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. 2019 Feb;43(2):396-404.
doi: 10.1007/s00268-018-4783-7.

What Exactly is Meant by "Loss of Domain" for Ventral Hernia? Systematic Review of Definitions

S G Parker  1 , S Halligan  2 , S Blackburn  3 , A A O Plumb  2 , L Archer  4 , S Mallett  4 , A C J Windsor  3
Affiliations

What Exactly is Meant by "Loss of Domain" for Ventral Hernia? Systematic Review of Definitions

S G Parker et al. World J Surg. 2019 Feb.

Abstract

Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed database was searched for articles reporting large hernia repairs that explicitly described LOD. Two reviewers screened citations and extracted data from selected articles, focusing on the definitions used for LOD, study demographics, study design, and reporting surgical specialty. One hundred and seven articles were identified, 93 full-texts examined, and 77 were included in the systematic review. Sixty-seven articles were from the primary literature, and 10 articles were from the secondary literature. Twenty-eight articles (36%) gave a written definition for loss of domain. These varied and divided into six broad groupings; four described the loss of the right of domain, six described abdominal strap muscle contraction, five described the "second abdomen", five describing large irreducible hernias. Six gave miscellaneous definitions. Two articles gave multiple definitions. Twenty articles (26%) gave volumetric definitions; eight used the Tanaka method [hernia sac volume (HSV)/abdominal cavity volume] and five used the Sabbagh method [(HSV)/total peritoneal volume]. The definitions used for loss of domain were not dependent on the reporting specialty. Our systematic review revealed that multiple definitions of loss of domain are being used. These vary and are not interchangeable. Expert consensus on this matter is necessary to standardise this important concept for hernia surgeons.

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Conflict of interest statement

Windsor A.C.J. declares conflicts of interest not directly related to the submitted work; educational Grants and speaker for: BARD, LifeCell and Cook. Parker S.G, Blackburn S, Plumb A.A, Archer L, Mallet S and Halligan S declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow chart of study selection
See this image and copyright information in PMC

References

    1. Shelton J, Poulose BK, Phillips S, Moore D, Nealon W, Penson D, et al. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16:179–183. - PubMed
    1. Dabbas N, Adams K, Pearson K, Royle GT. Frequency of abdominal wall hernias: is classical teaching out of date? J R Soc Med. 2011;2(1):1–6. - PMC - PubMed
    1. Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008;451:716–719. - PubMed
    1. The Royal College of Physicians (2004) Storing up problems: the medical case for a slimmer nation
    1. Hospital Episode Statistics (2017) UK ventral hernia data: report on request

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