bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOW TO PERFORM A CRANIAL DISSECTION OF A RIVES-STOPPA
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 inception in 1973 by surgeons Jean Rives and Rene Stoppa, the Rives-Stoppa technique has emerged as a cornerstone in abdominal wall surgery. Given the prevalence of the technique, a thorough understanding of its intricate steps and anatomical relationships is considered essential for competent cranial dissection.

Material and Methods
This video describes step by step the key elements of a cranial dissection according to the Madrid technique, instead of performing a classical Rives. In this approach, a horizontal section of the posterior rectus sheath is performed, allowing a transition to the preperitoneal plane without the risk of diaphragmatic injury. This technique allows unlimited dissection in the preperitoneal plane and allows lateral transition to a pretransversalis plane if necessary. The cranial dissection extends over the xiphoid, navigating along the preperitoneal midline fat until the central tendon of the diaphragm is visualized. The purpose is to facilitate optimal mesh placement with a substantial overlap, contributing to the overall success of the procedure.

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

Conclusions
Understanding the Rives-Stoppa technique coupled with a keen awareness of its anatomical intricacies, proves invaluable for general surgeons. Meticulous cranial dissection not only ensures proper surgical technique, but also serves as an important preventative measure against possible recurrence.
COMPLETELY PRE-PERITONEAL E-MILOS FOR SUBXIPHOID EVENTRATION
Authors: Urbani A , Lopez-Monclus J , Blazquez Hernando L A , Valle de Lersundi A R , Jodra V Vaello , Medina Pedrique M , De Luca M , Avilés Oliveros A , Garcia-Urena M A 
Published: May 2024

Abstract

Aim
To demonstrate the safety and efficiency of the endoscopic mini or less-open sublay operation (e-MILOS) for subxiphoid abdominal wall defects.

Methods
A 79-year-old man with a 2 cm subxiphoid eventration classified as M1 W1 by the European Hernia Society classification and confirmed by computer tomography.
Abdominal wall repair was performed with completely pre-peritoneal e-MILOS. Beginning with the incision through the previous scar and the reduction of the hernia sac in the abdomen, the procedure involved the dissection of the preperitoneal space to place a single-port system. Endoscopic dissection of the preperitoneal plane was carried out up to approximately 10 cm from the edges all around the defect. Placement of a preperitoneal Polypropylene mesh (15 × 15 cm) without fixation. Closure of the defect with a monofilament long absorbable suture.

Results
The patient was discharged on the sixth postoperative day without complications. One-month follow-up revealed no hernia recurrence, no pain, and no bulging.

Conclusion
This intervention demonstrated that E-MILOS is a valid alternative for subxiphoid eventration compared to open surgery, with the advantages of providing better and easier plane visualization.
MESH EXPLANTATION
Authors: Vashistha A 
Published: May 2024

Abstract

Materials and Method
A middle aged lady had multiple surgeries in the past. First she had undergone laparscopic umbillical mesh hernia repair (IPOM), then Sleeve Gastrectomy (in view for morbid obesity) was done, then again incisional hernia repair was done with Onlay Prolene mesh. Now patient came to us with Perforation peritonitis with ischemic bowel. Exploratory laparotomy was done with explantation of mesh and bowel resection with end-to-end anastomosis with primary closure of abdomen. The procedure was uneventful.

Result
The patient had an uneventful recovery.

Conclusion
Mesh used in abdominal surgeries should be used judiciously. Type of mesh being used: (Dual mesh/Biosynthetic mesh) should be considered in complex scenarios.
SPECIALISED HERNIA CLINIC AND DEDICATED HUBS IS IT THE ROUTE TOWARDS OPTIMISATION: DAY CASE INGUINAL HERNIA PERFORMANCE A 12 MONTH SERVICE EVALUATION
Authors: Alam T , Bahri A , Rajendiran S , Ebied H 
Published: May 2024

Abstract

Introduction
Guy’s and St Thomas’ Trust currently performs 88% of inguinal hernia repairs as day case procedures, above The British Association of Day Surgery target of 80%. A specialised hernia clinic was set up in our trust in May 2021, to better identify patients suitable for High Volume Low Capacity (HVLC) Hubs. These are new surgical hubs introduced following COVID to help with the backlog and provide ring fenced beds for low complexity procedures. The clinic also provides standardisation of patient information and literature provision together with enhanced training opportunities for junior surgeons.

Method
A retrospective review of elective day case inguinal and femoral hernia repairs from 01 Jan 2022 to 31 Dec 2022. We primarily assessed unexpected admissions (UA) and the effects of a specialised clinic on service provision and outcomes.

Results
An UA was required in 20 cases; the majority being discharged within 24 hours. The most common reason was due to post-operative acute urinary retention (AUR). Other reasons included monitoring as per request of Anaesthetics, comorbidities, post-operative pain and social reasons. We also found the specialised hernia clinic identified the majority of patients expected to require an admission post-operatively.

Conclusions
The most common reason for an UA was AUR and the most adjustable were social admissions, indicating pathway implementations should involve a retention pathway and home alone surgery, respectively. Furthermore, a specialised hernia clinic was able to better identify cases suitable for HVLC Hubs, therefore could streamline the experience for both patients and surgeons in training.
STUDY ON SELF GRIPPING MESH VS POLYPROPYLENE MESH IN LICHTENSTEIN’S TENSION FREE MESH REPAIRS
Authors: Alexander N , Arora A 
Published: May 2024

Abstract

Open (Lichtenstein’s) inguinal hernioplasty, most widely performed surgery for inguinal hernia is used as the gold standard to which other techniques are compared. In 2002, the EU trialist collaboration analyzed 58 randomized controlled trials and found the use of meshes superior to other techniques. Light weight polypropylene meshes were first introduced in 1998 and are still in use. A newly developed self gripping semi absorbable mesh with incorporated resorbable microhooks providing gripping properties has been said to be superior.

Aim
Observational study comparing the conventional light weight polypropylene mesh and self gripping mesh in inguinal (Lichtenstein’s) hernia repairs in terms of duration of surgery, post-operative pain, seroma formation, wound infection, mesh rejection, foreign body sensation and recurrence rates.

Methods
Observational study included 180 patients, 90 in control (polypropylene group) and 90 in study (self gripping group) satisfying the inclusion criteria. Patients were followed up at 3 months, 6 month and 9 months.

Results
Decreased postoperative pain and lesser duration of surgery noted with the self gripping mesh. However, recurrence rates, seroma formation, foreign body sensation and mesh rejection had no differences between the two groups.

Conclusion
Self gripping mesh found to be better when compared to polypropylene mesh in terms of post-operative pain and duration of surgery.
STUDIES ON SELF GRIPPING MESH VS POLYPROPYLENE MESH IN VENTRAL HERNIA REPAIR
Authors: Alexander N , Arora A 
Published: May 2024

Abstract

Primary open ventral hernia repair is one of the most common surgeries performed in clinical practice. In 2002, the EU trialist collaboration analyzed 58 randomized controlled trials and found the use of meshes superior to other techniques. Light weight polypropylene meshes were first introduced in 1998 and are still in use. A newly developed self gripping mesh, made of low weight polyester with incorporated resorbable micro hooks that provide gripping properties has been believed to be superior.

Aim
Observational study comparing the conventional light weight polypropylene meshes and self gripping mesh in ventral hernia repairs in terms of duration of surgery, post-operative pain, seroma formation and recurrence rates.

Methods
In the prospective observational study 180 patients were included, 90 in control (polypropylene group) and 90 in study (self gripping group) satisfying the inclusion criteria. Patients were followed up 3 months, 6 month and 9 months after surgery.

Results
Results showed decreased postoperative pain and lesser duration of surgery with the self gripping mesh. However, recurrence rates and seroma formation had no differences between the two groups.

Conclusion
The study concludes that the self gripping mesh is better when compared to polypropylene mesh in terms of decreased post-operative pain and lesser duration of surgery.
CURRENT ROLE AND OUTCOMES OF BARBED SUTURES IN FASCIAL CLOSURE OF VENTRAL HERNIA REPAIR: A MULTICENTER STUDY USING THE ABDOMINAL CORE HEALTH QUALITY COLLABORATIVE DATABASE
Authors: Arias-Espinosa L , Wang A , Wermelinger J W , Olson M , Phillips S , Pereira X , Damani T , Malcher F 
Published: May 2024

Abstract
Barbed sutures (BS) have been increasingly used in the last decades but little is known about their adoption in ventral hernia repair (VHR). The aim of this study was to document the use and outcomes of BS in VHR.
Prospectively collected data from the Abdominal Core Health Quality Collaborative (ACHQC) database (ACHQC) was retrospectively reviewed adult patients who underwent VHR with fascial closure from 2020 to 2022. A univariate analysis compared patients with BS against non-barbed sutures (NBS) across the preoperative, intraoperative, and postoperative timeframes.
BS (n = 4,054) were compared with NBS (n = 6,473). BS were used in 86.2% of minimally invasive (MIS) VHR and 92.2% of robotic surgery against 9.6% of open procedures. Notable differences existed including a higher BMI (32 vs 30.5; p &lt; 0.001), more incisional hernias (63.3% vs 51.1%; p &lt; 0.001), wider hernias (4 cm vs 3 cm; p &lt; 0.001), and higher ASA score (p &lt; 0.001) in patients with BS. Outcomes in BS included a shorter LOS (1.4 vs 2.4; p &lt; 0.001), less SSI (1.5% vs 3.6%; p &lt; 0.001), similar SSO (7.6% vs 7.3%; p = 0.657), readmission (3.0 vs 3.2; p = 0.691), and reoperation (1.5% vs 1.45%; p = 0.855), at a longer operative time (p &lt; 0.001). Hernia specific questionnaires for quality of life and pain in BS had a worse preoperative score that was later matched and favorable compared to NBS (p = 0.048). PRO concerning hernia recurrence suggested around 10% at two years (p = 0.532).
Use of barbed sutures in VHR is widespread and highly related to MIS. Outcomes from ACHQC cannot be reported as superior but suggest safety and non-inferiority.
VERY LOW RECCURENCE AT 5-YEAR FOLLOW AFTER TAPP WITH PRO-GRIP IN 1200 PATIENTS
Authors: Birk D 
Published: May 2024

Abstract

The aim of this study was to demonstrate the long term safety and the efficacy of the self-gripping Parietex ProGrip™ mesh (Medtronic) used with the laparoscopic approach for inguinal hernia repair. The incidence of chronic pain, post-operative complications, patient satisfaction and hernia recurrence at follow-up after 5 years.

Methods
Data were collected prospectively using the “hernia-med” register in 1579 primary inguinal hernias. All patients included had undergone surgical repair for inguinal hernia by the laparoscopic transabdominal preperitoneal approach using Parietex ProGrip™ meshes performed in the same hernia referral center in Germany. Pre-, per- and post-operative data were collected, and a follow-up after one and five years was performed prospectively. Complications, pain scored on a 0–10 numeric rating scale (NRS), patient satisfaction and hernia recurrence were assessed.

Results
The only complications were minor and were post-operative: hematoma/seroma (3 cases), secondary hemorrhage through the trocar's site (5 cases), hematuria, emphysema in the inguinal regions (both sides) and hematoseroma in 3,2%. The 5 year follow-up rate was 76%, respectively 1205 patients. There were only 14 reports of hernia recurrence: 1.2% of the hernias. Most patients (95.9%) were satisfied or very satisfied with their hernia repair with only 1.2% reporting severe pain (NRS score 7–10) and 3.6% reported mild pain.

Conclusion
This study demonstrates that in experienced hands, inguinal hernia repair surgery performed by laparoscopic transabdominal preperitoneal hernioplasty using Parietex ProGrip™ self-gripping meshes is rapid, efficient and safe with low pain and low hernia recurrence rate. The promising short term results held true also in the long term follow-up.
LOSS OF DRAINAGE VACUUM AFTER MINIMAL INVASIVE SUBLAY OPERATION – EARLY INDICATOR FOR AN INTERPARIETAL HERNIA WITH SMALL BOWEL OBSTRUCTION – A CASE REPORT
Authors: Borshchigov M , Badendieck S , Huschitt N , Koeppen D 
Published: May 2024

Abstract

Background
Newer repair techniques for abdominal wall hernias, such as the enchanced-view totally extraperitoneal technique or the mini- or less-open sublay operation are increasingly being used. With these new techniques special complications might occur.

Case Report
We present an 81-year-old patient with a recurrent ventral incisional hernia after IPOM repair. The preoperative abdominal CT scan showed the hernia defect, measuring 3 × 3 cm. A repair was performed in MILOS technique, the IPOM mesh was removed. The posterior the rectus sheath was closed under slight tension. A Mesh 15 × 15 cm without fixation and a 14 french Redon drainage were inserted. Over the next 4 postoperative days the drainage had a repeatedly loos of vacuum, until the patient developed clinical symptoms of a ileus. A CT scan showed a bowel dysfunction without a clear sign for incarceration. At this point, the suction drainage was without vacuum a total of seven times. A diagnostic laparoscopy was performed and a small bowel loop was found trapped between the implanted mesh and the posterior rectus sheath, as an interparietal retro-rectus hernia (iRRH). The intestinal loop could be removed, no necrosis or ischemia was found. The fascial defect was covered using vicryl mesh patch.

Conclusion
The role of vacuum drainage remains to be considered. Suction of remaining intraabdominal gas might occur due to fascia dehiscence and CT diagnostics can mislead surgeons decisions. Tension free fascial closure remains of capital importance. Mesh fixation, use of special stitching techniques, transversus-abdominis-release or preoperative application of botulinum toxin should be kept mind.
RECONSTRUCTIVE SURGERY OF THE ABDOMINAL WALL WITH TITANIZED PP MESH IN A CASE OF CHRONIC INFECTION OF ePTFE MESH
Authors: Cardin Guntsche V , Llompart Coll M M , Mensa Pueyo J , Espert Ibáñez J J 
Published: May 2024

Abstract

Background
The use of meshes in abdominal wall reconstructive surgery is common and globally considered the gold standard. Materials like expanded polytetrafluoroethylene (ePTFE) meshes or "Gore-Tex®", once popular, have been shown to pose higher risks of rejection and infection compared to polypropylene (PP) meshes.

Methods
In the case of a 59-year-old man with a history of costal chondrosarcoma that required resection of the 10th left rib in 2009, a Gore-Tex® mesh was used in abdominal wall reconstruction in 2009. He was referred to our center in 2021 due to mesh intolerance.
Explorations (thoraco-abdominal CT and PET-CT) revealed chronic mesh infection with a bacterial biofilm (collection of 20 × 4 × 7 cm (AP × T × CC) encompassing the prosthesis), associating a fistulous tract to the skin surface. Multi-resistant Staphylococcus was isolated, requiring 6 weeks of antibiotic treatment with dalbavancin and rifampicin.

Results
Surgical intervention involved block resection of the collection and fistulous tract, and repair using titanized-PP mesh. After 48 hours of uneventful postoperative course, he was discharged with a home hospitalization regimen of antibiotic therapy with IV Ceftriaxone+Daptomycin. No other microorganisms were isolated in surgical cultures, and the pathology result described a granulomatous reaction to a foreign body. At one-year follow-up, the patient remains asymptomatic, with explorations (CT, PET-CT) ruling out recurrence of infection.

Conclusions
PP meshes are recommended for abdominal reconstructive surgery due to their lower infection and rejection rates compared to ePTFE meshes, due to their macroporous characteristics. However, further research and multidisciplinary management are needed to understand long-term outcomes.
ABDOMINAL WALL PSEUDOHERNIA
Authors: Chamzin A , Theodoropoulos C , Galyfos G , Triantafyllou A , Saliaris K , Michalopoulos N V , Toutouzas K G , Theodorou D 
Published: May 2024

Abstract

Background
Latrogenic, traumatic, infectious or any other pathologic reason causing temporary or permanent denervation of a segment of the muscle of the abdominal wall may result in a protrusion of a group of muscles clinically evident as a hernia, but if there is no muscle or fascial defect, then it is categorized as pseudo hernia.

Aim
To report a case of a 53-year-old man with a history of Multiple Sclerosis (MS) and scoliosis who presented for evaluation of a painless protrusion of his left abdominal wall flank with exacerbation on upright position. Abdominal computed tomography did not reveal any herniation of abdominal contents, but magnetic resonance imaging of chest and abdomen showed a protrusion of a herniated soft disc at the T11–T12 neural foramen. Rest and non-steroidal anti-inflammatory drugs were prescribed, and the patient was followed for six months with resolution of his pseudohernia.

Conclusion
This case presents a rare instance of abdominal pseudohernia due to T11–T12 radiculopathy. Though MS is characterized by central nervous system, there are some references for peripheral nerve damage. In our case, due to the temporary feature of denervation and the complete restoration of function, there is no doubt that radiculopathy was the cause.
MANAGEMENT OF ACUTE PRESENTATION OF LEFT PARADUODENAL HERNIA WITH SPONTANEOUS REDUCTION
Authors: Chamzin A , Theodoropoulos C , Galyfos G , Triantafyllou A , Ioannou T , Michalopoulos N V , Toutouzas K G , Theodorou D 
Published: May 2024

Abstract

Background
Left paraduodenal hernia is an internal hernia developed due to the prolapsed small bowel through the fossa of Landzert and is usually presented as acute abdomen or bowel obstruction. This abstract is about a case report of a patient with signs of strangulated left paraduodenal hernia.

Methods
A 32-year-old female presented with acute reccurent abdominal pain. Investigations with an enhanced CT scan showed crowding of small bowel loops in the left paraduodenal area, twisting of mesenteric vessels and mild dilatation of small bowel loops, signs suggesting possible internal herniation.

Results
The CT scan is showing the initial presentation with signs of internal herniation and the subsequent MRI shows spontaneous resolution. Due to mild symptoms of the patient we proceeded to an exploratory laparoscopy to exclude sings of intestinal ischemia. Exploratory laparoscopy did not reveal any signs of ischemia and confirmed the prevalence of the fossa of Landzert, that was managed by widening the orifice of the herniation site.

Conclusions
Strangulation and incarceration can occur in up to 64% in paraduodenal hernia, so exploratory laparoscopy could be an adjunctive tool in excluding intestinal ischemia, verifying the site of herniation even in cases of spontaneous reduction and repairing the orifice to prevent recurrence.
LAPAROSCOPIC SOLUTION FOR AN UNEXPECTED FINDING IN AN INCARCERATED FEMORAL HERNIA, FIRST CASE PUBLISHED
Authors: Díaz Pérez D , Serrano González J , Reyna-Villasmil E , Hernández Bartolomé M A , Colao García L , Esteban Agustí E , García Val T , Chavarrías Torija N , Galindo Jara P 
Published: May 2024

Abstract

Aim
Femoral hernias (FH) are relatively uncommon, comprising &lt;2% of all hernias and 2–8% of all inguinal hernias. More common in women and frequently associated with incarceration/strangulation. Different contents in the hernial sac have been described in the literature, but the ileum accompanied by the adnexa (fallopian tube+ovary, FT/O) has never been described before.

Material and Method
Case and literature review.

Results
62-year-old woman with 48 hours of vomiting and non-reducible right inguinal hernia. Normal blood test and obstruction-patternt x-ray. Exploratory laparoscopy was decided, finding FH with an ischemic intestine in the crural orifice and, unexpectedly, herniated FT/O as well. The elements were reduced – they were viable – and repaired using TAPP with tetanized-low-density-PLP mesh. The course was uneventful and asymptomatic.

Conclusions
The FH appears inferior to the inguinal ligament, between the Gimbernat and the femoral vessels. Its size and ligamentous-anatomy facilitate incarceration. That they contain the adnexa represent &lt;3% and always in pediatric age associated with genital-anomalies. There are &lt;15 published reports of adult FH with incarcerated FT/O. The concomitance of intestine+adnex has not been previously published. Traditional treatment considers the anterior inguinocrural way, but we prefer the laparoscopic-approach to verify intestinal viability and, in this case, discover infrequently herniated organs. Avoids double incisions (Gregoire+laparotomy) in case of resection and accidental reductions without visualizing the hernia content. The posterior approach is an excellent tool that every emergency-surgeon must control, and in this case, it allowed us to describe – and resolve – the first published case of an atypical hernia.
LUMBAR HERNIA, A BIG UNKNOWN. CASE SERIES ON AN EXPERIENCED ABDOMINAL WALL UNIT
Authors: Dominguez Bastante M , Fernandez Baeza M , Santidrian Zurbano M , Mansilla Rosello A 
Published: May 2024

Abstract

Aim
Primary lumbar hernia or lumbar incisional hernia (LIH) is a rare pathology. It can cause serious quality of life problems or complications such as intestinal obstruction. Its management is complex, conservative treatment is being recommended in many centers. The objective is to describe our series of lumbar hernias/LIH.

Material and Methods
LIH and primary lumbar hernias operated by during 2019–2023. We have analyzed demographic and intervention-related data. The minimum follow-up has been 8 and the maximum 50 months. Morbimortality (Clavien Dindo classification), reinterventions and recurrences have been analyzed.

Results
100% of primary lumbar hernias and LHI seen in the out patient clinic were operated (8 patients). Demographic and intervention-related characteristics are described in Table 1.Aetiology Primary1 (12.5%) LHI7 (87.5%)Medium BMI (kg/m2)33.1 +/- 7.1Medium CeDAR (%)29.8 +/- 19Gender Male5 (62.5%) Female3 (37.5%)Medium age (years)54.6 +/- 17.6Prehabilitation Botulinum toxina3 (37.5%) Progressive pneumoperitoneum1 (12.5%)Clasification L47 (87.5%) M1M2M3L41 (12.5%) W26 (75%) W32 (25%)Surgical technique Preperitoneal5 (62.5%) HemiTAR2 (25%) Carbonell1 (12.5%)Medium stage (days)6.3 +/-4.3Complications  I (haematoma)1 (12.5%)  II (superficial surgical site infection)2 (25%)
Polypropylene meshes were used in all patients, 3 cases a long-term resorbable biosynthetic mesh was added. No reinterventions or recurrences have been recorded.

Conclusions
According to our results, repair with large meshes has a low rate of complications and no recurrences, which is why we recommend the intervention in experienced units.