Predicting fascial non-closure in ventral hernia repair with transversus abdominis release: risk factors, clinical outcomes, and implications for surgical planning.

Background: Posterior components separation with transversus abdominis release (TAR) reduces tension on the anterior and posterior fascial elements in complex ventral hernia repairs, but its use does not ensure complete fascial closure. This study evaluates the relationship between hernia size and anterior fascial closure success rates following TAR and identifies predictive factors for non-closure.

Methods: We retrospectively analyzed 1,677 patients who underwent open ventral hernia repair with TAR and synthetic mesh placement at a single institution from 2014 to 2023.

Subjective workload in operating room team members during robotic hernia procedures.

While robotic surgery has been dominated by a single platform in the United States for over 25 years, the introduction of new robotic systems may have an impact on subjective workload. Therefore, we aimed to establish baseline workload measurements for operating room team members using the DaVinci surgical robot during robotic hernia procedures, providing reference points for evaluating team adaptation as new robotic platforms are introduced. Within the operating room, subjective workload refers to the physical, cognitive, and temporal demands experienced during surgical procedures.

Mesh-related Outcomes of Biologic versus Synthetic Mesh for Single-stage Repair of Contaminated Ventral Hernias: A Five to Ten Year Analysis of a Randomized Controlled Trial.

Objective: To determine the five- to ten-year safety and durability outcomes of biologic versus synthetic mesh in contaminated ventral hernia repair.

Summary Of Background Data: Recent randomized controlled trials have demonstrated the safety and efficacy of synthetic mesh in clean-contaminated and contaminated ventral hernia repairs, but follow-up has typically been limited to two years. Concerns persist regarding long-term outcomes of synthetic mesh beyond this initial period.

Comparing robotic to open retromuscular ventral hernia repair: a multi-center propensity-matched analysis.

Introduction: Robotic retromuscular ventral hernia repair (r-RVHR) may benefit patients by converting an open surgery (o-RVHR) to a minimally invasive approach. Current comparative trials are limited by small patient cohorts and exploratory outcomes. This study compares short- and long-term outcomes of robotic versus open retromuscular ventral hernia repairs using a nationwide registry.

Does prior mesh infection matter? Clinical outcomes of patients undergoing complex abdominal wall reconstruction after infected mesh explantation.

Background: While mesh infection after ventral hernia repair often requires explantation and subsequent repair, the association between prior mesh infection with outcomes following complex abdominal wall reconstruction remains poorly understood.

Methods: A two-stage propensity score-matched analysis was performed using the Abdominal Core Health Quality Collaborative database. Patients undergoing clean, elective, open ventral hernia repair with prior mesh infections were compared with those with no prior wound morbidity and non-mesh-related surgical site infections (SSIs).

Development of a risk score to predict occurrence of deep sternal dehiscence requiring operative debridement.

Objective: Severe deep sternal wound (DSW) complications after cardiac surgery are a source of cost, morbidity, and mortality. Our objective was to develop and validate a clinical risk score for predicting risk of DSW requiring operative bone debridement, the most severe form of sternal dehiscence.

Methods: A retrospective review was conducted of patients who underwent open cardiac surgery at a single institution between October 2007 and March 2019.

Functional side-to-side splenorenal shunts to treat extrahepatic portal vein thrombosis in children.

Background: Surgical shunts are commonly used to manage complications resulting from extrahepatic portal vein thrombosis (EHPVT) in children. We describe a single-center experience utilizing a functional Side-to-Side Splenorenal Shunt (fSRS), created using either an enlarged inferior mesenteric vein (IMV) or left adrenal vein (LAV).

Methods: Pediatric patients with isolated EHPVT who were poor candidates for a Rex shunt and who underwent a fSRS procedure at our institution between 2003 and 2020 were reviewed.

Midaortic syndrome and renovascular hypertension.

Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta with or without the involvement of branch vessels. The majority of cases are thought to be idiopathic though MAS has been associated with a number of conditions including granulomatous vasculitis, neurofibromatosis-1 (NF-1), Alagille Syndrome, fibromuscular dysplasia (FMD), and Williams syndrome. Patients typically present with hypertension due to decreased renal perfusion.

Comparison of Various Modalities Utilized for Preoperative Planning in Microsurgical Reconstructive Surgery.

Background:  The benefits of preoperative perforator imaging for microsurgical reconstruction have been well established in the literature.

Methods:  An extensive literature review was performed to determine the most commonly used modalities, and their applicability, advantages and disadvantages.

Results:  The review demonstrated varioius findings including decreases in operative time and cost with the use of CT angiography to identification of perforators for inclusion in flap design with hand-held Doppler ultrasound.

Trends in Surgical Patents Held by Surgeons From 1993 to 2018.

Objective: This study aims to quantify the number of patent-holding surgeons and determine their specialty demographics.

Summary Background Data: The number of intellectual property filings related to surgery has exponentially increased over the past 40 years, yet surgeon inventor status among these inventions remains poorly defined.

Methods: A query of the United States Patent and Trademark Office (USPTO) Patent Full-Text and Image Database was performed over the years 1993 to 2018.