bluuebunny/crossref_metadata_2025_split huggingface dataset:
MINIMALLY INVASIVE BILAYER SUTURING TECHNIQUE FOR THE REPAIR OF CONCOMITANT VENTRAL HERNIAS AND DIASTASIS RECTI
Authors: Ngo P 
Published: May 2024

Abstract

Aim
Evaluation of a technique of repair of concomitant ventral hernia and diastasis recti without mesh.

Methods
The technique combines suturing repair of the hernia orifice and diastasis correction by suture and includes an open step through peri-umbilical incision and an endoscopic step.
The study is an observational report on 77 cases of concomitant ventral hernias and DR.

Results
The median diameter of the hernia orifice was 1.5 cm (0.8–3).
The median inter-rectus distance was 60 mm (30–120) at rest and 38 mm (10–85) at leg raise at tape measurement and 43 mm (25–92) and 35 mm (25–85) at CT scan respectively.
Postoperative complications involved 22 seromas (28.6%), 1 hematoma (1.3%) and 1 early diastasis recurrence (1.3%).
At mid-term evaluation, with 19 (12–33) months follow-up, 75 (97.4%) patients were evaluated. There were no hernia recurrences and 2 (2.6%) diastasis recurrences.
The patients rated the result of their operation as excellent or good in 92% and 80% of the cases at global and esthetic evaluations respectively. The result was rated bad at esthetic evaluation in 20% of the cases because of skin wrinkles, due to discrepancy between the unchanged cutaneous layer and the narrowed musculoaponeurotic layer.

Conclusion
The technique provides effective repair of concomitant ventral hernias up to 3 cm and diastasis recti. Nevertheless, the esthetic result can be flawed, because of the discrepancy between the unchanged cutaneous layer and the narrowed musculoaponeurotic layer.
STAGED, LAPAROSCOPIC HYBRID EPAULI REPAIR FOR LARGE PARASTOMAL HERNIA – CASE REPORT
Authors: Andersen G , Elden E , Haukø L G , Vorontsov D , Græslie H 
Published: May 2024

Abstract

Background
Managing large parastomal hernias poses significant challenges due to their high recurrence rates and the elevated risk for peri- and post-operative complications.

Method
Case report of a successful repair of a large parastomal hernia using a staged minimally invasive, hybrid approach.

Results
The patient underwent uncomplicated laparoscopic total colectomy in 2016 for ulcerative colitis. Several years later, in 2020, the patient presented to our hospital with a large parastomal hernia with obesity as comorbidity. To address this complex hernia, the patient was referred to the obesity team and underwent laparoscopic gastric sleeve resection in autumn 2021. In 2022, the patient's BMI had decreased to below 30, prompting the decision to proceed with hernia surgery. In May 2022, we performed chemical component separation using 300 units of Botox. Four weeks later, laparoscopic hybrid Epauli repair was undertaken. The laparoscopic component involved reducing hernia contents, abdominal wall dissection with Transversus Abdominis Release (TAR), mesh placement, and closing the posterior layer. Open surgery was interspersed throughout the laparoscopic procedure and at its conclusion. This included temporary stoma closure and reduction, temporary stoma site closure, medial repositioning of the stoma through rectus, excess skin excision, and stoma re-suturing. The patient experienced an uncomplicated recovery. In January 2023, the patient underwent complete abdominoplasty. A one-year postoperative CT scan and clinical control demonstrated a satisfactory outcome.

Conclusion
For complex and large parastomal hernias, hybrid surgery, combining open and minimally invasive approaches, offers a valuable operative strategy for managing such large hernias.
eTEP FOR GIANT TYPE 2 INGUINAL DIRECT HERNIA
Authors: Baste N 
Published: May 2024

Abstract
Standard 3 port technique
65/male
Large inguinal swelling 10 years.
H/O reducibility 6 months back, now irreducible since 6 months.
No symptoms of obstruction; BMI 35.
Steps of operative procedure:Standard 3 port eTEP.Extended extraperitoneal space creation.Retzius space dissection.Bogros space dissection.Identification of direct hernia.Dissection of sac from pseudosac.Defining boundaries of defect.Excision of pseudosac.Closure of direct hernia defect.Mesh placement.Drain placement.
Operative time 1.5 hours.
Blood loss 100 cc.
Post op drain kept.
CASE OF A LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL (TAPP) REPAIR FOR GIANT INGUINOSCROTAL HERNIA
Authors: Caruso R , Ferri V , Vicente E , Quijano Y , Duran H , Diaz E , Fabra I , Malave L , Ruiz P 
Published: May 2024

Abstract

Background
Giant inguinoscrotal (GIS) hernias are rarely encountered in clinical settings and are often associated with mental neglect for many years. This type of hernia is defined as “giant” if it descends belowthe mid-point of the inner thigh of a patient in an upright position. The laparoscopic repair approach of a GIS hernia is technically challenging. It has been claimed that laparoscopic surgery has several advantages over the open surgical approach, with less pain and an earlier recovery. The aim of this video is to evaluate the efficacy of TAPP (laparoscopic transabdominal preperitoneal) in order to treat a GIS hernia.

Case presentation
A 65-year-old male without a relevant past medical history was admitted to the emergency service with abdominal pain, belching and nausea. He denied any other symptoms, and no previous surgical operations were recorded. Physical examination showed a large mass in the left scrotum below the mid-point of the inner thigh of the patient in an upright position. A CT scan confirmed the diagnosis of a GIS. A laparoscopic TAPP procedure was decided upon as the best course of treatment.

Results
The patient underwent a successful repair procedure. The operation time was 150 min. No intraoperative blood transfusion was necessary. The patient’s diet was resumed on the first day post-surgery, and the post-operative hospital stay was three days.

Conclusions
Laparoscopic TAPP repair is a safe and feasible method for surgically managing GIS hernias.
LIRA WITHOUT TRAUMATIC FIXATIONS
Authors: Curado-Soriano A , Infantes-Ormad M , Sanchez-Ramirez M , Valera Sanchez Z , Naranjo Fernandez J R , Morales Conde S 
Published: May 2024

Abstract

Introduction
Over the last decade we have made progress in laparoscopic mesh fixation, mainly to avoid post-operative pain. Post-operative pain can be significant, causing discomfort and delaying discharge.
One of these advances has been the use of adhesives as a fixation system, there is currently a wide range available, from biological adhesives to cyanoacrylate derivatives. In our case, we present the absence of traumatic fixation systems in a LIRA type repair with glue.

Case
We present the case of a 49-year-old female patient who underwent laparoscopic appendectomy and presented with an incisional hernia over the umbilical trocar of 10 mm, with a defect of 4 cm in diameter in the transverse axis, multisacular, with associated diastasis. We used three trocars arranged in a fan between the left hypochondrium, left flank and left iliac fossa.
After releasing the preperitoneal fat, the aponeurotic flap of the posterior aponeurosis of the rectum was prepared, turned and sutured in the midline. We placed the mesh and fixed it completely with adhesive (n-butyl-2-cyanoacrylate). The patient was discharged the day after surgery, and at 15 months follow up, there were no recurrence or complications.

Discussion
The evolution of fixation systems has brought us the existence of cyanoacrylates that allow precise fixation without leakage at the point of application, combined with an adequate mesh that allows a low postoperative pain.
There are still gaps in the long-term results, it is therefore necessary to conduct studies on a larger number of patients to assess the long-term results.
PAIN PLUG EXPLANT USING TAPP TECHNIQUE
Authors: Curado-Soriano A , Infantes-Ormad M , Sanchez-Ramirez M , Valera Sanchez Z , Naranjo Fernandez J R , Morales Conde S 
Published: May 2024

Abstract

Introduction
Chronic pain in patients after inguinal hernia repair can be a serious problem that affects patients' lives. It is therefore important to prevent, as far as possible, the situations that can cause it, one of which is excess mesh and its placement in an inappropriate area.

Case
We present a very thin male patient who underwent surgery for a right inguinal hernia using a mesh plug technique three months post-operatively and began to experience persistent groin pain that worsened with exertion and left him incapacitated throughout the day.
This pain was not consistent with a dermatoma. Examination revealed induration in the area, with no clinical recurrence. The patient was referred for surgery due to pain and the previous mesh explant. A laparoscopic approach was performed with a transabdominal laparoscopic approach (TAPP), where no recurrence was observed but a folded mesh plug was found. Explant and repair with flat mesh without traumatic fixation were performed. The patient reported an improvement in pain, although it did not disappear completely. No recurrence at follow-up 12 months.

Discussion
The use of mesh plugs has been questioned on many occasions, not only because of problems related to chronic postoperative pain but also because of the migration of the plug into the cavity.
The excessive folding of the mesh favours the formation of meshomas which are difficult to explant due to their proximity to blood vessels and nerve structures, which can be injured by compression or irritation.
THE HALLEY’S COMET OF HERNIAS: GRYNFELT HERNIA
Authors: Gámez Alastuey M , García Galocha J L , Fra Corral D , Charef El-Jari L , Gallardo Robles A , Ossola Revilla M E , Peña Soria M J , García Torres J A 
Published: May 2024

Abstract

Background
This video aims to address the clinical presentation, diagnostic approach, and surgical treatment options for Grynfelt's lumbar hernia, a rare type of abdominal wall hernia, through the analysis of a clinical case and a review of the literature.

Method
A video is presented of a 72-year-old female patient who came to the clinic with onset lumbar pain. After confirming the diagnosis of Grynfelt hernia by CT scan, laparoscopic lumbar hernioplasty with mesh was performed.

Results
The patient underwent a laparoscopic lumbar hernioplasty, with the defect being corrected using a mesh. The postoperative period was uneventful, with the patient reporting good pain control and no signs of hernia recurrence or complications during the follow-up visit three weeks post-intervention. The use of abdominal tomography played a crucial role in the diagnosis and surgical planning, allowing for a clear visualization of the muscular wall and the herniated contents.

Conclusions
Grynfelt's lumbar hernia, although rare, can be effectively managed with a laparoscopic approach, ensuring minimal tissue damage and low recurrence rates. The introduction of synthetic meshes has significantly improved surgical outcomes. This case highlights the importance of a thorough diagnostic process, including abdominal tomography, for the successful treatment of lumbar hernias, emphasizing the effectiveness of laparoscopic surgery with mesh reinforcement in achieving durable repairs.
LINDBLOM HERNIA: URETER INCARCERATION IN LEFT SCIATIC FORAMEN. LAPAROSCOPIC APPROACH
Authors: Galocha J L G , Peña M J , Antoñanzas L L , Romera J L , Charef L , Torres A J 
Published: May 2024

Abstract

Background
Sciatic hernias are thought to be secondary to a partial loss of pelvic fascia, atrophy of the piriformis, congenital deformity, or a combination of either.
Hernia sac may contain small bowel, ureter, ovary, colon or bladder. Patients may have diverse symptoms and signs ranging from abdominal or pelvic pain or with complications due to incarceration of their contents such as ureteric or bowel obstruction.
The Curlicue sign is described as ureteric obstruction with U-shaped tortuosity through the sciatic foramen which is pathognomonic of uretero-sciatic hernia.
Various surgical approaches have been reported in the literature, from open laparotomy, abdominoperineal/trans-gluteal approach, to laparoscopy and minimally invasive approach to repair it. The defect can be repaired with a mesh, non-absorbable sutures, and reinforced with a peritoneal flap or epiplon.

Method
We describe a laparoscopic approach of a left-sided ureterosciatic hernia (Lindblom hernia) who associate an ipsilateral inguinal and obturator defect.

Results
80-year-old female come to our center with left flank pain associated with a decline in renal function. A CT scan showed severe left-sided hydro-nephrosis, and the diagnosis of Lindblom hernia was made. A JJ tube was inserted, which relieved the obstruction and improved the renal function preoperatory. A laparoscopic approach via TAPP was perform and the patient was discharged without complications in 24 hours.

Conclusion
Sciatic hernia are a rare cause of chronic pelvic pain and various surgical approaches have been reported to repair it.
ABDOMINAL WALL RECONSTRUCTION FOR GIANT BILATERAL SUBCOSTAL INCISIONAL HERNIA
Authors: Garcia-Urena M A , Medina M , Aviles A , Morejon S , Casanova A , Robin A , Munoz-Rodriguez J , Lopez-Monclus J , Roman L , Blazquez L A 
Published: May 2024

Abstract

Aim
Management of subcostal incisional hernias (SIHs) is particularly complicated, due to their proximity to costochondral limits added to the lack of aponeurosis in the lateral side of the abdomen. We present a case of abdominal wall reconstruction with posterior component separation (PCS) but using the same previous incision as a safe and reproducible technique for these complex cases.

Methods
This is a 59-year-old man who underwent Whipple procedure for pancreatic carcinoma in 2019.
He developed a big incisional hernia on the entire length of the previous incision, measuring about 30 cm wide and 17 cm long. After adequate optimization, we scheduled for abdominal wall reconstruction following a stepwise preperitoneal dissection in 4 different areas: subdiaphragmatic, lateral preperitoneal, retromuscular and midline preperitoneal. In order to join all these spaces, a medial release (Rives) and a lateral release (PCS) need to be made. The main anatomical landmarks are shown during the video recording.

Results
The patient was discharged uneventfully on the 5th postoperative day. After 2,5 years, the patient remains asymptomatic without signs of recurrence clinicalle and radiologically.

Discussion
These incisional hernias can be technically challenge and should be made in centers dedicated for abdominal wall reconstruction. Lessons learned from posterior component separation has helped us to develop this stepwise dissection using the same incision and avoiding risk of nerve injury.
PCS technique for the repair of SIHs through the same incision is a safe procedure avoiding harming to the linea alba.
WHITE LIGHT WITH ICG MODE AS A TECHNICAL RESOURCE IN URGENTE SURGERY: INTESTINAL HERNIA SECONDARY TO GASTRECTOMY
Authors: Gómez Menchero J , Navarro-Morales L , Licardie-Bolaños E , Moreno-Suero F , Morales-Conde S 
Published: May 2024

Abstract

Aim
Urgent esophagogastric procedures are a complex field even in expert hands; even more so is the second procedure in cases of reinterventions. For this reason, it is important to apply safe techniques to minimize the clinical risk of unwanted events. Image-guided surgery based on indocyanine green fluorescence (ICG) has gained strength in recent years thanks to its widespread use. The combination of a white light probe along with the ICG mode of the tower facilitates the identification and safe dissection of structures during revisional surgery.

Methods
We present a case report.

Results
58-year-old man with a history of total Roux-Y gastrectomy for distal esophageal adenocarcinoma, with anastomotic leak and need for endoscopic stent, uncomplicated posterior hernia and adequate follow-up at home. Consultation 5 months later due to chest pain and dyspnea for 48 hours. CT scan showed a giant paraesophageal hernia with signs of strangulation.
An urgent laparoscopic surgical intervention was decided upon with the discovery of a large volume of herniated jejunal loops that could be reduced after chelotomy. The use of the device allows us to safely visualize the path of the esophagus and the anastomosis, for correct and safe adhesion and reduction. Finally, a raffia of the pillars and a pexy of the jejunum loop of the anastomosis to the crura are performed. After 6 days of hospitalization, he was discharged without complications.

Conclusion
The use of the white light probe with the intraoperative ICG mode, provides greater safety during the procedure, thus being a surgical technical resource.
LAPAROSCOPIC APPROACH TO INGUINAL HERNIA WITH INCARCERATED OVARY IN A PATIENT WITH ENDOMETRIAL NEOPLASIA
Authors: Gutiérrez C , Serrano A , Antón I , Carreño-Sáez O , García-Pastor P , Bueno-Lledó  , Domingo S , Pous-Serrano S 
Published: May 2024

Abstract

Background
To present an infrequent case of inguinal hernia with ovarian content in an adult patient, as well as its minimally invasive approach in the context of an endometrial neoplasia.

Material and Methods
A 67-year-old female patient presents at the emergency department with a history of progressive weakness and asthenia of months of evolution. Given the finding of iron-deficiency anemia, admission was decided. Computed tomography revealed an endometrial neoplasia associated with a right inguinal hernia, describing a heterogeneous and nonspecific lesion of 8 cm inside it. Further imaging studies were requested by gynecology, establishing the suspicion of endometrial neoplasia with left parametrial invasion. Biopsy confirmed the presence of endometrial adenocarcinoma. Magnetic resonance imaging reported strangulated ovarian content inside the right inguinal canal.

Results
A joint scheduled surgery was decided, involving laparoscopic radical hysterectomy, selective sentinel lymph node biopsy, and hernioplasty simultaneously. Inguinal hernia repair was performed using trans-abdominal pre-peritoneal hernioplasty (TAPP), with prior excision of the right adnexa for deferred study. Polyvinylidene fluoride (PDVF) mesh was used and fixed with absorbable tackers. The patient was discharged without complications on the second postoperative day. The final surgical specimen showed a low-grade endometrioid carcinoma with mucinous differentiation, clear surgical margins, and two positive nodes (pT2N1).

Conclusion
Inguinal herniation of the ovary is an uncommon phenomenon. The treatment of this pathology can be safely performed through laparoscopic approach, even in patients with concurrent gynecological neoplasias requiring radical hysterectomy during the same surgical procedure.
A HYBRID APPROACH TO ABDOMINAL WALL REPAIR IN M2-3W2 HERNIA WITH CROHN´S HISTORY
Authors: Gutiérrez E , Guevara-Martínez J , Zapata C , Abad R , Fondevila C , Salido S 
Published: May 2024

Abstract

Objective
This presentation aims to showcase the case of a 68-year-old male with fistulizing Crohn's disease and a history of two prior surgeries involving ileocecal resection and resection of enterocutaneous fistulas. The main objective is to emphasize the benefits of a hybrid approach (combining laparoscopic and open surgery) in repairing certain incisional hernias resulting from extensive abdominal surgeries.

Materials and Methods
Preoperative evaluation included abdominopelvic CT and Botox administration for abdominal wall prehabilitation. The surgical intervention utilized a hybrid approach, incorporating laparoscopic eTEP for intrabdominal adhesion release, retrorectal space dissection, unilateral TAR, and closure of the posterior plane to isolate viscera from the mesh. Open surgery followed for the placement of a 30 × 30 cm polypropylene mesh and closure of the anterior aponeurosis.

Results
The video presents the clinical case, displaying preoperative tests, essential surgical steps, and postoperative outcomes with photographs and a follow-up computed tomography at 6 months. Through this, we aim to highlight the benefits of the hybrid approach, emphasizing its advantages in terms of laparoscopic dissection time and concluding with open surgery for mesh placement and aponeurotic closure. This proves especially valuable in cases where excessive tension might impede laparoscopic closure or necessitate the removal of redundant skin flaps.

Conclusion
This presentation advocates for the hybrid approach, highlighting its advantages in laparoscopic dissection time, convenient mesh placement, and the ability to address excessive tension and skin redundancy, making a compelling case for its application in specific scenarios.
ACUTE INTESTINAL OBSTRUCTION DUE TO A PARASTOMAL HERNIA EHS GRADE IV
Authors: Hansske B , Wannberg M 
Published: May 2024

Abstract

Background
Acute complications of parastomal hernias are a demanding entity in the field of abdominal wall reconstruction.

Method
An 82-year-old female patient with an incisional hernia and parastomal hernia presented at the emergency department due to vomiting and abdominal pain. She had formerly been operated for a rectal cancer with a deviating sigmoideostoma.

Results
A computed tomography scan could diagnose intestinal obstruction with stomach lying in the incisional hernia and smaller bowel in the parastomal hernia. Per-oral contrast did not proceed sufficiently to the larger bowel, contact was established with the referral hospital for parastomal hernias. A laparoscopy was performed there and after mobilisation of the stomach from the incisional hernia we decided even to mobilise the parastomal hernia to be able to perform an adequate hernia treatment. A smaller bowel perforation was handled by performing a stapled side-to-side anastomosis with the Barcelona technique. After approximation of the incisional as well as the parastomal hernia with slowly resorbable running sutures, a Sugerbaker procedure was performed using a 15 × 15 cm mesh. The incisional hernia was treated by using a 20 × 15 cm IPOM mesh. 10 days postoperatively the patient could be discharged. 2 months postoperatively the patient was completely satisfied with the result of the 4-hour long operation.

Conclusion
To achieve better outcomes in parastomal hernia treatment, these patients should be ccentralized. By discussing elective treatment much earlier, complicated emergency cases could diminish.