Top

Published in:

01-08-2017 | Original Paper

The bony anchoring reinforcement system (BARS) for flank hernia repair: a versatile technique

Authors: Andrew I. Elkwood, Steven D. Kozusko, Tushar R. Patel, Michael I. Rose, Matthew R. Kaufman, Russell L. Ashinoff, Adam Saad, Steven J. Binenbaum, Frank Borao

Published in: European Journal of Plastic Surgery | Issue 4/2017

Abstract

Background

Abdominal wall reconstruction, especially when fascial defects occur in the flank region, is a field of high interest given the morbidity of hernias. The flank hernia is a rare and challenging entity requiring adequate overlap and secure fixation for a successful repair.

Methods

This is a retrospective case series study including all patients undergoing flank hernia repair using the bony anchoring reinforcement system (BARS) technique from March 2013 through August 2015. An electronic chart review identified seven patients with flank hernias that underwent the BARS procedure.

Results

Six of the patients followed-up for a full year with one patient dropping out after returning to exercise and indicating high satisfaction with operative outcome. There was one recurrent hernia 29 months later. There were no surgical site or mesh infections.

Conclusions

The BARS technique is a versatile and efficacious open approach for repairing flank hernias. It allows for a large area of overlap and secure fixation to the bony structures in the pelvis.

Level of Evidence: Level V, therapeutic study

Akinduro OO, Jones F, Turner J, Cason F, Clark C (2015) Rare case of a strangulated intercostal flank hernia following open nephrectomy: a case report and review of literature. Int J Surg Case Rep 17:143–145CrossRefPubMedPubMedCentral

Kim DJ, Park JW (2015) A rare nonincisional lateral abdominal wall hernia. Ann Surg Treat Res 88(2):111–113CrossRefPubMedPubMedCentral

Phillips MS, Krpata DM, Blatnik JA, Rosen MJ (2012) Retromuscular preperitoneal repair of flank hernias. J Gastrointest Surg 16(8):1548–1553CrossRefPubMed

Edwards C, Geiger T, Bartow K, et al. (2009) Laparoscopic transperitoneal repair of flank hernias: a retrospective review of 27 patients. Surg Endosc 23(12):2692–2696CrossRefPubMed

Elkwood AI, Borao FJ, Ashinoff RL, et al. (2014) Complex incisional hernias repaired in conjunction with the bony anchoring reinforcement system (BARS) prevents hernia recurrence. Eur J Plast Surg 37(8):431–436CrossRef

Pezeshk RA, Pulikkottil BJ, Bailey SH, et al. (2015) An evidence-based model for the successful treatment of flank and lateral abdominal wall hernias. Plast Reconstr Surg 136(2):377–385CrossRefPubMed

Purnell CA, Park E, Turin SY, Dumanian GA (2016) Postoperative flank defects, hernias, and bulges: a reliable method for repair. Plast Reconstr Surg 137(3):994–1001CrossRefPubMed

Bisgaard T, Kehlet H, Bay-Nielsen MB, et al. (2009) Nationwide study of early outcomes after incisional hernia repair. Br J Surg 96(12):1452–1457CrossRefPubMed

Halm JA, Lip H, Schmitz PI, Jeekel J (2009) Incisional hernia after upper abdominal surgery: a randomized controlled trial of midline versus transverse incision. Hernia 13(3):275–280CrossRefPubMedPubMedCentral

10.

Kendall SW, Brennan TG, Guillou PG (1991) Suture length to wound length ratio and the integrity of midline and lateral paramedian incisions. Br J Surg. 78(6):705–707CrossRefPubMed

11.

Espositio TJ, Fedorak I (1994) Traumatic lumbar hernia: case report and literature review. J Trauma 37(1):123–126CrossRef

12.

Heniford BT, Iannitti DA, Gagner M (1997) Laparoscopic inferior and superior lumbar hernia repair. Arch Surg 132(10):1141–1144CrossRefPubMed

13.

Veyrie N, Poghosyan T, Corigliano N, Canard G, Servajean S, Bouillot JL (2013) Lateral incisional hernia repair by the retromuscular approach with polyester standard mesh: topographic considerations and long-term follow-up of 61 consecutive patients. World J Surg 37(3):538–544CrossRefPubMed

14.

Bolkier M, Moskovitz B, Ginesin Y, Levin DR (1991) An operation for incisional lumbar hernia. Eur Urol 20(1):52–53PubMed

15.

Cavallaro G, Sadighi A, Miceli M, Burza A, Carbone G, Cavallaro A (2007) Primary lumbar hernia repair: the open approach. Eur Surg Res 39(2):88–92CrossRefPubMed

Title: The bony anchoring reinforcement system (BARS) for flank hernia repair: a versatile technique
Authors: Andrew I. Elkwood
Steven D. Kozusko
Tushar R. Patel
Michael I. Rose
Matthew R. Kaufman
Russell L. Ashinoff
Adam Saad
Steven J. Binenbaum
Frank Borao
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Plastic Surgery / Issue 4/2017
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI: https://doi.org/10.1007/s00238-016-1272-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The bony anchoring reinforcement system (BARS) for flank hernia repair: a versatile technique

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2017

Analysis of the two-point discrimination test in daily routine practice

Erratum to: The outcome of primary brachial plexus reconstruction in extended Erb’s obstetric palsy when only one root is available for intraplexus neurotization

Hemi-facial reconstruction following extensive crush avulsion injury of the face

Fascio-cutaneous flaps for chest wall reconstruction after massive inflammatory breast cancer: a case series

Acellular bovine pericardium in implant-based breast reconstruction: A systematic review of the literature

Fatty degeneration of mammary glands in female-to-male transsexuals