bluuebunny/crossref_metadata_2025_split huggingface dataset:
P054 REDUCTION OF FAILURE RATES AFTER INCISIONAL HERNIA REPAIR BY ADDING A PROPHYLACTIC MESH
Authors: Lesch Carolin , Kallinowski Friedrich , Uhr Katharina , Vollmer Matthias , Gerhard Christian , Gutjahr Dominik , Krimmel Lena , Ludwig Yannique 
Published: December 2021

Abstract

Aim
“Can a mesh reduce failure rates after closure of a hernia defect?”

Material and Methods
“Porcine abdominal walls and bovine flanks were used as model tissues. After preparation, a 15 cm long incision was placed in the linea alba of the porcine abdominal wall. An additional round 5 cm defect was punched in the middle of the incision. The bovine flank was prepared in a similar manner.
The incisions with the defects were closed with running sutures in a small stitch, small bite technique. Monomax® 2-0 sutures were used with suture to wound lengths above 4:1.
Dynamesh® CiCAT meshes of three different sizes were placed in the sublay position.
The mesh-tissue compounds were investigated on our self-built hydraulic bench test simulating coughs. Dynamic intermitted strain (DIS) was repeatedly delivered with impacts around 210 mmHg. Each of ten preparation was loaded 425 times by the pressure peaks.”

Results
“Small stitch, small bite sutures using 2-0 Monomax® with a suture-incision-ratio of 4.5:1 can provide a durable defect closure. Under other conditions, suture lines can reopen. A mesh reduces the recurrence of incisional hernia depending on the mesh size.”

Conclusions
“An additional DIS-class A mesh in sublay position can provide sufficient support for a suture closing the defect of the abdominal wall. It can prevent a tear-out of the suture from the tissue. On average, a mesh-augmented defect closure reduces the recurrence rate of incisional hernia.”
P060 TROCAR SITE HERNIA AFTER GASTRIC SLEEVE
Authors: Ahlqvist Sandra , Edling Axel , Alm Magnus , Dackhammar Johan Blixt , Cengiz Yücel 
Published: December 2021

Abstract

Aim
Laparoscopy is common in abdominal surgery. Trocar site hernia (TSH) is a most likely underestimated complication. Among risk factors, obesity, the use of larger trocars and the umbilical trocar site has been described. In a previous study, CT scan in the prone position upon a ring was found to be a reliable method for the detection of TSH in obese.
Our aim was to examine the incidence of TSH after gastric sleeve.

Material and Methods
79 patients subjected to laparoscopic gastric sleeve in 2011-2016 were examined using CT in the prone position upon a ring. Symptoms of TSH were assessed using a digital survey.

Results
The incidence of trocar site hernia was 17 out of 79 (21,5 %), all at the umbilical trocar site. The mean follow-up time was 37 months. There was no clear correlation between symptomatic TSH and TSH on CT.

Conclusions
The incidence of TSH is high in this group of patients. Up to follow-up, none of the patients had been subjected to hernia repair. Although the consequence of trocar site hernia can be serious, the proportion of symptomatic TSH is unknown.
P071 SURGERY DURING COVID ERA - IMPACT IN ABDOMINAL WALL SURGERY - OUR EXPERIENCE
Authors: Gonçalves Mário Rui , Antunes Conceição , Carneiro Teresa , Liorci Milena , Capinha Mariana , Pereira Joaquim Costa 
Published: December 2021

Abstract

Aim
“COVID pandemic created unprecedented challenges for actual health care systems with hundreds of surgeries suspended with impact in Abdominal Wall Surgery (AWS) and other benign diseases. With this in mind, we implemented new and dedicated clinical pathways to allow more patients to be operated in outpatient regime, so we could have more availability of beds, staff and resources for COVID assistance.”

Material and Methods
“A retrospective observational study was conducted using data since January 2018 to May 2021. Our Hospital and Surgical Department suffered great organizational changes, namely creation of: dedicated medical and staff teams for COVID + (C+) and COVID- (C-) patients; dedicated pathways in our operating rooms for C+ cases; and, ultimately, designed and implemented protocols and agreements to maintain our Department fully operational, with a secure shift from elective to outpatient surgeries.”

Results
“During the study, a global number of 2541 AWS were performed. In the era pre-COVID (2018 - February 2020), we performed 968 surgeries with an average number of 37,2 AWS/month. Despite COVID pandemic (march 2020 - may 2021), our department performed a total of 1573 AWS, with an average number of 112,4 AWS/month. In resume, during COVID era, we increased AWS by more than 300%.”

Conclusions
“This study found that, inner organizational adaptations and creation of dedicated protocols/clinical pathways can maintain surgical departments performance despite the stress and uncertainty of a pandemic like COVID-19 with a very positive impact on benign pathologies such as AWS.”
P094 DIASTASIS POST-PREGNANCY PROGRAM
Authors: Santilli Osvaldo 
Published: December 2021

Abstract

Aim
This study aims to summarize our knowledge in rectus abdominis diastasis based on the experience collected by the multidisciplinary program.

Material and Methods
Retrospective analysis of a prospective database. The diastasis post-pregnancy program is an interdisciplinary protocol that aims to restore the anatomical and functional structure of the abdominal wall after the degenerative process of pregnancy. Used a systematic multidisciplinary evaluation that included an abdominal walls surgeon, plastic surgeon, physiotherapist, and radiologist. Following the findings, we propose a classification, adapting the specific treatment according to the degree of the patient's condition. Grade I only performed physiotherapy; Grade II: started physiotherapy plan, with associated surgical treatment due to lack of response; Grade III underwent surgery as the first treatment in addition to physiotherapy protocol.
Endoscopic-assisted linea alba reconstruction plus mesh have using to repair midline hernias in association with diastasis.

Results
From January 2017 and June 2019, 1085 patients completed the program. Clinical classification: Grade I: 760 patients (70 %) and Grade II: 248 patients (64%) performed physiotherapy as first-line treatment, with associated surgical treatment being necessary for 89 patients (36%); Grade III: 77 patients (7%) underwent surgery as first-line treatment, associated with physiotherapy postoperative protocol. Postoperative complications were: 31 seromas(14%) , 11 omphalitis (5%), 5 hematoma (2%) 1 (0.44%) required surgical dressing. Mc Gill and Us Check-up post-treatment test showed improvement in 77 % of patients. Please insert your text here.

Conclusions
Evaluation and treatment, in post-pregnant patients, using a multidisciplinary approach concept showed good initial results with important improvement anatomical, functional, clinical, and aesthetic.
P100 EARLY POSTOPERATIVE WOUND COMPLICATIONS AFTER MIDLINE LAPAROTOMY CLOSURE WITH SMALL BITES TECHNIQUE: EXPERIENCE FROM A TERTIARY REFERRAL CENTRE
Authors: Gudelis Adomas , Simutis Gintaras , Pacevicius Julius 
Published: December 2021

Abstract

Aim
To analyze the incidence and risk factors of surgical site infections (SSI) and wound dehiscence (WD) after closure of primary midline laparotomies with small-bites (SB) technique.

Material and Methods
Retrospective analysis using hospital prospective database of all midline abdominal wall closures (AWC) with SB technique performed in a University Hospital between December 2019 and February 2021. To achieve a proper protocol of AWC with SB technique, it is advised to have suture/wound length (SL/WL) – ratio of more than 4:1. Statistical analysis of the incidence of SSI and AWD, comparing the results when the protocol was properly used (A group) or not (B group), was performed. Between groups, no relevant differences were observed for patient characteristics.

Results
A total of 108 midline laparotomies were included for analysis. 55.5% of patients were male. The mean age was 62.8 years, mean body mass index was 24.3 kg/m2. 78.7% (85/108) were operated electively. SSI and WD have been recorded in 7 (6.5%) and 8 (7,4%) cases respectively. In 65 (60,2%) patients abdominal wall closure after primary laparotomy was achieved with proper protocol (group A). Median SL/WL in A and B group was 4.57 and 3.43 respectively. The rate of WD in A group (n = 1, 1,5%) was significantly (P=.006) lower than in B group (n = 7, 16,3%). Incidence of SSI was 7,7% (n = 5, A group) vs. 4,7% (n = 2; B group) (P=.420).

Conclusions
Using a proper AWC protocol has been effective to prevent WD in midline laparotomy.
P107 PREVENTION OF INCISIONAL HERNIA AFTER MIDLINE LAPAROTOMY WITH MODIFICATION OF CLOSURE TECHNIQUE: SYSTEMATIC REVIEW AND META ANALYSIS
Authors: Hernandez Edgard Efren Lozada , Bonilla Juan Pablo Hernandez , Moreno Enrique Obregon , Ugarte Diego Hinojosa , Herevia Aldo Jimenez , Gonzalez Juan Carlos Mayagoitia , Garcia Miguel Magdaleno 
Published: December 2021

Abstract

Aim
“Incisional hernia is the main complication after laparotomy, the prevention of this is currently aimed at preoperative rehabilitation, modification of the closure technique and the use of prophylactic mesh. The objective of the study was to measure the effectiveness of the modification in the laparotomy closure technique to reduce the incidence of incisional hernia.”

Material and Methods
“A systematic review and meta-analysis were carried out following the PRISMA guidelines. The first objective was to determine the incidence of incisional hernia at one year of follow-up, comparing the modification in the closure technique with the usual closure. The secondary objective was to determine the difference in wound dehiscence and surgical site infection between these two groups. Only clinical trials were included, and the random effects method was used for their analysis. PROSPERO registration number: CRD42021231107”

Results
“Seven clinical trials were included, comparing 1612 patients, the incidence of incisional hernia was significantly lower in the surgical technique modification group OR 0.55 (95% CI 0.38-79). Efficacy to reduce the incidence of wound dehiscence was also analyzed without finding a difference between the two groups OR 0.58 (95% CI 0.27-1.21). There was no statistically significant difference between both groups when comparing seroma hematoma and surgical site infection.”

Conclusions
“The modification in the laparotomy closure technique reduces the incidence of incisional hernia. However, when analyzing globally, only the Small bites and Reinforced tension line techniques contributed to this result.”
P112 INCIDENTAL INGUINAL HERNIA IN MEN
Authors: Burgmans Ine , van Coen Hessen , Bakker Wouter , Verleisdonk EgbertJan , Sanders Floris 
Published: December 2021

Abstract

Aim
“Ultrasound may contribute to establish the cause of nonspecific groin complaints. However, the risk is diagnosing an incidental inguinal hernia whereas the pain has an alternative cause. Overtreatment is to be prevented. Therefore, the aim of this study is to determine the prevalence of a previously unknown inguinal hernia among working-age men without groin complaints.”

Material and Methods
“A cross sectional study was conducted in healthy men aged 45-67 years. Men with a Body Mass Index (BMI) &gt; 40, a history of groin complaints, a known inguinal hernia or previous inguinal surgery were excluded. Ultrasound of both groins was performed in supine position with and without a Valsalva manoeuvre by a specialised ultrasound technician in consultation with a radiologist. In all groin ultrasounds showing an inguinal hernia, physical examination was executed by a hernia surgeon.”

Results
“In the months June and November of 2018, 200 groins of 100 men were analysed. In 16 (16%) men an inguinal hernia was found on groin ultrasound (95% confidence interval [8.8 – 23.2]). In 12 men this was a unilateral inguinal hernia and in 4 men a bilateral inguinal hernia. Ultrasound yielded no other pathology.”

Conclusions
“In a population of men aged 40-67 years without groin complaints, ultrasound detects an inguinal hernia in 16%. Hence, the probability of wrongly attributing groin complaints to an incidental inguinal hernia, diagnosed on ultrasound, is considerable. ”
P113 SPIN IS PRESENT IN THE MAJORITY OF THE ARTICLES EVALUATING ROBOT-ASSISTED GROIN HERNIA REPAIR: A SYSTEMATIC REVIEW
Authors: Hansen Danni , Fonnes Siv , Rosenberg Jacob 
Published: December 2021

Abstract

Aim
The number of articles published each year are increasing, resulting in greater competition to get work published. Spin is defined as specific reporting strategies used to distort the readers’ interpretation of results so that they are viewed more favourable. However, prevalence of spin in studies comparing robot-assisted groin hernia repair with traditional methods is unknown. The aim of the study was to determine the frequency and extent of misrepresentation of results, spin, in studies assessing robot-assisted groin hernia repair.

Methods
This systematic review was reported according to PRISMA guidelines, and a protocol was registered at PROSPERO before data extraction. Database search included PubMed, EMBASE and Cochrane Central.

Results
Of 35 included studies, spin was present in 57%. Within these, 95% had spin present in the abstract and 80% in the conclusion of the article. There was no association between study size and spin (p &gt; 0.05). However, presence of spin in studies positively minded towards robot-assisted hernia repair was higher (p &lt; 0.001) compared with those against or being neutral in their view of the procedure. Furthermore, being funded by or receiving grants from Intuitive Surgical were associated with a higher prevalence of spin (p &lt; 0.01) compared with those who were not.

Conclusion
Spin was found to be common in articles reporting on robot-assisted groin hernia repair, and presence of spin was higher in studies funded by or receiving grants from the robot company. This suggests that readers should be cautious when reading similar literature.
P117 INFLUENCE OF THE MESH FIXATION METHOD ON THE RESULTS OF OPEN INGUINAL HERNIA REPAIR
Authors: Navid Maria , Protasov Andrey , Guseinov Ilgar , Titarov Dmitriy , Podolskiy Mikhail , Khallyieva Ogulgerek 
Published: December 2021

Abstract

Aim
Study of postoperative outcomes after Liechtenstein inguinal hernia repair using self-gripping mesh and polypropylene mesh with suture fixation.

Material and Methods
Medical records of 289 open inguinal hernia repairs were analyzed: 176 – with sutured polypropylene mesh and 113 – using self-gripping mesh. To assess the quality of life we have used EuraHS Qol and SF-36. Statistical analysis was performed using SPSS.

Results
There were no significant differences in wound complications (such as swelling, seroma, hematoma, orchitis) between these groups (p &gt; 0,05). The duration of operation was significantly shorter with self-gripping mesh compared to sutured mesh (42,2 min. sd = 23,42 vs 58,5 min. sd = 16,70; p &lt; 0.001). Pain on the first and 6th days after implantation self-gripping mesh was present significantly less frequently in comparison with sutured mesh (χ2 (1, N = 289) =7.925, p = 0.005 and χ2 (1, N = 289) =24.740, p &lt; 0.001). NSAIDs intake time was less in self-gripping mesh group (3.01±1,07 vs 4.43±1,75 days; U = 11723, p &lt; 0.001). We have found no significant differences in both groups for all quality-of-life indicators EuraHS (p = 0.234) and SF-36 (p = 0.190).

Conclusions
Self-gripping mesh has comparable outcomes with sutured polypropylene mesh regarding the frequency of wound complications and quality of life on long-term follow-up. However, self-gripping mesh is associated with reduced operation time, pain in the short-term postoperative period, and taking NSAIDs compared to sutured mesh.
VP019 TESAR - TOTALLY ENDOSCOPIC SUBLAY ANTERIOR REPAIR - IN MIDLINE DEFECTS REPAIR
Authors: Fiori Federico , Ferrara Feancesco , Gentile Daniele , Boati Paolo , Calì Matteo 
Published: December 2021

Abstract

Aim
In recent years, many minimally invasive techniques have been presented in abdominall wall repair. Since 2018 we have been using TESAR techinque, an anterior endoscopic approach with mesh sublay, published in 2019 from our group.

Material and Methods
From May 2018 to May 2021 58 Patients referred to our Unit for clinical and radiological diagnosis of ventral defect (Midline hernia, Incisional hernia, Diastasis Recti&gt;5 cm). Exclusion criteria were: maximum defeact width 8 cm, and contraindications to general anesthesia

Results
All the patients underwent midline repair with TESAR technique. Three TAR were performed, with defect of 8 cm width previously treated with botox. No conversion to laparotomy occured, no intraoperative complications were registered. Total mean operative time was 156 +- 21,5 min. No postoperative major complications, 3 subcoutaneous seromas occurred ,all treated conservatively. The mean Hospital stay was 2.7 + 0.8 days.

Conclusions
TESAR is a feasible technique for extraperitoneal repair of midline defects with a totally endoscopic approach, allowing a safe repair with good outcomes in terms of resolutions of symtoms and postoperative complications. The video shows the main steps of the technique in diastasis recti and complicated ventral hernia repair.
O06 PATIENT-REPORTED KNOWLEDGE OF HERNIA SURGERY: A QUANTITATIVE STUDY OF FIRST TIME REFERRED PATIENTS TO AN ABDOMINAL WALL UNIT FOR HERNIA REPAIR
Authors: Jimenez Daniel Rosselló , Cano Manuel López , Gonçalves Victor Rodrigues , Tremolosa Mireia Verdaguer , Serra Judit Saludes , Salvá Alejandro Bravo , Pereira-Rodriguez Jose Antonio 
Published: December 2021

Abstract

Aim
The objective of this study was to gather information on patient-reported knowledge (PRK) in the field of hernia surgery.

Material and Methods
A prospective quantitative study was designed to explore different aspects of PRK and opinions regarding hernia surgery. Patients referred for the first time to a surgical service with a presumed diagnosis of hernia and eventual hernia repair were eligible, and those who gave consent completed a simple self-assessment questionnaire before the clinical visit.

Results
The study population included 449 patients (72.8% men, mean age 61.5). Twenty (4.5%) patients did not have hernia on physical examination. The patient’s perceived health status was “neither bad nor good” or “good” in 56.6% of cases. Also, more patients considered that hernia repair would be an easy procedure (35.1%) rather than a difficult one (9.8%). Although patients were referred by their family physicians, 32 (7.1%) answered negatively to the question of coming to the visit to assess the presence of a hernia. The most important reason of the medical visit was to receive medical advice (77.7%), to be operated on as soon as possible (40.1%) or to be included in the surgical waiting list (35.9%). Also, 46.1% of the patients considered that they should undergo a hernia repair and 56.8% that surgery will be a definitive solution.

Conclusions
PRK of patients referred for the first time to an abdominal wall surgery unit with a presumed diagnosis of hernia was quite limited and there is still a long way towards improving knowledge of hernia surgery.
O09 CLINICAL FEASIBILITY OF THE Q1.6 INGUINAL HERNIA APPLICATION: A PROSPECTIVE COHORT STUDY
Authors: van Hout Ludo , Bökkerink Willem , Vriens Patrick 
Published: December 2021

Abstract

Aim
Patient Reported Outcomes (PROs) are essential for evaluating hernia surgery. Current measuring instruments for PROs have disadvantages: often lengthy and burdensome paper questionnaires, used at predetermined moments with low patient compliance and time-consuming data processing. The Q 1.6 Inguinal Hernia application was developed to overcome these challenges. This pilot study reports the first clinical feasibility results.

Materials and Methods
the ‘twitch crowdsourcing’ concept was applied: during the interval of unlocking a smartphone or tablet a short question is asked, multiple times a day. Questions from validated questionnaires were implemented. The adaptive question engine generates an individualized set of questions. Alerts are automatically generated when a complication is suspected. All inguinal hernia patients in a high-volume inguinal hernia center were eligible for inclusion. Patients signed informed consent.

Results
229 patients answered over 50.000 pre- and postoperative questions of which 92% were answered. Pre- and postoperative patient characteristics and clinical outcomes confirmed a standard inguinal hernia population. Compliance was 91.7% after 14 days, 69.0% after 3 months and 28.8% after one year. Pain and functional limitations were measured with a numerical scale from zero to ten. After 3 and 7 days, 7.7% and 44.3% returned to work, respectively. Patients were highly satisfied (92.8% preferred the app to usual care).

Conclusions
this smartphone application shows promising results for clinical practice. Remote monitoring may become standard postoperative care after (inguinal) hernia surgery. The current application will be further improved and evaluated for cost-effectiveness, safety and validity.
O31 SUTURE OR MESH REPAIR FOR THE SMALLEST UMBILICAL HERNIAS: A NATIONWIDE DATABASE STUDY
Authors: Henriksen Nadia , Jensen Kristian Kiim , Bisgaard Thue , Helgstrand Frederik 
Published: December 2021

Abstract

Aim
High level evidence recommends the use of mesh for umbilical hernias with defects &gt;1 cm to reduce recurrence rates without increasing the risk of postoperative complications. For umbilical hernias with defect width ≤1 cm, the literature is sparse. The aim of the study was to assess outcomes after suture and mesh repair of umbilical hernias with defect width &lt;1 cm on a nationwide basis, and to evaluate outcomes after onlay mesh repair specifically.

Material and Methods
By merging data from the Danish Hernia Database and the National Patients Registry from January 2007 until December 2018, patients receiving elective repair of an umbilical hernia with defect width ≤1 cm were identified. Available data included details about comorbidity, surgical technique, 90-days readmission, 90-days reoperation and reoperation for recurrence.

Results
A total of 7,849 patients were included, of whom 25.7% (2,013/7,849) underwent mesh repair. The cumulative 5-year incidence of reoperation for recurrence was significantly decreased after mesh repair 3.1% (95% C.I. 2.1-4.1) compared with suture repair 6.7% (95% C.I. 6.0-7.4), P &lt; 0.001. Onlay mesh repairs had the lowest cumulative risk of recurrence at 5 years 2.0% (95% C.I. 0.6-3.5). For onlay mesh repairs, readmission 7.9%, (65/826)) and reoperation (3.9% (32/826)) rates within 90-days were comparable to suture repairs (6.5% (381/5,836) and 3.3% (192/5,836), P = 0.149 and P = 0.382, respectively.

Conclusions
Even for the smallest umbilical hernias, mesh repair significantly decreased the recurrence rate. Onlay mesh repair was associated with the lowest risk of recurrence without increasing early complications.