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The bony anchoring reinforcement system (BARS) for flank hernia repair: a versatile technique

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Abdominal wall reconstruction, especially when fascial defects occur in the flank region, is a field of high interest given the morbidity of hernias. The flank hernia is a rare and challenging entity requiring adequate overlap and secure fixation for a successful repair.

Methods

This is a retrospective case series study including all patients undergoing flank hernia repair using the bony anchoring reinforcement system (BARS) technique from March 2013 through August 2015. An electronic chart review identified seven patients with flank hernias that underwent the BARS procedure.

Results

Six of the patients followed-up for a full year with one patient dropping out after returning to exercise and indicating high satisfaction with operative outcome. There was one recurrent hernia 29 months later. There were no surgical site or mesh infections.

Conclusions

The BARS technique is a versatile and efficacious open approach for repairing flank hernias. It allows for a large area of overlap and secure fixation to the bony structures in the pelvis.

Level of Evidence: Level V, therapeutic study

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References

  1. Akinduro OO, Jones F, Turner J, Cason F, Clark C (2015) Rare case of a strangulated intercostal flank hernia following open nephrectomy: a case report and review of literature. Int J Surg Case Rep 17:143–145

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kim DJ, Park JW (2015) A rare nonincisional lateral abdominal wall hernia. Ann Surg Treat Res 88(2):111–113

    Article  PubMed  PubMed Central  Google Scholar 

  3. Phillips MS, Krpata DM, Blatnik JA, Rosen MJ (2012) Retromuscular preperitoneal repair of flank hernias. J Gastrointest Surg 16(8):1548–1553

    Article  PubMed  Google Scholar 

  4. Edwards C, Geiger T, Bartow K, et al. (2009) Laparoscopic transperitoneal repair of flank hernias: a retrospective review of 27 patients. Surg Endosc 23(12):2692–2696

    Article  PubMed  Google Scholar 

  5. Elkwood AI, Borao FJ, Ashinoff RL, et al. (2014) Complex incisional hernias repaired in conjunction with the bony anchoring reinforcement system (BARS) prevents hernia recurrence. Eur J Plast Surg 37(8):431–436

    Article  Google Scholar 

  6. Pezeshk RA, Pulikkottil BJ, Bailey SH, et al. (2015) An evidence-based model for the successful treatment of flank and lateral abdominal wall hernias. Plast Reconstr Surg 136(2):377–385

    Article  CAS  PubMed  Google Scholar 

  7. Purnell CA, Park E, Turin SY, Dumanian GA (2016) Postoperative flank defects, hernias, and bulges: a reliable method for repair. Plast Reconstr Surg 137(3):994–1001

    Article  CAS  PubMed  Google Scholar 

  8. Bisgaard T, Kehlet H, Bay-Nielsen MB, et al. (2009) Nationwide study of early outcomes after incisional hernia repair. Br J Surg 96(12):1452–1457

    Article  CAS  PubMed  Google Scholar 

  9. Halm JA, Lip H, Schmitz PI, Jeekel J (2009) Incisional hernia after upper abdominal surgery: a randomized controlled trial of midline versus transverse incision. Hernia 13(3):275–280

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kendall SW, Brennan TG, Guillou PG (1991) Suture length to wound length ratio and the integrity of midline and lateral paramedian incisions. Br J Surg. 78(6):705–707

    Article  CAS  PubMed  Google Scholar 

  11. Espositio TJ, Fedorak I (1994) Traumatic lumbar hernia: case report and literature review. J Trauma 37(1):123–126

    Article  Google Scholar 

  12. Heniford BT, Iannitti DA, Gagner M (1997) Laparoscopic inferior and superior lumbar hernia repair. Arch Surg 132(10):1141–1144

    Article  CAS  PubMed  Google Scholar 

  13. Veyrie N, Poghosyan T, Corigliano N, Canard G, Servajean S, Bouillot JL (2013) Lateral incisional hernia repair by the retromuscular approach with polyester standard mesh: topographic considerations and long-term follow-up of 61 consecutive patients. World J Surg 37(3):538–544

    Article  PubMed  Google Scholar 

  14. Bolkier M, Moskovitz B, Ginesin Y, Levin DR (1991) An operation for incisional lumbar hernia. Eur Urol 20(1):52–53

    CAS  PubMed  Google Scholar 

  15. Cavallaro G, Sadighi A, Miceli M, Burza A, Carbone G, Cavallaro A (2007) Primary lumbar hernia repair: the open approach. Eur Surg Res 39(2):88–92

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. The Plastic Surgery Center, The Institute for Advanced Reconstruction, 535 Sycamore Avenue, Shrewsbury, NJ, 07702, USA

    Andrew I. Elkwood, Tushar R. Patel, Michael I. Rose, Matthew R. Kaufman, Russell L. Ashinoff & Adam Saad

  2. Department of Plastic Surgery, The University of Tennessee Health Science Center, 910 Madison Ave Suite 315, Memphis, TN, 38163, USA

    Steven D. Kozusko

  3. 10 Industrial Way E, Suite 104, Eatontown, NJ, 07724, USA

    Steven J. Binenbaum & Frank Borao

Authors
  1. Andrew I. Elkwood
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  2. Steven D. Kozusko
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  3. Tushar R. Patel
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  4. Michael I. Rose
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  5. Matthew R. Kaufman
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  6. Russell L. Ashinoff
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  7. Adam Saad
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  8. Steven J. Binenbaum
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  9. Frank Borao
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Corresponding author

Correspondence to Steven D. Kozusko.

Ethics declarations

Ethical approval

For this type of retrospective study formal consent is not required.

Conflict of interest

Andrew I. Elkwood, Steven D. Kozusko, Tushar R. Patel, Michael I. Rose, Matthew R. Kaufman, Russell L. Ashinoff, Adam Saad, Steven J. Binenbaum, Frank Borao declare that they have no conflict of interest.

Funding

No grants or funding was received in preparation of this manuscript.

Patient consent

Informed consent was obtained from all individual participants included in this study.

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Cite this article

Elkwood, A.I., Kozusko, S.D., Patel, T.R. et al. The bony anchoring reinforcement system (BARS) for flank hernia repair: a versatile technique. Eur J Plast Surg 40, 315–322 (2017). https://doi.org/10.1007/s00238-016-1272-9

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  • DOI: https://doi.org/10.1007/s00238-016-1272-9

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