Combined open and laparoscopic approach for repair of flank hernias: technique description and medium-term outcomes of a single surgeon

Amaral, Pedro; Tastaldi, Luciano; Barros, Paulo Henrique Fogaça de; Neto, I. P. Abreu; Hernani, B. L.; Brasil, Hamilton Ribeiro; Mendes, Carlos José Lazzarini; Franciss, Maurice; Pacheco, André; Silva, R. Altenfelder; Roll, Sérgio

doi:10.1007/s10029-019-01880-5

Cited by 9 publications

(11 citation statements)

References 25 publications

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“…Other studies reporting on ventral hernia hybrid repair procedures appear to be promising as well [5,19,[26][27][28][29][30][31][32][33]. However, these studies included a low number of patients and multiple types of different hernias (primary, incisional, flank or stomal).…”

Section: Discussionmentioning

confidence: 99%

“…Other hybrid procedure studies reported intraoperative complications ranging from 0 to 16.7% [5,[28][29][30]33]. In the study that reported 16.7% intraoperative complications, they only treated patients with complex abdominal adhesions [23].…”

Section: Discussionmentioning

confidence: 99%

“…In the RCT by Ahonen-Siirtola et al [19], at 1-year follow-up, no statistically significant difference in hernia recurrence rates between both procedures was found (LIHR 7% vs hybrid incisional hernia repair 6%). Other hybrid incisional hernia repairs studies have a very low number of patients included in the studies, which makes it hard to draw conclusion about recurrence rates [27,29,30]. Recurrence rates found in LIHR are reported to be 9.7% (12 months)-24.0% (35 months) [17,40].…”

Section: Discussionmentioning

confidence: 99%

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A new three-step hybrid approach is a safe procedure for incisional hernia: early experiences with a single centre retrospective cohort

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Bus

et al. 2020

Hernia

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Purpose In this study, a three-step novel surgical technique was developed for incisional hernia, in which a laparoscopic procedure with a mini-laparotomy is combined: so-called ‘three-step incisional hybrid repair’. The aim of this study was to reduce the risk of intestinal lacerations during adhesiolysis and recurrence rate by better symmetrical overlap placement of the mesh. Objectives To evaluate first perioperative outcomes with this technique. Methods From 2016 to 2020, 70 patients (65.7% females) with an incisional hernia of > 2 and ≤ 10 cm underwent a elective three-step incisional hybrid repair in two non-academic hospitals performed by two surgeons specialised in abdominal wall surgery. Intra- and postoperative complications, operation time, hospitalisation time and hernia recurrence were assessed. Results Mean operation time was 100 min. Mean hernia size was 4.8 cm; 45 patients (64.3%) had a hernia of 1–5 cm, 25 patients (35.7%) of 6–10 cm. Eight patients had a grade 1 complication (11.4%), five patients a grade 2 (7.1%), two patients (2.8%) a grade 4 complication and one patient (1.4%) a grade 5 complication. Five patients had an intraoperative complication (7.0%), two enterotomies, one serosa injury, one omentum bleeding and one laceration of an epigastric vessel. Mean length of stay was 3.3 days. Four patients (5.6%) developed a hernia recurrence during a mean follow-up of 19.5 weeks. Conclusion A three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A new three-step hybrid approach is a safe procedure for incisional hernia: early experiences with a single centre retrospective cohort

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et al. 2020

Hernia

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“…It is defined as a hernia occurring lateral to the rectus muscle sheath, and within 3 cm above and below the umbilicus [ 3 ]. Most are incisional hernias from previous surgery for urologic procedures, aortic repair or iliac bone harvesting [ 4 ], and a smaller number are traumatic or congenital in origin. Flank incisional hernia occurs in ~17% of patients after nephrectomy or aortic repair [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Lack of familiarity among surgeons, difficulty determining extent of defect and weakness of surrounding tissues are other issues complicating repair [ 6 ]. In addition, there may be a flank bulge from concomitant abdominal muscle denervation from 11th and 12th thoracic nerve injury from the prior flank incision, which can persist postoperatively despite a successful hernia repair [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Hybrid laparoscopic and open repair of post-nephrectomy flank hernia

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Bruening

Bhattacharjya

2020

Journal of Surgical Case Reports

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Surgical repair of flank hernia is not routinely performed, due to perceived technical difficulties with the surgery and risk of recurrence, or the misconception that flank hernia is solely due to a denervation injury. Due to the rareness of flank hernia in the literature, there is no general consensus on the best method of surgical repair. We present the case of a patient with a symptomatic large flank hernia following open nephrectomy, in which a hybrid technique of open and laparoscopic flank hernia repair with sublay mesh and bone anchor fixation was successfully performed with good outcome. This case highlights the benefits of the hybrid approach, which allowed a laparoscopic assessment of the defect and adhesiolysis, followed by the open repair which enabled adequate mesh overlap, fixation to surrounding tissues and bone anchor fixation.

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