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Background: Subxiphoid incisional hernia occurs as a complication following median sternotomy and are difficult to repair. We present recent data of a standardized technique for correction of subxiphoid incisional hernias, and discuss possible anatomical and surgical factors related to recurrence of the hernia.Methods: A retrospective study with medical records analysis of patients submitted to surgical correction of subxiphoid incisional hernias through standardized treatment between July 2014 and September 2016. All procedures were carried out using the same standardized technique, surgical materials (threads and meshes) and pre- and post-operative care.Results: All of the surgical procedures carried out were elective. The hernia defect varied between 5 cm and 16 cm (mean of 7.4 cm); the procedure lasted between 32 and 75 min; the mean time of hospital stay was 2.2 days (range from 1 to 5 days). In five patients the correction of subxiphoid incisional hernia was carried out concurrently with another procedure. No death occurred as a result of the operations. Five patients had minor postoperative complications. Follow up time was between 7 and 33 months, with a recurrence rate of 0% at the time of writing.Conclusions: Despite the limitations of a short follow up period, the surgical technique described presented low rates of early recurrence by closing the hernia defect, using relaxing incisions in the musculature and aponeurosis and surgical mesh. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic totally extraperitoneal (TEP) hernia repair is a technically demanding procedure. Recent studies have identified BMI as an independent factor for technical difficulty in the learning period., Aim: To analyze the effect of overweight and obesity on the technical difficulties of TEP., Method: Prospective study on patients who underwent a symptomatic inguinal hernia by means of the TEP technique. Were analyzed gender, BMI, previous surgery, hernia type, operative time and complications. Technical difficulty was defined by operative time, major complications and recurrence. Patients were classified into four groups: 1) underweight, if less than 18,5 kg/m²; 2) normal range if BMI between 18,5 and 24,9 kg/m²; 3) overweight if BMI between 25-29,9 kg/m²; and 4) obese if BMI≥30 kg/m²., Results: The cohort had a total of 190 patients, 185 men and 5 women. BMI values ranged from 16-36 kg/m² (average 26 kg/m²). Average operating time was 55.4 min in bilateral hernia (15-150) and 37.8 min in unilateral (13-150). Time of surgery was statistically correlated with increased BMI in the first 93 patients (p=0.049)., Conclusion: High BMI and prolonged operative time are undoubtedly correlated. However, this relationship may be statistically significant only in the learning period. Although several clinical features can influence surgical time, upon reaching an experienced level, surgeons appear to easily handle the challenges.