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.

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.