Revista Sociedad Hispanoamericana de Hernia 00432 / http://dx.doi.org/10.20960/rhh.00432

Resumen| PDF

Revisión

Manejo perioperatorio de las hernias gigantes o con pérdida de derecho a domicilio en pacientes obesos

Laura Carballo Rodríguez , Lander Gallego Otaegui , Aintzane Lizarazu Pérez , Íñigo Augusto Ponce , Mikel Osorio-Capitán , María Isabel Bollo-Arocena

Prepublicado: 2021-09-15

Publicado: 2023-07-10

VOLUMEN 11, NÚM. 3, julio-septiembre (2023), PAG. 118 -132

Logo Descargas Número de descargas: 103059 Logo Visitas Número de visitas: 1864 Citas Citas: 0

Compártelo:

Introducción y objetivo: Describir los resultados publicados en la literatura acerca del manejo perioperatorio de las hernias gigantes o con pérdida de derecho a domicilio en los pacientes obesos y su optimización preoperatoria, así como el uso del neumoperitoneo progresivo preoperatorio y de la toxina botulínica A asociado o no a paniculectomía. Métodos: Se realiza una búsqueda sistemática en PubMed, Cochrane y en manuales de artículos publicados hasta abril de 2020 según los criterios de inclusión para la revisión. Se analizan treinta y nueve artículos. Resultados: La obesidad supone un aumento de más de dos veces del riesgo de comorbilidad en la reparación de hernias gigantes o con pérdida de derecho a domicilio en pacientes con IMC superior a 40 kg/m2. Una adecuada prehabilitación con dieta o cirugía bariátrica disminuiría dicha comorbilidad. Asimismo, el uso preoperatorio de neumoperitoneo progresivo y la infiltración de toxina botulínica A contribuyen a la adaptación progresiva al aumento de presión abdominal con elongación de los músculos abdominales, lo que facilita la reparación herniaria y mejora los resultados. La paniculectomía concomitante aumenta las complicaciones del sitio quirúrgico, pero puede ser beneficiosa en casos sintomáticos, mejorando los resultados y el riesgo de recurrencia a largo plazo. Conclusión: La actuación sobre factores modificables como la obesidad, junto a técnicas preoperatorias, facilitan la reparación herniaria y mejoran sus resultados. Sin embargo, se necesitan más estudios que determinen el IMC óptimo para intervenir, el tiempo necesario de prehabilitación y el método más apropiado en cada caso.

Palabras Clave : Hernia gigante, hernia con pérdida de derecho a domicilio, obesidad, neumoperitoneo preoperatorio progresivo, toxina botulínica A, paniculectomía.

Descargar PDF

Bibliografía
Artículos Relacionados

Oprea V, Matei O, Gheorghescu D, Leuca D, Buia F, Rosianu M, Dinca M. Progressive preoperative pneumoperitoneum (PPP) as an adjunct for surgery of hernias with loss of domain. Chirurgia (Bucur). 2014;109(5):664-9.

Sabbagh C, Dumont F, Fuks D, Yzet T, Verhaeghe P, Regimbeau JM. Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study. Hernia. 2012;16(1):33-40.
DOI: 10.1007/s10029-011-0849-2

Menzo EL, Hinojosa M, Carbonell A, Krpata D, Carter J, Rogers AM. American Society for Metabolic and Bariatric Surgery for Metabolic and Bariatric Surgery and American Hernia Society consensus guideline on bariatric surgery and hernia surgery. Surg Obes Relat Dis. 2018;14(9):1221-1232.
DOI: 10.1016/j.soard.2018.07.005

Vidovic D, Jurisic D, Franjic BD, Glavan E, Ledinsky M, Bekavac-Beslin M. Factors affecting recurrence after incisional hernia repair. Hernia. 2006;10(4):322-5.
DOI: 10.1007/s10029-006-0097-z

Langer C, Schaper A, Liersch T, Kulle B, Flosman M, Füzesi L, Becker H. Prognosis factors in incisional hernia surgery: 25 years of experience. Hernia. 2005;9(1):16-21.
DOI: 10.1007/s10029-004-0265-y

Wilson JA, Clark JJ. Obesity: impediment to postsurgical wound healing. Adv Skin Wound Care. 2004;17(8):426-35.
DOI: 10.1097/00129334-200410000-00013

Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW. Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg. 1996;171(1):80-4.
DOI: 10.1016/S0002-9610(99)80078-6

Tanaka EY, Yoo JH, Rodrigues AJ Jr, Utiyama EM, Birolini D, Rasslan S. A computerized tomography scan method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain. Hernia. 2010;14(1):63-9.
DOI: 10.1007/s10029-009-0560-8

Moreno IG. Chronic eventrations and large hernias; preoperative treatment by progressive pneumoperitomeum; original procedure. Surgery. 1947;22(6):945-53.

Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204(5):709-16.
DOI: 10.1016/j.amjsurg.2012.02.008

Urrútia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis (PRISMA declaration: a proposal to improve the publication of systematic reviews and meta-analyses). Med Clin (Barc). 2010;135(11):507-11.
DOI: 10.1016/j.medcli.2010.01.015

Novitsky YW, Orenstein SB. Effect of patient and hospital characteristics on outcomes of elective ventral hernia repair in the United States. Hernia. 2013;17(5):639-45.
DOI: 10.1007/s10029-013-1088-5

Nelson JA, Fischer JP, Cleveland EC, Wink JD, Serletti JM, Kovach SJ 3rd. Abdominal wall reconstruction in the obese: an assessment of complications from the National Surgical Quality Improvement Program datasets. Am J Surg. 2014;207(4):467-75.
DOI: 10.1016/j.amjsurg.2013.08.047

Desai KA, Razavi SA, Hart AM, Thompson PW, Losken A. The Effect of BMI on Outcomes Following Complex Abdominal Wall Reconstructions. Ann Plast Surg. 2016;76 Suppl 4:S295-7.
DOI: 10.1097/SAP.0000000000000673

Pernar LIM, Pernar CH, Dieffenbach BV, Brooks DC, Smink DS, Tavakkoli A. What is the BMI threshold for open ventral hernia repair? Surg Endosc. 2017;31(3):1311-1317.
DOI: 10.1007/s00464-016-5113-5

Giordano SA, Garvey PB, Baumann DP, Liu J, Butler CE. The Impact of Body Mass Index on Abdominal Wall Reconstruction Outcomes: A Comparative Study. Plast Reconstr Surg. 2017;139(5):1234-1244.
DOI: 10.1097/PRS.0000000000003264

Owei L, Swendiman RA, Kelz RR, Dempsey DT, Dumon KR. Impact of body mass index on open ventral hernia repair: A retrospective review. Surgery. 2017;162(6):1320-1329.
DOI: 10.1016/j.surg.2017.07.025

Smolevitz J, Jacobson R, Thaqi M, Millikan S, Millikan KW. Outcomes in complex ventral hernia repair with anterior component separation in class III obesity patients. Am J Surg. 2018;215(3):458-461.
DOI: 10.1016/j.amjsurg.2017.10.056

Liang MK, Holihan JL, Itani K, Alawadi ZM, Gonzalez JR, Askenasy EP et al. Ventral Hernia Management: Expert Consensus Guided by Systematic Review. Ann Surg. 2017,265(1):80-89.
DOI: 10.1097/SLA.0000000000001701

Rosen MJ, Aydogdu K, Grafmiller K, Petro CC, Faiman GH, Prabhu A. A Multidisciplinary Approach to Medical Weight Loss Prior to Complex Abdominal Wall Reconstruction: Is it Feasible? J Gastrointest Surg. 2015;19(8):1399-406.
DOI: 10.1007/s11605-015-2856-6

Liang MK, Bernardi K, Holihan JL, Cherla DV, Escamilla R, Lew DF et al. Modifying Risks in Ventral Hernia Patients With Prehabilitation: A Randomized Controlled Trial. Ann Surg. 2018;268(4):674-680.
DOI: 10.1097/SLA.0000000000002961

Newcomb WL, Polhill JL, Chen AY, Kuwada TS, Gersin KS, Getz SB et al. Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias. Hernia. 2008;12(5):465-9.
DOI: 10.1007/s10029-008-0381-1

Borbély Y, Zerkowski J, Altmeier J, Eschenburg A, Kröll D, Nett P. Complex hernias with loss of domain in morbidly obese patients: role of laparoscopic sleeve gastrectomy in a multi-step approach. Surg Obes Relat Dis. 2017;13(5):768-773.
DOI: 10.1016/j.soard.2017.01.035

Yang S, Chen J, Shen YM, Wang MG, Cao JX, Liu YC. Retrospective research on initiative content reduction technique for obesity patients with huge abdominal incisional hernia. Int J Abdom Wall Hernia Surg 2018;1:19-23.
DOI: 10.4103/ijawhs.ijawhs_2_18

Chandeze MM, Moszkowicz D, Beauchet A, Vychnevskaia K, Peschaud F, Bouillot JL. Ventral hernia surgery in morbidly obese patients, immediate or after bariatric surgery preparation: Results of a case-matched study. Surg Obes Relat Dis. 2019;15(1):83-88.
DOI: 10.1016/j.soard.2018.09.490

Alyami M, Passot G, Voiglio E, Lundberg PW, Valette PJ, Muller A et al. Feasibility of Catheter Placement Under Ultrasound Guidance for Progressive Preoperative Pneumoperitoneum for Large Incisional Hernia with Loss of Domain. World J Surg. 2015;39(12):2878-84.
DOI: 10.1007/s00268-015-3206-2

Mayagoitia JC, Suárez D, Arenas JC, Díaz de León V. Preoperative progressive pneumoperitoneum in patients with abdominal-wall hernias. Hernia. 2006;10(3):213-7.
DOI: 10.1007/s10029-005-0040-8

Dumont F, Fuks D, Verhaeghe P, Brehant O, Sabbagh C, Riboulot M et al. Progressive pneumoperitoneum increases the length of abdominal muscles. Hernia. 2009;13(2):183-7.
DOI: 10.1007/s10029-008-0436-3

Bueno-Lledó J, Torregrosa Gallud A, Jiménez Rosellón R, Carbonell Tatay F, García Pastor P, Bonafé Diana S et al. Preoperative preparation of “loss of domain” hernia. Progressive pneumoperitoneum and botulinum toxin type A. Cir Esp. 2017;95(5):245-253.
DOI: 10.1016/j.ciresp.2017.04.006

Caldinori MW, Romano M, Bozza F, Pluchinotta AM, Pelizzo MR, Toniato A et al. Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients. Br J Surg. 1990;77(3):306-7.

Rodriguez Ortega M, Garulet Gonzalez P, Ríos Blanco R, Jiménez Carneros V, Limones Esteban M. Neumoperitoneo en el tratamiento de hernias gigantes. Cir Esp, 2006, 80(4):220-3.
DOI: 10.1016/S0009-739X(06)70961-7

Tanaka EY, Yoo JH, Rodrigues AJ Jr, Utiyama EM, Birolini D, Rasslan S. A computerized tomography scan method for calculating the hernia sac and abdominal cavity volumen in complex large incisional hernia with loss of domain. Hernia. 2010;14(1):63-9.
DOI: 10.1007/s10029-009-0560-8

Sabbagh C, Dumont F, Robert B, Badaoui R, Verhaeghe P, Regimbeau JM. Peritoneal volumen is predictive of tension-free fascia closure of large incisional hernias with loss of domain: a prospective study. Hernia. 2011;15(5):559-65.
DOI: 10.1007/s10029-011-0832-y

López MC, Robres J, López Cano M, Barri J, Lozoya R, López S. Neumoperitoneo preoperatorio progresivo en pacientes con hernias gigantes de la pared abdominal. Cir Esp. 2013,91:444-449.
DOI: 10.1016/j.ciresp.2012.08.004

Renard Y, Lardière-Deguelte S, de Mestier L, Appere F, Colosio A, Kianmanesh R, Palot JP. Management of large incisional hernias with loss of domain: A prospective series of patients prepared by progressive preoperative pneumoperitoneum. Surgery. 2016;160(2):426-35.
DOI: 10.1016/j.surg.2016.03.033

Valezi AC, de Melo BGF, Marson AC, Liberatti M, Lopes AG Jr. Preoperative progressive pneumoperitoneum in obese patients with loss of domain hernias. Surg Obes Relat Dis. 2018;14(2):138-142.
DOI: 10.1016/j.soard.2017.10.009

Ibarra-Hurtado TR, Nuño-Guzmán CM, Echeagaray-Herrera JE, Robles-Vélez E, de Jesús González-Jaime J. Use of botulinum toxin type a before abdominal wall hernia reconstruction. World J Surg. 2009 Dec;33(12):2553-6.
DOI: 10.1007/s00268-009-0203-3

Ibarra-Hurtado TR, Nuño-Guzmán CM, Miranda-Díaz AG, Troyo-Sanromán R, Navarro-Ibarra R, Bravo-Cuéllar L. Effect of botulinum toxin type A in latral abdominal wall muscles thickness and length of patients with midline incisional hernia secondary to open abdomen management. Hernia. 2014;18(5):647-52.
DOI: 10.1007/s10029-014-1280-2

Chávez-Tostado KV, Cárdenas-Lailson LE, Pérez-Trigos H. Rev Hispanoam Hernia. 2014;2(4):145-151.
DOI: 10.1016/j.rehah.2014.06.001

Farooque F, Jacombs AS, Roussos E, Read JW, Dardano AN, Edye M et al. Preoperative abdominal muscle elongation with botulinum toxin A for complex incisional ventral hernia repair. ANZ J Surg. 2016;86(1-2):79-83.
DOI: 10.1111/ans.13258

Elstner KE, Jacombs AS, Read JW, Rodriguez O, Edye M, Cosman PH. Laparoscopic repair of complex ventral hernia facilitated by pre-operative chemical component relaxation using Botulinum Toxin A. Hernia. 2016;20(2):209-19.
DOI: 10.1007/s10029-016-1478-6

Rodriguez-Acevedo O, Elstner KE, Jacombs ASW, Read JW, Martins RT, Arduini F et al. Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia. Surg Endosc. 2018;32(2):831-839.
DOI: 10.1007/s00464-017-5750-3

Elstner KE, Read JW, Saunders J, Cosman PH, Rodriguez-Acevedo O, Jacombs ASW et al. Selective muscle botulinum toxin A component paralysis in complex ventral hernia repair. Hernia. 2020;24(2):287-293.
DOI: 10.1007/s10029-019-01939-3

Hodges PW. Neuromechanical stiffness of the spine. Thesis Dissertation. Karolinska Instituye, 2003.

Motz BM, Schlosser KA, Heniford BT. Chemical Components Separation: Concepts, Eidence, and Outcomes. Plast Reconstr Surg. 2018;142(3Suppl):58S-63S.
DOI: 10.1097/PRS.0000000000004856

Elstner KE, Read JW, Rodriguez-Acevedo O, Ho-Shon K, Magnussen J, Ibrahim N. Preoperative progressive pneumoperitoneum complementing chemical component relaxation in complex ventral hernia repair. Surg Endosc. 2017;31(4)1914-1922.
DOI: 10.1007/s00464-016-5194-1

Bueno-Lledó J, Torregrosa A, Jiménez R, Pastor PG. Preoperative combination of progressive pneumoperitoneum and botulinum toxin type A in patients with loss of domain hernia. Surg Endosc. 2018;32(8):3599-3608.
DOI: 10.1007/s00464-018-6089-0

Iljin A, Szymanski D, Kruk-Jeromin J, Strzelczyk J. The repair of incisional hernia following Roux-en-Y gastric bypass with or without concomitant abdominoplasty? Obes Surg. 2008;18(11):1387-91.
DOI: 10.1007/s11695-008-9488-9

Harth KC, Blatnik JA, Rosen MJ. Optimum repair for massive ventral hernias in the morbidly obese patient—is panniculectomy helpful? Am J Surg. 2011;201(3):396-400;discussion 400.
DOI: 10.1016/j.amjsurg.2010.08.023

Fischer JP, Tuggle CT, Wes AM, Kovach SJ. Concurrent panniculectomy with open ventral hernia repair has added risk versus ventral hernia repair: an analysis of the ACS-NSQIP database. J Plast Reconstr Aesthet Surg. 2014;67(5):693-701.
DOI: 10.1016/j.bjps.2014.01.021

Ross SW, Oommen B, Huntington C, Walters AL, Lincourt AE, Kercher KW et al. National outcomes for open ventral hernia repair techniques in complex abdominal wall reconstruction. Am Surg. 2015;81(8)778-85.
DOI: 10.1177/000313481508100815

Shubinets V, Fox JP, Tecce MG, Mirzabeigi MN, Lanni MA, Kelz RR et al. Concurrent panniculectomy in the obese ventral hernia patient: Assessment of short-term complications, hernia recurrence, and healthcare utilization. J Plast Reconstr Aesthet Surg. 2017;70(6):759-767.
DOI: 10.1016/j.bjps.2017.01.001

Diaconu SC, McNichols CHL, AlFadil S, Liang Y, Bai J, Silverman RP et al. Postoperative outcomes in obese patients that undergo ventral hernia repair versus ventral hernia repair with concurrent panniculectomy. Plast Reconstr Surg. 2019;143(4):1211-1219.
DOI: 10.1097/PRS.0000000000005471

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240(4):578-83; discussion 583-5.
DOI: 10.1097/01.sla.0000141193.08524.e7

Cox TC, Blair LJ, Huntington CR, Colavita PD, Prasad T, Lincourt AE et al. The cost of preventable comorbidities on wound complications in open ventral hernia repair. J Surg Res. 2016;206(1):214-222.
DOI: 10.1016/j.jss.2016.08.009

Aquina CT, Rickles AS, Probst CP, Kelly KN, Deeb AP, Monson JR et al. Muscle and adiposity research consortium (MARC). Visceral obesity, not elevated BMI, is strongly associated with incisional hernia after colorectal surgery. Dis Colon Rectum. 2015;58(2):220-7.
DOI: 10.1097/DCR.0000000000000261

Winters H, Knaapen L, Buyne OR, Hummelink S, Ulrich DJO, van Goor H et al. Pre-operative CT scan measurements for predictin complications in patients undergoing complex ventral hernia repair using the component separation technique. Hernia. 2019;23(2):347-354.
DOI: 10.1007/s10029-019-01899-8

Dabrowiecki S, Szcesny W, Poplawski C, Sosnowski D. Intragastric balloon (BIB System) in the treatment of obesity and preparation of patients for surgery- own experience and literature review. Polski Przeglad Chirurgiczny. 2011;83(4):181-7.
DOI: 10.2478/v10035-011-0028-2

Eid GM, Mattar SG, Hamad G, Cottam DR, Lord JL, Watson A et al. Repair of ventral hernias in morbidly obese patients undergoing laparoscopic gastric bypass should not be deferred. Surg Endosc. 2004;18(2):207-10.
DOI: 10.1007/s00464-003-8915-1

Bonatti H, Hoeller E, Kirchmayr W, Muhlmann G, Zitt M, Aigner F et al. Ventral hernia repair in bariatric surgery. Obes Surg. 2004 May;14(5):655-8.
DOI: 10.1381/096089204323093444

Paajanen H, Laine H. Operative treatment of massive ventral hernia using polypropylene mesh: a challenge for surgeon and anesthesiologist. Hernia. 2005;9(1):62-7.
DOI: 10.1007/s10029-004-0283-9

Kanters AE, Krpata DM, Blatnik JA, Novitsky YM, Rosen MJ. Modified hernia grading scale to stratify surgical site occurrence after open ventral hernia repairs. J Am Coll Surg. 2012; 215(6):787-793.
DOI: 10.1016/j.jamcollsurg.2012.08.012

Berger RL, Li LT, Hicks SC, Davila JA, Kao LS, Liang MK. Development and validation of a risk-stratification score for surgical site occurrence and surgical site infection after open ventral hernia repair. J Am Coll Surg. 2013;217(6):974-82.
DOI: 10.1016/j.jamcollsurg.2013.08.003

Willis,S., Schumpelick, V. Use of progressive pneumoperitoneum in the repair of giant hernias. Hernia. 2000; 4, 105-111
DOI: 10.1007/BF02353758

Smoot D, Zielinski M, Jenkins D, Schiller H. Botox A injection for pain after laparoscopic ventral hernia: a case report. Pain Med. 2011;12(7):1121-3.
DOI: 10.1111/j.1526-4637.2011.01147.x

Cakmak M, Caglayan F, Somuncu S, Leventoglu A, Ulusoy S, Akman H, Kaya M. Effect of paralysis of the abdominal wall muscles by botulinum A toxin to intraabdominal pressure: an experimental study. J Pediatr Surg. 2006;41(4):821-5.
DOI: 10.1016/j.jpedsurg.2005.12.023

Dressler D. Clinical applications of botulinum toxin. Curr Opin Microbiol. 2012;15(3):325-36.
DOI: 10.1016/j.mib.2012.05.012

Zendejas B, Khasawneh MA, Srvantstyan B, Jenkins DH, Schiller HJ, Zielinski MD. Outcomes of chemical component paralysis using botulinum toxin for incisional hernia repairs. World J Surg. 2013;37(12):2830-7.
DOI: 10.1007/s00268-013-2211-6

Kokotovic D, Sjolander H, Gögenur I, Helgstrand F. Watchful waiting as a treatment strategy for patients with a ventral hernia appears to be safe. Hernia. 2016;20(2):281-7.
DOI: 10.1007/s10029-016-1464-z

Mrdutt MM, Munoz-Maldonado Y, Regner JL. Impact of obesity on postoperative 30-day outcomes in emergent open ventral hernia repairs. Am J Surg. 2016;212(6):1068-1075.
DOI: 10.1016/j.amjsurg.2016.09.007

Pearson DG, Carbonell AM. Obesity and abdominal wall reconstruction: outcomes, implications, and optimization. Plast Reconstr Surg. 2018;142(3Suppl):30S-35S.
DOI: 10.1097/PRS.0000000000004845

Warren JA, Epps M, Debrux C, Fowler JL 3rd, Ewing JA, Cobb WS 4th et al. Surgical Site Occurrences of Simultaneous Panniculectomy and Incisional Hernia Repair. Am Surg. 2015;81(8):764-9.
DOI: 10.1177/000313481508100813

Zemlyak AY, Colavita PD, El Djouzi S, Walters AL, Hammond L, Hammond B et al. Comparative study of wound complications: isolated panniculectomy versus panniculectomy combined with ventral hernia repair. J Surg Res. 2012;177(2):387-91.
DOI: 10.1016/j.jss.2012.06.029

Caso Clínico: Paniculectomía masiva en lipodistrofia abdominal gigante: cuando el beneficio supera los riesgos

Juan Ramón Esteban Vico , Eduardo Simón Sanz , Trinidad Delgado Ruiz , José María García Sánchez , Abel Llinás Porte

Publicado: 2017-01-09 / http://dx.doi.org/10.20960/rhh.1

Resumen | PDF

Caso Clínico: Combinación de toxina botulínica A y neumoperitoneo preoperatorio progresivo abreviado como técnica adyuvante para la reparación de grandes hernias de la región inguinal. Reporte de un caso

Ezequiel Mariano Palmisano , Andrés Pérez Grassano , María Laura Schmidt

Publicado: 2017-12-19 / http://dx.doi.org/10.20960/rhh.106

Resumen | PDF

Original: Uso profiláctico de toxina botulínica A aplicada en pared abdominal para optimizar el cierre primario del abdomen abierto contenido en ratas wistar. Modelo experimental

Gerardo Sánchez Miranda , Efrén Flores Álvarez , Ramiro Gómez Arambulo , Miguel Magdaleno García , Alejandro Palafox Hernández , Victor Usamah Caldera Sabag , José Nava Román

Publicado: 2019-05-22 / http://dx.doi.org/10.20960/rhh.00223

Resumen | PDF

Original: Infiltración preoperatoria con toxina botulínica serotipo A en la reparación de hernias ventrales con defectos de tamaño de 10-15 cm: estudio multicéntrico

Ezequiel Mariano Palmisano , Olga Mustone , Guillermo Pou Santonja , Derlin Juárez Muas , Mariano Blanco

Publicado: 2019-08-06 / http://dx.doi.org/10.20960/rhh.00257

Resumen | PDF

Caso Clínico: Eventración con pérdida del derecho a domicilio con riñón derecho y cabeza de páncreas en su interior

Alberto García Picazo , Konstantin Shirai , Miguel Ángel García Ureña , Almudena Martínez Pozuelo

Publicado: 2019-11-20 / http://dx.doi.org/10.20960/rhh.00270

Resumen | PDF

Original: Eventración tras el cierre de la ileostomía de protección

Alba Vázquez Melero , Ventura Amador Barrameda , Aida Rico

Publicado: 2020-03-10 / http://dx.doi.org/10.20960/rhh.00305

Resumen | PDF

Original: Experiencia del manejo de la hernia ventral compleja con técnicas preoperatorias: neumoperitoneo y toxina botulínica en un centro de referencia en Bogotá (Colombia)

Paola Stephany González , Iván Katime , Hermes Enrique Pumarejo , Andrés Felipe Ortiz

Publicado: 2020-08-03 / http://dx.doi.org/10.20960/rhh.00367

Resumen | PDF

Caso Clínico: Hernia incisional complicada en paciente obeso mórbido de alto riesgo en tiempos de la COVID-19

Andrés Felipe Escudero Sepúlveda , Daniel González Betancourt , Gonzalo Ezequiel Scoles , Fabián Leonardo Escudero Sepúlveda

Publicado: 2020-09-13 / http://dx.doi.org/10.20960/rhh.00375

Resumen | PDF

Revisión: Uso de la toxina botulínica en la reconstrucción de la pared abdominal

Lander Gallego Otaegui , Mikel Osorio-Capitán , Laura Carballo-Rodríguez , Aintzane Lizarazu Pérez , Íñigo Augusto Ponce , María Isabel Bollo-Arocena

Publicado: 2021-01-27 / http://dx.doi.org/10.20960/rhh.00431

Resumen | PDF

Original: Dermolipectomía asociada al tratamiento quirúrgico de las hernias incisionales en pacientes obesos

Publicado: 2021-02-02 / http://dx.doi.org/

Resumen | PDF