bluuebunny/crossref_metadata_2025_split huggingface dataset:
P066 ELECTIVE LICHTENSTEIN INGUINAL HERNIOPLASTY IN GERIATRIC PATIENTS WITHOUT ANTIBIOTIC PROPHYLAXIS : HOW SAFE IS IT ?
Authors: Cijan Vladimir , Bojovic Predrag , Bojicic Jovana 
Published: December 2021

Abstract

Aim
Elective surgery is becoming increasingly common in geriatric patients, particularly as the population is aging. The incidence of inguinal hernia in the elderly is also increasing. Lichtenstein inguinal hernioplasty is the most frequent procedure for the elective repair. There is ambiguity about the usefulness of antibiotic prophylaxis in inguinal mesh hernioplasty and the evidence for its value is still a matter of debate. Our aim was to evaluate the outcomes of Lichtenstein inguinal hernioplasty without antibiotic prophylaxis in geriatric patients.

Material and Methods
A database of patients aged 70 and more undergoing elective Lichtenstein inguinal hernioplasty was established. Patients were randomly categorized in antibiotic (received antibiotics) and placebo group (received placebo). Demographics, American Society of Anesthesiologists (ASA) classification, comorbidity, hernia type, operating time and hospitalisation were analyzed. Infections were evaluated 1 week, 2 weeks and 1 month postoperatively according to Center for Disease Control criteria.

Results
Between 2015.-2019., 400 patients were evaluated, 200 patients in each group. All patients were operated under local anaesthesia with 24-hours hospitalisation. Groups were well matched regarding demographics, ASA-type, comorbidity, hernia type, operation time. Superficial surgical site infection developed in 16 patients from the antibiotic and 19 from the placebo group. Three from each group developed deep infection. Two mesh removal was required in the placebo group.

Conclusions
Prophylactic antibiotic usage in geriatric patients undergoing Lichtenstein inguinal hernioplasty did not show any significant beneficial efects in reduction of surgical site infection. Our results do not support the routine use of antibiotics for elective inguinal hernioplasty.
P092 EVOLUTIVE MANAGEMENT OF THE OPEN ABDOMEN WITH POSTERIOR SEPARATION TECHNIQUE FOR DEFINITIVE RECONSTRUCTION
Authors: Pérez Jorge Loro , Fernández Ismael Antón , Sánchez Laura González , Rivera Nestor Betancort , Hernández Juan Ramón Hernández 
Published: December 2021

Abstract

Aim
Traumatic evisceration in politrauma patients is rare, with a prevalence of 1 in 40,000 trauma patients. The main mechanism is high-energy trauma to an acute surface. Our objective is to apply theoretical knowledge regarding the complex abdominal wall as an independent entity, analyzing the particular case of a patient operated in our center.

Material and Methods
Description of a clinical case using data extracted from the electronic medical record and bibliographic search in Pubmed.

Results
The reviewed literature was applied to a traumatic evisceration case with a Grade IV on the Dennis Abdominal Trauma Scale. The decisions made during the different stages in the multidisciplinary management of the traumatic evisceration were discussed. The role of Negative Pressure Therapy, the use of biological meshes, full thickness grafts and / or the Posterior Separation of Components were used to achieve a continent and functional abdomen after an injury of that magnitude during a 4-year follow-up with excellent results.

Conclusions
At the moment there is no consensus on the management of these traumatic evisceration situations. It depends in many cases on the experience of the surgeon. These cases should be treated individually based on the size and location of the lesions. The approach must be carried out in different stages, always thinking about achieving an early closure of the abdomen and preserving the anatomy of the abdominal wall. The best strategy for open abdomen reconstruction is not well defined, but we believe that Posterior Component Separation is a good option.
P111 HIGH RATE OF INCISIONAL HERNIA AFTER MASS CLOSURE OF BURST ABDOMEN
Authors: Jensen Thomas Korgaard , Gögenur Ismail , Tolstrup Mai-Britt 
Published: December 2021

Abstract

Aim
This study investigated the long-term effect of a standardized strategy of fascial closure with a mass closure technique, using a slowly absorbable running stitch for burst abdomen and evaluated the incidence of incisional hernia in these patients.

Material and Methods
A single-center, retrospective study including all patients that underwent surgery for burst abdomen between June 2014 and April 2019 was followed up in October 2020 to report the rate of incisional hernias.

Results
94 patients underwent surgery for burst abdomen. 80 patients was enrolled for follow up. Index surgery was acute in 78%. Incisional hernia rate was 33%. 30-day mortality rate was 24%.

Conclusions
Standardized surgery for burst abdomen with a standardized mass-closure technique still results in high rates of incisional hernias.
P116 “KIGNSNORTH MODIFIED SCORE” FOR OPEN INGUINAL HERNIA REPAIR COMPLICATIONS PREDICTION. POINTHER STUDY
Authors: Bravo-Salva Alejandro , Gonzalez-Martin Alba , Salva-Puigserver Margarita , Tellez-Marques Clara , Sancho-Insenser Joan , Pera-Roman Miguel , Pereira-Rodriguez Jose Antonio 
Published: December 2021

Abstract

Aim
Aim of our study is to analysis of postoperative outcomes (30 days) after elective unilateral open anterior inguinal hernia repair and prove correlation to modified Kingsnorth (MK) score classification system.

Material and Methods
Prospective registered (NTC 04806828) study of all consecutive unilateral open anterior groin hernia repair performed at a University Hospital General Surgery Department from January 2019 to December 2020. Data was stored at National Spanish Groin Hernia Registry (EVEREG). All patients were preoperatively classified using MK score. Statistical analysis of postoperative complications and their relation to preoperative modified Kingsnorth scale was performed.

Results
403 patients were included. 61% were performed as ambulatory surgery. 15.7% had more than 5-8 MK punctuation. A total of 62 patients had postoperative complications, 81% of all complications were classified as Clavien I. Higher Surgery duration was directly related to higher MK (Pearson's correlation 0.291; P &lt; 0.0001score.) Statistically significant relationship with the presence of higher rate of complications were a KN score of 5-8 (OR 2.7; 95% CI 1.07-4.82; P = 0.03) whereas performance of surgery by an abdominal wall surgery specialist had less complications (OR 0.28; 95% CI 0.08-0.92; P = 0.03)

Conclusions
MK classification predicts surgical wound complications on patients who undergo a primary unilateral inguinal hernia surgery. A KN score of 5-8 had a higher probability of wound complications. When surgery was performed by a specialist in abdominal wall surgery, less postoperative complications were observed.
P125 MANAGEMENT OF PERICAECAL HERNIA CAUSING SMALL BOWEL OBSTRUCTION IN THE EVOLVING ERA OF LAPAROSCOPY. A CASE REPORT AND LITERATURE REVIEW
Authors: Salama Mohamed , Salama Mahmoud , Nasr Abdulrahman , Yadav Himanshu , Sami Babur 
Published: December 2021

Abstract

Introduction
“Internal hernias are an unusual cause of intestinal obstruction. Pericaecal hernias are an exceptionally rare type of internal hernia.
Laparoscopy for small bowel obstruction was previously considered inappropriate. We present a case of Pericaecal hernia causing small bowel obstruction treated successfully with a laparoscopic approach.”

Case-Report
“64 year old man presented with abdominal pain, vomiting and constipation for 3 days, no previous surgery. Small bowel obstruction confirmed on PFA and CT. He was treated conservatively for 10 days without settling. A an exploratory laparoscopy revealed a Pericaecal hernia. This was reduced with gentle manoeuvre and the peritoneal folds were divided to prevent recurrence. Recovery was uneventful.”

Discussion
“Perioperative diagnosis of internal hernia is extremely difficult. Pericaecal hernia is an uncommon type of internal hernia. CT diagnosis of internal hernia remains difficult. Laparoscopy is a valuable tool for diagnosis and treatment with the advantage of minimal invasiveness. However, the laparoscopic manipulation of distended bowel loops remain controversial because of high risk of perforation, reduced space to work in the peritoneal cavity and requirement of advanced laparoscopic skills. Laparoscopic treatment of Pericaecal hernia was reported about 17 years ago but has since been reported more frequently and in recent years there is a move towards laparoscopic diagnosis and management of Pericaecal hernias.”

Conclusions
“CT diagnosis of internal hernia remains difficult. With the advent of minimal access surgery, diagnostic laparoscopy may be a safe and feasible modality to diagnose and deliver definitive treatment of small bowel obstruction secondary to Pericaecal hernia.”
P135 ESTABLISHMENT OF MINIMALLY INVASIVE VENTRAL HERNIA REPAIR WITH EXTRAPERITONEAL MESH PLACEMENT AS A STANDARD APPROACH OF VENTRAL HERNIA REPAIR USING THE ROBOTIC PLATFORM
Authors: Mück Björn , Heinzelamann Frank , Vogel Robert , Büchler Peter 
Published: December 2021

Abstract

Aim
Several meta-analyses indicated, that extraperitoneal mesh placement in the retromuscular or preperitoneal space shows advantages over intraperitoneal mesh placement. Previous surgical interventions which included extraperitoneal mesh placement were usually performed using open surgery. For several years now, our hospital has pursued to treat ventral hernias using a minimally invasive approach with extraperitoneal mesh placement. A Da Vinci X system has been available since the beginning of 2019. The aim of this analysis is to show the process of changing the operative procedure in ventral hernia repair over the period from 2016 to 2020.

Material and Methods
All hernia operations from 2016-2020 were evaluated using our hospitals information system. Every surgical intervention which included ventral hernia repair with the indication for mesh implantation was taken into the analysis.

Results
In 2016, the proportion of minimally invasive procedures was 36.67%. In all of these cases an intraperitoneal mesh was implanted in the abdominal cavity (laparoscopic IPOM operation). Open surgery was performed in 63.33%, out of which we implanted an intraperitoneal mesh in 23.68%, a retromuscular mesh in 73.68% and an onlay mesh in 2.63% of the cases. In 2020, the proportion of minimally invasive operations was already 87.5%, of which 83.33% were performed robotically assisted and 16.67% laparoscopically. In 94.29% of the minimally invasive operated patients an extraperitoneal mesh implantation was carried out, among which 75.76% were placed in the retromuscular and 24.24% in the preperitoneal position.

Conclusions
The majority of elective operations on ventral hernias can be performed in a minimally invasive technique with retromuscular mesh placement, using the robot.
P137 DEGRADATION RESISTANCE OF PVDF MESH IN VIVO IN COMPARISON TO PP MESH
Authors: Wang Hongshi , Klosterhalfen Bernd , Müllen Andreas , Jockenhövel Stephan , Dievernich Axel , Otto Thomas 
Published: December 2021

Abstract

Aim
To researched the degradation resistance of PVDF mesh by comparing its morphological and chemical condition with PP mesh.

Material and Methods
PVDF and PP meshes analysed in this study were received from a previous animal experiment. To expose the surface of explanted meshes, a tissue removing method with protease was used and the result of this cleaning process was tested by X-ray Photoelectron Spectroscopy (XPS). The morphological condition of the mesh surface was compared using Scanning Electron Microscopy (SEM) and the chemical condition concerning degradation was analysed through Fourier Transform Infrared Spectroscopy (FTIR). The surface condition of PVDF mesh after 3-, 6-, 12- and 24-month implantation was illustrated and compared with two types of PP meshes.

Results
XPS revealed an absence of nitrogen, confirming the successful removal of tissue residues using protease. SEM results presented no notable morphological surface change of the PVDF mesh and progressive surface cracking processes over time of both types of PP meshes. FTIR spectra of the implanted PVDF meshes had no considerable difference from the spectrum of the pristine mesh, while FTIR spectra of both types of PP meshes had extra chemical functional groups increasing with implantation time, indicating progressive degradation.

Conclusions
PVDF mesh does not show signs of degradation up to 24 months after implantation while PP meshes progressively degrade with increasing time under the same conditions, which appears as worsening Environmental Stress Cracks. This study highlights the morphological and chemical stability of the PVDF mesh and demonstrates that the PVDF mesh is more resistant to degradation in comparison to the PP meshes.
P143 INSTRUCTION AND FEEDBACK METHOD FOR LAPAROSCOPIC HERNIA REPAIR USING SELF-MADE MANUAL WITH SELF-ASSESSMENT SHEET
Authors: Tanioka Toshiro , Yatabe Yusuke , Honda Masaki , Yagi Kenta , Saito Toshifumi , Ito Koji 
Published: December 2021

Abstract

Aim
We use the self-made manual to understand procedures easily, and the self-assessment sheet to improve trainees' skills efficiently. We investigated the effect of this method for trainees in laparoscopic inguinal hernia repair.

Material and Methods
In the original manual, surgical procedures and how to make surgical fields are explained using intraoperative photos, in order to clarify the purpose of the procedures in each scene of surgery. We also made the self-assessment sheet that sets goals according to the manual, and evaluates the trainee's attainment objectively. Trainees score the assessment sheet after every surgery. Trainers evaluate their sheets and give feedback on their skills with a radar chart.

Results
By using the same manual, trainees and trainers could share the same terms and thoughts easily during surgery. The self-assessment sheet made trainees effective to understand their weak points and improve their skills. At the beginning of the training, the much-experienced trainee got a higher score. As trainees experienced surgeries, they became getting higher scores. There was a significant correlation between a high score and a short operation time. A radar chart helped efficiently to understand trainees' weak points.

Conclusions
Using the self-made manual and the self-assessment sheet together was useful for both the trainer and the trainees to evaluate their attainment objectively. Scores and graphs helped trainees assess their skills efficiently.
P149 THE IMPACT OF COVID-19 ON TACKOMESH RANDOMISED CONTROLLED TRIAL COMPARING SPIRAL-TACK MESH-FIXATION DEVICES IN LAPAROSCOPIC INCISIONAL HERNIA REPAIR USING THE MANCHESTER TECHNIQUE
Authors: Pilkington James , Fullwood Catherine , Sheen Aali 
Published: December 2021

Abstract

Aim
Provide a report on all patients who underwent laparoscopic incisional hernia repair as part of the TACKoMesh RCT prior to unblinding of treatment arms.

Material and Methods
Trial recruitment was for primary incisional hernia with a defect diameter of 3–10cm. 63 patients (target 74-136) were operated on prior to the outbreak of COVID-19. Post-operative pain is the primary trial outcome.
Surgery was performed with either spiral-tack mesh-fixation device (Protack (permanent) or Reliatack (absorbable)), Symbotex IPOM mesh, and fascial closure with no 1 Maxon suture(s) using extracorporeal knot ties – the Manchester Technique.
Data was collected on trial forms and lifestyle questionnaires (SF-36 and CCS). All data were explored and described in RStudio v1.4.1106.

Results
Patients were aged 36-80 and 36(57.1%) patients were male. Mean preoperative BMI was 30.91(sd5.11,range21.15–43.93).
Mean operating time was 80.81(37.34,20-240)minutes. In 13(20.6%) patients multiple hernia defects were identified. A good degree of fascial closure was achieved in all patients using a median of 3(IQR 2.0-3.5)knots.
Median mesh-fixation time was 286(159.5-428.0)seconds and a mean 25.24(5.49,14-41)tacks/patient were used. Median length of hospital stay was 3.5(2.0–6.0)days.
Patients were asked “Please indicate on this scale [VAS 0–10] the pain that you currently experience from your incisional hernia during activity?”. Median responses for Day0/pre-op, Day1, Day6, Day30 and Day365 were 4.5, 8.0, 6.0, 3.0 and 1.5 respectively.
At one year, 7(11%) patients had experienced hernia recurrence and 33(52%) post-operative seroma.

Conclusions
Target recruitment was not possible owing to COVID-19. The Manchester Technique has comparable recurrence rates. Reported pain increases post-operatively but is reduced at post-operative day30 and day365.
P163 ROLE OF THE LAPAROSCOPIC APPROACH IN EMERGENT INGUINAL HERNIA REPAIR
Authors: Frias Joan Ricard Soler , León Anabel García , Tallon-Aguilar Luis , González Jose Tinoco , Arteaga Alejandro Sánchez , Ruiz Francisco Javier Padillo 
Published: December 2021

Abstract

Aim
Analyze the evolution of the laparoscopic approach in emergent inguinal hernia repair at our center.

Material and Methods
Retrospective review of patients with emergent inguinal hernia repair in our center from January 2011 to June 2020. Demographic, clinical and postoperative data were analyzed as well as the evolution of the laparoscopic approach.

Results
385 patients with incarcerated/strangulated inguinal hernia were registered. 58.96% were men, with a median age of 71. Of those, 22 patients (5.71%) were treated by laparoscopic approach and 363 (94.29%) by open approach. The open approach had a longer median hospitalization (4.82 vs 1.66 days), higher rate of surgical wound infection (5.51% vs. 0%), higher reoperation rate (3.31% vs 0%) and higher incidence of respiratory complications (1.97% vs 0%). 1 patient (4.54%) with laparoscopic approach required intestinal resection vs 48 patients (13.22%) of the open group, with a dehiscence rate of 0% vs 4.76% respectively. Mortality rate was 0% for the laparoscopic group and 2.75% in the open group.
In the last 18 months, 28.98% of urgent hernias repaired have been performed laparoscopically, while previously from 2011 to 2017 only 0.95%, due to the learning curve obtained in elective surgery where the laparoscopic approach has had a major development in the last 3 years.

Conclusions
Despite the evident patient selection bias because the approach choice by the surgeon in emergent inguinal hernia repair, laparoscopic approach is feasible and has lower morbidity-mortality compared to open approach in our center. In specialized centers this may be a treatment option for selected patient groups.
VP021 A WAY TO TREAT SPIGELIAN HERNIA
Authors: Barbosa Bruno , Pereira Raquel , Prudente Cesar , Diogo Maria Joao , Casimiro Carlos , Marques Vitor 
Published: December 2021

Abstract

Aim
“Spigelian hernia is uncommon and accounts for only 0.12–2% of all abdominal hernias. It is mandatory to perform surgical correction and in recent years the laparoscopic approach is gaining ground. The authors pretend to demonstrate a video of an outpatient laparoscopic repair of Spigelian hernia.”

Material and Methods
“53-year-old woman with a left Spigelian hernia referred to laparoscopic repair via intraperitoneal approach.”

Results
“The patient was submitted to laparoscopic correction with a Ventralex® mesh. The surgery went without any complication and under 30 minutes. A few hours after the surgery, the patient was discharged. In the follow-up appointment, the patient had no complaints or evidence of recurrence.”

Conclusions
“Spigelian hernias are rare and have a mandatory surgical indication. Traditionally, open surgical repair is most commonly used. However, laparoscopic approach is becoming increasingly popular since it allows faster recovery, shorter hospital stay, and less pain, with no commitment to recurrence. Currently, there are no studies that demonstrate the superiority of a laparoscopic technique (intraperitoneal, TAPP or TEP). The intraperitoneal route is a simple, faster, and easily reproducible approach.”
VP028 TAPP REPAIR FOR INCISIONAL LUMBAR HERNIA
Authors: Ribas Sónia , Pereira Ana Peixoto , Antunes Conceição 
Published: December 2021

Abstract

Aim
“Incisional hernias are very common and can present even after minimally invasive surgery for other pathologies. Laparoscopic ventral hernia repair first described by LeBlanc in 1992, gained great popularity, because of its known advantages over the open techniques.
In the last decade because of increasing concerns about the future risks of using an intra-peritoneal mesh, several minimally invasive techniques using a mesh outside abdominal cavity have been described. We report the use of a TAPP technique.”

Material and Methods
“48 yo female patient, that underwent a laparoscopic right adrenalectomy, for myelolipoma, in 2015, with subsequent incisional lumbar hernia (L4W1) in the extraction incision.”

Results
“The patient was submitted to a laparoscopic TAPP repair in ambulatory surgery with extended recovery. The hernia defect was closed with a barbed suture and it was used a 15x15cm medium weight polypropylene mesh without traumatic fixation. For pain control it was done a TAP block guided by laparoscopy. The duration of surgery was 90 minutes. The patient had no complications. No recurrence on follow-up (4 months).”

Conclusions
“New minimally invasive procedures for the repair of incisional hernias avoid the intraperitoneal mesh position and maintain all the advantages of the minimally invasive approach. Some of these techniques may be complex and have a long learning curve. TAPP seems reproducible and a good option if a good extra-peritoneal dissection is possible.
Larger series are needed, to accurately compare these new techniques with IPOM, open sublay and to select the best technique for each patient.”
P097 SHORT AND LONG-TERM COMPLICATIONS FOLLOWING ROBOTIC-ASSISTED RETROMUSCULAR VENTRAL HERNIA REPAIR
Authors: Nielsen Kristian Als , Frederichsen Mathias , Valsamidis Alexandros , Harthimmer Mads , Helligsø Per , Nielsen Michael 
Published: December 2021

Abstract

Aim
Robotic-assisted ventral hernia repair (rVHR) has become an attractive alternative to current laparoscopic and open procedures. The present study aims to determine short-and long-term complications following rVHR

Material and Methods
Patients undergoing rVHR from 01/01 2017 until 21/06 2020 were identified from the electronic medical record system. The medical case notes were reviewed and a telephone interview conducted to determine short and long-term complications. Patients with symptoms related to the repair were examined by a specialist in hernia surgery. US or CT scan was performed to determine the presence of absence of complications

Results
85 patients were included. Mean age was 57.8 years, 54 were males (63.5%). Mean ASA-score was 2.12 and BMI was 30.2 kg/m2. 11 patients (13%) had diabetes, 22 (26%) were active smokers, 37 (44%) had hypertension and 7 (8%) were taking anti-coagulants. The mean hernial defect was 16.1 cm2 and the mesh size was 205.4 cm2. Mean length of stay was 0.5 days and the follow-up time was 94 weeks. Hematoma was encountered in 10 (11.8%) patients. 8 (9.4%) reported of seroma and 1 (1.2%) of a superficial wound infection complicated by skin necrosis. 5 patients (5.9%) reported of chronic pain. 2 patients (2.3%) developed recurrence.

Conclusions
The study demonstrates that rVHR is feasible and associated with few complications and a very low recurrence rate. Patients who had pain before surgery were likely to have less pain following the procedure. Due to the short hospital stay the procedure is suitable as an outpatient procedure.