Skip to main content
Erschienen in: Hernia 4/2007

01.08.2007 | Original Article

Hernia repair with porcine small-intestinal submucosa

verfasst von: L. Ansaloni, F. Catena, S. Gagliardi, F. Gazzotti, L. D’Alessandro, A. D. Pinna

Erschienen in: Hernia | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Although at present nonabsorbable meshes are the preferred material for tension-free hernioplasty, some problems with their use have yet to be addressed (i.e., chronic pain and infections). In order to address these disadvantages, a collagen-based material, the porcine small-intestinal submucosa mesh (Surgisis Inguinal Hernia Matrix, Cook Surgical, Bloomington, IN, USA), has recently been developed for hernia repair.

Methods

With the aim of investigating the clinical safety and effectiveness of Surgisis IHM inguinal hernia repair, we report our experience of 45 consecutive hernioplasties with a medium-term follow-up. The surgical technique for the use of this material in hernioplasty is described in detail.

Results

Although some local (i.e., seromas) and general (i.e., hyperpyrexia), complications appeared in the immediate postoperative period (all of them disappeared spontaneously), no rejection or infection was observed after operations. At the 2-year follow-up, a low degree of pain and discomfort and no recurrences were observed.

Conclusions

We conclude that the Surgisis IHM hernioplasty is feasible with promising results and, from a clinical perspective, seems safe and effective.
Literatur
1.
Zurück zum Zitat Sachs M, Damm M, Encke A (1997) Historical evolution of inguinal hernia repair. World J Surg 21:218–223PubMedCrossRef Sachs M, Damm M, Encke A (1997) Historical evolution of inguinal hernia repair. World J Surg 21:218–223PubMedCrossRef
2.
Zurück zum Zitat Wantz GE (1999) Abdominal wall hernias. In: Shwarth SI, Shires GT, Spencer FC, Daly JM, Fisher JE, Galloway AC (eds) Principles of surgery, 7th ed. McGraw-Hill, New York Wantz GE (1999) Abdominal wall hernias. In: Shwarth SI, Shires GT, Spencer FC, Daly JM, Fisher JE, Galloway AC (eds) Principles of surgery, 7th ed. McGraw-Hill, New York
3.
Zurück zum Zitat Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193PubMedCrossRef Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193PubMedCrossRef
4.
Zurück zum Zitat Shulman AG, Amid PK, Lichtenstein IL (1992) The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg 58:255–257PubMed Shulman AG, Amid PK, Lichtenstein IL (1992) The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg 58:255–257PubMed
5.
Zurück zum Zitat Janu PG, Sellers KD, Mangiante EC (1997) Mesh inguinal herniorrhaphy: a ten-year review. Am Surg 63:1065–1069PubMed Janu PG, Sellers KD, Mangiante EC (1997) Mesh inguinal herniorrhaphy: a ten-year review. Am Surg 63:1065–1069PubMed
6.
Zurück zum Zitat McGillicuddy JE (1998) Prospective randomized comparison of the Shouldice and Lichtenstein hernia repair procedures. Arch Surg 133:974–978PubMedCrossRef McGillicuddy JE (1998) Prospective randomized comparison of the Shouldice and Lichtenstein hernia repair procedures. Arch Surg 133:974–978PubMedCrossRef
7.
Zurück zum Zitat Prior MJ, Williams EV, Shukla HS, Phillips S, Vig S, Lewis M (1998) Prospective randomized controlled trial comparing Lichtenstein with modified Bassini repair of inguinal hernia. J R Coll Surg Edinb 43:82–86PubMed Prior MJ, Williams EV, Shukla HS, Phillips S, Vig S, Lewis M (1998) Prospective randomized controlled trial comparing Lichtenstein with modified Bassini repair of inguinal hernia. J R Coll Surg Edinb 43:82–86PubMed
8.
Zurück zum Zitat Collaboration EH (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:854–859PubMedCrossRef Collaboration EH (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:854–859PubMedCrossRef
9.
Zurück zum Zitat Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518PubMedCrossRef Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518PubMedCrossRef
10.
Zurück zum Zitat Taylor SG, O’Dwyer PJ (1999) Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 86:562–565PubMedCrossRef Taylor SG, O’Dwyer PJ (1999) Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 86:562–565PubMedCrossRef
11.
Zurück zum Zitat Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128PubMedCrossRef Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128PubMedCrossRef
13.
Zurück zum Zitat Falagas ME, Kasiakou SK (2005) Mesh-related infections after hernia repair surgery. Clin Microbiol Infect 11:3–8PubMedCrossRef Falagas ME, Kasiakou SK (2005) Mesh-related infections after hernia repair surgery. Clin Microbiol Infect 11:3–8PubMedCrossRef
14.
Zurück zum Zitat Dayton MT, Buchele BA, Shirazi SS, Hunt LB (1986) Use of an absorbable mesh to repair contaminated abdominal-wall defects. Arch Surg 121:954–960PubMed Dayton MT, Buchele BA, Shirazi SS, Hunt LB (1986) Use of an absorbable mesh to repair contaminated abdominal-wall defects. Arch Surg 121:954–960PubMed
15.
Zurück zum Zitat Kropp BP, Eppley BL, Prevel CD, Rippy MK, Harruff RC, Badylak SF, Adams MC, Rink RC, Keating MA (1995) Experimental assessment of small intestinal submucosa as a bladder wall substitute. Urology 46:396–400PubMedCrossRef Kropp BP, Eppley BL, Prevel CD, Rippy MK, Harruff RC, Badylak SF, Adams MC, Rink RC, Keating MA (1995) Experimental assessment of small intestinal submucosa as a bladder wall substitute. Urology 46:396–400PubMedCrossRef
16.
Zurück zum Zitat Kropp BP, Sawyer BD, Shannon HE, Rippy MK, Badylak SF, Adams MC, Keating MA, Rink RC, Thor KB (1996) Characterization of SIS regenerated canine detrusor: assessment of reinnervation, in vitro compliance and contractility. J Urol 156:599–607PubMedCrossRef Kropp BP, Sawyer BD, Shannon HE, Rippy MK, Badylak SF, Adams MC, Keating MA, Rink RC, Thor KB (1996) Characterization of SIS regenerated canine detrusor: assessment of reinnervation, in vitro compliance and contractility. J Urol 156:599–607PubMedCrossRef
17.
Zurück zum Zitat Vaught JD, Kropp BP, Sawyer BD, Rippy MK, Badylak SF, Shannon HE, Thor KB (1996) Detrusor regeneration in the rat using porcine SIS graft: functional innervation and receptor expression. J Urol 155:374–378PubMedCrossRef Vaught JD, Kropp BP, Sawyer BD, Rippy MK, Badylak SF, Shannon HE, Thor KB (1996) Detrusor regeneration in the rat using porcine SIS graft: functional innervation and receptor expression. J Urol 155:374–378PubMedCrossRef
18.
Zurück zum Zitat Ansaloni L, Bonasoni P, Cambrini P, Catena F, De Cataldis A, Gagliardi S, Gazzotti F, Peruzzi S, Santini D, Taffurelli M (2006) Experimental evaluation of Surgisis as scaffold for neointestine regeneration in a rat model. Transplant Proc 38:1844–1848PubMedCrossRef Ansaloni L, Bonasoni P, Cambrini P, Catena F, De Cataldis A, Gagliardi S, Gazzotti F, Peruzzi S, Santini D, Taffurelli M (2006) Experimental evaluation of Surgisis as scaffold for neointestine regeneration in a rat model. Transplant Proc 38:1844–1848PubMedCrossRef
19.
Zurück zum Zitat Record RD, Hillegonds D, Simmons C, Tullius R, Rickey FA, Elmore D, Badylak SF (2001) In vivo degradation of 14C-labeled small intestinal submucosa (SIS) when used for urinary bladder repair. Biomaterials 22:2653–2659PubMedCrossRef Record RD, Hillegonds D, Simmons C, Tullius R, Rickey FA, Elmore D, Badylak SF (2001) In vivo degradation of 14C-labeled small intestinal submucosa (SIS) when used for urinary bladder repair. Biomaterials 22:2653–2659PubMedCrossRef
20.
Zurück zum Zitat Hodde J (2002) Naturally occurring scaffolds for soft tissue repair and regeneration. Tissue Eng 8:295–308PubMedCrossRef Hodde J (2002) Naturally occurring scaffolds for soft tissue repair and regeneration. Tissue Eng 8:295–308PubMedCrossRef
21.
Zurück zum Zitat Hodde JP, Record RD, Tullius RS, Badylak SF (2002) Retention of endothelial cell adherence to porcine-derived extracellular matrix after disinfection and sterilization. Tissue Eng 8:225–234PubMedCrossRef Hodde JP, Record RD, Tullius RS, Badylak SF (2002) Retention of endothelial cell adherence to porcine-derived extracellular matrix after disinfection and sterilization. Tissue Eng 8:225–234PubMedCrossRef
22.
Zurück zum Zitat Hodde J, Hiles M (2002) Virus safety of a porcine-derived medical device: evaluation of a viral inactivation method. Biotechnol Bioeng 79:211–216PubMedCrossRef Hodde J, Hiles M (2002) Virus safety of a porcine-derived medical device: evaluation of a viral inactivation method. Biotechnol Bioeng 79:211–216PubMedCrossRef
23.
Zurück zum Zitat Parker DM, Armstrong PJ, Frizzi JD, North JH (2006) Porcine dermal collagen (Permacol) for abdominal wall reconstruction. Curr Surg 63:255–258PubMed Parker DM, Armstrong PJ, Frizzi JD, North JH (2006) Porcine dermal collagen (Permacol) for abdominal wall reconstruction. Curr Surg 63:255–258PubMed
24.
Zurück zum Zitat Ma SZ, Li XH, Hu J (2006) Acellular extracellular matrix for inguinal hernia repair. Hernia 10:229–231PubMedCrossRef Ma SZ, Li XH, Hu J (2006) Acellular extracellular matrix for inguinal hernia repair. Hernia 10:229–231PubMedCrossRef
25.
Zurück zum Zitat Buinewicz B, Rosen B (2004) Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair. Ann Plast Surg 52:188–194PubMedCrossRef Buinewicz B, Rosen B (2004) Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair. Ann Plast Surg 52:188–194PubMedCrossRef
26.
Zurück zum Zitat Hodde J, Record R, Tullius R, Badylak S (2002) Fibronectin peptides mediate HMEC adhesion to porcine-derived extracellular matrix. Biomaterials 23:1841–1848PubMedCrossRef Hodde J, Record R, Tullius R, Badylak S (2002) Fibronectin peptides mediate HMEC adhesion to porcine-derived extracellular matrix. Biomaterials 23:1841–1848PubMedCrossRef
27.
Zurück zum Zitat Voytik-Harbin SL, Brightman AO, Kraine MR, Waisner B, Badylak SF (1997) Identification of extractable growth factors from small intestinal submucosa. J Cell Biochem 67:478–491PubMedCrossRef Voytik-Harbin SL, Brightman AO, Kraine MR, Waisner B, Badylak SF (1997) Identification of extractable growth factors from small intestinal submucosa. J Cell Biochem 67:478–491PubMedCrossRef
28.
Zurück zum Zitat Hodde JP, Record RD, Liang HA, Badylak SF (2001) Vascular endothelial growth factor in porcine derived extracellular matrix. Endothelium 8:11–24PubMed Hodde JP, Record RD, Liang HA, Badylak SF (2001) Vascular endothelial growth factor in porcine derived extracellular matrix. Endothelium 8:11–24PubMed
29.
Zurück zum Zitat Raeder RH, Badylak SF, Sheehan C, Kallakury B, Metzger DW (2002) Natural anti-galactose alpha1,3 galactose antibodies delay, but do not prevent the acceptance of extracellular matrix xenografts. Transpl Immunol 10:15–24PubMedCrossRef Raeder RH, Badylak SF, Sheehan C, Kallakury B, Metzger DW (2002) Natural anti-galactose alpha1,3 galactose antibodies delay, but do not prevent the acceptance of extracellular matrix xenografts. Transpl Immunol 10:15–24PubMedCrossRef
30.
Zurück zum Zitat Allman AJ, McPherson TB, Badylak SF, Merrill LC, Kallakury B, Sheehan C, Raeder RH, Metzger DW (2001) Xenogeneic extracellular matrix grafts elicit a TH2-restricted immune response. Transplantation 71:1631–1640PubMedCrossRef Allman AJ, McPherson TB, Badylak SF, Merrill LC, Kallakury B, Sheehan C, Raeder RH, Metzger DW (2001) Xenogeneic extracellular matrix grafts elicit a TH2-restricted immune response. Transplantation 71:1631–1640PubMedCrossRef
31.
Zurück zum Zitat Palmer EM, Beilfuss BA, Nagai T, Semnani RT, Badylak SF, Van Seventer GA (2002) Human helper T cell activation and differentiation is suppressed by porcine SIS. Tissue Eng 5:893–900CrossRef Palmer EM, Beilfuss BA, Nagai T, Semnani RT, Badylak SF, Van Seventer GA (2002) Human helper T cell activation and differentiation is suppressed by porcine SIS. Tissue Eng 5:893–900CrossRef
32.
Zurück zum Zitat Allman AJ, McPherson TB, Merrill LC, Badylak SF, Metzger DW (2002) The TH2-restricted immune response to xenogeneic small intestinal submucosa does not influence systemic protective immunity to viral and bacterial pathogens. Tissue Eng 8:53–62PubMedCrossRef Allman AJ, McPherson TB, Merrill LC, Badylak SF, Metzger DW (2002) The TH2-restricted immune response to xenogeneic small intestinal submucosa does not influence systemic protective immunity to viral and bacterial pathogens. Tissue Eng 8:53–62PubMedCrossRef
33.
Zurück zum Zitat Clarke KM, Lantz GC, Salisbury SK, Badylak SF, Hiles MC, Voytik SL (1996) Intestine submucosa and polypropylene mesh for abdominal wall repair in dogs. J Surg Res 60:107–114PubMedCrossRef Clarke KM, Lantz GC, Salisbury SK, Badylak SF, Hiles MC, Voytik SL (1996) Intestine submucosa and polypropylene mesh for abdominal wall repair in dogs. J Surg Res 60:107–114PubMedCrossRef
34.
Zurück zum Zitat Badylak S, Kokini K, Tullius B, Whitson B (2001) Strength over time of a resorbable bioscaffold for body wall repair in a dog model. J Surg Res 99:282–287PubMedCrossRef Badylak S, Kokini K, Tullius B, Whitson B (2001) Strength over time of a resorbable bioscaffold for body wall repair in a dog model. J Surg Res 99:282–287PubMedCrossRef
35.
Zurück zum Zitat Badylak S, Kokini K, Tullius B, Simmons-Byrd A, Morff R (2002) Morphologic study of SIS as a body wall repair device. J Surg Res 103:190–202PubMedCrossRef Badylak S, Kokini K, Tullius B, Simmons-Byrd A, Morff R (2002) Morphologic study of SIS as a body wall repair device. J Surg Res 103:190–202PubMedCrossRef
36.
Zurück zum Zitat Franklin ME, Gonzalez JJ, Glass JL (2004) Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up. Hernia 8:186–189PubMed Franklin ME, Gonzalez JJ, Glass JL (2004) Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up. Hernia 8:186–189PubMed
37.
Zurück zum Zitat Ueno T, Pickett LC, de la Fuente SG, Lawson DC, Pappas TN (2004) Clinical application of porcine small intestinal submucosa in the management of infected or potentially contaminated abdominal defects. J Gastrointest Surg 8:109–112PubMedCrossRef Ueno T, Pickett LC, de la Fuente SG, Lawson DC, Pappas TN (2004) Clinical application of porcine small intestinal submucosa in the management of infected or potentially contaminated abdominal defects. J Gastrointest Surg 8:109–112PubMedCrossRef
38.
Zurück zum Zitat Edelman DS (2002) Laparoscopic herniorrhaphy with porcine SIS: a preliminary study. JSLS 6:203–205PubMed Edelman DS (2002) Laparoscopic herniorrhaphy with porcine SIS: a preliminary study. JSLS 6:203–205PubMed
39.
Zurück zum Zitat Oelschlager BK, Barreca M, Chang L, Pellegrini CA (2003) The use of small intestine submucosa in the repair of paraesophageal hernias: initial observations of a new technique. Am J Surg 186: 4–8PubMedCrossRef Oelschlager BK, Barreca M, Chang L, Pellegrini CA (2003) The use of small intestine submucosa in the repair of paraesophageal hernias: initial observations of a new technique. Am J Surg 186: 4–8PubMedCrossRef
40.
Zurück zum Zitat Ansaloni L, Catena F, D’Alessandro L (2003) Prospective randomized, double-blind, controlled trial comparing Lichtenstein’s repair of inguinal hernia with polypropylene mesh versus Surgisis gold soft tissue graft: preliminary results. Acta Biomed Ateneo Parmense 74(Suppl 2):10–14 Ansaloni L, Catena F, D’Alessandro L (2003) Prospective randomized, double-blind, controlled trial comparing Lichtenstein’s repair of inguinal hernia with polypropylene mesh versus Surgisis gold soft tissue graft: preliminary results. Acta Biomed Ateneo Parmense 74(Suppl 2):10–14
41.
Zurück zum Zitat Franklin ME, Gonzalez JJ, Glass JL (2004) Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up. Hernia 8:186–189PubMed Franklin ME, Gonzalez JJ, Glass JL (2004) Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up. Hernia 8:186–189PubMed
42.
Zurück zum Zitat Helton WS, Fisichella PM, Berger R, Horgan S, Espat NJ, Abcarian H (2005) Short-term outcomes with small intestinal submucosa for ventral abdominal hernia. Arch Surg 140:549–560PubMedCrossRef Helton WS, Fisichella PM, Berger R, Horgan S, Espat NJ, Abcarian H (2005) Short-term outcomes with small intestinal submucosa for ventral abdominal hernia. Arch Surg 140:549–560PubMedCrossRef
43.
Zurück zum Zitat Catena F, Ansaloni L, Leone A, De Cataldis A, Gagliardi S, Gazzotti F, Peruzzi S, Agrusti S, D’Alessandro L, Taffurelli M (2005) Lichtenstein repair of inguinal hernia with Surgisis inguinal hernia matrix soft-tissue graft in immunodepressed patients. Hernia 9:29–31PubMedCrossRef Catena F, Ansaloni L, Leone A, De Cataldis A, Gagliardi S, Gazzotti F, Peruzzi S, Agrusti S, D’Alessandro L, Taffurelli M (2005) Lichtenstein repair of inguinal hernia with Surgisis inguinal hernia matrix soft-tissue graft in immunodepressed patients. Hernia 9:29–31PubMedCrossRef
44.
Zurück zum Zitat Sakorafas GH, Halikias I, Nissotakis C, Kotsifopoulos N, Stavrou A, Antonopoulos C, Kassaras GA (2001) Open “tension-free” repair of inguinal hernias; the Lichtenstein technique. BMC Surg 1:3PubMedCrossRef Sakorafas GH, Halikias I, Nissotakis C, Kotsifopoulos N, Stavrou A, Antonopoulos C, Kassaras GA (2001) Open “tension-free” repair of inguinal hernias; the Lichtenstein technique. BMC Surg 1:3PubMedCrossRef
45.
Zurück zum Zitat Edelman DS, Selesnick H (2006) “Sports” hernia: treatment with biologic mesh (Surgisis): a preliminary study. Surg Endosc 20:971–973PubMedCrossRef Edelman DS, Selesnick H (2006) “Sports” hernia: treatment with biologic mesh (Surgisis): a preliminary study. Surg Endosc 20:971–973PubMedCrossRef
46.
Zurück zum Zitat Gupta A, Zahriya K, Mullens PL, Salmassi S, Keshishian A (2006) Ventral herniorrhaphy: experience with two different biosynthetic mesh materials, Surgisis and alloderm. Hernia 10:419–425PubMedCrossRef Gupta A, Zahriya K, Mullens PL, Salmassi S, Keshishian A (2006) Ventral herniorrhaphy: experience with two different biosynthetic mesh materials, Surgisis and alloderm. Hernia 10:419–425PubMedCrossRef
47.
Zurück zum Zitat Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7PubMedCrossRef Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7PubMedCrossRef
48.
Zurück zum Zitat Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U (2006) Risk factors for long-term pain after hernia surgery. Ann Surg 244:212–219PubMedCrossRef Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U (2006) Risk factors for long-term pain after hernia surgery. Ann Surg 244:212–219PubMedCrossRef
49.
Zurück zum Zitat Bringman S, Wollert S, Osterberg J, Smedberg S, Granlund H, Heikkinen TJ (2006) Three-year results of a randomized clinical trial of lightweight or standard polypropylene mesh in Lichtenstein repair of primary inguinal hernia. Br J Surg 93:1056–1059PubMedCrossRef Bringman S, Wollert S, Osterberg J, Smedberg S, Granlund H, Heikkinen TJ (2006) Three-year results of a randomized clinical trial of lightweight or standard polypropylene mesh in Lichtenstein repair of primary inguinal hernia. Br J Surg 93:1056–1059PubMedCrossRef
Metadaten
Titel
Hernia repair with porcine small-intestinal submucosa
verfasst von
L. Ansaloni
F. Catena
S. Gagliardi
F. Gazzotti
L. D’Alessandro
A. D. Pinna
Publikationsdatum
01.08.2007
Verlag
Springer-Verlag
Erschienen in
Hernia / Ausgabe 4/2007
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-007-0225-4

Weitere Artikel der Ausgabe 4/2007

Hernia 4/2007 Zur Ausgabe

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Wie sieht der OP der Zukunft aus?

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Recycling im OP – möglich, aber teuer

02.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO2-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.