Irfan A. Rhemtulla

Role of Prophylactic Mesh Placement for Laparotomy and Stoma Creation

Incisional and parastomal hernias are a cause of significant morbidity and have a substantial effect on quality of life and economic costs for patients and hospital systems. Although many aspects of abdominal hernias are understood, prevention is a feature that is still being realized. This article reviews the current literature and determines the utility of prophylactic mesh placement in prevention of incisional and parastomal hernias.

Retromuscular Sublay Technique for Ventral Hernia Repair

Abstract Rives and Stoppa described the sublay technique of hernia repair more than half a century ago, but it took almost three decades to become truly appreciated and even longer for its full clinical potential and benefits to be realized. Modifications to the original operation have significantly improved surgical approaches, postsurgical outcomes, and quality of life. The retromuscular approach requires technical expertise and a firm grasp of the anatomy. With constant substitution of the terms sublay, retrorectus, retromuscular, preperitoneal, and Rives‐Stoppa throughout the literature, the nuances need to be distinguished to appreciate the surgical planes encountered during the operation. This article explains the origin of the nomenclature while clarifying these terms, describing the technique, highlighting outcomes, and discussing future considerations.

Abstract: Institutional Experience with Ultrasonic Debridement for the Treatment of Complex Wounds

BACKGROUND: Regret after gender-affirming surgery is considered a rare outcome. There is a paucity of literature examining the incidence and/or etiology of surgical deand re-transition. Coupled with the current issues in access and barriers for those seeking gender-affirming surgery, research in this field is extremely controversial. There are currently no professional guidelines or resources for providers who encounter patients who experience regret and/or seek detransition. In this paper the authors try to answer the question of how frequently gender surgeons are confronted with patients seeking the above care and what the current controversies are surrounding this very important topic.

Prophylactic mesh augmentation: Patient selection, techniques, and early outcomes

BACKGROUNDnIncisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh augmentation (PMA) has emerged as a technique to reduce IH formation. We aim to report patient selection, techniques and early outcomes after PMA.nnnMETHODSnRetrospective chart review identified descriptive characteristics, risk factors, operative technique, and early post-operative outcomes for PMA patients and matched non-PMA patients between January 1, 2016 and October 31, 2017.nnnRESULTSn18 consecutive PMA cases were performed (55.6% female, mean age 54.3 years and mean BMIu202f=u202f29.5u202fkg/m2). 88.9% of patients had at least two high-risk features for IH. Zero PMA patients developed IH compared to 5.3% non-PMA patients (pu202f=u202f0.314) (6-months mean follow-up). No difference in surgical site occurrences (SSO) were identified between the two groups.nnnCONCLUSIONSnEarly results are encouraging, demonstrating PMA is safe with equivocal SSO. Further studies are needed to assess if the reduction in IH formation is statistically significant with longer follow-up.