Tag Archives: hernia repair

General Surgery, Print Release

PUBLISHED: Small Bowel Obstruction Following Robotic Transabdominal Preperitoneal Ventral Hernia Repair (rTAPP) Due to Barbed Suture

Small Bowel Obstruction Following Robotic Transabdominal Preperitoneal Ventral Hernia Repair (rTAPP) Due to Barbed Suture
Kathleen C. Clement, MD; Keaton L. Altom, MD
Tripler Army Medical Center

Barbed suture is an increasingly popular type of suture used by surgeons across the world. It is an efficient suture that provides several benefits, including better distributed tensile strength, reduced surrounding inflammatory reaction and local tissue hypoxia, and less foreign body exposure. However, there have been a handful of cases of complications with barbed sutures over the past few decades.

This is the case of a patient who initially underwent an uncomplicated robotic transabdominal preperitoneal ventral hernia repair (rTAPP) and re-presented postoperative day two with a small bowel obstruction. This video shows the operative findings from the return to the operating room with the identification of a barbed suture that had become caught in the mesentery, causing kinking of the bowel.

General Surgery, Print Release

PUBLISHED: Robotic-Assisted Laparoscopic Paraesophageal Hiatal Hernia Repair with Fundoplication and Esophagogastroduodenoscopy

Robotic-Assisted Laparoscopic Paraesophageal Hiatal Hernia Repair with Fundoplication and Esophagogastroduodenoscopy
Hannah A. Bougleux Gomes, MD¹; Divyansh Agarwal, MD, PhD¹; Charu Paranjape¹’²
¹Massachusetts General Hospital/Brigham and Women’s Hospital
²Newton-Wellesley Hospital

A hiatal hernia occurs when part of an intra-abdominal organ, most commonly the stomach, migrates through the diaphragmatic crura. The condition can cause a range of uncomfortable symptoms, including heartburn, chest pain, and difficulty swallowing. While several individuals with a hiatal hernia can manage their symptoms with lifestyle changes and anti-reflux medications, some with refractory symptoms or complications secondary to the hernia require surgical treatment to repair the defect.

Here we present the case of a 60-year-old female with a paraoesophageal hiatal hernia and chronic gastrointestinal reflux disease (GERD) refractory to proton-pump inhibitors (PPI), dietary changes, and lifestyle modifications. She underwent an elective robotic hiatal hernia repair, fundoplication, and esophagogastroduodenoscopy (EGD) as a two-hour procedure with routine postprocedure recovery. This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure.

General Surgery, Print Release

PUBLISHED: Robotic-Assisted Laparoscopic (rTAPP) Bilateral Inguinal Hernia Repair

Robotic-Assisted Laparoscopic (rTAPP) Bilateral Inguinal Hernia Repair
David Lourié, MD, FACS, FASMBS
Huntington Memorial Hospital

There are over 1 million hernia repairs performed annually in the US, and robotics is revolutionizing the adoption of minimally-invasive hernia repairs. From 2015 to 2018, robotic laparoscopic hernia repairs have explosively grown from less than 2% to 20% of all hernia repairs performed in the US.

Hernia repairs are among the most basic procedures for general surgeons, and there is substantial enthusiasm on the part of surgeons regarding the rapid changes in techniques as well as the best methods of teaching them. Surgical training programs may find it difficult to maintain training for their residents and fellows in the face of rapidly evolving technology. Here, Dr. Lourié presents the case of a 28-year-old male with bilateral inguinal hernias that were repaired using a robotic-assisted laparoscopic approach.

General Surgery, Print Release

PUBLISHED: Shouldice Repair for Left Direct Inguinal Hernia

Shouldice Repair for Left Direct Inguinal Hernia

Michael Reinhorn, MD, FACS
Mass General Brigham – Newton-Wellesley Hospital
Boston Hernia and Pilonidal Center
Tufts University School of Medicine

Divyansh Agarwal, MD
Massachusetts General Hospital

Lauren Ott, PA-C
Mass General Brigham – Newton-Wellesley Hospital
Boston Hernia and Pilonidal Center
Tufts University School of Medicine

In this article, Dr. Michael Reinhorn shows the case of a 51-year-old male who presented with left groin pain and a bulge in the area, worsened while straining or after a long day of physical activity. The patient underwent a mesh-free hernia repair performed via the four-layer Shouldice technique as a 50-minute ambulatory/day-surgery procedure. This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure.

General Surgery, Print Release

PUBLISHED: Robotic eTEP Retrorectus Rives-Stoppa Repair for Ventral Hernia

Robotic eTEP Retrorectus Rives-Stoppa Repair for Ventral Hernia
Alta Bates Summit Medical Center

Rockson C. Liu, MD, FACS

In this case, Dr. Rockson Liu with Epic Care at Alta Bates Summit Medical Center performs a robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia that was partially reducible but mostly incarcerated, and greater than 6 cm in a 63-year-old female. Robotic ports were placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces were combined with a preperitoneal bridge of the peritoneum. The defects were closed robotically, and a medium-weight, macroporous polypropylene mesh was placed within the retrorectus space.

General Surgery, Preprint Release

PREPRINT RELEASE: Robotic eTEP Retrorectus Rives-Stoppa Repair for Ventral Hernia

Robotic eTEP Retrorectus Rives-Stoppa Repair for Ventral Hernia
Alta Bates Summit Medical Center

Rockson C. Liu, MD, FACS
General Surgery, Epic Care, Alta Bates Summit Medical Center

In this case, Dr. Rockson Liu performs a robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia that was partially reducible but mostly incarcerated, and greater than 6 cm in a 63-year-old female. Robotic ports were placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces were combined with a preperitoneal bridge of the peritoneum. The defects were closed robotically, and a medium-weight, macroporous polypropylene mesh was placed within the retrorectus space.

General Surgery, Global Surgery, Preprint Release

PREPRINT RELEASE: Intraperitoneal Mesh Repair for Incisional Hernia

Intraperitoneal Mesh Repair for Incisional Hernia
Hospital Leonardo Martinez, Honduras

Yoko Young Sang, MD
Resident Physician
General Surgery
Louisiana State University Shreveport

Shabir Abadin, MD, MPH (Operating Surgeon)
Endocrine and General Surgeon
World Surgical Foundation

The patient in this case had an emergency exploratory laparotomy and diverting colostomy several years ago for a perforated colon. Following reversal of the colostomy, she developed an incisional hernia that also involved the stomal site. Here, Dr. Abadin performs an intraperitoneal mesh repair while on a surgical mission in Honduras with the World Surgical Foundation.

General Surgery, Preprint Release

PREPRINT RELEASE: Rives-Stoppa Retromuscular Repair for Incisional Hernia


Rives-Stoppa Retromuscular Repair for Incisional Hernia
Massachusetts General Hospital

Peter Fagenholz, MD
Assistant Professor of Surgery
Harvard Medical School

Katherine Albutt, MD
Resident Physician
Harvard Medical School

In this case, Dr. Peter Fagenholz at MGH performs a ventral incisional hernia repair on a 76-year-old female who developed a hernia following a right colectomy for colon cancer.

General Surgery, Global Surgery, Pediatrics, Preprint Release

PREPRINT RELEASE: Pediatric Infant Bilateral Open Inguinal Hernia Repair – Twin B


Pediatric Infant Bilateral Open Inguinal Hernia Repair – Twin B
Romblon Provincial Hospital

Domingo Alvear, MD
Founder, World Surgical Foundation

Lissa Henson, MD
Philippine Society of Pediatric Surgeons

In this case, Dr. Alvear performs a bilateral open inguinal hernia repair on the second of two twin babies while on a surgical mission with the World Surgical Foundation in the Philippines. On one side, the ovary was trapped within the hernia sac. Here, Dr. Alvear demonstrates his technique for preserving the ovary in this setting, which is effective, much quicker, and much safer with fewer complications for anesthesia.

General Surgery, Global Surgery, Pediatrics, Preprint Release

PREPRINT Release: Pediatric Infant Bilateral Open Inguinal Hernia Repair


Pediatric Infant Bilateral Open Inguinal Hernia Repair
Romblon Provincial Hospital

Domingo Alvear, MD
Founder, World Surgical Foundation

Lissa Henson, MD
Philippine Society of Pediatric Surgeons

Jaymie Ang Henry, MD, MPH
Florida Atlantic University, G4 Alliance

In another case with the World Surgical Foundation, Dr. Alvear performs a bilateral inguinal hernia repair on an infant.