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Hiatal Hernia

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or...

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Related Experiment Video

Updated: May 6, 2026

Use of a Rat Model to Study Ventral Abdominal Hernia Repair

Use of a Rat Model to Study Ventral Abdominal Hernia Repair

Published on: October 2, 2017

Development of an Enhanced Recovery After Surgery Program in Ventral Hernia.

John K Ewing¹, Kyle E Cassling², Michael A Hanneman¹

¹Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

The American Surgeon

|August 3, 2024

Summary

Enhanced Recovery After Surgery (ERAS) programs improved ventral hernia care by reducing hospital stays and opioid use. This pathway demonstrates successful ERAS implementation for hernia patients.

Keywords:

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Area of Science:

Surgical Pathway Development
Hernia Surgery Outcomes
Enhanced Recovery Protocols

Background:

Enhanced Recovery After Surgery (ERAS) programs, initially successful in colorectal surgery, are evolving for ventral hernia repair.
Ventral hernia repair presents unique challenges for ERAS pathway adoption.
This study details the creation and implementation of a specialized ERAS pathway for ventral hernia patients.

Purpose of the Study:

To develop and implement a comprehensive Enhanced Recovery After Surgery (ERAS) pathway tailored for ventral hernia repair.
To evaluate the impact of the ERAS pathway on key clinical outcomes and compliance.
To establish a standardized, evidence-based approach to ventral hernia patient care.

Main Methods:

A multidisciplinary team developed a 6-month ERAS pathway incorporating 75 process and outcome measures across all care phases.
Key components included preoperative optimization, non-opioid multimodal analgesia, early diet, and mobilization.
A comparative analysis was performed between pre-implementation (PGL) and post-implementation (AGL) periods.

Main Results:

ERAS compliance improved significantly, rising from 73.9% in the PGL group to 82.9% in the AGL group.
Average length of stay (LOS) decreased from 2.27 days to 1.92 days post-implementation.
Average daily postoperative opioid consumption (MME) was reduced by 46.8%, from 25.4 to 13.5.

Conclusions:

Enhanced Recovery After Surgery (ERAS) is effectively applicable to ventral hernia patient care, leading to tangible improvements.
Successful implementation requires strong institutional support and robust multidisciplinary collaboration.
The developed ERAS pathway demonstrates significant reductions in length of stay and opioid utilization for hernia repair.