Evaluation of Long-term Performance of the GORE SYNECOR Intraperitoneal Biomaterial in the Treatment of Inguinal Hernias.

Background: The objective of this study was to analyze device safety and clinical outcomes of inguinal hernia repair with the GORE SYNECOR Intraperitoneal Biomaterial device, a hybrid composite mesh.

Methods: This retrospective case review analyzed device/procedure endpoints beyond 1 year in patients treated for inguinal hernia repair with the device. Three objectives were evaluated: procedural endpoint-incidence through 30 days of surgical site infection, surgical site occurrence (SSO), ileus, readmission, reoperation, and death; device endpoint-serious device incidence of mesh erosion, infection, excision/removal, exposure, migration, shrinkage, device-related bowel obstruction and fistula, and hernia recurrence through 12 months; and patient-reported outcomes of the bulge, physical symptoms, and pain.

Evaluation of long-term performance of an intraperitoneal biomaterial in the treatment of ventral hernias.

Background: One-year device safety and clinical outcomes of ventral hernia repair with the GORE® SYNECOR Intraperitoneal Biomaterial, a hybrid composite mesh was evaluated.

Methods: This retrospective, multicenter, case review analyzed device/procedure endpoints and patient-reported outcomes in patients treated for hernia repair ≥ 1 year from study enrollment.

Results: Included were 459 patients (with 469 ventral hernias) with a mean age of 58 ± 15 years; 77.

A Tailored Approach to Laparoscopic Fundoplication: Outcomes in Patients with Esophageal Dysmotility.

Background: Esophageal dysmotility is a common finding in patients being evaluated for antireflux surgery, although its implication remains unclear. We aimed to evaluate outcomes of patients with esophageal dysmotility after fundoplication.

Methods: A retrospective review of a prospective quality-database was performed.

Long-Term, Prospective, Multicenter Study of Poly-4-Hydroxybutyrate Mesh (Phasix Mesh) for Hernia Repair in Cohort at Risk for Complication: 60-Month Follow-Up.

Background: Long-term resorbable mesh represents a promising technology for ventral and incisional hernia repair (VIHR). This study evaluates poly-4-hydroxybutyrate mesh (P4HB; Phasix Mesh) among comorbid patients with CDC class I wounds.

Study Design: This prospective, multi-institutional study evaluated P4HB VIHR in comorbid patients with CDC class I wounds.

Patient-reported bowel and bladder function is not adversely impacted by bariatric surgery.

Introduction: This study aims to assess the effect of bariatric surgery on patient-reported outcomes of bowel and bladder function. We hypothesized that bariatric surgery does not worsen bowel and bladder function.

Methods And Procedures: A retrospective review was conducted of a prospectively maintained surgical quality database.

Subjective vs. objective assessment of simulation performance on laparoscopic cholecystectomy: are we evaluating the right things?

Background: Simulation using virtual reality (VR) simulators is an important tool in surgical training. VR laparoscopic simulators can provide immediate objective performance assessment without observer evaluation. This study aims to explore the correlation between subjective observer evaluation and VR laparoscopic simulator performance metrics in a laparoscopic cholecystectomy (LC) simulation module.

A modular simulation curriculum to teach endoscopic stenting to practicing surgeons: an "Into the fire" approach.

Background: Flexible endoscopy is a valuable tool for the gastrointestinal (GI) surgeon, creating a need for effective and efficient training curricula in therapeutic endoscopic techniques for trainees and practicing providers. Here, we present a simulation-based modular curriculum using an "into the fire" approach with hands-on pre- and post-testing to teach endoscopic stenting to practicing surgeons.

Methods: Three advanced flexible endoscopy courses were taught by expert surgical endoscopists from 2018 to 2019.

Crural closure, not fundoplication, results in a significant decrease in lower esophageal sphincter distensibility.

Introduction: The esophagogastric junction (EGJ) is a complex anti-reflux barrier whose integrity relies on both the intrinsic lower esophageal sphincter (LES) and extrinsic crural diaphragm. During hiatal hernia repair, it is unclear whether the crural closure or the fundoplication is more important to restore the anti-reflux barrier. The objective of this study is to analyze changes in LES minimum diameter (D) and distensibility index (DI) using the endoluminal functional lumen imaging probe (FLIP) during hiatal hernia repair.

Teaching EndoFLIP Impedance Planimetry to Practicing Endoscopists: An "Into the Fire" Approach to Simulation.

There are growing interests from practicing endoscopists to implement the functional lumen imaging probe (FLIP) impedance planimetry system. We present a simulation-based curriculum using an "into the fire" approach with hands-on pre- and post-tests to teach the use of this technology. The curriculum consists of a series of pre-tests, didactic content, mentored hands-on instructions, and post-tests.

Inguinal hernia mesh is safe in 1720 patients.

Background: There is substantial media and patient interest in the safety of mesh for hernia repair. However, there is a lack of data regarding health-related quality of life (HRQOL) outcomes in patients who undergo inguinal hernia repair (IHR) with mesh. The purpose of this study is report short and long-term postoperative quality of life outcomes in patients following IHR with mesh.

Prospective, multicenter study of P4HB (Phasix™) mesh for hernia repair in cohort at risk for complications: 3-Year follow-up.

Background: This study represents a prospective, multicenter, open-label study to assess the safety, performance, and outcomes of poly-4-hydroxybutyrate (P4HB, Phasix™) mesh for primary ventral, primary incisional, or multiply-recurrent hernia in subjects at risk for complications. This study reports 3-year clinical outcomes.

Materials And Methods: P4HB mesh was implanted in 121 patients via retrorectus or onlay technique.

Anti-reflux mucosectomy (ARMS) results in improved recovery and similar reflux quality of life outcomes compared to laparoscopic Nissen fundoplication.

Background: Anti-reflux mucosectomy (ARMS) is a new endoscopic procedure involving a hemi-circumferential endoscopic mucosal resection (EMR) around the gastroesophageal junction. We aim to compare perioperative and quality of life outcomes of patients with reflux who underwent ARMS to a comparable group who underwent laparoscopic Nissen fundoplication (NF).

Methods: A retrospective review of a prospectively maintained quality database was performed.

Comparing cost and outcomes between peroral endoscopic myotomy and laparoscopic heller myotomy.

Background: Peroral endoscopic myotomy (POEM) has previously been shown to be equally if not more expensive than laparoscopic Heller myotomy (LHM). We compare perioperative outcomes and charges between POEM and LHM at a single institution.

Methods: Outcomes and charge data of 33 patients who underwent LHM and 126 patients who underwent POEM were analyzed.

Teaching peroral endoscopic pyloromyotomy (POP) to practicing endoscopists: An "into-the-fire" approach to simulation.

Background: Peroral endoscopic pyloromyotomy, or gastric peroral endoscopic myotomy, is a novel endoscopic procedure for the treatment of refractory gastroparesis. We present a simulation-based curriculum using an "into-the-fire" approach with hands-on pre- and post-tests to teach this procedure.

Methods: Six, 1-day peroral endoscopic pyloromyotomy courses were taught by an expert surgical endoscopist in 2018 to 2019.

Predictors of chronic pain after laparoscopic inguinal hernia repair.

Background: Multiple studies have analyzed predictors for chronic pain after open hernia repair. The purpose of this study is to determine which factors predict the development of chronic pain after a laparoscopic inguinal hernia repair.

Methods: We identified patients who underwent laparoscopic inguinal hernia repair between 2008 and 2020 at a single institution.

Using a standardized intra-operative endoflip protocol during fundoplication to identify factors that affect distensibility.

Introduction: The Endoluminal Functional Lumen Imaging Probe (Endoflip) can be used to provide objective measurements of the gastroesophageal junction during fundoplication, and recent publications have suggested that this device could improve surgical outcomes. However, the impact of operative variables has not been clearly reported. The aim of this study is to determine the effect of these variables on functional lumen imaging probe (FLIP) measurements.

Comparing short-term patient outcomes after fundoplication performed over a traditional bougie versus a functional lumen imaging probe.

Background: The functional lumen imaging probe is a balloon-based catheter that can be used as a bougie during fundoplication. Our goal was to compare the short-term, quality-of-life outcomes and esophageal-injury rate after fundoplication over a functional lumen imaging probe compared to a traditional bougie.

Methods: This is a retrospective review of a quality database at a single center.

Use of Impedance Planimetry (Endoflip) in Foregut Surgery Practice: Experience of More than 400 Cases.

Background: We provide a comprehensive report of our institution's experience with the endoluminal functional lumen imaging probe (Endoflip) impedance planimetry system, a device that can be used intraoperatively to objectively evaluate the distensibility of any sphincter of the gastrointestinal tract. We aim to describe the variety of ways in which the Endoflip can be used in a foregut surgeon's practice.

Study Design: This is a retrospective review of a prospectively maintained quality database of all patients in which the functional lumen imaging probe (FLIP) system was used between February 2013 and June 2019.

Long-term outcomes after subtotal reconstituting cholecystectomy: A retrospective case series.

Background: Subtotal cholecystectomy, where the gallbladder infundibulum is transected to avoid dissecting within the triangle of Calot, has been suggested to conclude laparoscopic cholecystectomy while avoiding common bile duct injury. However, some reports suggest the possibility of recurrent symptoms from a remnant gallbladder.

Methods: A retrospective database containing 900 randomly selected cholecystectomies occurring between 2009 and 2015 was reviewed for instances of subtotal cholecystectomy.

Primary Care Physicians' Perceptions of Bariatric Surgery and Major Barriers to Referral.

Background: Each year from 2011 to 2017, fewer than 1% of eligible Americans underwent bariatric surgery to treat obesity and obesity-related comorbidities. Recent studies have suggested that a lack of knowledge within the primary care specialty about the safety and efficacy of bariatric surgery greatly affects referral. This study aimed to analyze a large cohort of primary care physicians' (PCPs) clinical perceptions regarding bariatric surgery and to identify major barriers to referral that could inform the implementation of a future educational strategy to address underutilization of bariatric surgery.

Predictors for recurrence after open umbilical hernia repair in 979 patients.

Background: Our study aims were to evaluate factors that predict recurrence after open umbilical hernia repair with either mesh or primary closure.

Methods: Consecutive patients (n = 1,125) undergoing open umbilical hernia repair from 2009 to 2018 were identified from a prospectively managed, quality database. Kaplan-Meier curves and log-rank tests were used to analyze recurrence-free survival for preoperative, intraoperative, and postoperative factors.