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Biomedical subjects

A W Robbins

Publications and source records attributed to A W Robbins.

17 recordsLinked to original sources
PubMed1998

Mesh plug repair and groin hernia surgery.

Since the mid-1980s, dramatic progress has been made in the evolution of hernia surgery, highlighted by the increasing use of prosthetic mesh. Among the mesh-based "tension-free" hernioplasties, the use of mesh plugs has garnered a large number of spirited enthusiasts, and plug herniorrhaphy has become the fastest growing hernia repair currently employed by the American surgeon. To demonstrate the simplicity and effectiveness of mesh plugs, a 9-year experience with almost 3300 patients is reported. Technical details are discussed and presentation of a literature search serves to further emphasize the utilitarian nature of this elegantly unsophisticated surgical operation.

Biocompatible Materials↗
PubMed1998

Classification systems and groin hernias.

The once simple division of groin hernias into indirect and direct inguinal and femoral components is no longer adequate to reflect a more sophisticated understanding of the pathophysiology and management of these lesions. Similarly, the availability of a concise, easy-to-use, logical, and recognizable classification scheme would facilitate a better understanding of modern repair techniques and confirmation of operative results.

Hernia, Inguinal↗
PubMed1998

Recurrent Groin Hernia: Reduction in Complications by PerFix Hernioplasty.

Repair of the recurrent groin hernia remains one of the more perplexing problems encountered by the general surgeon. Surgical results have shown little improvement in the more than 100 years of modern hernia surgery. Despite the utilization of a multitude of complex and technically demanding operative procedures, such varied surgical techniques as wide dissection, detailed anatomic repair, multi-layered repair, relaxing incisions, tissue flaps, suture of living tissue, weaving of a reinforcing lattice of suture or tissue, transposition of cord, and orchiectomy, have engendered little more than increased disability and complications.

Journal Article↗
PubMed1998

The mesh plug technique for recurrent groin herniorrhaphy: a nine-year experience of 407 repairs.

BACKGROUND: Recurrent inguinal hernias can be repaired efficaciously by mesh plug techniques, which have had better results than traditional tissue-based repairs in several small studies. This report provides a detailed description and assessment of the anterior, tension-free, "umbrella" mesh plug method for recurrent groin herniorrhaphy. METHODS: We performed a retrospective analysis of 407 patients with recurrent inguinal and femoral hernias treated with an umbrella mesh plug repair since 1989. Information was recorded about postoperative recovery and complications, and patients were examined for rerecurrences 1 week after operation and annually thereafter. RESULTS: Of the 320 patients with a first-time recurrence, 6 (2%) had a recurrence after placement of a mesh plug. Of the 87 patients who had undergone 2 or more prior repairs, 8 (9%) had a rerecurrence subsequent to a mesh plug hernioplasty. Nine (64%) of the 14 rerecurrences were noted within 1 year of operation; 4 (29%) were found 2 years after operation and 1 (7%) during postoperative year 3. During the 9 years of follow-up study, a mesh plug has not been involved in any infectious process requiring removal. There have been no instances of draining sinus tracts, ischemic orchitis, long-term pain, vascular and embolic phenomena, or plug erosion and migration. Two hundred fifteen (53%) of the patients took no pain medication. One hundred fifty-nine patients (39%) used nothing more than nonprescription pain medicine. Three hundred seventy-five patients (92%) returned to normal daily activities within 4 days of the herniorrhaphy. CONCLUSIONS: Patients with recurrent groin hernias, who undergo a minimal-dissection umbrella mesh plug repair, have a rapid recovery and few postoperative complications.

Follow-Up Studies↗
PubMed1997

[Hernioplasty with mesh implant].

Eight years of experience (1989-1996) in over 3,000 patients has revealed that the PerFix mesh plug hernioplasty is a simple surgical operation and in a standardized form can be utilized to repair virtually any primary or recurrent inguinal or femoral hernia. Recurrence rates remain acceptably low (< 1% in primary and 2% in recurrent repairs) and, most importantly, operative morbidity and short- and long-term complications are essentially eliminated. As a direct consequence, individuals are able to resume their normal daily activities promptly and return quickly to work.

Follow-Up Studies↗
PubMed1996

Open mesh plug hernioplasty: the less invasive procedure.

Surgical repair of inguinal hernia is among the oldest and most common operations performed by S general surgeons. Currently, 700,000 procedures are performed annually in the United States.“ Regardless ofthe large volume of hernia surgery which is performed, the results are less than ideal. It is estimated that the recurrence rate of primary hernia repair remains at 10% to 15% with a higher rate following repair of recurrent hernia.“ Equally important, there is frequently a long period of disability and discomfort. Many surgeons still advise their patients to refrain from work, exercise, and heavy lifting for periods of 3 to 8 weeks. While it is common in the United States for hernia surgery to be performed on an ambulatory basis, it is still not unusual that patients are hospitalized for several days to a week in other parts of the world. lt is readily apparent that unnecessary days spent in hospital add a great burden to every country’s healthcare expenditures.

Journal Article↗
PubMed1993

Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States.

Although demographic and socioeconomic data regarding the natural history of hernia disease are difficult to find, studies from the National Center for Health Statistics show that approximately 700,000 groin herniorrhaphies are completed annually in the United States. More than 60% of these operations are performed on an outpatient basis. Classification schemes relative to hernia repair serve as an important communication tool when retrieving and reporting operative results in a more comprehensive, reliable, and meaningful fashion. Part of the growing movement toward ambulatory surgery includes the construction of office-based operating suites by general surgeons. Because of the increasing number of hernioplasties completed in the outpatient setting, the use of a laparoscopic approach for hernia repair does not appear to provide any cost-saving benefits over existing conventional techniques.

Adolescent↗
PubMed1993

The mesh-plug hernioplasty.

The evolution of tension-free hernioplasty techniques; culminating in the mesh-plug repair, is presented. Experience with 1563 cases is described. Recurrences have been virtually eliminated. The factors of no tissue tension and decreased dissection are believed to be the two most important reasons why there is greater patient comfort, rapid rehabilitation, lowered cost, and diminished complications with the mesh-plug technique. The mesh-plug hernioplasty is recommended for the treatment of all groin hernias.

Adolescent↗
PubMed1993

"Tension-free" inguinal herniorrhaphy: a preliminary report on the "mesh plug" technique.

BACKGROUND: Since 1984 we have completed 3897 inguinal herniorrhaphies. This article compares our results with a conventional Cooper ligament repair versus the "mesh hernia plug" method. METHODS: From 1984 through 1988 we performed 2886 conventional Cooper ligament repairs. From 1989 through 1991 we completed 1011 mesh hernia plug repairs. RESULTS: Despite an acceptable recurrence rate (1.8%), we abandoned the Cooper ligament technique because of persistent difficulties with immediate postoperative pain, inability to reasonably resume day-to-day activities, delayed capacity regarding return to work, and four cases of femoral vein compression. Of the hernias repaired by the mesh plug method, the recurrence rate remains remarkably low (0.2%), and except for four superficial infections and three cases of urinary retention, no other significant complications have been reported. CONCLUSIONS: Compared with conventional sutured surgical techniques, a plug repair uses less overall dissection and ensures a "tension-free" hernioplasty. We believe that the two factors of no tissue tension and decreased dissection are the most important reasons for greater patient comfort, rapid rehabilitation, decreased recurrence, and lessened overall complication rates with the mesh hernia plug technique.

Adolescent↗
PubMed1983

Sleep apnea syndrome after poliomyelitis.

We present a case of severe breathing abnormality during sleep in a young man who had had poliomyelitis 20 yr before. His sleep disorder led to respiratory failure and cor pulmonale, which were greatly improved by oxygen therapy. A study of this case and those previously described supports the notion that brainstem damage during acute poliomyelitis is important in the later appearance of sleep-disordered breathing. In addition, such patients usually have mechanical abnormalities involving the thoracic cage and respiratory muscles. These ventilatory restrictions amplify the pathophysiologic effects of abnormal central nervous system control of breathing during sleep, and we suggest that their presence has a key role in the development of sleep apnea syndrome in these patients.

Adult↗
PubMed1980

Occupational ill-health--a review of the symptoms and signs.

This review presents a brief history of occupational health contrasting the United States' experience to European developments. Recent legislation is reviewed, including attempts to amend the Occupational Safety and Health Act and to institute a national program of workers' compensation. Developments in the executive agencies in the Carter administration are discussed with attention to the new occupational health standards for lead and for cotton dust. Following this discussion several scientific issues are reviewed. They include problems surrounding latency, synergism, and the introduction of new toxic hazards. Finally, the review covers three major policy issues: control technology, information for workers, and industry responsibility.

Health Education↗