bluuebunny/crossref_metadata_2025_split huggingface dataset:
P073 SYNCHRONOUS VERSUS DELAYED SURGICAL TREATMENT OF MORBID OBESITY AND VENTRAL HERNIA. PRELIMINARY RESULTS OF A RETROSPECTIVE SINGLE CENTER STUDY
Authors: Barone Gisella , Bertoglio Camillo Leonardo , Maspero Marianna , Girardi Valerio , Morini Lorenzo , Grimaldi Simona , Ferrari Giovanni 
Published: December 2021

Abstract

Aim
The worldwide increase in morbid obese patients raises controverises regarding the best timing of treatment for concomitant ventral hernias (VH). We present the preliminary experience at a referral center for bariatric surgery (BS): synchronous versus delayed ventral hernia repair (S-VHR, D-VHR) have been compared.

Material and Methods
From 2009, 40 consecutive morbid obese patients eligible for BS presented with concomitant VH. Symptoms and characteristics of the VH were evaluated to choose between S-VHR (28 patients), primary (n = 12) or mesh augmented (n = 16), and D-VHR (12 patients). 90-day postoperative complications and hernia recurrence were evaluated.

Results
3 patients out of 16 in the mesh group experienced superficial surgical site infections. 4 patients in the D-VHR had a bowel incarceration within 20 days after BS and required emergency surgery with mesh implantation. No complications occurred in the primary repair group. The recurrence rate was around 19% in both groups of the S-VHR. Nonetheless the group that received mesh repair had a significant higher mean value of the defect. In the D-VHR cohort 1 patient was lost at follow up while 3 patients were not operated on due to inadequate weight loss. No recurrences occurred in the 4 patients requiring emergency surgery.

Conclusions:
D-VHR is associated with worse early postoperative outcomes; primary suture repair should be considered in preventing bowel incarceration but synchronous mesh repair is preferred in large symptomatic hernias for its acceptable postoperative morbidity and hernia recurrence at 1 year.
P076 DIFFERENT SURGICAL APPROACH IN DIASTASIS RECTI REPAIR: IMPORTANCE OF AN OVERALL VIEW OF THE DISEASE
Authors: Fiori Federico , Ferrara Francesco , Gentile Daniele , Baldi Caterina , Benuzzi Laura , Boati Paolo , Stella Marco , Calì Matteo 
Published: December 2021

Abstract

Aim
Diastasis Recti (DR) is characterized by a defect of the linea alba sometimes associated with midline hernias, and frequent lipocutaneous excess. We present our experience in the treatment of diastasis recti with Inter Recti Distance (IRD) &gt; 50mm -with or without umbilical hernia- by 3 different approaches.

Material and Methods
From January 2018 to February 2020, 104 patients were referred to our unit for clinical and radiological diagnosis of DR with IRD &gt; 50 mm. Three different surgical approaches were used, based on presence of lipocoutaneous excess: laparoabdominoplasty, laparominiabdominoplasty and minimally-invasive/endoscopic with Totally Sublay Anterior Repair (TESAR) approach.

Results
We performed 28 TESAR (29.8%), 44 laparoabdominoplasties (42.3%) and 32 laparominiabdominoplasties (30.8%). Overall complication rate was 26% (27 patients). In 3 (2.9%) cases major surgical complications (Clavien-Dindo 3-4) occurred, all for open operations. Minor complications (Clavien-Dindo 1-2) included: 13 cutaneous ischemia, 10 small muscular hematomas and 1 subcutaneous seroma. The overall median post-operative stay was 3 days (range 2 – 14 days), and 3, 4 and 3 days for TESAR, laparoabdominoplasty and laparominiabdominoplasty groups, respectively. No recurrence registered to date.

Conclusions
Our experience shows the importance of an overall view of the functional and cosmetic impairment created by the DR. The surgeon must obtain an optimal functional outcome also aiming for the best cosmetic result. Therefore different approaches have to be considered, tailored to the clinical, instrumental and psychological aspects of the disease. The complication rate, while in line with the literature, emphasize how in this type of operation the critical issues of functional as well as morphological surgery coexist.
P088 SURGEON AS A RISK FACTOR OF REDUCED EURAHS QOL SCORE AFTER HERNIA REPAIR
Authors: Woleský Jakub , Jíšová Barbora , East Barbora 
Published: December 2021

Abstract

Aim
Our aim was to analyze patient’s reported EuraHS QoL (quality of life) scores before and after hernia surgery. And find whether the result is surgeon dependent or not, because hernia repair often serves as a training surgery for young surgeons or is performed by surgeons with no hernia interest. However, even a simple groin hernia repair can lead to life-long pain or reduced QoL and the risk of complications following incisional hernia repair is much higher.

Material and Methods
We have utilized the EuraHS database and its QoL questionnaire and prospectively entered all patients undergoing any hernia repair at our department since Jan. 2019.

Results
519 patients have been included. Many patients in the incisional hernia cohort have reported no or very little symptoms before the operation. Only 251 have completed their 1 month follow-up with the QoL questionnaire. 63 patients have been contacted and questioned 1 year post-surgery to this date. In 6 cases the QoL scores are lower than pre-repair. 45 patients had a record of major complication or reoccurrence requiring surgery so far. Unfortunately 31 of those did not fill up the QoL questionnaire. 37 were operated on by resident with a supervision of a surgeon without a hernia interest.

Conclusions
Results of hernia repair are surgeon dependent and an internal audit of current practices is needed at many general surgery departments.
P093 RESULTS OF CYTOREDUCTION SURGERY AND HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY (HIPEC) WITH SIMULTANEOUS COMPLEX RECONSTRUCTION OF THE ABDOMINAL WALL
Authors: Fernández Ismael Antón , Pérez Jorge Loro , GonzálezSánchez Laura , Tomasety Eudaldo López , Hernández Juan Ramón Hernández 
Published: December 2021

Abstract

Aim
“Cytoreductive surgery (CRS) together with the application of hyperthermic intraperitoneal chemotherapy (HIPEC) has proven to be a feasible and effective method in the management of selected patients with peritoneal metastases and/or primary peritoneal tumors. Infiltration of the abdominal wall is a frequent finding in these patients, which often leads to extensive resections and complex parietal reconstructions in the same surgical act. This may be associated with wound complications and the consequent delay in postoperative therapy of the patient. For this reason, an exquisite management of the abdominal wall is required. Our goal is to evaluate the technique and results of two clinical cases that required simultaneous complex reconstructions.”

Material and Methods
“Review patients undergoing CRS and HIPEC and simultaneous complex abdominal wall reconstruction between 2015 and 2020. Analysis of oncological history, description of the defect resulting from cytoreduction and the reconstruction technique used, postoperative course and medium-term results.”

Results
“Different techniques were used to reconstruct the abdominal wall according the caracteristics of the defect after cytoreduction. The simultaneous performance of reconstruction techniques did not increase the hospital stay nor the rate of complications of the surgical wound. Systemic chemotherapy was continued without delay and we have no evidence of incisional hernias in the medium term.”

Conclusions
“In our experience, the use of abdominal wall reconstruction techniques in the same surgical time after performing CRS and HIPEC is safe and with good results in the medium term.”
P106 PROPHYLACTIC MESH FOR PREVENTION OF INCISIONAL HERNIA IN HIGH-RISK PATIENTS: PVDF “VISIBLE” MESH BEHAVIOUR ON MRI
Authors: Aguilera Beatriz Carrasco , Torres Marina da Silva , Rodicio Jose , Valle Ana Fernández del , Moreno Maria , Amoza Sonia , Ruiz Pablo Del Val , Garcia Miguel Martinez-Cachero , Alvarez Lourdes Sanz , Menéndez Rafael , Ureña Miguel Ángel García 
Published: December 2021

Abstract

Aim
According to the guidelines, prophylactic mesh placement appears to be an effective, safe procedure in high-risk patients for the prevention of incisional hernia (IH) after midline laparotomy, without its use being standardized. Knowing its radiological behaviour can resolve doubts about its use.

Material and Methods
This was a prospective observational cohort study. The included patients needed to have more than one risk factor for IH (age&gt; 60 years old, Body Mass Index &gt; 30kg/m2, diabetes, chronic bronchopathy, heart disease, smoking, kidney disease, neoplasia, liver disease, immunosuppression or an emergency operation). Follow-up included 6-week and 12-month postoperative magnetic resonance imaging (MRI). If MRI was not performed, we used the follow-up computed tomography (CT).

Results
Between July 2016 and March 2021, 54 patients were enrolled in the study. Surgery was emergent in 14.8% of cases, clean-contaminated in 87% and upper gastrointestinal surgery in 51.9%. A total of 43 MRI and 3 CT at 6-week and 30 MRI and 2 CT at 12-month were carried out. The median of the mesh area were 150.7 vs 150,1cm2 respectively. 91% of cases had the mesh lined to the fascia at 12 months. The bridging in the linea alba was zero in 61% at 6-weeks and 24% at 12-month follow-up, mean 9 vs 19mm (p = 0.001).

Conclusions
The use of imaging tests to know the postoperative behaviour of a Polyvinylidenfluorid (PVDF) “visible” mesh shows us that there is no mesh contraction at one year or detachment of the fascia, however we observe a significant tendency in the separation of the linea alba.
P110 MANAGEMENT OF THE OPEN ABDOMEN WITH COMBINED THERAPIES. HOW TO AVOID THE VENTRAL HERNIA AND BE ABLE TO PERFORM THE REPAIR OF THE ABDOMINAL WALL IN A DEFINITIVE WAY
Authors: Aguirre Miguel 
Published: December 2021

Abstract

Aim
To demonstrate that in patients with abdominal sepsis, delayed primary fascial closure and definitive abdominal wall repair can be achieved, in the same hospitalization, using combined therapies, which reduces the percentage of ventral hernias.

Material and Methods
Medical records, tomography images and outpatient controls of 9 patients were reviewed, which required open abdomen management for abdominal sepsis using negative pressure therapy combined with a dynamic fascial mesh traction, from February 2020 until May 2021.

Results
9 patients (2 men and 7 women), all Grade 2C open abdomen according to Björck clasification, with a median age of 43 years (25-71). The median time therapy was 29±3 days. The primary fascial closure rate was 100% (n = 9), 77.8% (n = 7) underwent a definitive repair of the abdominal wall with absorbable synthetic mesh in the same hospitalization, while 22.2% (n = 2) did not, due to being cancer patients.
The mortality rate was 11.1% (n = 1) due to pneumonia and the fistula rate was 11.1% (n = 1). None developed an incisional hernia at the one-year follow-up.

Conclusions
The combination of negative pressure therapy with dynamic fascial mesh traction, in the management of the open abdomen, allows us to achieve a 100% delayed primary fascial closure, avoiding ventral hernia. In the same hospitalization, while the patient leaves the critical stage, we can achieve a definitive repair of the abdominal wall using absorbable synthetic meshes returning the biomechanics to the abdominal wall, improving the quality of life of these patients.
P126 LAPAROSCOPIC TREATMENT OF HYDROCELE IN FEMORAL CANAL: A CASE REPORT
Authors: Malaibari Zaid , Niebuhr Henning 
Published: December 2021

Abstract

Aim
The hydrocele of the femoral canal (Femorocele) is one of the rarest entities of femoral hernia (1). All of the reported cases were an intraoperative diagnosis and were treated with an open approach. We are reporting, the probably first femorocele diagnosed and treated laparoscopically.

Material and Methods
A 57-years-old female patient was presented in our outpatient clinic with pain and an unclear lump in the groin area for 6 months. The sonographic examination revealed a cystic structure in the groin area resampling Nuck’s cyst. An elective laparoscopic exploration and transabdominal preperitoneal (TAPP) repair was planned.

Results
A laparoscopic exploration was carried out. Intraoperatively, the cystic structure was not found in the Nuck’s Canal, but in the femoral canal as a content of a femoral hernia with some pre-peritoneal fat. By the extraction of the cyst, a gush of clear fluid was noted. After the usual preparation of the preperitoneal area, a mesh was placed in TAPP technique.

Conclusions
This rare variety of femoral hernias, femorocele, is commonly misdiagnosed as a strangulated hernia or Nuck’s cyst (as in this case) among other differential diagnoses (2). All published femorocele cases were treated with an open approach. As demonstrated here, such unclear cases can be laparoscopically explored and treated accordingly.
P131 A NEW THREE-STEP HYBRID APPROACH IS A SAFE PROCEDURE FOR INCISIONAL HERNIA: EARLY EXPERIENCES WITH A SINGLE CENTRE RETROSPECTIVE COHORT
Authors: Van den Dop Matthijs , Smet Gijs De , Bus Michaël , Lange Johan , Koch Sascha , Hueting Willem 
Published: December 2021

Abstract

Aim
In this study, a three-step novel surgical technique was developed for incisional hernia, in which a laparoscopic procedure with a mini-laparotomy is combined: so-called ‘three-step incisional hybrid repair’. The aim of this study was to reduce the risk of intestinal lacerations during adhesiolysis and recurrence rate by better symmetrical overlap placement of the mesh.

Material and Methods
From 2016 to 2020, 70 patients (65.7% females) with an incisional hernia of &gt; 2 and ≤10 cm underwent an elective three-step incisional hybrid repair in two non-academic hospitals performed by two surgeons specialised in abdominal wall surgery. Intra- and postoperative complications, operation time, hospitalisation time and hernia recurrence were assessed.

Results
Mean operation time was 100 min. Mean hernia size was 4.8 cm; 45 patients (64.3%) had a hernia of 1–5 cm, 25 patients (35.7%) of 6–10 cm. Eight patients had a grade 1 complication (11.4%), five patients a grade 2 (7.1%), two patients (2.8%) a grade 4 complication and one patient (1.4%) a grade 5 complication. Five patients had an intraoperative complication (7.0%), two enterotomies, one serosa injury, one omentum bleeding and one laceration of an epigastric vessel. Mean length of stay was 3.3 days. Four patients (5.6%) developed a hernia recurrence during a mean follow-up of 19.5 weeks.

Conclusions
A three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low.
P138 PREPERITONEAL ENDOSCOPIC GROIN HERNIA SURGERY - REASSESSMENT OF TOPOGRAPHIC ANATOMY AS A BASIS FOR STANDARDIZED DESCRIPTION OF SURGICAL STEPS
Authors: Heimke Marvin , Heinze Tilmann , Kuthe Andreas , Wedel Thilo , Strey Christoph W 
Published: December 2021

Abstract

Aim
Fascial groin anatomy remains a conundrum. In particular, a clear anatomical allocation of the correct extraperitoneal dissection planes and spaces in total extraperitoneal endoscopic hernia surgery (TEP) has not yet agreed upon. The differing anatomical concepts are reflected by the variability of surgical approaches, the considerably long learning curves and subsequent complications. Thus, the aim of this study was to reassess the topographic anatomy of the groin region providing a basis to standardize the surgical steps of TEP according to clearly defined anatomical landmarks.

Material and Methods
Video analysis of intraoperative surgical anatomy of groin hernia patients was correlated with the findings retrieved by macroscopic anatomical studies. The groin region of formalin fixed body donors was subjected to a stepwise dissection exposing the fascial system of the abdominal wall layer-by-layer and via different angles. Selected areas of interest were processed for histological study. Surgically relevant anatomical landmarks were defined and termed according to the most appropriate anatomical nomenclature.

Results
The essential surgical dissection steps during TEP could be related to specific anatomical landmarks extending within the extraperitoneal space of the ventral and dorsolateral abdominal wall. The definition of fascial structures and interfaces and the identification of structures at risk allowed the identification of correct dissection planes for mesh placement.

Conclusions
Our study helps to clarify the definition and nomenclature of anatomical key structures required for a standardized description of TEP in a simplified model. The data may contribute to reduce complications and improve surgical teaching and training.
P142 IPOM PLUS: WHAT WE DO AND WE WANT SHARE AND DISCUSS
Authors: Agresta Ferdinando , Mazzarolo Giorgio , Licitra Edelweiss 
Published: December 2021

Abstract

Aim
In this video we want to share and discuss what we have learned from our 20 year experience in IPOM PLUS procedures

Material and Methods
We use only all 5 mm trocars , instruments and 30 degree optic and we always use a low intraabdonimal pressure (10mmHg).
The major technical trick in is to carefully prepare and manage the abdominal wall context, in order to free all the hernia areas.

Results
Our IPOM experience is almost more than 500 case, elective as emergency. Normally we use a double prolene (with the film versus the intestine) mesh with a 5 cm overlap. Besides the well known needed physical characteristics of the mesh, on the surgeon’s side, a mesh should be smooth, stiff, wide enough to cover all the possible defects, easy to handle and, especially for its possible use in laparoscopy, with a certain degree of and thickness just what it is needed in order to let it pass through a 5 mm trocar once rolled up. We use to close the defect in order to avoid serosa and SS - Morbidity and we use to fix the mesh with absorbable tackers

Conclusions
Most of the advantages of laparoscopy rely on the minimal access and the possibility to manage and examine the abdominal context, especially in emergency, and to close the defect and to fix the mesh with tackers.
P147 REHABILITATION AFTER VENTRAL HERNIA SURGERY IN THE NETHERLANDS: A SURVEY
Authors: Berkvens Elske , Bloemendaal Bob , Poelman Marijn , Reilingh Tammo de Vries , Johannes Wegdam 
Published: December 2021

Abstract

Aim
After any type of musculoskeletal surgery, post-operative rehabilitation with advices on weight baring and physical therapy is normal practice. Rehabilitation protocols lead to early mobilization and shorter hospitalization. Although ventral hernia repair (VHR) is musculotendinous surgery with tremendous impact on muscle strength and coordination, standardized and evidenced rehabilitation protocols for VHR are lacking. This survey aims to provide insight into the rehabilitation protocols after VHR, commonly used in the Netherlands.

Material and Methods
Hernia-surgeons in all Dutch hospitals were addressed in May 2021 by an electronic survey. Three cases were presented; non-complex (2 cm, primary umbilical repair), moderate-complex (8 cm, Rives-Stoppa) and complex (13 cm, myofascial release). Use of abdominal binders, advice on physical strain and referral for physical therapy were surveyed.

Results
75 of 75 (100%) Dutch hospitals responded. In order of increasing hernia complexity an abdominal binder was prescribed in respectively 10%, 74% and 92% with various duration. Reduced physical strain was advised in 73%, 90% and 91%, mainly with a duration of 4-6 weeks (40%, 58% and 70%). Patients were referred for physical therapy after discharge in 4%, 15% and 41%.

Conclusions
This study describes the practice of rehabilitation after VHR in the Netherlands. Although abdominal binder prescription and physical strain advices increases with hernia complexity, there is no uniformity in duration. Physical therapy was advised only in a minority of the VHR patients, even after complex reconstructions. Lack of standardized rehabilitation protocols after VHR underlines the need for guidelines.
P150 UTILISATION OF OVINE REINFORCED TISSUE MATRIX IN PAEDIATRIC RECONSTRUCTIVE SURGERY
Authors: Engall Nick , Peters Robert Thomas , Lansdale Nick , Craigie Ross James 
Published: December 2021

Abstract

Aim
Abdominal and thoracic reconstructive surgery has always been an aspect of surgical care in children for conditions such as congenital abdominal wall defects, large hiatus herniae, incisional herniae and chest wall defects following tumour surgery. Biosynthetic matrices are ideal for reconstructive surgery in the paediatric population as consideration needs to be given to future growth and potential need for reoperation. Moreover, the use of synthetic materials in this setting is known to be associated with long term issues.
We present the results of our experience with ovine reinforced tissue matrix1 in paediatric reconstructive surgery.

Material and Methods
All patients who underwent an operation at our institution using the biosynthetic matrix from March 2019 to April 2021 were identified retrospectively by searching theatre databases. Patient demographics, diagnoses and case notes were reviewed.

Results
The biosynthetic matrix was used in 26 children, (15 male and 11 female). Median age at insertion was 5.1 years (2.1 – 7.1 years). Median weight at insertion was 14.0kg (11.3 – 28.1kg). Patients had a history of hiatus hernia (n = 10), exomphalos (n = 6), emergency laparotomy (n = 3), congenital diaphragmatic hernia (n = 2) sternal sarcoma (n = 1), rib sarcoma (n = 1), gastroschisis (n = 1), recurrent umbilical hernia (n = 1) and direct inguinal hernia (n = 1).
There were no hernial recurrences. There was a surgical site occurrence (SSO) in 12% - skin dehiscence (n = 2) and wound infection (n = 1). Median length of follow up was 7.9 months (4.5-9.0 months).

Conclusions
Our series demonstrates that ovine biosynthetic matrices can be used safely in paediatric reconstructive surgery with excellent outcomes and a very low rate of SSO.
1. OviTex®-TELA Bio
VP026 LIRA-TAPE TECHNIQUE. A NEW PROCEDURE FOR RESTORING THE MIDLINE BY MIS IN SUPRAPUBIC AND MIDDLE SIZE MIDLINE HERNIAS
Authors: Gómez-Menchero Julio , Bohorquez Antonio Gila , Ramirez Jose Luis Guerrero , Herranz Pablo de la , Moreno Joaquin Luis García , Morales-Conde Salvador 
Published: December 2021

Abstract

Aim
LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) was described in 2018 in order to reduce the tension in the midline as an alternative for Closing the defect (CD) during Laparoscopic Ventral Hernia Repair. TAPE (Transabdominal Partial Extraperitoneal) was described in 2011 in order to repair complex suprapubic hernias to reduce the recurrence rate. We present a case of suprapubic hernia associated to a medium-size midline hernia using LIRA combined with TAPE as a new procedure for abdominal wall reconstruction

Material and Methods
50 years old female affected with a M5 W2 hernia associated to a M2-3 W2. (EHS Classification). Preoperative scan was performed.

Results
3 Ports (2 of 5 mm, 1 of 12 mm) in the left mid axillary line for LIRA and supraumbilical (10 mm) and right paraumbilical (5mm) to assist TAPE were placed. A peritoneal flap is created to expose de pubic arch and the Coopeŕs Ligament. CD was performed in suprapubic defect using a barbed suture and continued for LIRA procedure in the posterior rectus sheath. An intraabdominal mesh was placed (Polyvinylidene fluoride (PVDF) mesh, Dynamesh (®)-IPOM (FEG Textiltechnik mbH, Aachen, Germany. The mesh overlapped the suprapubic arch and was fixed using helicoidal sutures and covered the whole incision in the midline. Pelvic flap covered partially the mesh. Patient was discharge in 72 h

Conclusions
Complex hernias close to bones, as suprapubic hernias, can be restored using a minimal invasive approach, even those associated to mid-line defects. LIRA-TAPE is a safe and reproducible association for restoring the midline with a low rate of complications.