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.

Comparing Ventral Hernia Repair Outcomes in Patients With and Without Liver Insufficiency.

Background: In patients with liver insufficiency, there is a high prevalence of ventral hernias. However, the decision to proceed with elective surgery must be balanced with the increased perioperative risk in patients with liver disease. Our study aimed to compare ventral hernia repair outcomes in patients with and without liver insufficiency.

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.

Characterizing a clinically significant radiographic parastomal hernia recurrence: post hoc analysis of a randomized controlled trial.

Introduction: Parastomal hernia recurrence is common but poorly defined. We aimed to correlate radiographic recurrence and reoperation for parastomal hernia recurrence with patient-reported outcomes (PROs) to determine the clinical significance of radiographic recurrence and identify potential screening tools.

Methods: Patient data in the one- and two-year follow-up windows of a registry-embedded randomized controlled trial comparing open retromuscular Sugarbaker and keyhole mesh parastomal hernia repairs (2019-2022) were analyzed.

Venous thromboembolism after ventral hernia repair with transversus abdominis release.

Introduction: Venous thromboembolism (VTE) events, such as pulmonary embolism (PE) and deep venous thrombosis (DVT), are a significant source of morbidity and mortality after major abdominal wall reconstruction. We aim to describe the incidence of VTE events in patients undergoing ventral hernia repair (VHR) with transversus abdominis release (TAR) at our institution.

Methods: The Abdominal Core Health Quality Collaborative registry was queried for patients, 18 years and older, who underwent VHR with TAR at our institution between August 2014 and December 2023.

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).

Preoperative weight loss for open abdominal wall reconstruction: study protocol for a randomized controlled trial.

Background: Obesity is widely recognized as a risk factor for poor outcomes following ventral hernia repair. This belief has led many surgeons to implement arbitrary body mass index (BMI) cutoffs, typically 35-40 kg/m, before offering elective hernia repair. These practices are based on low-quality evidence and create significant challenges for patients with symptomatic hernias who lack access to metabolic and bariatric surgery or obesity medications.

Lateral abdominal wall hernias after coughing: a single center experience.

Purpose: Forceful coughing is assumed to be an uncommon etiology for lateral abdominal wall hernias. The literature regarding this topic is very limited and there is a lack of consensus in management, both operative and non-operative. We aim to report our center's experience in repair of lateral abdominal wall hernias secondary to vigorous coughing.

Patient reported outcomes and decision regret scores in redo-paraesophageal hernia repair.

Introduction: Recurrent paraesophageal hernia (PEH) repair presents significant technical challenges, with limited data weighing the benefit to the operative risk. This study aims to describe our experience with recurrent PEH repair, including long-term surgical and patient reported outcomes (PROs).

Methods: We conducted a retrospective review of recurrent PEH repairs from June 2018-March 2023 using our institutional database.

Consensus in ERAS protocols for ventral hernia repair: evidence-based recommendations from the ACHQC QI Committee.

Purpose: Enhanced recovery after surgery (ERAS) protocols are widely used in the post-operative care of hernia patients. Despite their prevalence, an absence of published consensus guidelines creates significant heterogeneity in practices. The aim of this study was to evaluate elements in ERAS protocols utilized in ventral hernia repair from institutions across the United States and provide consensus recommendations for each identified element.

The role of chemotherapy in the management of pancreatic acinar cell carcinoma.

Introduction: Pancreatic acinar cell carcinoma (pACC) is a rare malignancy with unique clinical and molecular features. The role of chemotherapy in pACC management is not well established.

Methods: The National Cancer Database (NCDB) for pACC was used.

Research prioritization in hernia surgery: a modified Delphi ACHQC and VHOC expert consensus.

Purpose: Numerous clinical practice guidelines and consensus statements have been published in hernia surgery, however, there is still a need for high-quality evidence to address remaining unanswered questions. The aim of this study was to conduct research priority setting through a modified Delphi process to identify a list of top research priorities in hernia surgery.

Methods: A structured literature review of clinical practice guidelines was performed by the steering committee.

Women speaker representation at SAGES annual meetings: a cross-sectional analysis.

Background: Gender representation trends at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Annual Meetings and the effect of the 2018 'We R SAGES' initiatives are unknown. We assessed gender trends in oral presentations at the SAGES Annual Meeting between 2012 and 2022 with a focus on assessing the impact of the 2018 initiatives.

Methods: Abstracts selected for oral presentations from 2012 to 2022 were reviewed for presenter and first, second, and senior author gender.

The Role of Neoadjuvant Immunotherapy in the Management of Merkel Cell Carcinoma with Clinically Detected Regional Lymph Node Metastasis.

Background: Immunotherapy is emerging as a promising option for certain locally advanced and metastatic cutaneous malignancies. However, the role of neoadjuvant immunotherapy (NIO) in Merkel cell carcinoma (MCC) with clinically detected regional lymph node metastasis (CDRLNM) has not been fully elucidated.

Methods: For this study, MCC patients with CDRLNM who underwent surgical excision were selected from the National Cancer Database (NCDB).

The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair.

Introduction: Fixation of mesh during minimally invasive inguinal hernia repair is thought to contribute to chronic post-herniorrhaphy groin pain (CGP). In contrast to permanent tacks, absorbable tacks are hypothesized to minimize the likelihood of CGP. This study aimed to compare the rates of CGP after laparoscopic inguinal hernia repair between absorbable versus permanent fixation at maximum follow-up.

Examining the Role for Donor-specific Antibody Testing in Simultaneous Liver-kidney Transplantation: A Single-center Analysis of Outcomes.

Background: Simultaneous liver-kidney transplantation (SLKT) is increasingly used for patients with concurrent end-stage liver and renal disease. Emerging evidence suggests that simultaneous liver transplant can provide a tolerogenic benefit to multiorgan transplant recipients. Posttransplant donor-specific antibody (DSA) may be associated with worse outcomes; however, the role for testing DSA in SLKT is unclear.

Contemporary strategies to assess and manage liver donor steatosis: a review.

Purpose Of Review: Due to a persistent shortage of donor livers, attention has turned toward ways of utilizing marginal grafts, particularly those with steatosis, without incurring inferior outcomes. Here we review the evaluation and utilization of steatotic liver allografts, highlight recently published data, and discuss novel methods of graft rehabilitation.

Recent Findings: Although severe liver allograft (>60%) steatosis has been associated with inferior graft and recipient outcomes, mild (<30%) steatosis has not.

Effect of COVID-19 on Surgical Training Across the United States: A National Survey of General Surgery Residents.

Introduction: COVID-19 emerged as a global pandemic in 2020 and has affected millions of lives. Surgical training has also been significantly affected by this pandemic, but the exact effect remains unknown. We sought to perform a national survey of general surgery residents in the United States to assess the effect of COVID-19 on surgical resident training, education, and burnout.

Grade IV Renal Laceration in a 13-Year-Old Boy With Cross-fused Renal Ectopia.

A 13-year-old boy presented with gross hematuria following a skateboarding accident and was found to have cross-fused renal ectopia of the left kidney with a grade IV right renal laceration and urinary extravasation. Despite a double-J ureteral stent, urinoma drain, and indwelling bladder catheter, his urinoma drain maintained high output. He underwent a ureteral stent exchange and upsizing.

Leiomyoma of the testis: case report, review of literature, and discussing the role of contrast-enhanced ultrasound.

Leiomyomas are benign mesenchymal neoplasms that originate from smooth muscle cells. Leiomyoma of the testis is exceedlingly rare. We present a case demonstrating a 1.

Current status of artificial intelligence applications in urology and their potential to influence clinical practice.

Objective: To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome predictionin urologic diseases and evaluate its advantages over traditional models and methods.

Materials And Methods: A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms "urology", "artificial intelligence", "machine learning" were included and categorized by the application of AI in urology.