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Hernia Surgery pp 401-407 | Cite as

Emergent Surgical Management of Ventral Hernias

  • Phillip ChangEmail author
  • Levi D. Procter
Chapter

Abstract

The emergency care of ventral hernias is complex. The key to improved morbidity and mortality is operating on these patients prior to progressing to strangulation. The type of operation depends on many factors, including location of the hernia, patient’s physiology, imaging findings, and prior repairs with or without mesh. The operations can be open, laparoscopic, or a combination of both. The use of laparoscopy has a significant role in assessing bowel viability and repair. Dealing with large ventral hernias in a damage control surgery should focus on sepsis source control and abdominal closure. In these patients, definitive and complex abdominal wall closures with non-biologic prosthesis should be avoided. The goal is survival and planning a formal abdominal wall construction in the future with a non-biologic prosthesis. This chapter will review these topics.

Keywords

Emergent Ventral Hernia Mesh Strangulation Incarceration Reducible Laparoscopy Surgery Incisional 

References

  1. 1.
    Alvarez JA, Baldonedo RF, Bear IG, Solis JA, Alvarez P, Jorge JI. Incarcerated groin hernias in adults: presentation and outcome. Hernia. 2004;8(2):121–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Derici H, Unalp HR, Bozdag AD, Nazli O, Tansug T, Kamer E. Factors affecting morbidity and mortality in incarcerated abdominal wall hernias. Hernia. 2007;11(4):341–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Nilsson H, Nilsson E, Angeras U, Nordin P. Mortality after groin hernia surgery: delay of treatment and cause of death. Hernia. 2011;15(3):301–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Nilsson H, Stylianidis G, Haapamaki M, Nilsson E, Nordin P. Mortality after groin hernia surgery. Ann Surg. 2007;245(4):656–60.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Martinez-Serrano MA, Pereira JA, Sancho JJ, Lopez-Cano M, Bombuy E, Hidalgo J. Risk of death after emergency repair of abdominal wall hernias. Still waiting for improvement. Langenbecks Arch Surg. 2010;395(5):551–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Nieuwenhuizen J, van Ramshorst GH, ten Brinke JG, de Wit T, van der Harst E, Hop WC, et al. The use of mesh in acute hernia: frequency and outcome in 99 cases. Hernia. 2011;15(3):297–300.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hernandez-Irizarry R, Zendejas B, Ramirez T, Moreno M, Ali SM, Lohse CM, et al. Trends in emergent inguinal hernia surgery in Olmsted County, MN: a population-based study. Hernia. 2012;16(4):397–403.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Panagiotopoulou IG, Richardson C, Gurunathan-Mani S, Lagattolla NR. Infection of laparoscopically inserted inguinal hernia repair mesh following subsequent emergency open surgery: a report of two cases. Ann R Coll Surg Engl. 2012;94(1):e3–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Romain B, Chemaly R, Meyer N, Brigand C, Steinmetz JP, Rohr S. Prognostic factors of postoperative morbidity and mortality in strangulated groin hernia. Hernia. 2012;16(4):405–10.CrossRefPubMedGoogle Scholar
  10. 10.
    Compagna R, Rossi R, Fappiano F, Bianco T, Accurso A, Danzi M, et al. Emergency groin hernia repair: implications in elderly. BMC Surg. 2013;13(2):S29.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Lohsiriwat D, Lohsiriwat V. Long-term outcomes of emergency Lichtenstein hernioplasty for incarcerated inguinal hernia. Surg Today. 2013;43(9):990–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Primus FE, Harris HW. A critical review of biologic mesh use in ventral hernia repairs under contaminated conditions. Hernia. 2013;17(1):21–30.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Argudo N, Pereira JA, Sancho JJ, Membrilla E, Pons MJ, Grande L. Prophylactic synthetic mesh can be safely used to close emergency laparotomies, even in peritonitis. Surgery. 2014;156(5):1238–44.CrossRefPubMedGoogle Scholar
  14. 14.
    Huerta S, Pham T, Foster S, Livingston EH, Dineen S. Outcomes of emergent inguinal hernia repair in veteran octogenarians. Am Surg. 2014;80(5):479–83.PubMedGoogle Scholar
  15. 15.
    Koizumi M, Sata N, Kaneda Y, Endo K, Sasanuma H, Sakuma Y, et al. Optimal timeline for emergency surgery in patients with strangulated groin hernias. Hernia. 2014;18(6):845–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Fitzgibbons Jr RJ, Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda DJ, McCarthy Jr M, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA. 2006;295(3):285–92.CrossRefPubMedGoogle Scholar
  17. 17.
    Stroupe KT, Manheim LM, Luo P, Giobbie-Hurder A, Hynes DM, Jonasson O, et al. Tension-free repair versus watchful waiting for men with asymptomatic or minimally symptomatic inguinal hernias: a cost-effectiveness analysis. J Am Coll Surg. 2006;203(4):458–68.CrossRefPubMedGoogle Scholar
  18. 18.
    Altom LK, Snyder CW, Gray SH, Graham LA, Vick CC, Hawn MT. Outcomes of emergent incisional hernia repair. Am Surg. 2011;77(8):971–6.PubMedGoogle Scholar
  19. 19.
    Beadles CA, Meagher AD, Charles AG. Trends in emergent hernia repair in the United States. JAMA Surg. 2015;150(3):194–200.CrossRefPubMedGoogle Scholar
  20. 20.
    Samuel JC, Tyson AF, Mabedi C, Mulima G, Cairns BA, Varela C, et al. Development of a ratio of emergent to total hernia repairs as a surgical capacity metric. Int J Surg. 2014;12(9):906–11.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Chan G, Chan CK. Long-term results of a prospective study of 225 femoral hernia repairs: indications for tissue and mesh repair. J Am Coll Surg. 2008;207(3):360–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Sawayama H, Kanemitsu K, Okuma T, Inoue K, Yamamoto K, Baba H. Safety of polypropylene mesh for incarcerated groin and obturator hernias: a retrospective study of 110 patients. Hernia. 2014;18(3):399–406.CrossRefPubMedGoogle Scholar
  23. 23.
    Venara A, Hubner M, Le Naoures P, Hamel JF, Hamy A, Demartines N. Surgery for incarcerated hernia: short-term outcome with or without mesh. Langenbecks Arch Surg. 2014;399(5):571–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Carbonell AM, Cobb WS. Safety of prosthetic mesh hernia repair in contaminated fields. Surg Clin North Am. 2013;93(5):1227–39.CrossRefPubMedGoogle Scholar
  25. 25.
    Gallegos NC, Dawson J, Jarvis M, Hobsley M. Risk of strangulation in groin hernias. Br J Surg. 1991;78(10):1171–3.CrossRefPubMedGoogle Scholar
  26. 26.
    Oishi SN, Page CP, Schwesinger WH. Complicated presentations of groin hernias. Am J Surg. 1991;162(6):568–70. discussion 71.CrossRefPubMedGoogle Scholar
  27. 27.
    Hachisuka T. Femoral hernia repair. Surg Clin North Am. 2003;83(5):1189–205.CrossRefPubMedGoogle Scholar
  28. 28.
    Naude GP, Ocon S, Bongard F. Femoral hernia: the dire consequences of a missed diagnosis. Am J Emerg Med. 1997;15(7):680–2.CrossRefPubMedGoogle Scholar
  29. 29.
    Kirkpatrick S, Schubert T. Umbilical hernia rupture in cirrhotics with ascites. Dig Dis Sci. 1988;33(6):762–5.CrossRefPubMedGoogle Scholar
  30. 30.
    McKay A, Dixon E, Bathe O, Sutherland F. Umbilical hernia repair in the presence of cirrhosis and ascites: results of a survey and review of the literature. Hernia. 2009;13(5):461–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Triantos CK, Kehagias I, Nikolopoulou V, Burroughs AK. Surgical repair of umbilical hernias in cirrhosis with ascites. Am J Med Sci. 2011;341(3):222–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Eker HH, van Ramshorst GH, de Goede B, Tilanus HW, Metselaar HJ, de Man RA, et al. A prospective study on elective umbilical hernia repair in patients with liver cirrhosis and ascites. Surgery. 2011;150(3):542–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Ecker BL, Bartlett EK, Hoffman RL, Karakousis GC, Roses RE, Morris JB, et al. Hernia repair in the presence of ascites. J Surg Res. 2014;190(2):471–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Choi SB, Hong KD, Lee JS, Han HJ, Kim WB, Song TJ, et al. Management of umbilical hernia complicated with liver cirrhosis: an advocate of early and elective herniorrhaphy. Dig Liver Dis. 2011;43(12):991–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Sartelli M, Coccolini F, van Ramshorst GH, Campanelli G, Mandala V, Ansaloni L, et al. WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg. 2013;8(1):50.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Bury K, Smietanski M, Justyna B, Gumiela P, Smietanska AI, Owczuk R, et al. Effects of macroporous monofilament mesh on infection in a contaminated field. Langenbecks Arch Surg. 2014;399(7):873–7.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Grevious MA, Cohen M, Jean-Pierre F, Herrmann GE. The use of prosthetics in abdominal wall reconstruction. Clin Plast Surg. 2006;33(2):181–97.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.University of KentuckyLexingtonUSA

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