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TitleMeshes: Benefits and Risks [electronic resource] / edited by Volker Schumpelick, Lloyd M. Nyhus
ImprintBerlin, Heidelberg : Springer Berlin Heidelberg, 2004
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Descript XVIII, 479 p. online resource


Within a few years the surgical approach to abdominal wall hernias has focused on mesh-based treatment options. This dramatic change has set the stage for the third Suvretta meeting. All aspects of the mesh world have been discussed in detail by more than 50 international experts during an intense week resulting in an assessment of success and failures. After posing the question, whether meshes have defeated recurrences in the groin, epidemiological clinical data on recurrences were presented and show that this problem still exists. In particular, novel molecular biology-based research results stress the pathophysiological importance of a defective scarring process in these patients with inherent conclusions for future therapies. Regarding the variety existing meshes, there are already more than 100 different mesh devices, a comprehensive review of their chemical and textile properties was presented, with emphasis on their impact on biological responses. However, more than 90% of the participants articulated the need for improved mesh prosthesis, because their characteristic inflammatory and fibrotic foreign body reaction cause minor and major complications, e.g. pain, infections, adhesions, damage of the spermatic cord. The differentiated use of meshes in various procedures was discussed, including groin, incisional, parastomal, diaphragmal and hiatal hernias as well as their use in extended abdominal wall defects or in paediatric or plastic surgery. In summary this book summarizes the most up-to-date knowledge about meshes and hopefully serve as manual for both practical surgeons and scientists involved in the growing world of mesh


I The Problem: How to Treat a Hernia -- 1 Have We Defeated Hernia Recurrence in the Groin? An Epidemiological Approach -- 2 Risk Factors Predisposing for the Development of Incisional Hernias -- 3 Expenses and Profits: Economical Aspects of Hernia Surgery -- II Reasons for Recurrence: a Pathophysiological Approach -- 4 Recurrences: the Fault of the Surgeon -- 5 The Fault(s) of the Patient: Scar Reaction and Biological Recurrence -- 6 Collagen - the Crucial Cause? -- 7 Pharmacotherapy of the Wound - Prevention of Hernia? -- III The World of Mesh -- 8 Textile Variations and Characteristics of the Plastic Meshes -- 9 Polypropylene: the Standard of Mesh Materials -- 10 Polyester Mesh - a French Solution? -- 11 ePTFE: Worth the Price? -- 12 PVDF: a New Alternative? -- 13 The World of Mesh -- IV Anatomic Basics -- 14 The Abdominal Wall - Where to Place the Mesh? -- V Mesh Biology -- 15 Pathophysiology and Pathology of the Foreign-Body Reaction to Mesh Implants -- 16 Long-term Inertness of Meshes -- 17 How to Construct a Mesh? Impact of Structure, Filament and Pore Size for Tissue Ingrowth -- VI Mesh-Related Complications: Exception or the Rule?-Impact of Technique and Material -- 18 Mesh Related Problems - How to Objectify -- 19 Shrinkage: Fake or Fact? -- 20 The Catastroph: Mesh Infection and Migration with Fistula Formation - Life Long Risk? -- 21 Prevention of Adhesion - Just an Illusion? -- 22 Does the Mesh Damage the Spermatic Cord? -- 23 Complaints - Usual Complications of Meshes? -- 24 Foreign-Body Carcinogenesis of Surgical Meshes -- VII Indications for Mesh Repair Today -- 25 Mesh Repair in the Groin: for Every Hernia at all Ages? -- 26 Mesh Repair in the Abdominal Wall: Are There Mesh-Free alternatives? -- 27 Mesh-Reinforced Repair of Diaphragmatic Hernia -- 28 Parastomal Hernia: Prevention and Treatment -- 29 Indications for Mesh Repair: Mesh Repair for Laparostomy - an Underestimated Procedure -- 30 The Use of Prosthetic Mesh for the Pediatric Hernia Repair -- 31 Meshes in Reconstructive Plastic Surgery -- VIII Actual Guidelines for Mesh Repair: Why to Prefer a Certain Technique? -- Open Technique in the Groin -- 32 Can the Lichtenstein Tension-Free Repair Wipe Out Hernia Recurrence? -- 33 Vypro II in Lichtenstein Repair: Risk or Benefit? -- 34 TIPP, an additional, alternative or a dispensable technique? -- 35 Prolence Hernia System: Quick and Effective Repair for Inguinal Hernia -- 36 The Preperitoneal Prosthetic Approach for the Repair of Recurrent Inguinal Hernia: Is There Still a Place for the Wantz Technique? -- 37 GPRVS: radical but too invasiveโ{128}ฆ? -- 38 The ยปGrid-Ironยซ repair of groin hernia, a standard procedure? -- Laparoscopic Techniques in the Groin -- 39 TEP: for super specialists, not for the general surgeon? -- 40 Transperitoneal Laparoscopic Inguinal Hernia Repair (TAPP) - an Inferior Method? -- Incisional Hernia -- 41 Incisional Hernia Prevention -- 42 Laparoscopic Ventral and Incisional Hernia Repair: The Texas Endosurgery Institute Experience -- 43 Explantation of Meshes as a Routine in Future? -- IX The Ideal Mesh - What Should it Look Like? -- 44 The Ideal Mesh - How Should it Look Like? A Surgical Approach - Open Abdominal Wall -- 45 The Ideal Mesh for Abdominal Wall Repair - for Laparoscopic Procedures -- X Recommendations of the Experts -- 46 Dutch Guidelines for Inguinal Hernia -- XI Conclusion -- 47 Panel Discussion: Hernia Therapy in the Groin and for Incisional Hernia -- Appendix: Questionnaire

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