bluuebunny/crossref_metadata_2025_split huggingface dataset:
MESH REPAIR AND LONG TERM COMPLICATIONS
Authors: Osorio Capitán M , Arruabarrena A , Aramendia I , Uranga A , Clemares M , Busto M J , Lopes C , Erro J M 
Published: May 2024

Abstract

Background
Biomedical engineering and new surgical approaches have grown together, remaining a big amount of surgical resources available today. Nevertheless, several mesh repair complications have been described, both acute and chronic. Chronic pain, fluid collections, mesh adhesions and failures have been described, characterized by enterocutaneous fistulizing disease, mesh shrinkage and migrations. Through this communication, 2 examples of those long-term complications are presented.

Material and Methods
The first patient is an 82-year-old woman with an anterior component separation made in 2016. 6 years after abdominal wall repair was carried out, the patient was hospitalized as an abdominal wall abscess was diagnosed. An enterocutaneous fistula between previous mesh and the small bowel was finally detected. A SNAP procedure was adopted, proceeding to a complete fistula escision at last. An intraabdominal long-term absorbable mesh was placed for posterior reinforcement.
The second patient is a 76-year-old man with a previous Spiegel´s hernioplasty made in 2002. The patient reported pain in the left lower quadrant, where the mentioned hernioplasty was carried out. A plug-mesh intraabdominal migration was detected through radiological imagenes. Finally, a Transabdominal Preperitoneal Repair (TAPP) procedure was made to withdraw the previous mesh and to repair the groin area.

Results
No complication was described after 6–12 months. Both patients had their symptoms solved.

Conclusion
Abdominal wall repair specialization requires knowledge about new techniques and their complications. It is crucial to know and to identify complications as soon as possible to their succesful repair.
LAPAROSCOPIC E-TEP IN GIANT TYPE I DIRECT INGUINAL HERNIA
Authors: Radhakrishnan S 
Published: May 2024

Abstract

Case Profile
68 yrs old, Male presented with complaints of Large right sided Inguino-Scrotal swelling since 3 yrs.
Swelling was intermittent, partially reducible and associated with a dragging type of Pain.
No other co-morbidities. CT-scan:
Tanaka Index – 20%

Plan
Laparoscopic E-TEP hernia repair.

Procedure
Supine Position under General Anesthesia.
Hernia contents reduced under anesthesia.

Ports
Enhanced Pre-Peritoneal space created by cutting Posterior Rectus Sheath from Arcuate line.
Space of Retzius & Bogros dissected.
Spermatic Cord dissected. Hernial sac dissected and separated from Pseudo sac.
Excision of Pseudo sac done.
Hernial Defect sutured with Non-absorbable barbed suture
15 × 12 cm Polypropylene mesh placed obtaining adequate coverage of Myopectineal orifice of Fruchaud.
Hemostasis confirmed. Pneumo pre-peritoneum deflated.
Port sites closed.
Dressing and strapping done.
Post operative period uneventful.
Discharged on post op day 4.
TAPP APPROACH POR BILATERAL INGUINAL HERNIA AND PLACEMENT OF CATHETER FOR CAPD: AN EXAMPLE OF HEALTHCARE EFFICIENCY
Authors: Rodríguez Mogollo J I , Tallón Aguilar L , Tinoco González J , Bustos Jiménez M , Sánchez Arteaga A , Padillo Ruíz F J 
Published: May 2024

Abstract

Introduction
Nowadays, the increasing complexity of patients, as well as continuous technological advances results in the existence of subjects with various pathologies susceptible to surgical management in the same procedure, with the consequent decrease in risk for the patient and greater efficiency for the healthcare system. The case described below is a clear example.

Methods
We present the case of a patient with bilateral inguinal hernia who also presents with end-stage renal disease due to polycystic kidney disease pending dialysis initiation. The patient opts for peritoneal dialysis; therefore, the repair of inguinal defects is evaluated along with the placement of the dialysis catheter in the same surgical setting.

Results
A TAPP approach was used for the repair of bilateral inguinal hernia, and subsequently, the 5 mm trocar in the left flank was utilized for the insertion of the peritoneal dialysis catheter under straight vision and its proper intraabdominal placement in the Douglas pouch.

Conclusion
Minimally invasive surgery opens up a broad field of opportunities that enables us to perform multiple procedures in a single intervention, reducing, thus, surgical and anaesthetic risks for the patient. Additionally, it allows us to reduce significantly economic costs and increase efficiency by cutting down on admission times, as it is the case presented in which all the patient's needs are addressed with a single surgical intervention.
COMPLEX ABDOMINAL WALL REPAIR IN CHRONIC MESH INFECTION WITH GASTROINTESTINAL RECONSTRUCTION
Authors: Román García de León L , Munoz-Rodriguez J M , Garcia-Urena M A , Blazquez Hernando L A , Robin Valle de Lersundi A , Polaino Moreno V , Torguet Munoz M E , Grillo Marin C , Callau Pontaque J , Lopez-Monclus J 
Published: May 2024

Abstract

Aim
To present the use of a biosynthetic mesh in a case of complex abdominal wall repair in chronic mesh infection and gastrointestinal tract reconstruction.

Material and Methods
This is an 89-year-old male with a history of radical cystectomy with Bricker reconstruction. As an immediate complication, he presented intestinal perforation with the need for the creation of an end ileostomy and fascial dehiscence with bridging of the abdominal wall with a bilayered mesh. Post-operatively he developed wound dehiscence with chronic mesh exposure and infection.
We performed a complete excision of the infected mesh, reconstruction of the intestinal transit and abdominal wall repair with a Rives technique with left Posterior Component Separation (PCS) according to the Madrid modification, with a prophylactic key-hole for the Bricker ileal Conduit. A biosynthetic scaffold was placed due to the infection situation (CDC-class 4 according to the CDC-Centers for Disease Control classification for Wound infection).

Results
Postoperatively the patient suffered a surgical site infection with suspected anastomotic leakage that was managed conservatively. Consequently, he developed a wound and an anterior layer dehiscence, with mesh exposition and infection. The complication was managed with antibiotherapy and negative pressure therapy, achieving complete wound closure and resolution of the infection without recurrence of the hernia in the follow-up.

Conclusions
The use of a biosynthetic scaffold is a feasible and useful resource for abdominal wall reconstruction in patients with chronic mesh infection, with good performance even in the case of early infection and environmental exposition.
TRANSFORMING TEP TO E-TEP USING ROLA TECHNIQUE WITHOUT CHANGING PORT POSITION
Authors: Sampang D C 
Published: May 2024

Abstract

Background
TEP technique is claimed to be the fastest procedure in posterior inguinal hernioplasty in experienced hands. It has lesser risk of visceral injuries and trocar site hernia occurrence. However, because of the absence of triangulation there is poor ergonomics and difficult to learn and teach in fellows and residents. Professor Jorge Daes modified the technique into e-TEP by placing his optical port 5 cm above the umbilicus and 4 cm lateral to linea alba opening the ipsilateral retrorectus space with the premise that the extraperitoneal space can be reached from almost anywhere in the anterior abdominal wall.

Method
The ROLA technique is the release of lateral part of linea arcuata coming from the TEP port position by identifying linea semilunares. Two ways of utilizing the ROLA technique either by bottom-up or top-down approach.

Results
Without adding or changing port positions you will be able to transform the small TEP space into humungous e-TEP space and can accommodate large mesh 15 × 15 cm if indicated, can equilibrate when the peritoneum is opened and no need to add or change working port. Incarcerated hernias can be managed easily now by the TEP technique expanded to e-TEP space.

Conclusion
The ROLA technique is safe and replicable technique that can be accessed through craniocaudal and caudocranial views. This would also be the preparation of advancing hernia surgeon in bottom-up technique for e-TEP TAR.
TOTAL VISCERAL SAC SEPARATION (TVS) APPROACH FOR MIDLINE VENTRAL HERNIA. CASE REPORT
Authors: Torroella A , Cárdenas G , Gonzabay V , Mastroianni G , Boccalatte L , Ginestà C 
Published: May 2024

Abstract

Background
Since the introduction of minimally invasive surgery, modifications in surgical technique of abdominal wall repair are being developed to achieve equal or even better results, guaranteeing early recovery, with lower risk of recurrence and less surgical aggression. According to the EHS guidelines, preperitoneal open repair is gold standard for M3W1 hernias. The aim of this study is to illustrate a completely extraperitoneal laparoscopic approach with preperitoneal mesh location for midline hernia repair.

Method
75-year-old woman with medical history of midline laparotomy due to an appendiceal peritonitis surgery, who currently presented a midline eventration (M3W1). It was performed a laparoscopic approach with a preperitoneal space mesh placement. After the arch of Douglas identification, the preperitoneal space between the parietal peritoneum and the posterior sheath of the rectum is dissected. The hernia is identified and reduced, and dissection proceeds until it exceeds the defect. After placing a 12 × 26 cm titanium mesh fixed with cyanocrylate, the hernia defect is closed with 2/0 Vicryl simple stitches using an endoclose suture device.

Results
Postoperative pain on the VAS scale was 1, and the patient was discharged on the first postoperative day. At the moment, she remains without hernia recurrence.

Conclusions
TVS approach reproduces the indications of the EHS Guidelines, with the advantages of minimally invasive surgery. It also offers the possibility of treating in the same surgical procedure other unnoticed hernias, with a larger mesh isolated from the viscera and preserving retromuscular space. In a near future, robotic approach could provide great benefits for carrying out this technique.
HOW TO PERFORM A CAUDAL DISSECTION OF A RIVES-STOPPA: STEP BY STEP WITH ANATOMICAL RELATIONSHIPS
Authors: Tuñón-Féquant C I , López-Monclus J , Blázquez-Hernando L A , Robin-Valle de Lersundi A , Muñoz-Rodríguez J , Medina-Pedrique M , De Luca M , Avilés-Oliveros A , García-Ureña M A 
Published: May 2024

Abstract

Introduction
Since its introduction, the Rives-Stoppa technique has become a cornerstone in abdominal wall surgery. Widely adopted, this technique necessitates a comprehensive understanding of its procedural steps and the associated anatomical relationships. The aim of this video is to provide a careful description of the caudal dissection.

Material and Methods
We advise to follow, first, a bilateral retromuscular dissection with the nerve bundles as lateral landmarks (“ambivium”), the procedure advances caudally through a preperitoneal approach to access the Retzius space. Subsequent preperitoneal dissections on each side expose Cooper's ligaments. The intermediate fascia needs to be opened to establish a connection between the preperitoneal space of Bogros space and the preperitoneal prevesical Retzius space, facilitating the creation of the space described by Stoppa and enabling the placement of a large, preformed mesh.

Results
This detailed guide provides an overview of the Rives-Stoppa technique, highlighting key anatomical relationships that are critical for the general surgeon. The meticulous cranial dissection performed by this technique enhances surgical precision and reduces the probability of postoperative recurrence.

Conclusions
A thorough understanding of the Rives-Stoppa technique, coupled with precise anatomical knowledge, proves invaluable for general surgeons. Successful caudal dissection is imperative for mastering the technique and minimizing the risk of subsequent hernia recurrences.
ROBOTIC INGUINAL HERNIA MESH REPAIR (rTAPP) POST ROBOTIC ASSISTED RADICAL PROSTATECTOMY
Authors: Vashistha A 
Published: May 2024

Abstract

Materials and Method
Patient had undergone robotic assisted radical prostatectomy and later developed inguinal hernia on left side.
Patient was taken for Diagnostic Laparoscopy and 3 Robotic ports were made (8 mm each, one port was Supraumbillical and the other two ports were on the same line 8 to 10 cm lateral to supraumbillical port) and peritoneal flap raised for left inguinal hernia by meticulous dissection and reduction of the hernia sac was done and mesh placed. The procedure was uneventful.

Result
At our institution we have performed cases of Robotic Inguinal mesh Hernioplasty (rTAPP) after post Robotic Assisted Radical Prostatectomy. Out of 10 cases of Diagnostic Laparoscopy, due to dense adhesions in view of previous surgery and non-availability of flap, only four cases could be done by robotic TAPP and the rest were converted to the conventional method.

Conclusion
Robotic rTAPP, in view of a stable platform, better vision and hemostasis, resulted in precise dissection and the best results for such complex cases.
ROBOTIC NISSEN’S FUNDOPLICATION FOR HIATAL HERNIA WITH REFLUX
Authors: Vashistha A 
Published: May 2024

Abstract

Materials and Method
Robotic assisted Nissen Fundoplication were done in 25 cases and were evaluated for post operative pain, dysphagia and duration of hospital stay as compared to that of Laparoscopic Nissen Fundoplication.
Patients were placed in semilithotomy position with four ports technique (8 mm) and one epigastric port for Nathansen Retractor. Harmonic Energy device was used for Hemostasis and Short Gastric mobilisation. Hiatus was closed with 2–0 Ethibond suture and after complete mobilisation of fundus and esophageal dissection. Approximately 4–6 cm of esophagus was mobilised intra abdominally and fundus wrapped around the Esophagus. Two sutures were taken (one from Esophagus to Stomach, another from Stomach to Stomach). Use of Umbillical tape was done for Esophageal mobilisation.
25 cases of Robotic Assisted Nissen Fundoplication and 25 cases of Laparoscopic Nissen Fundoplication were compared for post operative pain, dysphagia and discharge from the hospital. All the parameters were better in score with Robotic surgery than in Laparoscopic surgery.

Conclusion
Robotic Nissen Fundoplication in view of precision, stable platform, better vision and hemostasis with good intra-abdominal mobilisation of esophagus leads to lesser incidence of dysphagia and early discharge from the hospital.
ROBOTIC SINGLE FLAP METHOD FOR BILATERAL INGUINAL HERNIA MESH REPAIR (rTAPP)
Authors: Vashistha A 
Published: May 2024

Abstract

Materials and Method
Single Flap method was used in 25 cases of Bilateral Inguinal Hernia. Patients were taken for rTAPP with three 8 mm ports, one port was supraumbillical and the other two ports were on the same line approximately 8 cm lateral to the supraumbillical port.
Incision was made on the peritoneum approximately 5–7 cm from the defect in the midline and flap developed. Dissection was done in the preperitoneal plane in the middle to raise the central flap upto the Space of Retzius and then bilateral dissection was done to reduce the Inguinal Hernia. 16 × 12 cm bilateral mesh placed and sutured in place after defining the critical view of Myopectineal Orifice. Absorbable 2–0 V-loc suture was used to close the flap from midline to the lateral side.

Result
Evaluation of 25 cases was done in view of duration of surgery, blood loss and discharge from the hospital. Mean operating time was around 45 minutes to 62 minutes in single flap method with great precision and hemostasis.

Conclusion
Robotic single flap method for bilateral inguinal hernia has the advantage of better vision and hemostasis as compared to two flaps method for bilateral inguinal hernia.
ROBOTIC TRIPLE NEURECTOMY FOR POSTOPERATIVE INGUINAL PAIN
Authors: Villalobos R , Maestre Y , Barranquero A G , Gas C , Semeraro C , Escartin A 
Published: May 2024

Abstract

Background
Postoperative chronic inguinal pain is a very catastrophic situation in a patient that underwent an inguinal hernia repair. The first step is to dismiss is a recurrent hernia exits. Then the patient is diverting to the pain unit in order to assess the use of drugs, infiltrations, rhizolysis or another treatment. If these procedures don´t work, a triple neurectomy is consider improving the pain. Literature defends the proximal neurectomy to have better results. We present a patient that was subjected to a robotic triple neurectomy approach because he continued with pain despite 3 hernioplasties and different treatments with the pain unit.

Method
A Veress needle was used to create the pneumoperitoneum. After that, an 8 mm robotic trocar was introduced just above the belly bottom, then 1 upward equidistant 8 mm trocar and another downward were placed. The trocars were numbered in 1, 2, 3 from the up to the down. The fourth arm was put away. Number 1 was used for the bipolar fenestrated, number 2 for the camera and number 3 for the scissors and needle driver.

Results
After peritoneal dissection of the myopectineal orifice (MPO), a plug mesh and direct defect were found. The MPO was dissected then we continued upward, and the parietal compartment was dissected to achieve the nerves. After a rigorous dissection a segment of the iliohypogastric, ilioinguinal and genitofemoral nerves were divided. A15 × 15 cm Dynamesh IPOM was placed in the MPO and fixed in the Cooper´s ligament. Finally, the peritoneum was closed using a 2–0 barbed suture. The patient revealed progressive decreasing of the pain after one month.

Conclusion
The excellent vision and manipulation of the robotic platform could improve our results in these complex cases.
COMPARISON OF TOTAL EXTRAPERITONEAL (TEP) AND EXPANDED VIEW TOTAL EXTRAPERITONEAL (eTEP) METHODS AT INGUINAL HERNIA REPAIR
Authors: Agar M , Agca B , Tasdelen I , Fersahoglu A T , Bilgili A , Segmen O , Fersahoglu M , Gunes Y , Topaloglu B , Ergin A , Aydin M T , Iscan Y , Memisoglu K 
Published: May 2024

Abstract

Background
Laparoscopic hernia repair has been accepted as first-line treatment for inguinal hernia by major surgical institutions today, with low complication and recurrence rates. The aim of this prospective clinical study, we compared two different laparoscopic approaches in terms of technical ease, patients' early postoperative quality of life, pain management, complication and early recurrence rates.

Method
Patients with inguinal hernia who were planned to undergo laparoscopic hernia repair were randomized and operated with total extraperitoneal repair (TEP) and extended view total extraperitoneal repair (eTEP) methods in July and August 2023. During the postoperative follow-up, 24th-hour pain scores and 24th-hour quality of life scores were noted with a visual analogue scale (VAS) and quality of recovery test (QoR T15). At the 1st week outpatient clinic follow-up, their pain scores were questioned with VAS. They were checked by physical examination for complications or early recurrence. Patients were called for follow-up at the 1st and 3rd months after the surgery.

Results
The number of fixative staples was significantly higher in TEP group (p &lt; 0.001). The operation time was significantly shorter in eTEP group (p: 0.031). Time to return to work was significantly longer in TEP group (p: 0.024). VAS scores on the 1st postoperative day were found to be significantly lower in eTEP group (p &lt; 0.001), no significant difference was detected in the 1st week scores. The QoR test scores on the first postoperative day were significantly higher in eTEP group (p:0.006). The difference between number of patients with seroma, ecchymosis or hematoma was not significant in two groups.

Conclusions
Both methods we used did not make a significant difference in the incidence of complications. On the other hand, we revealed that eTEP method may be more advantageous in terms of ease of surgery, patients' quality of life in the early period.
CONGENITAL DIAPHRAGMATIC HERNIA IN PATIENT WITH 1P36 DELETION
Authors: Alhatemi A Q M 
Published: May 2024

Abstract

Introduction
Congenital Diaphragmatic Hernia (CDH) is a condition characterized by the protrusion of abdominal contents into the thoracic cavity due to a defect in the diaphragm. While typically observed in the neonatal period, CDH can present in later life.

Case Presentation and Management
This case report describes the presentation, diagnosis, and management of a nine-year-old boy with 1p36 deletion syndrome who presented with respiratory distress, abdominal pain, vomiting, and anorexia. The initial diagnosis was tension pneumothorax (Figure 1), and thus the patient underwent chest tube placement. However, a high-resolution CT scan revealed a left hemi diaphragmatic hernia, and the patient eventually underwent an emergency laparotomy due to acute-onset respiratory distress. Intraoperatively, a diagnosis of Bochdalek hernia with gastric perforation was made, and the CDH and gastric perforations were resolved successfully.

Results and Conclusion
This case highlights the importance of considering late-presenting CDH as a possible diagnosis in paediatric patients with similar symptoms and the radiological findings suggestive of tension pneumothorax. Early recognition and prompt surgical intervention can lead to the successful management of such cases.Figure 1.Preoperative Chest radiograph showing large hyperlucency, and the dimension were approximately 18 × 10 cm in the left hemithorax. A significant mediastinal shift to the right can be observed.
A SINGLE-CENTRE, RETROSPECTIVE STUDY OF INCISIONAL HERNIA REPAIR OUTCOMES POST KIDNEY TRANSPLANTATION
Authors: Anastasopoulos N A , Hussain S , Herbert P , Muthusamy A , Dor F , Papalois V 
Published: May 2024

Abstract

Background
Incisional hernias (IH) post renal transplantation (RT) can cause significant morbidity in renal transplant recipients (RTR). This was a retrospective cohort study of outcomes post IH-repair in RTR.

Method
We analysed all the IH repairs in RTR from May 2018 to May 2023. We documented post-transplant andx post IH-repair complications, length of stay, survival, and recurrence. Data analysis was performed using Jamovi 2.3.28.

Results
We performed 35 IH repairs in RTR from 05/2018 to 05/2023 in patients with a mean age of 56.7 ± 10.1 years and a mean BMI 29.7 ± 6.49 kg/m2. A history of previous hernia operation and open abdominal operations was present in 11.4% and 22.9%, respectively. The types of repairs performed were primary: 5.7%, onlay: 62.9%, inlay: 2.9% and sublay: 28.6%. In terms of mesh, in 18.1% a polyglactin 910 mesh was used, 57.6%, polypropelene and in 24.4% a composite mesh. Mean hernia neck size was 8.9 ± 5.6 cm. Post repair, there was no perioperative mortality, no significant episodes of perioperative bleeding and no collections drained, with an average 5.5 ± 3.9 days of length of stay. 20% of this cohort experienced a recurrence post-hernia repair. There was a 6% of superficial wound dehiscence rate and a 3% of surgical site infection. Pearson’s correlation test revealed that hernia recurrence was not related with neck size, post-transplant complications or pre- and post-transplant characteristics, as well as post-transplant outcomes.

Conclusion
One in five RTR that underwent an IH repair experienced a recurrence. Patient BMI, previous abdominal operations and wound complications post-transplant are not risk factors for hernia recurrence or other IH repair complications.