bluuebunny/crossref_metadata_2025_split huggingface dataset:
REMOVAL OF GIANT ABDOMINAL PSEUDOCYST PRIOR TO LAPAROSCOPIC BARIATRIC SURGERY
Authors: Gutiérrez C , Serrano A , Nieto M , Carreño-Sáez O , Carbó J , Palassi R , Pous-Serrano S 
Published: May 2024

Abstract

Background
To present a case of an abdominal wall pseudocyst as a complication of hernia repair.

Material and Methods
We present a 35-year-old men with a body mass index of 62,2 and a surgical history of two urgent surgeries for incarcerated umbilical hernia. In both cases, hernioplasty was performed using a supraaponeurotic polypropylene mesh. During the follow up, there is evidence of a large mass in the central abdominal region. The tomography scan reveals a subcutaneous tumor in the anterior abdominal wall, measuring 22 (transverse) × 18 (anteroposterior) × 21 (craniocaudal) cm, that suggest a chronic post-surgical collection.
Surgical treatment is decided. It includes complete excision of the pseudocyst, laparoscopic vertical gastrectomy with trocar placement on the musculoaponeurotic layer, and abdominal wall repair with partially resorbable composite intraperitoneal mesh. Dermolipectomy is associated with the use of indocyanine green (ICG) to verify adequate cutaneous perfusion.

Results
The histopathological analysis reveals the presence of a pseudocyst, with no signs of malignancy and no epithelial cells. The patient shows a favorable progression and is discharged on the fifth postoperative day. Subsequent follow-ups confirm the resolution of the lesion, no hernia recurrence and a weight lost percentage of 51%.

Conclusions
Abdominal wall pseudocyst is a rare complication that can occur after hernia repair. It is characterized by a fluid collection lacking epithelium and a diameter greater than 10 cm. Obesity and prosthetic material are commonly identified as primary risk factors. Radical surgical excision is considered the definitive treatment and can be performed simultaneously with bariatric surgery. Fluorescence with ICG is as a valuable tool to evaluate skin perfusion.
IS THERE A NEED FOR DATA-DRIVEN APPROACHES TO REDUCE VARIABILITY IN VENTRAL HERNIA REPAIR?
Authors: Hall S K , Connaghan R , Haikka P , Luke Y 
Published: May 2024

Abstract

Background
The surgical community diverges on optimal technique to repair ventral hernias. New techniques are disseminated regularly, and there is a lack of evidence-based consensus on best practices. Diversity in technique leads to variability in patient outcomes, with up to 20% of patients experiencing an adverse event postoperatively. This paper demonstrates the extent of subjectivity in ventral hernia repair by examining differences in opinions of 14 hernia surgeons.

Method
Fourteen surgeons, all involved in training, were recruited from teaching hospitals distributed globally. A survey was issued, asking them to rank the phases of robotic-assisted ventral hernia repair by importance and teaching order. Kendall’s W was used to quantify correlation between their rankings.

Results
Kendall’s coefficient was nonsignificant for importance of surgical phases (W = 0.3) and for order of trainee contribution (W = 0.3). Preference for techniques (e.g. eTEP, TAPP), as estimated by self-reported case volumes, had a similarly low concordance of 0.1, with no single technique receiving majority consensus as the most preferred. All surgeons recorded their cases, 64% (N = 9) recording every case.

Conclusion
These results evidence significant divergence in how ventral hernia repairs are performed. Disparity is likely to increase rather than decrease among the next generation of surgeons, due to differences in training regimens. The authors conclude there is a need for a data-driven approach to quantify the variability in this procedure. With most surgeons already recording their cases, digital technologies offer powerful tools, like AI-supported automatic video analysis, to transform video data into valuable insights for driving standardization.
TRANS-ABDOMINAL PRE-PERITONEAL LAPAROSCOPIC HERNIA REPAIR: A SINGLE CENTER EXPERIENCE
Authors: Havlova K , Husarova T , Schutz S O , Murín M , Pohnan R 
Published: May 2024

Abstract

Introduction
Lichtenstein procedure and laparoscopic repair are the most recommended techniques for inguinal hernia repair. Laparoscopic techniques should be generally preferred for its benefits in faster recovery and lower rate of complications. Trans-abdominal preperitoneal (TAPP) laparoscopic repair is one of the common procedures. According to the European Hernia Society (EHS) the learning curve for laparoscopic technique of hernia repair is estimated at 50–100 procedures. There are several studies which resulted in lower numbers, mostly due to prior experience in laparoscopic techniques.

Method
We analyzed TAPP procedures for primary unilateral inguinal hernias between 2019 and 2023. In 2019 only the most senior residents performed their first TAPP surgeries, while by 2023, second year residents performed their first TAPP procedures.

Results
The residents had statistically significantly longer operating time, which is in line with the expected learning curve. They did not achieve enough surgeries to complete the learning curve. However, there was no statistically significant difference in perioperative complication rate. From 2019 to 2023 we raised the mini-invasive primary inguinal hernia repair from 24.7% to 52.57%. The percentage of TAPP surgeries performed by residents went from 16.13% to 36.95%, respectively.

Conclusion
While surgery in the Czech Republic has an excellent tradition and level of expertise, it is not a rule that all residents have enough experience leading the surgeries, especially laparoscopic, under the guidance of senior surgeons. Thus, local experience showing safety and feasibility of early experience as a leading surgeon in procedures like laparoscopic hernioplasty is valuable.
HERNIA SURGERY TRENDS AND LANDSCAPE IN LATVIA: A COMPREHENSIVE ANALYSIS
Authors: Ivanovs I , Berzina A A 
Published: May 2024

Abstract

Background
This study analyzes hernia surgeries in Latvia across years and healthcare facilities, aiming to discern trends and methodologies amid budgetary constraints and healthcare disparities.

Method
Analyzing hernia surgeries from 2016 to 2022, this study evaluated total repairs, elective surgeries, laparoscopic techniques, and specific methodologies at Riga East University Hospital and Latvian healthcare institutions.

Results
Hernia repairs fluctuated annually: 4516 (2016), 4285 (2017), 4315 (2018), 4639 (2019), 4169 (2020), 4527 (2021), reaching 5488 in 2022. In 2022, laparoscopic incisional hernia surgeries accounted for 19% (67 cases) of 226 total incisional hernia surgeries. Elective hernia surgeries ranged from 86.4% to 93.3% from 2017 to 2019, slightly declining in subsequent years (probably effect of COVID-19). Laparoscopic abdominal wall hernia surgeries varied from 15.3% to 20.2%. There was a notable surge in laparoscopic groin surgeries, and a shift towards TAPP (437 cases) over TEP (65 cases) in 2022. Emerging minimally invasive procedures – E-TEP (130), SCOLA (60), TARM (20) became apparent since 2019. At Riga East University Hospital, hernia surgeries significantly increased from 527 (2020) to 633 (2022). Laparoscopic techniques in groin hernias rose from 16% (2019) to 26% (2022), while laparoscopic incisional hernia surgeries declined from 11% (2019) to 8% (2022).

Conclusion
This study sheds light on the dynamic landscape of hernia surgeries in Latvia, highlighting trends in procedures, preferences, and adoption of innovative techniques. Understanding these trends is crucial for healthcare professionals to enhance hernia care strategies and adapt to the constraints and disparities within Latvia's healthcare system.
POSITIVE SCRATCH COLLAPSE TEST IN ANTERIOR CUTANEOUS NERVE ENTRAPMENT SYNDROME (ACNES): EVIDENCE FOR A PERIPHERAL NEUROPATHY?
Authors: Jacobs M L Y E , ten Have T , Schaap L , Scheltinga M R M , Roumen R M H 
Published: May 2024

Abstract

Background
Chronic abdominal pain is occasionally caused by an abdominal wall entity such as Anterior Cutaneous Nerve Entrapment Syndrome (ACNES). This syndrome is thought to occur due to entrapped intercostal nerve branches (Th7-12) within the rectus abdominis muscles. This clinical diagnosis is based on subjective clues in patient history and physical examination. In contrast, in carpal tunnel syndrome an additional diagnostic test is used, which is referred to as the scratch collapse test (SCT). The SCT has shown positive results not only in other peripheral entrapment neuropathies involving the ulnar, peroneal, and long thoracic nerve, but also in three recently described ACNES patients. We investigated whether the SCT is of diagnostic use in patients suspected of having ACNES.

Method
A prospective, case-control study was performed among patients with ACNES (n = 20) and two control groups without ACNES (acute abdomen n = 20; healthy n = 20), all were consecutively included. ACNES was diagnosed based on previously published criteria. The SCT test was executed at the painful abdominal area in both patient groups and at a corresponding area in healthy controls. Predictive values, sensitivity, and specificity were calculated. Videos of tests were evaluated by blinded observers.

Results
SCT was judged positive in 19 of 20 ACNES patients, but not in any of the 40 controls. A 95% sensitivity (CI:75–99) and 100% specificity (CI: 83–100) were calculated.

Conclusion
This study provides strong evidence that ACNES should be considered as an entrapment neuropathy, while a positive SCT should be considered as a major diagnostic criterion.
ANALYSIS OF THE USE OF POLY-4-HYDROXYBUTYRATE MESH FOR INGUINAL HERNIA REPAIR: OUR FIRST 200 CASES
Authors: Kaufman J P 
Published: May 2024

Abstract

Introduction
Inguinal hernia repair remains one the most common operation that general surgeons perform on an annual basis. Selection of a tissue based repair versus permanent or bio-rebsorbable biomaterials still remains an issue for both patients and surgeons when faced with options for inguinal hernia repair. Other studies have demonstrated the long-term strength profile associated with a resorbable mesh comprised of poly-4-hydroxybutyrate, in Ventral Hernia Repair. We however looked at the application of this type of bioprosthetic for use in inguinal hernia repair (IHR)

Methods
We retrospectively reviewed the continuous application of poly-4-hydroxybutyrate for open inguinal hernia repair at one center in the US.
The study involves IHR with poly-4-hydroxybutyrate mesh in subjects across all types of open inguinal hernia to yield a larger overall, all-comers dataset at a minimum of 12-month postoperative timeframe follow-up. The trial includes a review comprised of 201 consecutive subjects. Poly-4-hydroxybutyrate plug and patch mesh was utilized in the groin for all primary and reccurent indirect, direct and femoral defects. Hernia complication rates including: recurrence rates, surgical site occurrences (SSO) requiring intervention, surgical site infection (SSI), seroma, wound dehiscence, skin necrosis, hematoma, were reviewed and will be reported.

Results
When the data for the subjects were reviewed it revealed that the distribution of the hernias were 24.4% direct, 68.1% indirect, 6.5% pantaloon, 1% femoral. 43% were left sided and 54% were right sided hernias; 90.55% were performed open and 9.45% were done MIS/Laparoscopically. Duration of follow-up was a minimum of 12 months. Overall complication rate was 2.99% inclusive of recurrence and when looked at independently the recurrence rate was 0.5% representing one laparoscopic recurrence.

Conclusions
Intermediate-term outcomes following inguinal hernia repair with poly-4-hydroxybutrate mesh in subjects with a minimum of one year of follow-up demonstrate low rates of recurrence and reasonable rates of SSO at the 12-month postoperative timeframe. Longer term follow-up will also be presented for 2 years and is also ongoing: Both 3 and 5-year (36,60-month) in the US at the same center and will be reported when results are available at a later date. Further study is needed to understand where and how this technology can be applied for IHR.
INTERPARIETAL POSTOPERATIVE HERNIA. PRESENTATION OF TWO CASES
Authors: Kochylas N , Papaeleftheriou S , Magganas D 
Published: May 2024

Abstract

Aim
Interparietal postoperative hernias are rare cases where the content herniates through layers of the abdominal wall, without reaching the skin and the subcutaneous fat. They are difficult to diagnose, since they cannot be palpated from the outside. They usually present acutely with small bowel obstruction.

Case 1
69-year-old female with a history of gastrectomy 8 years before, Rives-Stoppa for incisional hernia 4 years before and multiple episodes of partial small bowel obstruction. CT scan showed small bowel loops between the posterior rectus sheath and the mesh. Surgery confirmed the diagnosis of interparietal hernia, the small bowel was reduced and the posterior sheath was sutured. The previous mesh was not removed and a new mesh was placed underneath it.

Case 2
38-year-old female with a history of caesarean section 1 year before, presented to the emergency room with acute lower abdominal pain. No mass was palpated. CT scan showed incisional hernia with small bowel loops between the rectus muscle and the anterior sheath. Intraoperatively, the small bowel was reduced and the abdominal wall was sutured by layers.

Conclusion
Interparietal hernia is rare, with only case reports in the literature. It will usually present as an emergency and the CT scan is invaluable for the diagnosis. The difference in our cases, compared to others published, is that in our cases the interparietal hernia presented itself, long after the index operation.
OPEN PREPERITONEAL APPROACH FOR RIGHT SUBCOSTAL HERNIA: FIRST EXPERIENCE
Authors: Laskou S , Sapalidis K 
Published: May 2024

Abstract

Aim
The right subcostal incision, also known as Kocher, represents a transverse incision, which is most commonly utilized in hepatobiliary procedures. Although it offers good exposure of the upper abdomen, it is associated with high morbidity in terms of an incisional hernia since it bears the drawback of sectioning muscle fibers. Such incision are difficult to correct due to the close proximity to the costal margin.

Material and Methods
We present the case of a 50 year-old male with an LIW2 right subcostal incisional hernia. After routine preoperarative investigations the patient underwent an open preperitoneal repair with polypropylene mesh.

Results
Operative time was 150 minutes with minimal intraoperative blood loss. Postoperative period was uneventful and he was discharged on postoperative day 5th. He was followed-up on 7 days, 2 and 6 months postoperatively with no signs of recurrence.

Conclusions
The presence of subcostal hernia requires adequate surgical treatment. Its surgical correction requires rebuilding the muscle-aponeurotic acquired defect with fixation of the appropriate mesh.
ROBOTIC APPROACH TO ABDOMINAL WALL RECONSTRUCTION DECREASES TOTAL POST-OPERATIVE OPIOID EXPOSURE, BUT NOT DAILY OPIOID USE, COMPARED TO OPEN APPROACH: THE RETROSPECTIVE VENTRAL HERNIA REPAIR AND POST-OPERATIVE OPIOID USE (RETRO-HERO) STUDY
Authors: Liu Hennessey R Q , Yang Y , Guan R , Zhang Y , Meneghetti A T , Chiu C 
Published: May 2024

Abstract

Background
Many surgical specialties have shown a significant reduction in post-operative opioid use with adoption of the robotic platform. This has not been shown in General Surgery or in ventral hernia repairs. We compared post-operative opioid usage after open and robotic-assisted abdominal wall reconstruction (oAWR, rAWR).

Method
This is a retrospective cohort analysis of all patients with ventral hernias ranging between 5 to 15 cm who underwent either oAWR or rAWR between 01/2020 to 11/2022. Patient characteristics, surgery and length of hospital stay (LOS) information, post-operative opioid usage, and patient-reported pain scores were reviewed.

Results
74 patients undergoing oAWR and 27 after rAWR in the study period met inclusion criteria. There was no difference in age, sex distribution, BMI, comorbidities, size, and hernia characteristic between the two groups. Median LOS was significantly longer for open repairs (5 (4–6) days vs. 2 (2–3) days, p &lt;0.05). Median total in-hospital opioid use measured in mg Oral Morphine Equivalent (OME) and was significantly higher for open repairs (71.25(15–159) vs. 7.5 (0–60), p &lt;0.05). However, there was no difference in daily opioid use, multimodal pain control, or total discharge opioid prescription. Multivariable logistic regression analysis indicates lower age is a significant contributor to high opioid use (OR = 0.95 (0.9–0.99), p =0.02) but the use of the robot platform was not (OR = 1.7 (0.56–4.95), p = 0.88).

Conclusion
oAWR patients had higher total post-operative opioid exposure but there is no difference in daily opioid use. Future studies should explore the potential of the robotic approach at minimizing opioids by way of standardized multimodal pain management protocols.
INTRAOPERATIVE FASCIAL TRACTION FOR TREATMENT OF W2 AND W3 VENTRAL HERNIAS
Authors: Marques-Antunes J , Correia P , Osorio C , Magalhães J , Guimarães M , Nora M , Pereira A 
Published: May 2024

Abstract

Background
Component separation techniques are increasingly employed in abdominal wall reconstruction surgery. The use of adjuvant techniques, such as intraoperative vertical dynamic fascial traction, enhances the compliance of the abdominal wall. This facilitates closure of the abdominal wall using less disruptive techniques without compromising effective treatment. Our aim is to retrospective review our results regarding the effectiveness and complication rate of intraoperative fascial traction for the treatment of complex ventral hernias.

Method
Conducted a retrospective analysis of 10 patients who underwent surgery using intraoperative fascial traction for W2 and W3 ventral hernias.

Results
Preoperatively, fascial distances measured ranged from 55 cm to 145 cm, with the majority of patients (70%) having a fascial distance greater than 10 cm. Most patients received other adjuvant treatments (nine cases with botulinum toxin injection and one with pre-operative progressive pneumoperitoneum). Posterior component techniques were employed in 40% of patients (half with W2 hernias and the other half with W3 hernias). The complication rate was 10%, with one case of hemorrhage requiring percutaneous embolization. During the average 6-month follow-up period (ranging from 1 to 17 months), one recurrence was observed.

Conclusion
Intraoperative fascial traction is a feasible and safe adjuvant technique for abdominal wall reconstruction. The use of adjuvants in complex abdominal wall hernia surgery may, in some patients, downstage the hernia, thereby avoiding the need for component separation techniques. This approach enables tension-free closure of the abdominal wall in a less invasive manner.
RECURRENCE AFTER MINIMALLY INVASIVE REPAIR OF INGUINAL HERNIA: INCIDENCE AND ASSOCIATED FACTORS
Authors: Marques-Antunes J , Rodrigues E , Magalhães J , Guimarães M , Nora M , Pereira A 
Published: May 2024

Abstract

Background
Minimally invasive laparoscopic surgery for inguinal hernia allows an approach to the entire myopectineal orifice, leading to an expected lower recurrence rate and/or incidence of occult hernias. Nevertheless, the literature reports recurrence rates of up to 12%, depending on the reported follow-up time.

Methods
Retrospective analysis of laparoscopic surgical corrections of inguinal hernias between January 2018 and March 2023. Evaluation of recurrence rate and factors associated with its development.

Results
During the analyzed period, 388 patients underwent laparoscopic surgical correction of inguinal hernia. In 183 patients, the surgical correction was bilateral, corresponding to 571 operated hernias (82% via TAPP and 18% via TEP). During an average follow-up of 22 months (6–65), the recurrence rate was 2.1%, diagnosed on average 14 months after surgery. The presence of postoperative wound complications and chronic pain were the only factors significantly associated with recurrence (p = 0.026, p &lt;0.001, respectively). Factors such as gender (p = 0.155), age (p = 0.13), BMI (p = 0.3), smoking (p = 0.52), technique used (p = 0.391), recurrent hernia (p = 0.42) did not show an association with hernia recurrence. In multivariate analysis, the presence of postoperative complications was the only independent risk factor for recurrence (p = 0.04, OR 4).

Conclusion
In our study, the recurrence rate aligns with what is described in the literature. Limitations include the fact that only patients who returned to our hospital were diagnosed, and the short follow-up time in some cases. The learning curve of surgeons, both residents and specialists, during the implementation of the technique in our service may also impact these results.
ANALYSIS OF `ENHANCED-VIEW TOTALLY EXTRAPERITONEAL (eTEP) RIVES STOPPA (RS)` APPROACH FOR VENTRAL HERNIA: QUALITY OF LIFE AND EARLY RESULTS
Authors: Marrero Marrero P , Fernández Hernández L , Mon Martín F , González de Vera O , Lorenzo Rocha N , Delgado Plasencia L J 
Published: May 2024

Abstract

Background
Primary and incisional ventral hernias (PVH and IVH) are a common pathology which substantially impact patient’s quality of life (QoL). The first and only study addressing QoL following eTEP-RS to date was pubished by Rayman et al. in 2023. The purpose of this study was to evaluate the QoL, early postoperative complications and hernia recurrence rate following laparoscopic enhanced-view Totally Extra-Peritoneal (eTEP) Rives Stoppa (RS) for PVH and IVH repair.

Method
A retrospective review of a prospectively maintained database of all patients undergoing eTEP- RS from December 2022 to November 2023. Data retrieved included demographics, clinical and operative variables. Computed tomography scan was performed before and six months after surgery. QoL was assessed using the EuraHS-QoL scale prior to-and following eTEP-RS.

Results
During the study period, 29 patients met the inclusion criteria. PVH was the most common pathology (86.2%). Median follow-up time: 9 months. 8 patients (27%) had at least 13 months of follow-up. There were not hernia recurrence. Pre-operative and post-operative EURAHS-QoL questionnaire scores were available for 100% of patients enrolled in this study and showed significant improvement in pain (11.24 vs. 2.6, p &lt;0.001), restrictions (median of 16 vs. 9.04, p &lt;0.001) and cosmetic appearance (15.2 vs. 2.1, p &lt;0.001).

Conclusion
Abdominal wall repair using the eTEP-RS approach improves subjective QoL variables with and aceptable post-operative complications and without hernia recurrence in a short-term follow-up. So far, these are the second published results where QoL is evaluated in patients undergoing eTEP-RS.