bluuebunny/crossref_metadata_2025_split huggingface dataset:
P084 MESH USE IN THE UNITED STATES: MESH TYPES AND THEIR INDICATIONS
Authors: Fadaee Negin , Khanmohammed Zayan , Tung Robert , Huynh Desmond , Towfigh Shirin 
Published: December 2021

Abstract

Aim
Synthetic non-absorbable mesh repair is considered standard of care for most hernias in the United States (US). The introduction of biologic absorbable mesh in the 2000’s has changed this practice and now novel synthetic absorbable and hybrid meshes are available. We aim to describe US trends of mesh use.

Material and Methods
We surveyed the Abdominal Core Health Quality Collaborative database for all repairs using mesh from 2012 to 2021. Mesh types and indications were analysed.

Results
Among 47,555 patients who underwent hernia repair with mesh, the majority were with synthetic non-absorbable meshes (96%). Absorbable mesh was placed in 2,039 (4%) patients and included biologic absorbable (893, 44%), synthetic absorbable (1,070, 52%), and hybrid (76, 4%) meshes. Synthetic non-absorbable mesh use was significantly predominant in all wound classes, including dirty/contaminated wounds (P &lt; 0.01) [Figure 1]. Over time, we noted a trend toward lower incidence of absorbable and hybrid mesh use, from 18% to 2% (P &lt; 0.01). Interestingly, we noted a relative increase in annual incidence of absorbable and hybrid mesh use in clean wounds, from 20% to 63% (P &lt; 0.01) [Figure 2]. Figure 1Mesh type used in each wound classFigure 2Absorbable mesh use in clean vs. not clean wounds.

Conclusions
In the United States, synthetic non-absorbable meshes are commonly used during hernia repairs in dirty and contaminated fields. At the same time, there is a significant increase in the use of absorbable and hybrid meshes in the repair of hernias with clean wound classification. The costs and long-term outcomes of such surgeon choices have yet to be validated.
P085 CLINICAL AND LONGITUDINAL PATIENT REPORTED OUTCOMES AFTER TRANSVERSUS ABDOMINIS RELEASE: A SINGLE SURGEON EXPERIENCE
Authors: Christopher Adrienne , Morris Martin , Barrette Louis-Xavier , Broach Robyn , Fischer John 
Published: December 2021

Abstract

Aim
Posterior component separation with transversus abdominis release (TAR) is a novel complex abdominal wall repair technique that maximizes medial myofascial flap advancement in a vascularized, pre-peritoneal plane. Here, we add to a growing body of literature on this technique by assessing longitudinal clinical and patient reported outcomes (PROs) after ventral hernia repair (VHR) with TAR.

Material and Methods
Adult patients undergoing VHR with TAR between 10/1/2015 and 01/15/2020 by a single surgeon were retrospectively identified. Patients with parastomal hernias and &lt;12 months of follow-up were excluded. Clinical outcomes and PROs using the Abdominal Hernia Questionnaire (AQH) and Hernia Related Quality of Life Survey (HerQLes) were assessed.

Results
57 patients were included with a median age and body mass index of 60 and 30.6 kg/m2, respectively. The average hernia defect was 384 cm2 [IQR 205-471], and all patients had retro-muscular mesh placed. The most common complications were delayed healing (19.3%) and seroma (14.0%). One patient required return to the OR for management of a complication and there were no cases of mesh infection or explantation. Previous hernia repair and concurrent panniculectomy were risk factors for developing any complication (p &lt; 0.05). One patient (1.8%) recurred at a median follow-up of 25.7 months [IQR 18.2-42.1]. Significant improvement in disease-specific PROs was observed and maintained throughout the follow-up period (pre to post p &lt; 0.05).

Conclusions
Longitudinal clinical and patient-reported outcomes after VHR with TAR are limited. We conclude that TAR is a safe and efficacious adjunct in the repair of complex hernia defects.
P091 POSTOPERATIVE OUTCOMES THAT MATTER TO PATIENTS UNDERGOING INGUINAL HERNIA REPAIR: A QUALITATIVE STUDY
Authors: Gram-Hanssen Anders , Laursen Jannie , Zetner Dennis , Rosenberg Jacob 
Published: December 2021

Abstract

Aim
Explore which postoperative outcomes are important to patients operated for inguinal hernia to gain a better insight into the patient experience going through surgery.

Material and Methods
Qualitative study using semi-structured individual interviews. Based on phenomenology and hermeneutics. Participants were all male, between 44-66 years of age, and had undergone inguinal hernia repair. Patients were interviewed either shortly after surgery (≤ 10 days) or 3-6 months postoperatively. Data were analyzed with directed content analysis based on six domains defined a priori based on the literature. Reported according to the COnsolidated criteria for REporting Qualitative research (COREQ) and Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0).

Results
Ten patients were included and interviewed. Data aligned well with the six predefined domains. Major domains: Function, Sensation, Expectations. Minor domains: Appearance, Social Aspects, Satisfaction with surgeon/staff. Preoperative functional limitations were the main motivation for seeking surgery, and postoperative functional improvement seemed to be the most important factor determining overall patient satisfaction.

Conclusions
Patients consider a wide range of factors when assessing the outcome of their inguinal hernia repair. Our results suggest that the current practice of outcome assessment of inguinal hernia repair may be too narrow and may not adequately reflect the patients’ experience. This study is a part of an ongoing development of a Core Outcome Set for inguinal hernia research.
P099 READMISSIONS AND EMERGENCY ROOM VISITS FOLLOWING OUTPATIENT AND INPATIENT HERNIORRHAPHIES
Authors: Shmelev Artem , Batarseh Laith , Ahad Ahmad 
Published: December 2021

Abstract

Aim
Analysis of all healthcare encounters (readmissions and emergency department visits, EDV) following both inpatient and outpatient abdominal hernia repairs (AHR), with respect to the timeline of such encounters.

Material and Methods
Patients undergoing AHR were identified in Maryland State Inpatient and State Ambulatory Surgery and Services Databases, 2016-2017, and all their hospital and ED encounters were assembled into a comprehensive database, covering almost 95% of all AHR performed in Maryland.

Results
Of the total 26,215 patients who underwent AHR (3,333 inpatient and 22,950 outpatient; 48.7% inguinal and 53.0% ventral/umbilical), 5,802 (22.1%) had at least one postoperative encounter (4,186 EDV, 1,415 readmissions, and 248 encounters for mostly outpatient another AHR). 419 (80.4%) post-operative encounters within the first 48 hours were EDV and 98 (18.8%) were readmissions. Fraction of EDV within later encounters was in 69.6–71.1% range. Most frequent reasons for EDV were urinary complaints (24.1%, 10.6% and 4.0% on POD 0–2, 3–7, and 8–30, respectively), followed by pain control issues (18.1%, 24.9%, 14.4%) and delayed return of bowel function or constipation (10.5%, 9.9%, 3.4%). Readmissions mainly occurred for aforementioned GI complaints (15.3%, 19.9%, 6.9% on POD 0–2, 3–7, and 8–30, respectively), local surgical site infections (5.1%, 15.5%, 26.8%), and respiratory complications (8.2%, 6.6%, 4.1%).

Conclusions
2.3% of all patients had at least one readmission while 6.4% patients had at least one EDV within 30 days following herniorrhaphy. Early postoperative EDV were mainly caused by urinary complaints, inadequately controlled pain, or delayed bowel function. Factors associated with these largely preventable complications require dedicated analysis.
P101 BIOSYNTHETIC MESH LIMITS ADHESION FORMATION FOLLOWING INCISIONAL HERNIA REPAIR
Authors: Manchip Gillian , Shaw Alex , Herrick Sarah 
Published: December 2021

Abstract

Aim
Adhesions are fibrous bands of scar tissue that form following peritoneal injury, commonly intra-abdominal surgery, and are associated with serious morbidity such as small bowel obstruction and pain. Surgical meshes used for incisional hernia repair are associated with increased incidence and severity of adhesions. There is limited consensus on which mesh may induce the least adhesions following incisional hernia repair, and most previous data has come from experimental animal models. We aimed to evaluate existing primary research to investigate whether biological mesh limits adhesion formation compared to synthetic or biosynthetic mesh when used in patients for incisional hernia repair and also to assess whether there is correlation with existing animal model data.

Material and Methods
A systematic search was conducted on PubMed and EMBASE. The number of mesh-related adhesions, character of adhesions and adhesion-related complications were documented. Results were compared to previously published results from animal models.

Results
Thirty-two studies were included, 11 of which did not document whether the adhesions were mesh related. A total of 14,161 participants underwent incisional hernia repair, 8,526 of whom were included in follow-up analysis. Overall, 9.7% developed adhesions. Biological mesh induced a high rate of dense adhesions, whereas biosynthetic mesh induced loose, filmy adhesions suggested to cause fewer complications. These findings were similar to findings from experimental animal models.

Conclusions
Bio-synthetic mesh was superior in causing fewer and less dense adhesions. Further analysis of mesh-induced adhesion formation on a larger scale is required to fully understand the consequences of different mesh types.
P104 POSTOPERATIVE OUTCOME AND COMPLICATIONS AFTER STOMA REVERSAL SURGERY WITH CICATRIAL HERNIA HERNIA PROPHYLAXIS BY MESH AUGMENTATION IN SUBLAY TECHNIQUE USING GORE® BIO A® MESH
Authors: Ceno Marsela , Paul Dietmar NV , Berger Dieter 
Published: December 2021

Abstract

Aim
At the surgery hospital of Klinikum Mittelbaden in Baden-Baden (Prof. Dr. Dieter Berger) stoma reversal surgery was performed on 127 patients in the time from Nov. 15, 2010 to Mar. 11, 2015.
All 127 patients were treated with a resorbable synthetic mesh (GORE® BIO-A® mesh) in sublay technique to close abdominal wall incisions.
Primary wound closure was carried out in all cases.
In order to evaluate the rate of postoperative hernias, which literature reports to be over 30 percent and a common complication, all 127 patients were included in a prospective study.

Material and Methods
In total, 104 of the included patients (n = 127) took part in the follow-up examinations. 72 patients underwent clinical examinations and imaging diagnostics, 21 were surveyed on the telephone whenever their presentation at a follow-up exam was impossible, whereas 11 patients deceased during the follow-up period. These cases were analyzed on the basis of the previous examinations which had been part of the respective health records.
The follow-up examination took place after a median time span of 87 weeks (8 -218 weeks).

Results
The total herniation rate of 7.7 percent (n = 8/104) in the examined patient population was thus much lower than described in the literature.

Conclusions
According to our own prospective analysis, we were able to register a very low herniation rate compared to the literature when the resorbable synthetic mesh (GORE® BIO-A®) was applied in sublay technique for stoma reversal.
One disadvantage could lie in the increased perioperative wound infection rate.
5/8 hernias were observed after the occurrence of perioperative wound infections.
P115 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL (TAPP) HERNIA REPAIR IN DECOMPENSATED CIRRHOSIS
Authors: Pisarenco Sergiu , Anghelici Gheorghe , Zugrav Tatiana 
Published: December 2021

Abstract

Aim
To evaluate the possibilities, benefits and safety of laparoscopic treatment of inguinal hernias in patients with cirrhosis of the liver and ascites, in particular to evaluate the TAPP approach for the treatment of inguinal hernias in patients with cirrhosis of the liver and ascites.

Material and Methods
Group I - TAPP repair in 16 patients with liver cirrhosis and ascites. Group II - Lichtenstein type hernioplasty in 15 patients with liver cirrhosis and ascites. All patients underwent planned surgery after dosing preoperative laparocentesis and correction of liver function indices.

Results
In the first group of patients no complications developed, no suppurative complications were observed, no edema, no leakage of ascites fluid. Postoperatively, all patients recovered well, noticed less pain. Only 25 percent of patients required analgesics. Patients were discharged at home 3-5 days postoperatively. In group II - minor complications were observed: 1 local hematoma, 1 seroma. Postoperative pain syndrome was more pronounced. All patients required analgesics. Duration of hospitalization 4-6 days. During a 10-month follow-up, no patients had recurrence and chronic pain.

Conclusions
TAPP repair provided the opportunity to assess macroscopic changes in the liver and possibly to perform liver biopsies, if necessary. TAPP repair reduces days of hospitalization and postoperative recovery by reducing pain syndrome with a low percentage of analgesics. TAPP repair can be a useful treatment option for patients with liver cirrhosis accompanied by ascites.
P134 ROBOTICALLY ASSISTED EXTENDED VIEW TOTALLY EXTRAPERITONEAL VENTRAL HERNIA REPAIR (ETEP) - ESTABLISHMENT OF A NEW SURGICAL TECHNIQUE
Authors: Mück Björn , Heinzelmann Frank , Vogel Robert , Büchler Peter 
Published: December 2021

Abstract

Aim
Even today, operations which include retromuscular mesh placement are usually performed using an open approach. Thanks to advent of robotics, these technically demanding operations can be carried out using minimally invasive techniques. The objective of this investigation is to establish a novel minimally invasive surgical method as part of a feasibility study in a hospital providing specialised care.

Material and Methods
We carried out a retrospective analysis, out of all patients who were operated on a ventral hernia, using a robotically assisted totally extraperitoneal technique, during the period between September 2019 and May 2021. For evaluation we used data from our hospitals information system. All patients had given their consent, to participate in the Herniamed quality assurance study.

Results
From September 2019 to May 2021, 33 patients underwent robotic surgery on a ventral hernia, using a totally extraperitoneal approach. 23 patients had an incisional hernia (69.70%), 10 patients had a primary hernia (30.30%). We did perform a total of 3 unilateral and 2 bilateral Transversus Abdominis Releases (TAR). A lateral approach was chosen in 26 patients and a caudal “bottom-up” approach in 7 patients. There were no intraoperative complications. A conversion was not necessary. Postoperative complications did occur in 3 patients (2 Clavien Dindo 1, 1 Clavien Dindo 3a). Reoperation was not needed.

Conclusions
The eTEP technique is a promising surgical method, that can also be carried out in a hospital providing specialised care, with an acceptable risk of complications. This technique enables us, to combine the advantages of minimally invasive surgery with those of extraperitoneal mesh placement.
P139 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL REPAIR FOR SMALL AND MEDIUM PRIMARY UMBILICAL AND MIDLINE HERNIAS
Authors: Mitura Kryspin 
Published: December 2021

Abstract

Aim
Complications of open mesh repair for primary umbilical and midline hernias (PUMH) may lead to significant re-admissions and follow-up costs. Although laparoscopic intraperitoneal onlay mesh repair reduces infection rates, especially in overweight patients, it’s controversial in these hernias, mainly due to potential adhesions’ formation. Laparoscopic transabdominal preperitoneal technique (lap-TAPP) may address these issues, as it combines advantages of both open and laparoscopic approaches. The aim of this study is to present the initial results of lap-TAPP for PUMH in regard to its feasibility and complication rates.

Material and Methods
We evaluated 25 consecutive cases of lap-TAPP repair for PUMH. Patients’s characteristics, intraoperative findings, and postoperative complications after 30-days follow-up were analyzed.

Results
21 male and 4 female patients were included in analysis (mean BMI 29.8 kg/m2). Surgery time was 82 minutes (55-120). We found 20 umbilical and 11 epigastric linea alba hernias. Mesh size was 144cm2 (120-225); mean hernia defect width was 25mm (10-40). In 9 patients (36%) the peritoneal rents were created which were easily closed with sutures. All patients were discharged on 1 POD with no complications. After 30-days we found no recurrences or bulging, no pain complaints. We found one subcutaneous small hematoma with no need for intervention.

Conclusions
Laparoscopic TAPP for small and medium PUMH is a safe and feasible technique with low complication rate. However, this method is technically demanding and time consuming while performed with laparoscopic approach as it requires precise and subtle plane dissection, and non-ergonomic closure hernia defect.
P140 OBSERVATIONAL STUDY WITH ONE YEAR FOLLOW-UP ON ROBOTIC ASSISTED RETRO-RECTUS VENTRAL HERNIA REPAIR (RTARUP) WITH A SELF-FIXATING MESH
Authors: Muysoms Filip , Dewulf Maxime , Nachtergaele Femke , Pletinckx Pieter 
Published: December 2021

Abstract

Aim
Laparoscopic retro-rectus ventral hernia repair avoids the need for intra-peritoneal mesh placement and penetrating mesh fixation. The robotic platform facilitates the execution of this technique.

Material and Methods
From a prospective consecutive single center database all patients that underwent a robotic assisted trans-abdominal retro-rectus ventral hernia repair (rTARUP) via lateral single docking using a self-fixating mesh (ProGrip) were identified.

Results
Between September 2016 and December 2019, 203 patients were included. There were 89 (44%) umbilical hernias, 34 (17%) epigastric hernias and 80 (39%) incisional midline hernias. Patients had a mean BMI of 29 kg/m2. The mean hernia diameter was 3.2 cm and mainly located in zone M2-M3-M4 of the EHS classification. The mean operative time was 85 min (SD: 33 min) and all except one were clean operations. The self-fixating mesh was mostly 15 cm wide with a variable length between 15 and 30 cm. No intra-operative complications or conversions to open surgery. Intra-hospital complications were seen in 12 patients (6%) and one patient needed a reoperation for bleeding. The operation was performed in day care in 37% of patients and hospital stay was less than 24 hours in 80%. There were 6 readmissions within 30 days of surgery (3%). At 12 months clinical follow-up 3 patients were documented with a recurrence and 2 underwent an laparoscopic intra-peritoneal hernia repair. Due to COVID-19 restrictions a clinical follow-up was only possible in 73 % of patients and needs updating.

Conclusions
This case series reports favorable early clinical outcome of an innovative retro-rectus repair using the robotic platform.
P145 DERMOID CYST MASQUERADING AS INCARCERATED INGUINAL HERNIA
Authors: Ramadan Moh'd Shafiq , Al-Zuhd Huda , Atari Anas 
Published: December 2021

Abstract

Aim
“For pre operative optimization and educational purposes, rare possibilities should be included in the differential diagnosis””

Material and Methods
“CASE REPORT.
Inguinal hernia is one of the common operations done by surgeons, often diagnosed clinically. Here we present a case of 29 year old male patient presented with inguinal swelling for 3 years. He was admitted for the surgical ward as a case of incarcerated inguinal hernia for elective repair under GA. Intra op the mass was not consistent with inguinal hernia, two other possibilities were a concern that can cause the swelling; 1) testes, which was excluded by examining the scrotum, 2) Dermoid/Epidermoid cyst which was checked by the mass content of hair and pasty fluid”

Results
“DERMOID CYST”

Conclusions
“Most surgeons depend on clinical picture in diagnosing inguinal hernia, thus even other rare possibilities should be included in the differential diagnosis.
Unusual presentations of inguinal hernia should be having radiological evaluated.”
P155 DE GARENGEOT HERNIA: A CASE REPORT
Authors: Ferri Enrico , Fanelli Melania Claudia , Latham Lorenzo , Inversini Davide , Odeh Murad , Ietto Giuseppe , Pappalardo Vincenzo , Carcano Giulio , Morabito Marika 
Published: December 2021

Abstract

Aim
“The De Garengeot’s hernia, from Rene De Garengeot, who was the first to describe the appendix inside a femoral hernia sac in 1731, is a rare type of crural hernia. The diagnosis is challenging and surgery must be performed without delay. The incidence of appendicitis in this type of hernia is about 0.08-0.13%. The aim of this work is to describe our experience in the management of this rare subtype of hernia in a 82-year-old women”

Material and Methods
“A 82-year-old patient with a right groin bulge presented to the Emergency. At the physical examination the abdomen was treatable; there was no sign of bowel obstruction. Blood test values were normal, except for a high PCR value. The US of the groin region demonstrated a right femoral hernia containing a bowel tract, irreducible at the probe’s pressure. The patient underwent surgery, with diagnosis of De Garengeot’s hernia; a direct hernia repair followed by an open appendectomy were performed. The patient did not present any complications and was discharged on the second postoperative day”

Results
“The De Garengeot hernia is a rare entity that requires an early treatment; the preoperative diagnosis is difficult and often clinical features are similar to a common incarcerated hernia. There are many surgical options for the management of the De Garengeot hernia, but there is not a consensus for the best surgical approach”

Conclusions
“De Garengeot's hernia is rare, being indistinguishable from an incarcerated femoral hernia in general. This case report is about a De Garengeot’s hernia patient, who presented a good recovery after surgery.”
VP007 MULTIRECIDIVATED DESMOÍD TUMOR OF THE THORAX-ABDOMINAL WALL
Authors: Hernando Luis Blázquez , Guerrero Belén Porrero , Mena Antonio , Villar Jose Manuel Molina , Saldaña David , Monclús Javier López , Lersundi Alvaro Robín del Valle , Méndez Carlos San Miguel , Rodríguez Joaquin Muñoz , Ureña Miguel Ángel García , Cebrián José María Fernández 
Published: December 2021

Abstract

Aim
Treatment of recurrent desmoid tumors represents a real challenge for the surgeon. The purpose of the video is to show the treatment of a multirecidivated complex desmoid tumor that affects the lateral thoracoabdominal wall.

Material and Methods
24-year-old woman with the diagnosis of recurrent desmoid tumor. She was operated in 2014 for a 10 cm desmoid tumor in the left chest wall with affected margins in the biopsy. In 2016 she underwent surgery for a 5 cm recurrence, which was excised en bloc along with the 6th, 7th, 8th and 9th rib arches. In 2018 she presented a recurrence in the scar treated by radiotherapy. She now presents a recurrence that in the CT scan is seen as an 8 cm tumor that affects the thoraco-abdominal wall.

Results
We perform a complete resection with free margins and “en bloc” resection of the 8th, 9th, 10th and 11th rib arches. We repair the defect using a reverse TAR and rebuild the wall with the Madrid APPROACH technique with BioA and polypropylene meshes.
The patient was discharged 11 days after surgery without any complications. The pathological study showed an 8 cm desmoid tumor with free surgical margins. The patient a year after surgery remains disease free.

Conclusions
The resection of a desmoid tumor that affects the abdominal and/or thoracic wall, especially if it is recurrent, represents a challenge for the surgeon. Component separation techniques and Madrid APPROACH may be very useful to achieve an optimal repair.