Endoscopic-assisted repair of combined ventral hernias and diastasis recti: minimizing seroma incidence by quilting.

Background: To reduce the incidence of seromas, we have adapted the quilting procedure used in open abdominoplasty to the endoscopic-assisted repair of concomitant ventral hernia (VH) and diastasis recti (DR). The aim of this study was to describe the technique and assess its efficacy by comparing two groups of patients operated on with the same repair technique before and after introducing the quilting.

Methods: This retrospective study included data prospectively registered in the French Club Hernie database from 176 consecutive patients who underwent surgery for concomitant VH and DR via the double-layer suturing technique.

Minimally invasive bilayer suturing technique for the repair of concomitant ventral hernias and diastasis recti.

Background: According to EHS guidelines, mesh repair is recommended in case of concomitant diastasis recti (DR) and ventral hernia more than 1 cm in diameter. Since in this situation, the higher risk of hernia recurrence may be attributed to the weakness of aponeurotic layers, in our current practice, for hernias up to 3 cm, we use a bilayer suture technique. The study aimed at describing our surgical technique and evaluating the results of our current practice.

Mid-term results of VTEP (Ventral hernia repair by Totally ExtraPeritoneal approach).

Background: Techniques of retromuscular repair of ventral hernias aim at avoiding complications linked to intraperitoneal patch. Aim of the study was to evaluate results of the VTEP technique.

Methods: On 187 patients who underwent a VTEP, evaluation was carried out on 128 patients with a minimum follow-up of 1 year.

Stapled VTEP (sVTEP), diastasis and the "swollen abdomen".

Background: In the VTEP series, some patients declared that their abdomen was "somewhat swollen", and the authors suggested that this might be related to disruption of the posterior sheath due to the crossing. Following this observation, we decided to evaluate the systematic repair of the posterior sheath.

Methods: In 50 consecutive patients operated for ventral hernias, the VTEP procedure was modified, using the linear stapler to perform simultaneous division and closure of the posterior sheath.

Ventral hernia repair by totally extraperitoneal approach (VTEP): technique description and feasibility study.

Background: The repair of ventral hernias by intra-peritoneal patch (IPOM) involves a risk of pain due to stapling as well as intestinal adhesions. Extraperitoneal placement of the patch without fixation can prevent these drawbacks. Techniques of endoscopic preperitoneal repair were previously described by others.

Transinguinal preperitoneal patch (TIPP) under local anesthesia with sedation.

Transinguinal preperitoneal placement of the patch (TIPP) combines the advantages of the preperitoneal patch and the simplicity of the inguinal approach. The aim of the study was to evaluate the feasibility of TIPP under local anesthesia (LA) with sedation on a series of unselected patients. All 161 patients referred to one of us for inguinal hernia repair were included in a prospective evaluation; they were operated on for 169 inguinal hernias, in LA with sedation.

Effect of lopinavir/ritonavir monotherapy on quality of life and self-reported symptoms among antiretroviral-naive patients: results of the MONARK trial.

Background: Standard-of-care for HIV-infected patients consists of combining three antiretroviral drugs. However, other therapeutic strategies could be beneficial given long-term toxicity and quality of life (QOL) issues associated with taking multiple antiretroviral drugs for many years. In the prospective, open label, randomized, pilot monotherapy antiretroviral Kaletra (MONARK) trial among antiretroviral-naive patients, lopinavir/ritonavir (LPV/r) monotherapy was found to be less suppressive for HIV RNA than a standard triple-drug therapy of LPV/r plus zidovudine/lamivudine (on-treatment analysis after 48 weeks).