bluuebunny/crossref_metadata_2025_split huggingface dataset:
USE OF FASCIAL TRACTION DEVICE IN OPEN ABDOMEN CLOSURE – A CASE REPORT
Authors: Fernandez Baeza M , Santidrian Zurbano M , Dominguez Bastante M , Mansilla Rosello A 
Published: May 2024

Abstract

Aim
Open abdomen management is a therapeutic option for patients in whom abdominal wall closure should not or cannot be performed. Deferred closure of the abdominal wall often presents difficulties and comorbidity. The use of a fascial traction device may yield benefits in these patients.

Material and Methods
Description of a clinical case.

Results
A 68-year-old male with diabetes mellitus, hypertension, history of smoking, and former alcohol use underwent orthotopic liver transplantation for alcoholic cirrhosis, hepatitis C virus, and hepatocellular carcinoma. Complications included hemorrhagic shock requiring re-intervention. Damage control surgery was performed leaving the abdomen open, and a fascial traction device was applied. The device was maintained for 5 hours, followed by a 1-hour rest period, repeated for 4 days. Following this period, with patient stabilization, abdominal wall closure was performed, demonstrating significant fascial approximation and achieving primary closure using the small bites technique in two layers. The only complication encountered was a seroma. The patient was discharged 27 days post-intervention.

Conclusions
In patients with an open abdomen, deferred closure of the abdominal wall is often complex due to fascial retraction. Therefore, the use of fascial traction devices in these cases may offer a significant advantage for abdominal wall closure, potentially avoiding or reducing fascial retraction and, in many cases, obviating the need for complex wall repair techniques in these fragile patients.
EARLY EXPERIENCE OF ROBOTIC INGUINAL HERNIA REPAIR WITH THE NEW HUGO RAS SYSTEM IN EUROPE
Authors: Ferri V , Vicente E , Quijano Y , Hernandez S. F , Duran H , Diaz E , Fabra I , Malave L , Ruiz P , Balelli L , Broglio A , Caruso R 
Published: May 2024

Abstract

Introduction
Less than 1 year ago, the new robotic system Hugo RAS (Medtronic, Minneapolis, MN, USA) was approved for general surgery. It introduced the novelty of utilizing independent robotic arms in a multimodular system, providing versatility for performing increasingly complex surgeries that require different angles.

Results
A total of 42 inguinal hernia repairs were performed using the HUGO system in 25 patients, including 17 bilateral inguinal hernias and 8 unilateral hernias. The average docking time was 5.4 minutes (range: 4.3–7.8 minutes). The average console time was 67.9 minutes for bilateral repairs and 31.3 minutes for unilateral repairs. The average total procedure time was 113.1 minutes for bilateral repairs and 52.2 minutes for unilateral repairs.

Conclusions
The HUGO RAS system is safe, reproducible, and suitable for complex hernias. We have introduced an alternative guide setup for this surgery. Our series represents the first patient series in Europe and the second worldwide.
TREATMENT OF ABDOMINAL WALL SARCOMAS: OUR EXPERIENCE
Authors: Galán Raposo L , Gotor Santos T , Sánchez-Brunete Medina V , Sutil Reguera N , Gómez Shevyakova O , Gisbert Aparicio M , de Diego Domínguez A , Fernández Fernández-Rebollos A , Medrano Montero I , Herrera Kok J H , Diago Santamaría M V 
Published: May 2024

Abstract

Aim
To describe the reconstruction of the abdominal wall after excision of a NFS.

Material and Methods
We present a case of a 27-year-old patient with NF1 and a diagnosis of NFS located between the greater and lesser oblique muscles of the left flank. After performing a complete extension study, the tumour was excised en bloc including the last costal arches, lateral abdominal wall and left iliac blade. The left deep epigastric artery was preserved to ensure perfusion of the muscle flap. The peritoneum was sutured using polyglycolic acid mesh. Subsequently, biosynthetic trimethylene carbonate mesh and irreabsorbable polyvinylidene fluoride mesh were interposed. Then, a left latissimus dorsi muscle free flap and a free skin graft were performed.

Results
Postoperative course without complications, discharge after 20 days. Histological result confirmed complete excision with a minimum margin of 1 cm. Treatment was completed with adjuvant chemotherapy. At 2 years follow-up there were no recurrences or incisional hernia.

Conclusions
NFS is a rare and invasive neoplasm that requires an aggressive and complex procedure. Its approach requires a multidisciplinary team with experience in the treatment of soft tissue sarcomas.
PARASTOMAL HERNIA REPAIR IN BRICKER TYPE URINARY DIVERSION USING THE MODIFIED PAULI TECHNIQUE: A CASE REPORT
Authors: Gallardo A , Garcia J L , Talavera P , López L , Peña M J , del Campo M , Gámez M , Charef L , Fra D , Torres A 
Published: May 2024

Abstract

Introduction
The incidence of parastomal hernia (PH) associated with Bricker ileal urinary diversion is approximately 20%. Surgery becomes necessary in the presence of symptoms or development of complications.

Clinical case
A 77-year-old woman with a Bricker urinary diversion following radical cystectomy presented to the emergency department with 72 hours of evolving obstructive symptoms, coupled with a large PH featuring incarcerated bowel. A CT scan confirmed complete intestinal obstruction.
Urgent surgery was conducted, revealing ileum incarceration without perforations. Reduction of the intestinal content was performed, restoring viability. Transversus abdominis release (TAR) around the stoma was executed, followed by the placement of a retromuscular progrip mesh using the Pauli technique. The patient was discharged after 8 days without complications.

Discussion
The surgical treatment of PH remains controversial, lacking a consensus as the most effective technique. We opted for modified Pauli technique, involving retromuscular dissection, subsequent components separation via TAR and mesh repair according to the Keyhole technique. This combination leverages the advantages of each of procedures to reduce the recurrence risk: retromuscular mesh placement physiologically pushing the wall, utilization of wider prostheses reinforcing a larger surface area, complete mesh contact with the wall facilitating integration around the defect, and direct stoma exit without the need for repositioning.

Conclusions
The modified Pauli technique with Keyhole mesh placement, while demanding, can provide advantages in emergency surgery without causing significant postoperative complications.
INCARCERATED URETER IN INGUINAL HERNIA: A CASE REPORT
Authors: González Valverde F M , Rodríguez-Lucas J M , Medina-Manuel E , Sandoval Marin J , Moreno García C , Alarcon P , Jimenez-Moreno I M , Hurtado Vázquez A M , Del Valle-Ruiz S R 
Published: May 2024

Abstract

Aims
To describe a clinical case of a right inguinal hernia with an incarcerated ureter.

Methods
A 75-year-old male patient with a history of radical prostatectomy and rectal neoplasia was followed up. On control CT scan, a right indirect inguinal hernia containing a small segment of right ureter was identified as a finding at abdominal level.

Results
Incidental finding of a right indirect inguinal hernia with a small segment of ureter, paraperitoneal. Due to the patient's age, comorbidities and absence of symptoms, follow-up and expectant management was decided.

Conclusions
Inguinal hernias with retained ureter are very rare, with a predominance of indirect hernias. There are 2 types: paraperitoneal and extraperitoneal. The most common is paraperitoneal, in up to 80% of cases, where the ureter is accompanied by a hernial sac and other intra-abdominal organs may appear. Extraperitoneal hernias are usually associated with retroperitoneal fat. Treatment is usually herniorrhaphy.
ROBOTIC UNILATERAL TRANSVERSUS ABDOMINIS RELEASE FOR LATERAL INCISIONAL HERNIAS – ANALYSIS OF 14 CASES
Authors: Gröger C , Kundel L , Adam U , Köckerling F , Riediger H 
Published: May 2024

Abstract

Background
Originally described for complex midline hernias, the transversus abdominis release (TAR) might be useful for the repair of lateral incisional hernias by facilitating the tension free defect closure and allowing a sufficient overlap of extraperitoneal placed meshes. Robotic surgery is the latest innovation in abdominal wall surgery.

Method
We present our data of 14 cases of robotic hernia repairs using TAR for lateral incisional hernias regarding perioperative data und early outcome.

Results
Between January 2023 and January 2024 14 robotic hernia repairs for lateral incisional hernias were performed. Mean defect diameter was 5 cm (range: 2–15 cm). Two patients presented with additional ventral hernias. All meshes were placed in the extraperitoneal space. Ipsilateral transversus abdominis release was performed in all 14 patients for tension free defect closure and for sufficient overlap of the implanted meshes (polypropylene, mean mesh dimension: 17 × 16 cm, 302 cm²). Mean operation time was 169 min (range: 76–343 min). In the postoperative course one patient underwent diagnostic laparoscopy to rule out bowel injury. Another patient underwent laparotomy on the first postoperative day for repair of a small bowel injury after extensive adhesiolysis (Mesh exchanged for bioresorbable scaffold with hydrogen barrier, discharge at day 7). The median hospital stay was 3 days (range: 2–7).

Conclusion
Robotic surgery for lateral incisional hernia repair with extraperitoneal mesh placement and defect closure using TAR shows promising perioperative results. Long-term results need to be further investigated.
EVALUATING THE IMPACT OF AGE ON TAPP INGUINAL HERNIA REPAIR OUTCOMES: A RETROSPECTIVE ANALYSIS
Authors: Janik M , Sroczyński P , Jędras K 
Published: May 2024

Abstract

Aim
This study aims to assess the influence of advanced age on the safety and efficacy of Transabdominal Preperitoneal (TAPP) inguinal hernia repair.

Material and Methods
Conducted at the General Surgery Clinic of the Military Institute of Aviation Medicine in Warsaw, this retrospective analysis included 128 patients who underwent elective unilateral TAPP hernia repair from January 2022 to March 2023. Patients aged 65 and above (n = 54) were compared to a control group below 65 (n = 74). Data on demographics, operative details, and postoperative outcomes were analyzed using descriptive and inferential statistics.

Results
The elderly group (mean age 72.02) showed no significant difference in operative time (mean 71.83 minutes) or hospitalization length (mean 3.089 days) compared to the control group. Surgical site infections were non-existent in the elderly group versus 2.78% in the control. Hernia recurrence was slightly higher in the elderly (1.79%) than in the control group (1.39%), but not significantly.

Conclusions
The study reveals that advanced age does not adversely affect the safety or efficacy of TAPP hernia repair, with comparable outcomes in elderly and younger patients. These findings suggest that age alone should not be a contraindication for TAPP procedure, highlighting the importance of evaluating individual patient risk factors. Further research with larger cohorts is recommended to consolidate these findings.
IN SITU EVALUATION OF THE HERNIA MESH BIOMECHANICAL STABILITY
Authors: Jourdan A , Vegleur A , Bodner J , Rousset P , Le Ruyet A , Passot G 
Published: May 2024

Abstract

Aim
Biomechanical stability between the mesh and the surrounding tissues is crucial to achieve successful tissue integration and avoid migration. In this study, we propose a novel approach that combines experimental and numerical methods to measure mesh stability in situ in cadavers, during insufflation of the abdominal cavity.

Methods
Micro stainless-steel beads (Ø 0.8 mm) were attached to a hernia mesh, creating a 2 cm spaced grid (Figure 1). The mesh was implanted in the retro-rectus plane and beads were placed in the rectus muscle tissue. A catheter inserted into the abdominal cavity allowed pressure insufflation. CT scans captured abdominal acquisitions at 0, 5, 15 and 30 mmHg. Using 3D segmentation software, beads were marked, and coordinates exported. A finite element model, based on initial bead positions, determined deformed configurations. Principal strain in mesh and muscle was computed and compared.

Results
Beads motion was mainly oriented toward the anterior direction. It reached 49.3 ± 10.5 mm at 30 mmHg and was limited above 15 mmHg (Figure 2). At 30 mmHg, the relative displacement between muscle and mesh beads was 1.3 ± 0.3 mm and the principal strain was 4.7 ± 1.1% in the mesh and 12.9 ± 4.7% in the muscle. The mesh was stretched in the longitudinal direction.

Conclusions
This methodology is a promising tool for the assessment of hernia mesh stability. It can capture relative displacement and strain difference between mesh and muscle. It could be used to compare the impact of different fixation modalities on the response of the hernia repair.
Figure 1: Synthetic hernia mesh with micro beads Figure 2: Experimental and numerical workflow
SPIGELIAN HERNIA. PRESENTATION OF 2 CASES
Authors: Kochylas N , Papaeleftheriou S , Taibiris G , Magganas D 
Published: May 2024

Abstract

Aim
Spigelian hernias are rare hernias that account for &lt;2% of ventral hernias. They manifest in the “Spiegel zone” and are usually small. The treatment is surgical since they pose a serious risk of strangulation. Here are presented 2 cases of strangulated Spigelian hernias.

Case 1
87-year-old female presented to the emergency room (ER) due to small bowel obstruction secondary to a large incarcerated spigelian hernia. In surgery the small bowel loops were reduced and the hernia repaired with composite mesh intraperitoneally. Her postoperative course was uneventful.

Case 2
54-year-old male presented to the ER with a strangulated Spigelian hernia. Intraoperatively, ischemic small bowel loops were reduced and enterectomy was performed through a midline incision. The hernia itself was repaired with primary closure with Nylon loop. 1 year later the patient presented with incisional hernia from the midline incision and underwent a Rives-Stoppa repair. No spigelian hernia recurrence was discovered at the time.

Conclusion
Spigelian hernias are rare, with a high rate of incarceration. The optimal surgical approach varies, especially in strangulated cases, and depends on the particulars of each case and the resources of the center.
LAPAROSCOPIC INGUINAL HERNIA REPAIR AND EVALUATION OF POSTOPERATIVE QUALITY OF LIFE IN ELDERLY PATIENTS: SINGLE CENTER RESULTS
Authors: Korucuk E , Gumus T , Temel R , Basci F , Sezer T O , Ersin S 
Published: May 2024

Abstract

Background
Inguinal hernias (IH) constitute approximately 75% of all abdominal wall hernias and occur in 25–30% of the population. Although surgery is the only treatment for IHs, there is no definite consensus on the technique. In our study, we aimed to compare IH repair techniques in elderly patients.

Method
Between December 2018 and December 2023, 280 patients who underwent laparoscopic TAPP (L-TAPP) repair and Lichtenstein hernioplasty (LH) for IH in our center were included and retrospectively reviewed. Patients were divided into 2 groups according to the operation technique and age limit of 65 years.EuroQol-5D-3L scale was used as a quality of life (QOL) test.

Results
The mean age of the patients was 56.23 years. 264 (94.3%) were male, 16 (5.7%) were female. There were 93 (33.2%) patients over 65 years of age.LH was administered to 62 (66.7%) and L-TAPP to 31 (33.3%) of these patients.When the patients who underwent L-TAPP were evaluated, there was no statistically significant difference in terms of early and late complications and recurrence. When the QOL of both patient groups was evaluated, no significant difference was observed, while life satisfaction was high. When patients over 65 years of age were divided into LH and L-TAPP, there was no statistically significant difference in terms of hernia types, hospitalization time, early and late complications and recurrence. When the QOL was evaluated, in terms of usual activities and self-care parameters, it was found to be significantly different with more favorable results in the L-TAPP group.

Conclusion
Accordingly, we think that laparoscopic repair of IH in elderly patients can be safely performed in experienced centers and patients who underwent L-TAPP had a better quality of life.
RARE CAUSE OF BOWEL OBSTRUCTION – CASE REPORT OF AN APPENDICULAR TOURNIQUET INSIDE AN ILEOSTOMY REVERSAL SIDE HERNIA SAC
Authors: Koumenis A , Piperos T , Manthas A , Nannou E , Mariolis-Sapsakos T 
Published: May 2024

Abstract

Background
The aim of this case report is to outline a rare instance of an appendicular tourniquet presented as bowel obstruction inside an incisional hernia at the ileostomy reversal site (IRS).

Material and Methods
A 65-year-old female patient presented to our outpatient clinic on a schedule appointment with a profound neglected IRS hernia. She had previously undergone an open low anterior resection with loop ileostomy for rectal cancer. The ileostomy was reversed four months postoperative. The patient was complaining of intermittent mild abdominal pain and constipation which she was managing by her own with laxative. A CT scan was ordered which showed a large hernia containing mostly small intestine protruding from two different hernia sides – one as an IRS incisional hernia and a concurrent middle line incisional hernia.

Results
In agreement with the patient an operation was schedule, and the patient was to follow a strict diet until the operation date. Two weeks after the initial appointment the patient was admitted to the emergency department with severe abdominal pain and vomiting. The hernia side was found to be red and tender on touch and metallic bowel sounds were heard on osculation over it.
An emergency surgery was deemed necessary to examine the cause of the obstructive ileus. A midline incision was chosen and an extensive symphysiolysis was conducted. After mobilization of most of the intestine from the hernia sac, an appendicular tourniquet was discovered. Τhe appendix was fused in a loop strangulating the bowel section under it which started to show signs of ischemia. We continued the symphysiolysis until all the protruding sections where reduced and an appendectomy was also performed. A hernioplasty with dual mesh onlay placement was performed to reinforce the abdominal wall.

Conclusion
Although a rare occurrence an appendicular tourniquet inside a hernia sac is possible causing irreversible bowel strangulation and subsequent necrotization deeming the condition a surgical emergency.
BIOMECHANICAL HIP AND LEG FUNCTIONS CHANGES AFTER INGUINAL HERNIA REPAIR USING DIFFERENT MINIMALLY INVASIVE METHODS
Authors: Kubiliūtė E , Margelis E , Jasaitis K , Kiudelis M 
Published: May 2024

Abstract

Background
Medical researchers typically assess patient recovery post minimally invasive hernia repair with visual analogue scales or short surveys. Yet, data on hip and leg function changes following surgery via objective tests is scarce. This study aims to determine the impact of minimally invasive hernia repair methods on patient mobility, recovery speed, and resumption of daily activities.

Methods
A prospective randomized clinical study with 123 male patients undergoing primary inguinal hernia repair randomly divided them into two groups (transabdominal pre-peritoneal (TAPP) and total extraperitoneal (TEP) inguinal hernia repair). The groups were assessed for surgical complications, recovery time, hip and leg strength measured by dynamometer, mobility measured by goniometer, and hip and leg stability measured by the Y balance test. All tests were performed before the procedure, on the first postoperative day, and at 1, 2, and 4 weeks after the procedure. Differences between preoperative and postoperative results were calculated and compared.

Results
66 patients were included in the TAPP group, and 57 in the TEP group. There were no significant differences in surgery time, complications, hospital stay, and recurrence rate between the two groups. Almost all hip and leg functions for patients who underwent TAPP recovered one to two weeks faster compared to those who underwent TEP. Only leg adduction strength recovered faster after the TEP procedure.

Conclusions
TAPP inguinal hernia repair showed smaller biomechanical hip and leg changes and faster function recovery than the TEP procedure with the same early and late postoperative results.
HIGH PREVALENCE OF CHOLELITHIASIS IN PATIENTS PRESENTING WITH UMBILICAL HERNIA, AND VICE VERSA
Authors: Kulacoglu H , Sahin A , Ugurlu C , Celasin H , Akin K 
Published: May 2024

Abstract

Background
We aimed to find the prevalence of the coexistence of cholelithiasis in a prospective multicenter cross-sectional study.

Method
The main outcome measures were the presence of cholelithiasis in patients who admitted with an umbilical hernia (UH) and the presence umbilical hernia in patients who were diagnosed with cholelithiasis (CL). Patients with an umbilical hernia were examined by biliary ultrasound.

Results
25.9% of CL were diagnosed with umbilical hernia, while 29.6% of UH were diagnosed with cholelithiasis. In multivariate analysis, obesity was an independent risk factor for umbilical hernia in the CL group, whereas female sex was an independent risk factor for cholelithiasis in the UH group.

Conclusion
The prevalence of cholelithiasis in patients with umbilical hernia and the prevalence of umbilical hernia in patients with cholelithiasis are both high. Umbilical hernia patients especially who have high BMI values should be examined with biliary ultrasound before planning a hernia repair.