Assessment of ideal ratio of mesh area to number of fixation tacks in laparoscopic ventral and incisional IPOM Plus hernia repair.

Background: To clarify the optimum mesh-tack ratio MTR (mesh area in cm divided by the number of fixation tacks) in laparoscopic ventral and incisional hernia repair, we compared IPOM Plus procedures with more intensive mesh fixation to those with standard mesh fixation.

Methods: In a retrospective cohort study, 84 patients (mean hernia width 6.6 ± 4.

Comparison of mesh fixation devices for laparoscopic ventral hernia repair: an experimental study on human anatomic specimens.

Background: As there is a lack of clarity in terms of the tensile strength of mesh fixation for laparoscopic ventral hernia repair (LVHR), our aim was to investigate the immediate tensile strength of currently available mesh fixation devices on human anatomic specimens.

Methods: Sixteen recently deceased body donators (mean body mass index of 24.4 kg/m) were used to test the immediate tensile strength (Newton) of 11 different LVHR mesh fixation devices.

[Individualized or standard approach to the abdomen : Currently available data].

Background: Every abdominal incision can lead to early (e. g. abdominal infection) and late complications (e.

Needlescopic Surgery Versus Single-port Laparoscopy for Inguinal Hernia.

Background And Objectives: In recent years, 2 modifications of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair-needlescopic (nTAPP) surgery and single-port (sTAPP) surgery-have greatly improved patient outcomes over traditional approaches. For a comparison of these 2 modifications, we sought to investigate and compare the extent of surgical trauma and postoperative consequences for the abdominal wall in these two procedures.

Methods: In a retrospective study, 50 nTAPP and 35 sTAPP procedures occurring at a community hospital from November 1, 2009, through July 31, 2012 were reviewed.

Impact of two extubation techniques on the intra-abdominal pressure: a preliminary study.

Purpose: High pressure peaks might be a risk factor for the development of abdominal hernia. The course of abdominal pressure during extubation remains unclear. This preliminary study assessed the impact of two established extubation techniques.

The application of the V-Loc closure device for gastrointestinal sutures: a preliminary study.

Background: Leakage is one of the major complications in gastrointestinal surgery. This preliminary study compared a new barbed absorbable thread for gastrointestinal sutures with monofil suture material in a cadaver model.

Methods: In this study, mechanical experiments were performed in 20 recently deceased individuals.

Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair.

Background: Mesh tearoff from the tissue is the most common reason for hernia recurrence after hernia surgery involving the use of a synthetic mesh. Various fixation systems were critically compared in terms of their retention strength and the formation of adhesions.

Methods: In a prospective study with 25 Sprague-Dawley rats, two pieces of Parietex composite meshes measuring 2 x 3 cm were fixed intraperitoneally in a paramedian location.

Clinically diagnosed groin hernias without a peritoneal sac at laparoscopy--what to do?

Background: Groin or femoral hernias may be concealed behind intact peritonea when the laparoscopic transabdominal preperitoneal (TAPP) mesh technique is used. The aim of this study was to determine the causes, frequency, and surgical procedures in cases of clinically diagnosed hernias without peritoneal defects.

Methods: A prospective controlled study comprising 1795 consecutive patients undergoing 2190 laparoscopic TAPP herniorraphies was conducted.

Influence of a new self-gripping hernia mesh on male fertility in a rat model.

Background: The number of mesh-based therapies of inguinal hernias is increasing compared with the classical suture techniques such as Shouldice and Bassini. Many different types of meshes with regard to material, pore size and surface coating are available. A recently offered mesh (Parietene Progrip) combines the properties of a standard lightweight polypropylene mesh with a whole surface fixation by incorporation of micro hooks.

Anatomical changes after inguinal hernia treatment: a reason for chronic pain and recurrent hernia?

Background: Chronic pain and hernia recurrence are the most frequent long-term complications of treating inguinal hernia. One reason may be postsurgical changes in the anatomy of the groin.

Methods: In a retrospective investigation from 1994 to 2008, 1,194 patients undergoing 1,421 laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphies were studied.

Comparison of a new self-gripping mesh with other fixation methods for laparoscopic hernia repair in a rat model.

Background: Microhooks are small structures on the surface of the Progrip (PG; Sofradim Corp) mesh to ensure its anchorage in tissue. Additional fixation is not required. The aim of this animal study was to compare the strength of incorporation, foreign body reaction, and changes in material after implantation of this novel mesh with the current fixation alternatives, namely the hernia stapler (HS) and fibrin glue (FG).

Biomechanical properties of lightweight versus heavyweight meshes for laparoscopic inguinal hernia repair and their impact on recurrence rates.

Background: Laparoscopic inguinal hernia repair can be performed using light- or heavyweight meshes. Apart from the size of the mesh, its friction coefficient (mu(0)) and flexural stiffness are of crucial importance to avoidance of hernia recurrence.

Methods: In the current biomechanical study, tensile tests were performed to determine the ultimate tensile strength and modulus of elasticity of six lightweight meshes and six heavyweight meshes for laparoscopic inguinal hernia repair.

Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial.

Background: The aim of this prospective randomized multicenter trial was to evaluate the recurrence rates and complications of open versus laparoscopic repairs of inguinal hernias.

Methods: Patients with primary unilateral inguinal hernias were randomized to Shouldice repair, Bassini operation, tension-free hernioplasty (Lichtenstein repair), laparoscopic transabdominal extraperitoneal hernioplasty (TEP), or laparoscopic transabdominal preperitoneal hernioplasty (TAPP). The primary outcome parameter was the rate of recurrence at 3 years.

Preliminary results with the reinforced tension line: a new technique for patients with ventral abdominal wall hernias.

Background: After median laparotomy, excessive horizontal tensile forces on the suture base or scar tissue lead to incisional hernias or recurrent hernias. Our new suture technique, known as reinforced tension line (RTL), allows peak tensile forces to be distributed from the suture base to the surrounding tissue through a longitudinal suture, thereby preventing the suture from cutting through the tissue.

Methods: From April 2002 to April 2005, the RTL technique was used to treat 103 patients with ventral abdominal wall hernias > or = 3 cm in size.

Measurement of the tensile strength of the ventral abdominal wall in comparison with scar tissue.

Background: Paramedian laparotomies lead to incisional hernias in approximately 30% of cases. In contrast, incisional hernias occur very rarely in the linea alba or the ventral abdominal wall. In this setting we investigated the difference between scar tissue and the non-incised abdominal wall tissue.

Mesh fixation with the helical fastener in laparoscopic herniorrhaphy: initial results.

In laparoscopic herniorrhaphy, an alternative to mesh fixation with a stapler is now offered by the helical fastener. The helical fastener was used in 46 patients (39 men and 7 women) with 30 unilateral and 15 bilateral inguinal hernias and 1 femoral hernia. We also used a 5-mm optical system, with which we were able to reduce the size of the trocar incisions.

Static calculations for mesh fixation by intraabdominal pressure in laparoscopic extraperitoneal herniorrhaphy.

In laparoscopic extraperitoneal herniorrhaphy, there have been no static calculations for nonfixed prostheses with regard to the ideal size of the prosthesis, mesh overlap on the hernial orifice, friction coefficient, and shear forces. The aim of the present study was to perform these static analyses. The friction coefficient of a polypropylene mesh was measured in an experimental setting.

Selection of patients for laparoscopic antireflux surgery.

Since the first laparoscopic fundoplication was performed, the frequency of antireflux surgery has increased rapidly with some centers now having an experience of about 1,000 procedures. The question arises whether this increase is due to a change in indications for the surgical treatment of gastrointestinal reflux disease (GERD) despite the simultaneous appearance of powerful antisecretory medications. Adequate knowledge of the pathophysiology of GERD is necessary in order to establish selection criteria for patients suitable for laparoscopic antireflux surgery.

Bursting strength evaluation after different types of mesh fixation in laparoscopic herniorrhaphy.

Background: In laparoscopic inguinal herniorrhaphy, meshes commonly have been fixed with a stapler. Recently, a new mode of fixation using a helical fastener has been introduced. The purpose of this experimental study was to compare the stability achieved by various types of mesh fixation.

[Reinterventions in anaplastic cancers and sarcomas of the thyroid gland].

In the years 1979-1988, operations were performed on 41 anaplastic carcinomas and 11 sarcomas of the thyroid gland. Out of these cases reoperation was indicated in 18 patients (34.6%): in 11 cases only a palliative tracheotomy could be done (group I), whilst in the remaining 7 patients surgical removal of the recurrent tumour was possible (group II).

[Prognostic factors in highly malignant thyroid tumors].

Patients diagnosed as suffering from highly malignant thyroid tumours die within a few months due to rapid tumour progression. Survival depends on some valuable prognostic factors, namely tumour size, lymph node involvement, metastatic status, fast tumour growth and preoperative N. recurrens paresis.

[Malignant lymphomas of the thyroid gland].

In the period from 1957-1989 43 malignant lymphomas of the thyroid gland were treated in the surgical department of Kaiser Elisabeth hospital. 42 were classified as non-Hodgkin lymphomas and one as a Hodgkin lymphoma. The sex distribution was 32 women (mean age 70) to 11 men (mean age 72).