The influence of a multidisciplinary team meeting and prehabilitation on complex abdominal wall hernia repair outcomes

Jong, Dite L. C. de; Wegdam, Johannes A.; Berkvens, E B M; Nienhuijs, Simon W.; Reilingh, T. S. de Vries

doi:10.1007/s10029-023-02755-6

Cited by 9 publications

(2 citation statements)

References 41 publications

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“…A "hernia optimization clinic" was shown to improve risk management and even increase operative yield by operating patients previously deemed inoperable. Furthermore, case discussion in a multidisciplinary team followed by a preconditioning programme could recompense the increased risk of complications associated with the presence of risk factors [9,45].…”

Section: Implementing a Prehabilitation Clinicmentioning

confidence: 99%

Prehabilitation: Enhancing Recovery and Outcomes in Hernia Surgery

Paiva de Oliveira,

Maillo

2023

Hernia Updates and Approaches

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As patients get older and clinical situations become more complex, optimization before surgery is paramount. Physicians always tried to improve the pre-surgical status of patients, but they followed stochastic models. The structured intervention to improve nutritional status, cardiorespiratory and neurocognitive function and minimize frailty has been called prehabilitation. It improves functional status before and after surgery in multiple settings suggesting a possible lower length of stay, as documented by several RCTs, and improved outcomes. Hernia surgery has evolved immensely in the past decades, providing solutions for patients and situations not long ago deemed inoperable. For incisional hernia, especially if complex, the recurrence rate may increase to 60%, most of which occur in the first 2 years. The difficulty rises for each repair attempt, so teams have their best opportunity in the first intervention. Most complex hernias started as simple ones. Prehabilitation interventions may contribute to outcome optimization in hernia surgery.

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Section: Implementing a Prehabilitation Clinicmentioning

confidence: 99%

Prehabilitation: Enhancing Recovery and Outcomes in Hernia Surgery

Paiva de Oliveira,

Maillo

2023

Hernia Updates and Approaches

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“…In a systematic review by Deerenberg, large hernias (>10 cm) were classified as 'simple' in 80% and as 'complex' (involving tissue loss, intra-abdominal infection, infected mesh, or parastomal hernia repair) in 20% of cases. The most recent definition is abdominal wall hernia complex if it exhibits at least one of the following factors: width exceeding 10 cm, parastomal hernia, infected mesh, presence of a stoma, fistula or abscess, or loss of domain greater than 20% [ 4 ]. Patients with at least one modifiable risk factor, such as a body mass index (BMI) > 30 kg/m 2 , active nicotine use, diabetes mellitus (HbA1c > 6.5), chronic obstructive pulmonary disease (COPD) (beyond Gold I), use of immunosuppressive medication, or a metabolic equivalent (MET) score < 4, fall into this category.…”

Section: Introductionmentioning

confidence: 99%

Exploring Variable Approaches in Complex Hernia Repair: A Comprehensive Literature Review

Meza-Hernandez,

Huchim-Servín,

Escamilla-Lopez

et al. 2024

Cureus

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Surgeons have long grappled with categorizing complex hernias, leading to varied interpretations and fluctuating incidence rates. Complex Abdominal Wall Reconstruction (CAWR) addresses repairs for large hernias, with defined factors including size, previous repairs, mesh placement, infections, and comorbidities. This review explores pivotal surgical techniques for complex hernia repair, starting with Preoperative Progressive Pneumoperitoneum (PPP) and progressing to innovative methods like Botulinum Toxin Type A. Mesh fixation, both open and laparoscopic, plays a crucial role, with synthetic and biological mesh options discussed. Hybrid techniques and the "sandwich" approach are proposed for intricate cases. Each technique presents advantages and limitations, emphasizing the ongoing quest for optimal outcomes.

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„Loss of domain“ und Verringerung der medianen Nahtspannung

Eucker,

Rosenberg

2023

Chirurgie

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The influence of a multidisciplinary team meeting and prehabilitation on complex abdominal wall hernia repair outcomes

Cited by 9 publications

References 41 publications

Prehabilitation: Enhancing Recovery and Outcomes in Hernia Surgery

Prehabilitation: Enhancing Recovery and Outcomes in Hernia Surgery

Exploring Variable Approaches in Complex Hernia Repair: A Comprehensive Literature Review

„Loss of domain“ und Verringerung der medianen Nahtspannung

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