Background: Transversus abdominis release (TAR) is increasingly used to address complex ventral hernias; consequently, associated complications are seen more frequently. Our hernia center has a growing experience with redo-transversus abdominis release (redo-TAR) to address large, complex hernia recurrences after failed TAR. Here, we describe our outcomes after abdominal wall reconstruction with redo-TAR.
Study Design: Adults undergoing elective open, redo-TAR at our institution from January 2015 to February 2021 were queried from a prospectively collected database in the Abdominal Core Health Quality Collaborative. The primary outcome was 30-day wound morbidity. Secondary outcomes were long-term composite hernia recurrence and patient-reported quality of life.
Results: Sixty-five patients underwent redo-TAR. Median age was 60 years, 50.8% were female, and median BMI 31.8 kg/m. Median recurrent hernias were 16 cm wide by 25 cm long. Frequent mechanisms of recurrence included linea semilunaris injury (27.7%), mesh fracture (18.5%), infection (16.9%), and posterior sheath disruption (15.4%). Wound complications occurred in 33.8% and 16.9% required procedural intervention. With median clinical and PRO follow-up of 12 and 19 months, respectively, the composite hernia recurrence rate was 22.5% and patients reported significantly improved quality of life (HerQLes: median + 36.7, PROMIS: median - 9.5).
Conclusion: Redo-TAR may be performed as a salvage procedure to reconstruct complex defects after failed TAR, however, in our center, it is associated with increased wound morbidity and fairly high composite recurrence rates. Despite this, patients report improvements in quality of life and pain. Tracking outcomes after TAR will facilitate understanding how to manage its failures.
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http://dx.doi.org/10.1007/s10029-021-02457-x | DOI Listing |
J Robot Surg
December 2024
Mid-Florida Surgical Associates, Clermont, FL, 34711, USA.
Robotic assisted laparoscopy is increasingly popular for primary ventral and incisional hernia repair. A variety of robotic techniques have been described. More data is needed to evaluate the indications and benefits of these approaches.
View Article and Find Full Text PDFJ Laparoendosc Adv Surg Tech A
December 2024
Department of General Surgery, Aulss 5 Polesana, Viale Tre Martiri, Rovigo, Italy.
In the field of abdominal wall hernias, several innovative procedures have been developed, including the extended/enhanced-view totally extraperitoneal (eTEP) hernia repair technique. Initially introduced for laparoscopic hernia repair by J. Daes, it was subsequently applied to ventral hernia repair (VHR) and incisional hernia repair (IVHR) by I.
View Article and Find Full Text PDFSurgery
November 2024
Department of Surgery, Cleveland Clinic Center for Abdominal Core Health Cleveland Clinic Foundation, Cleveland, OH.
Background: Traumatic abdominal wall hernias are rare and commonly involve the lateral abdominal wall due to shearing off the oblique and transversus abdominis muscles from the iliac crest. The vast majority of the current literature focuses on the index trauma admission, includes few patients, and provides little to no detail about the hernia repair itself. We aim to report our center's high-volume experience with a definitive repair of chronic traumatic lateral abdominal wall hernias.
View Article and Find Full Text PDFHernia
November 2024
Head of Gastrointestinal surgical Department, Virgen Macarena Hospital, University of Seville, Seville, Spain.
Propose: The aim was to evaluate results in terms of intra and postoperative complications, hospital stay, postoperative pain, functional recovery, aesthetic results and recurrence rate of totally endoscopic retromuscular hernia repair(eTEP-TAR)compared to conventional laparoscopic incisional hernia repair with defect closure(IPOM+)for right subcostal incisional hernias.
Methods: Data from consecutive patients requiring conventional minimally invasive subcostal incisional hernia repair collected from January 2014 to December 2018 were compared with patients underwent eTEP from January 2019 to July 2024 in a case-control study.
Results: 51 patients in the IPOM + group and 46 in eTEP group were included.
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