# Hernia Recurrence — GCMD Library living collection

Everything in the library about hernia recurrence — built automatically from dossiers that name it.

Updated: n/a · 4 episodes · 30 cited statements

## Episodes
### Evidence & Research
- [BOB in Ped Surg 2023 - CAPS Winner - Christina Theodorou, MD](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327) — video · [machine version](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327.md)
- [BOB Ped Surg 2023 - Christina Theodorou, CAPS  - Presentation](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346) — video · [machine version](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346.md)
- [A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460) — video · 0:51 · [machine version](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460.md)
- [A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527) — video · 0:51 · [machine version](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=0) Introduction to CAPS Meeting Finalists (Ep 1)
- [3:53](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=233) Biodegradable Polyurethane Patch Study Presentation (Ep 1)
- [7:35](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=455) Expert Discussion of Study Limitations and Clinical Implications (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=0) Introduction and Background on Congenital Diaphragmatic Hernia Repair (Ep 2)
- [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=60) Polyurethane Patch Development and Study Design (Ep 2)
- [2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=120) Results: Recurrence and Diaphragmatic Excursion (Ep 2)
- [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=180) Histology, Conclusions, and Study Limitations (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=0) Nationwide comparison of laparoscopic versus open pediatric inguinal hernia repair outcomes (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=0) Nationwide comparison of laparoscopic versus open pediatric inguinal hernia repair outcomes (Ep 4)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "A nationwide study examined over 53,000 children who had inguinal hernia repair across the United States." — Lizzie Lee (host_summary) [Ep 3 · 0:06](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=6)
- "Approximately 16% of pediatric inguinal hernia repairs in the study were performed laparoscopically." — Lizzie Lee (host_summary) [Ep 3 · 0:13](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=13)
- "The majority of pediatric inguinal hernia repairs in the study were open repairs." — Lizzie Lee (host_summary) [Ep 3 · 0:15](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=15)
- "Laparoscopic inguinal hernia repair had more than 3 times the risk of same-side recurrence compared to open surgery." — Lizzie Lee (host_summary) [Ep 3 · 0:23](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=23)
- "Laparoscopic inguinal hernia repair was linked to fewer future surgeries on the opposite side (metachronous hernias)." — Lizzie Lee (host_summary) [Ep 3 · 0:30](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=30)
- "The findings comparing laparoscopic and open inguinal hernia repair held up after adjusting for hospital differences and patient factors." — Lizzie Lee (host_summary) [Ep 3 · 0:36](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=36)
- "Open inguinal hernia repair has a lower risk of same-side recurrence compared to laparoscopic repair." — Lizzie Lee (host_summary) [Ep 3 · 0:40](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=40)
- "Laparoscopic inguinal hernia repair may reduce the chance of needing surgery on the contralateral side." — Lizzie Lee (host_summary) [Ep 3 · 0:40](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11460?t=40)
- "A nationwide study examined over 53,000 children who had inguinal hernia repair across the United States." — Lizzie Lee (host_summary) [Ep 4 · 0:06](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=6)
- "Approximately 16% of the pediatric inguinal hernia repairs in the study were performed laparoscopically." — Lizzie Lee (host_summary) [Ep 4 · 0:13](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=13)
- "The majority of pediatric inguinal hernia repairs in the study were open repairs." — Lizzie Lee (host_summary) [Ep 4 · 0:15](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=15)
- "The study compared two key outcomes: hernia recurrence on the same side and the need for a second hernia operation later on." — Lizzie Lee (host_summary) [Ep 4 · 0:17](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=17)
- "Laparoscopic inguinal hernia repair had more than 3 times the risk of same-side recurrence compared to open surgery." — Lizzie Lee (host_summary) [Ep 4 · 0:23](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=23)
- "Laparoscopic inguinal hernia repair was linked to fewer future surgeries on the opposite side (metachronous hernias)." — Lizzie Lee (host_summary) [Ep 4 · 0:30](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=30)
- "The findings comparing laparoscopic and open inguinal hernia repair held up even after adjusting for hospital differences and patient factors." — Lizzie Lee (host_summary) [Ep 4 · 0:36](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=36)
- "Open inguinal hernia repair has a lower risk of same-side recurrence compared to laparoscopic repair." — Lizzie Lee (host_summary) [Ep 4 · 0:40](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=40)
- "Laparoscopic inguinal hernia repair may reduce the chance of needing surgery on the contralateral side." — Lizzie Lee (host_summary) [Ep 4 · 0:40](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=40)
- "In cases of large congenital diaphragmatic hernia defects, diaphragmatic replacements are used, most commonly synthetic patches such as PTFE or Gore-Tex." — Christina Theodorou (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=0)
- "Synthetic patches for diaphragmatic hernia repair are associated with significant morbidity including hernia recurrence, bowel obstructions, and chest wall deformities as the child grows." — Christina Theodorou (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=0)
- "The ideal diaphragm replacement would integrate with native tissue, mechanically match the function of the diaphragm and allow for growth with the child." — Christina Theodorou (opinion) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=0)
- "Biodegradable forms of polyurethane have been used in tissue repair recently such as vascular and muscular tissue replacement and have high mechanical strength." — Christina Theodorou (clinical) [Ep 2 · 1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=60)
- "The study created 4 mm diaphragmatic defects in rats followed by immediate patch repair, with cohorts of six animals each plus a sham cohort of six rats." — Christina Theodorou (clinical) [Ep 2 · 1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=60)
- "Animals were survived for four weeks with fluoroscopic evaluation of diaphragmatic excursion at one and four weeks post-op." — Christina Theodorou (clinical) [Ep 2 · 1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=60)
- "No recurrences were seen in either the polyurethane or Gore-Tex cohort at four weeks." — Christina Theodorou (clinical) [Ep 2 · 2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=120)
- "At one week post-op, there was no difference in diaphragmatic excursion between sham, Gore-Tex, and polyurethane animals." — Christina Theodorou (clinical) [Ep 2 · 2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=120)
- "At four weeks, Gore-Tex had limited diaphragm rise compared to sham, but no difference was found between polyurethane and sham." — Christina Theodorou (clinical) [Ep 2 · 2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=120)
- "There were no differences in diaphragmatic excursion between polyurethane and Gore-Tex at any time point." — Christina Theodorou (clinical) [Ep 2 · 2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=120)
- "An inflammatory capsule was formed surrounding both polyurethane and Gore-Tex patches." — Christina Theodorou (clinical) [Ep 2 · 3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=180)
- "There was no significant difference in the size of the inflammatory capsule between the polyurethane and Gore-Tex cohorts." — Christina Theodorou (clinical) [Ep 2 · 3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=180)
- "The study had small numbers of animals in each cohort (six per group), likely under powering detection of significant differences." — Christina Theodorou (clinical) [Ep 2 · 3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=180)
- "Most diaphragmatic hernia recurrences occur at least a few months out from surgery, most commonly within the first two years." — Christina Theodorou (clinical) [Ep 2 · 3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=180)
- "The biodegradation rate of the polyurethane patch can be altered to match the rate of tissue in-growth with the goal of complete replacement over time with native diaphragm tissue." — Christina Theodorou (clinical) [Ep 2 · 3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-christina-theodorou-caps-presentation-6346?t=180)
- "Synthetic patches such as PTFE or Gore-Tex used for large diaphragmatic defects are associated with significant morbidity, including hernia recurrence, bowel obstructions, and chest wall deformities as the child grows." — Christina Theodoro (clinical) [Ep 1 · 3:53](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=233)
- "Biodegradable forms of polyurethane have been used in tissue repair recently, such as vascular and muscular tissue replacement, and have high mechanical strength." — Christina Theodoro (clinical) [Ep 1 · 4:40](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=280)
- "In the rat model study, 4mm diaphragmatic defects were created followed by immediate patch repair, with six animals in each cohort plus a sham cohort of six rats." — Christina Theodoro (clinical) [Ep 1 · 5:10](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=310)
- "No recurrences were seen in either the polyurethane or Gore-Tex cohort at four weeks." — Christina Theodoro (clinical) [Ep 1 · 6:00](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=360)
- "At one week, there was no difference in diaphragmatic excursion between sham, Gore-Tex and polyurethane animals." — Christina Theodoro (clinical) [Ep 1 · 6:10](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=370)
- "At four weeks, Gore-Tex had limited diaphragm rise compared to sham, but no difference was found between polyurethane and sham." — Christina Theodoro (clinical) [Ep 1 · 6:20](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=380)
- "There were no differences in diaphragmatic excursion between polyurethane and Gore-Tex at any time point." — Christina Theodoro (clinical) [Ep 1 · 6:35](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=395)
- "An inflammatory capsule was formed surrounding both patches, with no significant difference in the size of that inflammatory capsule between the cohorts." — Christina Theodoro (clinical) [Ep 1 · 6:45](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=405)
- "The study had small numbers of animals in each cohort, likely underpowering detection of significant differences." — Christina Theodoro (clinical) [Ep 1 · 7:10](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=430)
- "Most recurrences of diaphragmatic hernia occur at least a few months out from surgery, most commonly within the first two years." — Christina Theodoro (clinical) [Ep 1 · 7:20](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=440)
- "The biodegradation rate of the polyurethane patch cannot be too fast because then there will be another hernia." — Tony (clinical) [Ep 1 · 8:03](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=483)
- "Understanding the intrinsic strength of the polyurethane patch at different time periods will be really important for its use as a diaphragm patch." — Tony (opinion) [Ep 1 · 8:03](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=483)
- "There is some evidence that absorbable patches are not as good and the recurrence rate is higher for diaphragmatic hernias compared to non-absorbable patches." (clinical) [Ep 1 · 8:25](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=505)
- "Tony personally uses a Gore-Tex patch that stays there forever and gets embedded into the tissues because of the high incidence of recurrent hernias with biodegradable patches." — Tony (opinion) [Ep 1 · 8:43](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=523)
- "A short-term study showing that the polyurethane patch works is not adequate evidence to translate it to patient care." — Tony (opinion) [Ep 1 · 10:20](https://library.globalcastmd.com/watch/bob-in-ped-surg-2023-caps-winner-christina-theodorou-md-6327?t=620)

## Changelog
- Sep 25: 4 items added automatically

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