Concurrent Panniculectomy With Abdominal Wall Reconstruction: A Propensity-scored Matched Study of Quality Improvement Outcomes.

Background: Concurrent panniculectomy with abdominal wall reconstruction (CP-AWR) as a single-stage operation has reported increased complications, but constant quality improvement can improve results. This study describes outcomes for 21 years, impacted by evidence-based-practice changes.

Methods: Prospectively maintained database was reviewed for CP-AWR and separated by surgery date: "early" (2002-2016) and "recent" (2017-2023).

The impact of a closing protocol on wound morbidity in abdominal wall reconstruction with mesh.

Introduction: Wound complications (WC) after abdominal wall reconstruction (AWR) are associated with increased cost, recurrence, and mesh infection. Operative closing protocols (CP) have been studied in other surgical disciplines but not in AWR. Our aim was to study the effect of a CP on WC after AWR.

Long-term outcomes after open parastomal hernia repair at a high-volume center.

Background: Open parastomal hernia repairs (OPHR) are complex with high recurrence rates and no clear optimal technique. This report summarizes long-term OPHR outcomes at a high-volume hernia center.

Methods: OPHRs were identified from a prospectively maintained institutional database.

Does defect size matter in abdominal wall reconstruction with successful fascial closure?

Background: Conflicting literature suggests that larger defects in abdominal wall reconstruction both increase the risk of recurrence and have no impact on recurrence. In our prior work, hernias with defect areas ≥100 cm were associated with increased discomfort, operative time, and length of stay but not recurrence or reoperation. Our goal was to determine if defect size, even in giant hernias, would impact recurrence after mesh repair with complete fascial closure.

Open versus laparoscopic versus robotic inguinal hernia repair: A propensity-matched outcome analysis.

Background: Inguinal hernia repair is one of the most common surgical procedures in the world. Each repair technique, open, laparoscopic, and robotic, has its advantages and advocates. Prior studies have compared 2 techniques, but there are little data comparing all 3 approaches with long-term follow-up.

Implementation of a penicillin allergy protocol in open abdominal wall reconstruction: Preoperative optimization program.

Introduction: Beta-lactam prophylaxis is the first-line preoperative antibiotic in open abdominal wall reconstruction. However, of the 11% patients reporting a penicillin allergy (PA), most receive second-line, non-β-lactam prophylaxis. Previously, abdominal wall reconstruction research from our institution demonstrated increased wound complications, readmissions, and reoperations with non-β-lactam prophylaxis.

Outcomes of synthetic and biologic mesh in abdominal wall reconstruction: A propensity-matched analysis in Centers for Disease Control and Prevention class 1 and 2 wounds.

Introduction: The choice of biologic compared with synthetic mesh in abdominal wall reconstruction remains controversial, especially in Centers for Disease Control and Prevention class 1 and 2 wounds. This study evaluated wound complications and hernia recurrence with a 2:1 propensity-matched sample and extended follow-up.

Methods And Procedures: A prospectively maintained abdominal wall reconstruction database was queried for patients undergoing open abdominal wall reconstruction using biologic or synthetic mesh in Centers for Disease Control and Prevention class 1 and 2 wounds.

Comparison of Medical Research Abstracts Written by Surgical Trainees and Senior Surgeons or Generated by Large Language Models.

Importance: Artificial intelligence (AI) has permeated academia, especially OpenAI Chat Generative Pretrained Transformer (ChatGPT), a large language model. However, little has been reported on its use in medical research.

Objective: To assess a chatbot's capability to generate and grade medical research abstracts.

The carolinas crossover, a preperitoneal crossover for enhanced-view totally extraperitoneal (eTEP) ventral hernia repair (VHR): a novel technique.

Purpose: To present a novel technique of preperitoneal cross-over for eTEP VHR.

Methods: Patients who underwent robotic eTEP with mesh utilizing a preperitoneal cross over technique were identified using a single-institution hernia database. This novel technique involves minimally invasive access to the retro-rectus space on one side with midline cross over into the preperitoneal space on the contralateral side.

The benefits of preoperative smoking cessation on abdominal wall reconstruction outcomes: An examination of abstinent versus never smokers.

Introduction: Active smoking is related to wound and respiratory complications following abdominal wall reconstruction (AWR), but no AWR studies directly compare outcomes of abstinent-smokers (AS), fulfilling four-weeks of smoking cessation, to non-smokers (NS).

Methods: Prospectively maintained institutional database was queried for all AWR between 2012 and 2019. AS and NS were included.

Deep learning model utilizing clinical data alone outperforms image-based model for hernia recurrence following abdominal wall reconstruction with long-term follow up.

Background: Deep learning models (DLMs) using preoperative computed tomography (CT) imaging have shown promise in predicting outcomes following abdominal wall reconstruction (AWR), including component separation, wound complications, and pulmonary failure. This study aimed to apply these methods in predicting hernia recurrence and to evaluate if incorporating additional clinical data would improve the DLM's predictive ability.

Methods: Patients were identified from a prospectively maintained single-institution database.

Machine learning, deep learning and hernia surgery. Are we pushing the limits of abdominal core health? A qualitative systematic review.

Introduction: This systematic review aims to evaluate the use of machine learning and artificial intelligence in hernia surgery.

Methods: The PRISMA guidelines were followed throughout this systematic review. The ROBINS-I and Rob 2 tools were used to perform qualitative assessment of all studies included in this review.

Open repair of flank and lumbar hernias: 142 consecutive repairs at a high-volume hernia center.

Background: Flank and lumbar hernias (FLH) are challenging to repair. This study aimed to establish a reproducible management strategy and analyze elective flank and lumbar repair (FLHR) outcomes from a single institution.

Methods: A prospective analysis using a hernia-specific database was performed examining patients undergoing open FLHR between 2004 and 2021.

The Utilization of Laparoscopic Ventral Hernia Repair (LVHR) in Incarcerated and Strangulated Cases: A National Trend in Outcomes.

Introduction: Early after its adoption, minimally invasive surgery had limited usefulness in emergent cases. However, with improvements in equipment, techniques, and skills, laparoscopy in complex and emergency operations expanded substantially. This study aimed to examine the trend of laparoscopy in incarcerated or strangulated ventral hernia repair (VHR) over time.

Factors Associated With Respiratory Failure After Open Ventral Hernia Repair: An Evaluation of the NSQIP Database.

An analysis of ACS-NSQIP open ventral hernia repair (OVHR) data (2017-2019) was performed. Respiratory failure (RF) occurred in 643 patients (1%) and not in 63,213 (99%) (nRF). Respiratory failure patients were older (63.

Missing the Mark: Evaluating the Validity of the Ventral Hernia Screen in Detecting Recurrence.

Purpose: Hernia recurrence is a primary metric in evaluating the success of ventral hernia repair (VHR). Current screening methods for hernia recurrence, including the validated Ventral Hernia Screening (VHS) questionnaire, have not yet been critically evaluated. The purpose of this study was to evaluate the predictive value of the VHS for hernia recurrence.

Disparate potential for readmission prevention exists among inpatient and outpatient procedures in a minimally invasive surgery practice.

Background: Administrators have focused on decreasing postoperative readmissions for cost reduction without fully understanding their preventability. This study describes the development and implementation of a surgeon-led readmission review process that assessed preventability.

Methods: A gastrointestinal surgical group at a tertiary referral hospital developed and implemented a template to analyze inpatient and outpatient readmissions.

Early warning: End-tidal carbon dioxide is associated with central venous oxygenation under continuous cardiorespiratory monitoring in a porcine model of hemorrhagic shock and resuscitation.

Background: End-tidal carbon dioxide (ETCO) has previously shown promise as a predictor of shock severity and mortality in trauma. ETCO monitoring is non-invasive, real-time, and readily available in prehospital settings, but the temporal relationship of ETCO to systemic oxygen transport has not been thoroughly investigated in the context of hemorrhagic shock.

Methods: A validated porcine model of hemorrhagic shock and resuscitation was used in male Yorkshire swine (N ​= ​7).

Defining surgical risk in octogenarians undergoing paraesophageal hernia repair.

Background: With an aging population, the utility of surgery in elderly patients, particularly octogenarians, is of increasing interest. The goal of this study was to analyze outcomes of octogenarians versus non-octogenarians undergoing paraesophageal hernia repair (PEHR).

Methods: The Nationwide Readmission Database was queried for patients > 18 years old who underwent PEHR from 2016 to 2018.

Prospective, international analysis of quality of life outcomes in recurrent versus primary ventral hernia repairs.

Background: Quality of life (QOL) has become a key outcome measure following ventral hernia repair (VHR), but recurrent and primary VHR have not been compared in this context previously.

Methods: The International Hernia Mesh Registry (2008-2019) was used to identify patients with QOL data scored by the Carolinas Comfort Scale preoperatively and postoperatively at 1 year.

Results: Repairs were performed in 227 recurrent and 1,122 primary VHs.

The incidence and impact of enterotomy during laparoscopic and robotic ventral hernia repair: a nationwide readmissions analysis.

Introduction: Our aim was to define the national incidence of enterotomy (ENT) during minimally invasive ventral hernia repair (MIS-VHR) and evaluate impact on short-term outcomes.

Methods: The 2016-2018 Nationwide Readmissions Database was queried using ICD-10 codes for MIS-VHR and enterotomy. All patients had 3-months follow-up.

Preservation of deep epigastric perforators during anterior component separation technique (ACST) results in equivalent wound complications compared to transversus abdominis release (TAR).

Purpose: The use of component separation results in myofascial release and increased rates of fascial closure in abdominal wall reconstruction(AWR). These complex dissections have been associated with increased rates of wound complications with anterior component separation having the greatest wound morbidity. The aim of this paper was to compare the wound complication rate between perforator sparing anterior component separation(PS-ACST) and transversus abdominus release(TAR).

State-of-the-art abdominal wall reconstruction and closure.

Open ventral hernia repair is one of the most common operations performed by general surgeons. Appropriate patient selection and preoperative optimization are important to ensure high-quality outcomes and prevent hernia recurrence. Preoperative adjuncts such as the injection of botulinum toxin and progressive preoperative pneumoperitoneum are proven to help achieve fascial closure in patients with hernia defects and/or loss of domain.