bluuebunny/crossref_metadata_2025_split huggingface dataset:
P105 PREVENTION OF INCISIONAL HERNIA WITH A REINFORCED TENSION LINE (RTL) VS PRIMARY SUTURE ONLY IN MIDLINE LAPAROTOMIES: 3 YEARS FOLLOW UP
Authors: Hernandez Edgard Efren Lozada , Chavez Elizabeth Escamilla , Villegas Leticia Hernandez 
Published: December 2021

Abstract

Aim
“Incisional hernia (IH) has an incidence of 10–23%, which can increase to 38% in specific risk groups. The objective of this study is to report the results at 3 years of follow-up of the use of the reinforced tension line (RTL) technique compared with primary suture only (PSO) closure in the prevention of IH in high-risk patients undergoing laparotomy.”

Material and Methods
“Open randomized controlled clinical trial. Included were patients older than 18 years who underwent midline laparotomy, emergency or scheduled, who were considered high risk, and who completed 3-year follow-up. The patients were randomized 1:1 to the RTL technique or to PSO. The objective was to report the incidence of IH and the complications associated with the closure method. Intention-to-treat analysis and Cox regression were performed.”

Results
“A total of 124 patients were randomized; 51 patients from the RTL group and 53 patients from the PSO group finished the 3-year follow-up. The incidence of IH was higher in the PSO group (15/53, 28.3%) than the RTL group (5/51, 9.8%) (p = 0.016, OR 0.35, 95% CI 0.14–0.88, number needed to treat 5.4, log-rank test p = 0.017). The groups were similar in the rates of surgical site infection, hematoma, seroma, and postoperative pain during follow-up.”

Conclusions
“The RTL technique is useful in the prevention of IH when compared with PSO in high-risk midline laparotomy patients, and it is not associated with a higher percentage of complications. Clinical trials NCT02136628, retrospectively registered”
P109 MANAGEMENT OF THE OPEN ABDOMEN WITH COMBINED THERAPIES. HOW TO AVOID VENTRAL HERNIAS 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.
P114 ROBOTIC INGUINAL HERNIA REPAIR (RTAPP): ANATOMY LESSONS AND RESULTS OF A CASUISTIC OF 302 OPERATED HERNIAS
Authors: Dietz Ulrich 
Published: December 2021

Abstract

Aim
The purpose of this study is to apply the resources of robotics to inguinal hernia repair (r-TAPP) and to investigate where specific optimizations to the surgical technique of can be achieved.

Material and Methods
The results of 302 consecutive r-TAPP surgeries performed over an 18-month period are presented. It is a cohort study without a control group. The study was approved by the ethics committee (Ref. No. 2019-02046). Decisions on interventions (suturing of the transverse fascia or fibrin glue sealing of the inguinal canal) and mesh size were made intraoperatively. Patients were followed up six weeks postoperatively.

Results
In every fourth patient, a femoral, obturator, or Spieghel hernia was diagnosed in addition to symptomatic inguinal hernia. Mesh fixation with absorbable suture at 4 points was matured. The operative time averaged 71 minutes for unilateral, 103 minutes for bilateral and 95 minutes for unilateral recurrent hernias. 48% of procedures were performed by residents. Seroma incidence decreased from 15.0% in the first period to 5.1% in the third study period. None of the patients experienced pain symptoms due to nerve lesion. The study provided new clarity about the blood supply patterns of the lipoma, the course of the genital branch and the constitution iliac fascia.

Conclusions
Suturing of the transversal fascia, fibrin glue sealing of the inguinal canal, and suture fixation of the mesh are steps who must be validated in future studies. Robotics provides optimal conditions for residents training, without learning curve on the patient and with predictable OR times. Postoperative seroma formation and complication rate of r-TAPP are low.
P119 THE IMPLEMENTATION OF ROBOTIC TEP AND ETEP APPROACH IN THE MODERN INGUINAL HERNIA REPAIR : A SINGLE CENTER EXPERIENCE
Authors: Archontovasilis Fotis , Tselios Ioannis 
Published: December 2021

Abstract

Aim
In a robotic surgery era, the totally extraperitoneal (TEP) inguinal hernia repair is less common than the transabdominal preperitoneal (TAPP) approach. The enhanced-view TEP (eTEP) has been proposed as a modification to the standard TEP technique. The aim of this study is to present a single centre’s experience in Robotic TEP and eTEP inguinal hernia repair technique.

Material and Methods
This is a case-series presentation of patients with inguinal hernia that underwent robotic TEP and eTEP repair in a single institution. Patients’ characteristics were reviewed and perioperative outcomes were extracted. All patients were followed-up at the outpatient surgical unit. Intraoperative and postoperative parameters were analyzed.

Results
21 patients (10% females) with a mean age of 58.5 years underwent robotic TEP (14 patients) and eTEP (7 patients) inguinal hernia repair. Eight patients were treated for bilateral hernia (total number of 29 hernias) and two were operated for recurrence. No conversion to open or TAPP repair was required. The mean operative time was 108 minutes for the bilateral hernias and 75 minutes for the unilateral cases. All patients were discharged the same day, after 3 to 5 hours postoperatively. Four of the patients used pain medication postoperatively. No major complications or recurrences were revealed during a mean postoperative follow-up time of 14 months

Conclusions
Robotic TEP and eTEP are safe and efficient surgical options in the treatment of inguinal hernia in experienced centres. The two techniques can result in high-quality outcomes regarding hospital stay, pain control and elimination of hernia recurrence.
P120 ASSOCIATION BETWEEN SERUM ESTRADIOL LEVELS AND MEN WITH GROIN HERNIA : A CASE - CONTROL STUDY
Authors: Muduli Nikhil , Sahu Alok , Barik Haramohan , Dalai Parikshita 
Published: December 2021

Abstract

Aim
To assess if increased serum levels of estradiol is an independent risk factor for occurrence of groin hernia in men.

Material and Methods
We performed a hospital based case-control study. Men diagnosed with groin hernia were taken as cases and men who did not have groin hernia but were admitted for other elective surgery were taken as controls. Cases were matched to controls based on age and BMI. Morning fasting blood sample was collected from both cases and controls used to measure serum estradiol levels.

Results
A total of 46 hernia cases and 91 non-hernia controls were included in the study. The mean age and BMI of both cases and controls were not significantly different. The mean serum estradiol level for cases was 53.5 ±7.11 pg/ml. This value was significantly higher (p &lt; 0.001) than for the control group which was 28.3 ± 3.14 pg/ml. A strong positive association was observed between increasing serum estradiol levels and hernia incidence. Men in 4th (highest) quartile of estradiol levels had a relative risk of 2.27 (95% CI:1.33-3.04) compared to men in 2nd quartile. Men in 1st (lowest) quartile didn’t have any hernia cases.

Conclusions
The knowledge may allow treatment or prevention with novel nonsurgical approaches. Therapy with aromatase inhibitors might prevent recurrence after hernia repair or even help men avoid surgery in the first place. Prevention of hernia will lead to decrease in morbidity and cost burden due to surgical treatment to a long extent.
P123 TAPP - THE BEST APPROACH FOR INGUINAL HERNIA ASSOCIATED WITH ADULT CRYPTORCHIDISM: CASE REPORT AND LITERATURE REVIEW
Authors: Ungureanu Claudiu , Octav Ginghina , Mirica Radu , Niculae Iordache 
Published: December 2021

Abstract

Aim
Cryptorchidism is a rare condition of adult male. The diagnosis is based on examination: impalpable testis and CT/MRI. The surgical correction of cryptorchidism is possible in childhood, but in adult orchiectomy is recommended, considering the malignancy risk. The association with hernia is uncommon.

Material and Methods
We report the case of a 23 years old male with left inguinal hernia and concomitant left cryptorchidism. MRI revealed the intra-abdominal left testicle, with reduced size and short vessels. Lab analysis were normal. We underwent laparoscopic exploration: the left testicle was small and had pelvic localization. A large inguinal hernia was also confirmed. We decided to perform laparoscopic TAPP (transaabdominal preperitoneal repair) and left orchiectomy. The evolution was uneventful and patient discharged 1st day postoperatively. Histology revealed testicular atrophy with no malignancy, also no spermatogenesis was present. No recurrence was found during follow-up.

Results
Cryptorchidism in adult is rare. The association with hernia is even more rare. The open management is not easy, often in pelvic/abdominal localization, the inguinal approach can be cumbersome. There is no standard of care for these cases, but we found the minimally invasive approach to be a good choice. Laparoscopic surgery has the advantage of enhanced exploration and orhidectomy can be easily performed. Associated with the orchidectomy, hernia cure can be facilitated by laparoscopic TAPP procedure.

Conclusions
In cases of concomitant hernia and cryptorchidism, we emphasize the idea of simultaneously cure hernia via laparoscopic TAPP procedure associated with orchidectomy as feasible and safe.
P129 THORACIC VS. ABDOMINAL APPROACHES FOR DIAPHRAGMATIC HERNIA REPAIR: A NATIONWIDE STUDY OF CLINICAL OUTCOMES
Authors: Centeno Andrea Carolina Quiroga , Navas Orlando , Serrano Juan Paulo , Ochoa Sergio Alejandro Gómez 
Published: December 2021

Abstract

Aim
“To compare the outcomes of different surgical approaches for diaphragmatic hernia (DH) repair.”

Material and Methods
“Adult patients with a principal admitting diagnosis of uncomplicated DH registered in the National Inpatient Sample in the period 2010-2015 were included. Patients with obstruction, gangrene, or congenital hernias were excluded. The primary outcome was in-hospital mortality. Secondary outcomes were the incidence of complications, length of stay, and hospital charges. A multivariate logistic regression model adjusted by age, sex, elective admission, comorbidities, and hospital characteristics was used to analyze the impact of the surgical approach on the evaluated outcomes.”

Results
“A total of 14910 patients with DH were included (median age 65 years, 74% women). Abdominal approaches were the most commonly performed (78.9% laparoscopy and 13.6% open). Patients that underwent open abdominal and thoracic repairs had a higher risk of complications (sepsis, pneumonia, surgical site infection, prolonged postoperative ileus, and acute myocardial infarction), longer hospital stay, higher total hospital costs, and a significantly higher risk of mortality (OR 2.62. 95% CI 1.59-4.30 and OR 4.60; 95% CI 2.37-8.91, respectively) compared to patients that underwent laparoscopic abdominal repair. Individuals whose DH repair was performed through thoracoscopy had a similar mortality risk to those who underwent laparoscopic abdominal repair (OR 0.87; 95% CI 0.11-6.43).”

Conclusions
“Nowadays, laparoscopy has become the most used approach for DH repair. In the present cohort, it was associated with better outcomes in terms of complications, length of hospital stay, and mortality, as well as lower health costs. Additional studies assessing hernia characteristics are required to validate this result.”
P130 HYBRID OPERATION TECHNIQUE FOR INCISIONAL HERNIA REPAIR, A SYSTEMATIC REVIEW AND META-ANALYSIS OF INTRA- AND POSTOPERATIVE COMPLICATIONS
Authors: Van den Dop Matthijs , Smet Gijs De , Kleinrensink Gert-Jan , Hueting Willem , Lange Johan 
Published: December 2021

Abstract

Aim
Incisional hernia (IH) occurs approximately in 15% of patients after midline surgery. Surgical treatment for IHs include a solely open or solely laparoscopic approach with mesh placement. Recently, hybrid (combined laparoscopic and open) approaches are being performed. This systematic review evaluates the perioperative complications of hybrid incisional hernia repair (HIHR).

Material and Methods
EMBASE, Medline via OvidSP, Web of Science, Cochrane and Google Scholar databases were searched. Studies providing data on intra- and postoperative complications in patients who underwent HIHR were included. Data on intra- and postoperative complications were extracted and meta-analyses were performed. Study quality was assessed with the Newcastle Ottowa Scale, ROBINS-I tool, and Cochrane risk of bias. PROSPERO registration: CRD42020175053.

Results
Results: Nine studies (n = 1596 patients) were included. Five studies compared intra-operative complications between HIHR and laparoscopic incisional hernia repair (LIHR) with a pooled incidence of 1.8% in HIHR group and 2.8% in LIHR group (p = 0.13). Comparison of postoperative prevalence of surgical site occurrences (SSOs) (24% versus 31%, p = 0.02) and surgical site occurrences requiring interventions (SSOPIs) (1.5% versus 4.1%, p &lt; 0.01) were in favour of the HIHR group. Overall postoperative complications seemed to occur less frequent in the HIHR group, though no hard statements could be made due to the vast heterogeneity in reporting between studies.

Conclusions
Although the majority of studies were retrospective and included a small number of patients, HIHR led to less SSOs and SSOPIs compared to LIHR. This systematic review forms a strong invitation for more randomized controlled trials to confirm the benefits of this approach.
P141 USE OF POLYPROPYLENE STRIPS FOR REINFORCEMENT OF THE CRUROPLASTY IN LAPAROSCOPIC PARAESOPHAGEAL HERNIA REPAIR: A RETROSPECTIVE COHORT STUDY
Authors: Van den Dop Matthijs , Smet Gijs De , Mamound Aziz , Lange Johan , Wijnhoven Bas , Hueting Willem 
Published: December 2021

Abstract

Aim
Laparoscopic paraesophageal hernia repair is an effective treatment for symptomatic paraesophageal hernias. To reduce recurrence rates, the use of prosthetics for the crural repair has been suggested. Mesh-related complications are rare, but known to be disastrous. To address another form of crural repair, polypropylene strips are suggested. This study aimed to assess peri- and postoperative complications of reinforcement of the cruroplasty with polypropylene strips.

Material and Methods
From 2013 to 2020, patients with a type II, III or IV primary or recurrent paraesophageal hernia that underwent cruroplasty with polypropylene strips were retrospectively reviewed. Intra- and postoperative complications were graded according to the Clavien-Dindo classification. The incidence of symptomatic recurrent hiatal hernia (CT or endoscopy proven) and hospital stay were assessed.

Results
One-hundred-and-fifty-eight patients were included. Mean age was 65 years (standard deviation 10.4), 119 patients were female (75.3%). Almost 50% of surgeries took place between 2018 and 2020. Median follow-up was 7 months (interquartile range 17.5). Mean operation time in the primary hernia group was 159 minutes (standard deviation 39.0), and length of stay was 4.4 days. In 3/158 patients (2.0%) intra-operative complications occurred. Two patients developed a grade IV and seven patients a grade III postoperative complication. No mortality was recorded. Twelve recurrences (8.2%) were detected in the primary hernia group, and one (9.1%) in the recurrent hernia group.

Conclusions
There were no mesh-related complications seen and symptomatic recurrence rate was low, but longer follow up is needed.
P157 EFFECTS OF COVID-19 PANDEMIC ON THE SCIENTIFIC PUBLICATIONS IN HERNIA FIELD
Authors: Kulacoglu Hakan , Celasin Haydar 
Published: December 2021

Abstract

Aim
The increase in the number of publications in the hernia field has been higher than the most of our areas of surgery. COVID-19 pandemics has affected many elective surgical procedures like hernia repairs. We assumed that the declines in case volumes might cause some falls in related publications, and searched the literature in order to find the number of herniology publications before and during the pandemic.

Material and Methods
A systematic PUBMED search was done for three consecutive decades “1991-2000”, “2001-2010” and “2011-2020” by using the key words “inguinal and hernia”, “umbilical and hernia”, “incisional and hernia”, “mesh and hernia”, “laparoscopic and hernia”, “robotic and hernia”, and “experimental and hernia”. Later, a comparison of years 2019 and 202o was done.

Results
Although increases were detected for all searches with the key words, the largest rise was seen in publications related to “robotic and hernia”. Some undulations were recorded during the years, but the number of publications showed obvious increases decade by decade. A very small decrease was found in the number of publications for “experimental and hernia” only, however all other searches presented increases during the first year of the pandemic, 2020 in comparison with 2019.

Conclusions
The increases in the number of publications in hernia field continued during the last decade. COVID-19 pandemic did not cause a decrease in these publications the first year. We assume that year 2021 can be a more correct criteria in order to observe the potentially negative effect of the pandemic.
P161 EMERGENCY LAPAROSCOPIC REPAIR OF A PARASTOMAL HERNIA
Authors: Cuevas María Jose , Pinilla Diego , Sánchez Alejandro , Tinoco José , Tallón Luis , Padillo Francisco Javier 
Published: December 2021

Abstract

Aim
The aim of this video is to present the laparoscopic approach to an incarcerated parastomal hernia, using the modified Sugarbaker technique.

Material and Methods
A 50-year-old man with a definitive terminal colostomy after undergoing an abdominoperineal resection due to a rectal cancer, consulted in the emergency room with abdominal pain and an incarcerated mass below the colostomy, without evidence of intestinal obstruction. A CT scan was performed, with the finding of infarcted epiploic appendages inside the parastomal hernia. After evaluation of the case, emergency surgery was decided, opting for a laparoscopic approach to the parastomal hernia, employing the modified Sugarbaker technique.

Results
Following the dissection of the hernial sac and resection of the necrotic fat content, a partial closure of the hernial orifice was done. A hernioplasty was performed using a composite synthetic mesh, that was fixated with helical sutures. After surgery, the patient evolved favorably and was discharged 72 hours after the procedure. In the one year of follow-up, the patient was asymptomatic and there were no data of recurrence either on the clinical examination or the control CT scan.

Conclusions
The laparoscopic approach to an incarcerated parastomal hernia is possible and safe when performed in well-selected cases by the hands of experienced surgeons, offering good short and long-term results.
VP020 ENDOSCOPIC PREPERITONEAL APPROACH IN STRANGULATED INGUINAL HERNIA
Authors: Gómez Jorge Zárate , Hernández Pedro Álvarez de Sierra , Luengas David Fernández , Someso Silvia Conde , Eslait Guillermo Supelano , Iribar Begoña Peinado , Godino Jesús Merello 
Published: December 2021

Abstract

Aim
According to the clinical sympthoms and radiological findings minimal invasive surgery can be an option to repair an strangulated inguinal hernia.

Material and Methods
We present the different ways we have used in our Hospital to treat incarcerated inguinal hernia combining endoscopic preperitoneal and laparoscopic approach

Results
Multiple treatment schemes are possible for inguinal incarcerated hernia. The choice must be made according to the surgeońs experience, patient´s characteristic and the risk of intestinal ischemia.
Laparoscopy combined with preperitoneal endoscopic inguinal repair allows us to explore and to treat possible complications of intestinal ischemia with no need of laparotomy.

Conclusions
Laparoendoscopic techniques are an option to consider when treating an incarcerated inguinal hernia, even if bowel resection is needed.
Thanks to laparoscopic approach, laparotomy can be avoided in many cases.
O04 DETERMINING THE EFFECT OF MESH WIDTH AND FIXATION PATTERNS ON THE STRENGTH OF PROPHYLACTICALLY REINFORCED LAPAROTOMY INCISIONS
Authors: Christopher Adrienne , Sanchez Jonathon , Fischer John 
Published: December 2021

Abstract

Aim
Research indicates that prophylactic mesh may help prevent incisional hernia after laparotomy, but best practice patterns in these situations are still evolving. Here, we compare the failure loads (FLs) and biomechanical stiffness (BMS) of 35 porcine abdominal wall laparotomy incisions reinforced with meshes of various widths and fixation distances using biomechanical testing.

Material and Methods
In each specimen, a ten centimeter (cm) incision was made and closed using continuous 1-0 Maxon suture. Specimens were randomized to mesh width (none, 2.5cm, 3cm, 4cm, 6cm, 8cm) and tack separation (1.5cm, 2cm apart), and the meshes secured in an onlay fashion. Cyclic loads oscillating from 15 Newtons (N) to 140N were applied to stimulate abdominal wall stress, and the specimens subsequently loaded to failure. FLs (N) and BMS (N/mm) were comparatively analyzed.

Results
All specimens failed via suture pull-through. FLs and BMS were lowest in specimens with suture-only (421.43 N; 11.69 N/mm). FLs and BMS were significantly higher in 4cm mesh specimens (567.51N) than those with suture, 2.5cm, and 3.0cm mesh (all p &lt; 0.05). FLs in specimens with a greater number of tacks were consistently higher in meshes of similar sizes, although these did not reach significance.

Conclusions
Four cm mesh re-enforcement is superior to suture-only and smaller meshes at preserving strength in laparotomy closure in the early stages of healing, but larger meshes (6cm, 8cm) do not provide additional benefit. Meshes with more fixation points may be advantageous, but additional data is needed to make definitive conclusions.