantage of radical prostatectomy is obliteration of the preperitoneal space of Bogros, which can make future totally extraperitoneal (TEP) herniorrhaphy difficult and prone to complication.

Extended mesh repair with external oblique muscle reinforcement for abdominal wall contour abnormalities following TRAM flap.

Many patients undergoing reconstructive surgery after mastectomy opt for reconstruction with the transverse rectus abdominis myocutaneous (TRAM) flap. Among the morbidities related to TRAM flap reconstruction is the development of abdominal wall contour abnormalities, including bulges or hernias. Several repair techniques at the flap abdominal wall donor site have been described for use at the time of flap harvest in an attempt to reduce the risk of such abdominal wall complications.

Robotic-assisted single-incision right colectomy: early experience.

Background: Application of laparoendoscopic single-site surgery (LESS) is increasing across surgical disciplines. In addition to the possibility of decreased postoperative pain, LESS offers better cosmesis with virtually 'scarless' surgeries, while avoiding the increased costs and complexity of natural orifice surgery. Instrument conflict minimization often requires the crossing of articulating instruments, which we believe can be more intuitively facilitated using the daVinci-S((R)) robotic system.

Laparoscopic Hartmann's procedure: a viable option for treatment of acutely perforated diverticultis.

Background: A laparoscopic technique for acutely perforated diverticulitis (i.e., laparoscopic Hartmann's procedure) has not been described.

Fate of retained capsule: a pathognomonic for surgery.

Since its introduction in 2001, Wireless Video Capsule enteroscopy is gaining acceptance due to its high diagnostic potential and minimal risk. In some centers, it offers an alternative approach to visualize the small intestine and to evaluate patients with suspected small bowel disease. We present a series of known complications of this procedure and call for a more proactive role in the management of retained capsule.

A standardized technique for robotically performed sigmoid colectomy.

Background: We describe a standarized eight-step technique to perform sigmoid colectomy using the da Vinci robot (Intuitive Surgical, Sunnyvale, CA) in both the left upper and lower abdominal quadrants.

Materials And Methods: Between March 2005 and June 2006, 11 robotic sigmoid colectomies were performed on patients with diverticulitis or cancer. The procedures were performed through 4 ports, using a medial to lateral approach and involved moving the robot during the procedure.