Hernia Repair Sequelae

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Volker Schumpelick, Robert J. Fitzgibbons
Springer Science & Business Media, Mar 10, 2010 - Medical - 529 pages
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Even the best hernia repair can result in postoperative difficulties for the patient caused by repair sequelae as for example pain, infertility, infection, adhesion and dislocation of the protheses. That can happen many years later and now, where the general principle of hernia repair is well understood all over the world, these sequelae are noticed more and more. To define them, to evaluate the absolute and relative risk of these sequelaes and to describe the ways of their prevention, diagnosis and treatment, the 5th Suvretta meeting had focussed on this subject. We discussed if there’s a principle risk by technique, material or both. The results of these discussions and the future handling and evaluation of this problem was the aim of this meeting. Even the best method can be made better by optimization of its single components.

Even the best hernia repair can result in postoperative difficulties for the patient caused by repair sequelae such as pain, infertility, infection, adhesion and dislocation of the prostheses. This can happen many years later, and now that the general principle of hernia repair is broadly understood all over the world, these sequelae are being noticed more and more. The 5th Suvretta meeting was held in order to define these sequelae, to evaluate the absolute and relative risks they pose, and to discuss the methods of their prevention, diagnosis and treatment. We discussed whether the principal risk was related to technique, material or both. This discussion and the future approach to and evaluation of this problem were the aims of the meeting, working on the premise that even the best method can be made better by optimizing its individual components.

 

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Contents

1 Are There Adverse Effects of Herniorrhaphy Techniques on Testicular Perfusion?
3
2 The Effects of Mesh Bioprosthesis on the Spermatic Cord Structures in a Rat Model
13
3 Damage to the Spermatic Cord by the Lichtenstein Procedure in a Pig ModelPreliminary Results
20
4 Influence of Prosthetic Implants on Male Fertility in Rabbits and Rats
29
5 The Effects of a Mesh Bioprosthesis on the Spermatic Cord Structures
39
6 Influence of Prosthetic Implants on Male Fertility in Rats
43
7 What Can We Do To Decrease the Risk of Vas Deferens Injury due to Inguinal Hernioplasty?
49
8 The LongTerm Effect on Testicular Function of a Mesh Bioprosthesis Used for Inguinal Hernia Repair
56
37 Lightweight Macroporous Mesh vs Standard Polypropylene Mesh in Lichtenstein Hernioplasty
275
38 Does the Choice of Prosthetic Mesh Type Make a Difference in Postherniorrhaphy Groin Pain?
278
39 New Understanding of the Causes and Surgical Treatment of Postherniorrhaphy Inguinodynia and Orchialgia
287
Neurectomy Mesh Explantation or Both?
293
41 Results of Tailored Therapy for Patients with Chronic Inguinal Pain
299
IV Risk for Adhesion
302
42 Adhesion as a Chronic Inflammatory Problem? Risk for Adhesions Migration and Erosions?
303
Present Status
317

What Do Vas and Nerves Look Like?
65
A Review
71
II Risk for Infection
76
A Frequent Problem?
79
12 Patient Factors as a Major Determinant of Wound Outcome and Infection After Surgery
86
13 MeshRelated Infections After Hernia Repair
97
14 Human Acellular Dermal Matrix for Ventral Hernia Repair in the Compromised Surgical Field
103
15 Fate of the Inguinal Hernia Following Removal of Infected Prosthetic Mesh
112
16 Mesh InfectionTherapeutic Options
119
17 Does Antibiotic Prophylaxis Prevent the Occurrence of Wound Infection After Groin Hernia Surgery?
125
24Year Results of Aseptic and Antiseptic Measure Implementation in 4620 Clean Cases Based on UpToDate Microbiological Research
135
Pros and Cons
142
III Risk for Pain
152
A Reflection of Both Individual Pain Propensity and Surgical Strategy
155
21 Chronic Pain After Inguinal Hernia Repair
163
22 What Do We Know About the Pathophysiology and Pathology of Neuropathic Pain?
168
23 Surgical Trauma of NervesCauses of Neuropathic Pain Classification and Options in Surgical Therapy
177
How Should We Handle the Nerves?
184
25 What To Consider as Clinicians About Chronic Postoperative Pain and Inguinal Herniorrhaphy
191
26 Risk Factors for Chronic Pain After Groin Hernia Surgery
198
27 Ischemic Inflammatory Response Syndrome as an Alternative Explanation for Postherniorrhaphy Pain
207
28 Postoperative CRPS in Inguinal Hernia Patients
213
29 Chronic Pain After Open Mesh Repair of Incisional Hernia
220
30 Clinical Results After Open Mesh Repair
227
31 Acute and Chronic Pain After Laparoscopic Incisional Hernia Repair
233
32 Effect of Nerve Identification on the Rate of Postoperative Chronic Pain Following Inguinal Hernia Surgery
238
A Report from the SMIL Study Group
245
The Lesser of Two Evils? A Review of PatientReported Outcomes from the VA Hernia Trial
251
The Choice of Prosthesis Outweighs That of Technique
256
36 The Effect of Polypropylene Mesh on the Ilioinguinal Nerve in Open Mesh Repair of Groin Hernia
265
44 IPOM Results of 344 Consecutive Patients with a PVDFDerived Prosthesis
323
14 Years of Patient Data Accrual
330
46 Tissue Ingrowth Adhesion and Mesh Contraction
345
47 Effect of Different Mesh Materials on Adhesion Formation
353
An Updated Review of the Literature
365
49 Porosity and Adhesion in an IPOM Model
375
50 Benefit of Lightweight andor Titanium Meshes?
380
51 ePTFE Prostheses and Modifications
393
52 The Role of Stem Cells in Abdominal Wall Repair
400
V Risk for Migration and Erosion
410
Lessons Learned from a 15 Year Experience
411
54 Mesh Migration into the Esophageal Wall After Mesh Hiatoplasty
421
55 Complications After Gastric BandingResults in Germany
429
56 Alloplastic Implants for the Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse
439
57 Prophylactic IPOM Mesh To Prevent Parastomal Hernias
445
Pitfalls and Complications
450
59 Concept of Visible Mesh and Possibilities for Analysis of Mesh Migration and Shrinkage
457
VI Strategy to Improve Results
461
The Surgeon or the Material?
462
Standard Procedure in a Standard Patient Versus Tailored Surgery with Procedures Adjusted to Individual Patients
467
VII Pro and Contra
473
62 In Support of a Standard Technique for Inguinal Hernia Repair
475
Groin Hernia
479
64 In Support of Standard Procedure in Abdominal Hernia Repair
485
65 In Support of Individualized Procedures in Abdominal Wall Hernia Repair
492
66 In Support of Standard Procedure in Hiatal Hernia Repair
503
67 Strategy To Improve the Results? In Support of Individualized Procedures in Hiatal Hernia Repair
513
68 Questionnaire
520
Subject Index
525
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