bluuebunny/crossref_metadata_2025_split huggingface dataset:
LAPAROSCOPIC ETEP (EXTENDED TOTALLY EXTRAPERITONAL REPAIR) VENTRAL HERNIA SURGERY – RESULTS FROM 2021 TO 2023
Authors: Andersen G , Elden E , Vorontsov D , Græslie H 
Published: May 2024

Abstract

Background
In our surgical department, we've recently shifted to ETEP surgery with retromuscular mesh placement as our preferred technique for both primary ventral hernias and recurrent hernias with prior implants. This abstract outlines the outcomes of 30 cases treated with ETEP surgery between 2021 and 2023.

Methods
The cohort of 30 patients presents a diverse range of hernia complexities, from umbilical hernias with diastasis recti to large ventral hernias with prior implants.

Results
Our surgical times varied widely, spanning from 122 to 420 minutes, with a median of 197 minutes. Hospital stays with a median of 3 days (range 1–12). Six cases required bilateral Transversus Abdominis Release (TAR), while five patients needed unilateral TAR. Two patients underwent hybrid surgery with both open and laparoscopic surgery. Postoperative complications included four cases of bleeding, with two necessitating laparoscopic reoperation within 24 hours. Follow-up comprised clinical assessments and CT scans 1–3 months post-surgery, with additional CT scans for some patients one year post-surgery. Except for one early breakdown of the posterior layer and one small linea alba injury, CT scans showed adequate abdominal wall reconstruction in all patients. To date, we have not encountered any hernia recurrences or wound or mesh infections, with only one patient developing a symptomatic seroma after surgery.

Conclusion
Laparoscopic retromuscular mesh placement via ETEP surgery appears promising for achieving superior anatomical abdominal wall reconstruction compared to IPOM. Our results thus far indicate favorable outcomes based on post-surgery CT evaluations and clinical follow-up.
IMPLEMENTATION OF A MULTIDISCIPLINARY COMPREHENSIVE HERNIA CENTRE: OUTCOMES AND LESSONS LEARNT
Authors: Birch A , Cocciolo F , Alabbasi I 
Published: May 2024

Abstract

Background
AWR is an elective procedure aimed at enhancing the quality of life for individuals dealing with complex hernias. Patients with obesity, a history of smoking, or diabetes tend to experience poorer outcomes in elective hernia repair. Pre-optimization before surgery becomes crucial to enhance patients’ surgical outcomes.

Aim
A multidisciplinary clinic and pre-optimization process have been implemented. This paper seeks to underscore the progress achieved through the adoption of a multidisciplinary approach, emphasizing the importance of a comprehensive strategy in managing these challenging cases.

Methods
Once patients get referred to the Comprehensive hernia centre, they are seen in clinic and discussed at the weekly Multidisciplinary Team (MDT) meeting and if appropriate they will be sign-posted into the pre-optimising process. A weekly Advanced Clinical Practitioner (ACP) telephone clinic has been established for the ongoing monitoring of patients requiring pre-optimization. Upon achieving their pre-optimization goals, patients are placed on the surgery list, and if required, their surgery is expedited appropriately. The paper includes a review of all patients seen in the MDT clinic at the Comprehensive Hernia Centre in 2023.

Results
49 patients were listed for pre-optimization, with 8 needing smoking cessation, 45 requiring weight loss, and 13 needing diabetes control. Within the same period, 42 patients underwent surgery, with 22 requiring pre-optimization. Currently, 68 patients are undergoing post-surgery follow-up.

Conclusion
Our data shows that the majority of patients undergoing AWR require pre-optimisation, particularly regarding weight loss. By having a dedicated telephone clinic patient can be supported to achieve their targets prior to AWR surgery.
HOW TO IMPLEMENT THE NEW METHOD? INITIAL EXPERIENCE WITH INTRAOPERATIVE FASCIAL TRACTION IN CZECHIA
Authors: Bystricky P , Suhajek S , Benda P , Oupicky J , Peteja M , Polednik J , Prudius V 
Published: May 2024

Abstract

Aim
Midline closure can be difficult or impossible when restoring large abdominal wall defects. There are several possibilities how to close the midline, but most of these techniques are not easy to learn and perform properly. Intraoperative fascial traction (IFT) is a relatively new method that delivers promising results in recent studies. It can avoid inapproprate use of other complex techniques, especially component separation. The aim of this retrospective analysis was to demonstrate the effectiveness and potential pitfalls of implementing this new method, and evaluate complication rate of ITF under the specific conditions of Czechia.

Materials and Methods
This multicentric retrspective review evaluates first 16 cases of complex hernias treated by intraoperative fascial traction in 7 Czech centres.

Results
The average fascial distance measured intraoperatively was 13,3 cm. The mean operation time was 155 min, including 30 min of fascial traction. A mesh in a sublay position was applied in all cases. In all cases, it was possible to achieve midline closure, but in 2 cases, an additional component separation was performed. Postoperative complications occured in 2 patients (12,5%); both of them needed a NPWT due to an infected subcutaneous serohematoma and subcutaneous dehiscence.

Conclusions
IFT is a new and effective procedure for treatment of complex abdominal wall defects. In a relatively small setting, our own protocol was applied, including patient selection, hands-on workshops and supervision, intensive exchange of experiences. Easy implementation, effectiveness and safety of this method were proved.
PREHABILITATION FOR EVERY AWR? COMPARISON OF LONG-TERM RESULTS OF SUBLAY/TAR TECHNIQUE
Authors: Bystricky P , Suhajek S , Keprta D 
Published: May 2024

Abstract

Aim
Patients with complex abdominal wall defects are recommended to be treated in specialised centres. Prehabilitation of these patients, including physiotherapy, weight loss, diabetes management, smoking cessation, is strongly recommended. However, most of „non-complex“ hernias are often treated by general surgeons without any knowledge of the importance of patient´s prehabilitation. The aim of our study was to compare 2 groups of patients with complex/non-complex hernias, and to determine if patients with non-complex hernias without comorbidities can profit from preoperative optimization, too.

Materials and Methods
50 patients treated in 1 centre by the same team were included in this retrospective review. 2 subgroups of patients were determined: A; W1–2 hernia, no prehabilitation, sublay-mesh only, and B; W3 hernia, prehabilitation, component separation technique-TAR. Complications were evaluated by Clavien-Dindo classification. A clinical control, standardized ultrasound, and a standardized questionnaire, were made 7–24 months after surgery.

Results
Operation time and length of hospital stay was shorter in subgroup A. There was no difference in recurrence in 2 subgroups, determined by clinical examination and ultrasound. Post-op complication rate (mainly wound complications) was surprisingly higher in the subgroup A. The Quality-of-Life Questionnaire showed greater limitations before treatment but better outcomes and improvement in the subgroup B.

Conclusions
Preoperative optimization has demonstrated patient´s benefits and better results in complex incisional hernias. It can reduce complication rate, improve patient´s outcome and increase of patient´s satisfaction also for W1–2 hernias without comorbidities.
OPEN INGUINAL HERNIA REPAIR WITH SELF-GRIPPING PARIETEX PROGRIP MESH: A GOLD STANDARD TECHNIQUE WITH 0% CHRONIC PAIN AND RECURRENCE
Authors: Ceci F , Mascagni P , Scorsi A , Saraceno F , Muzi M G 
Published: May 2024

Abstract

Background
Chronic pain and recurrence rates are the main challenge in modern inguinal hernia surgery. The purpose of our study was to retrospectively evaluate the early and long-term results after a standard, safe and effective technique using a self-gripping mesh (Parietex Progrip®, Covidien).

Method
The study was conducted from 2018 to today in a Hernia Center. 106 patients underwent open inguinal hernioplasty with Progrip mesh. Reassessments performed at 1 week, 1, 6 months, 3 and 5 years recording complications above all chronic pain and recurrence.

Results
The average age was 57 years, SD +/- 11.7. Two patients were affected by recurrent inguinal hernia and 5 by bilateral inguinal hernia. The sample consists of 98 males and 8 females. The mean operating time was 52 minutes SD +/- 15.56. No recurrences, cases of chronic pain or mesh infections were recorded postoperatively; we found 2 seromas at the first outpatient check-up, 1 in a patient treated for a recurrent hernia.

Conclusion
This case series is the continuation of our previous experience begun in 2006 including data on 970 procedures (0 chronic pain and 3 relapses), for a total of 1076 patients performed by a single operating surgeon. Our results show 0% chronic pain and recurrence in 106 patients and encourage the use of self-gripping mesh (Progrip) in inguinal hernioplasty.
HERNIA RECURRENCE AFTER LAPAROSCOPIC MESH REMOVAL FOR CHRONIC POSTOPERATIVE INGUINAL PAIN FOLLOWING PREPERITONEAL REPAIR: LONG-TERM OUTCOMES
Authors: Chaoui A M , Zwaans W A R , Loos M J A , Slooter G D , Rops J P 
Published: May 2024

Abstract

Introduction
Minimally invasive inguinal hernia repair results in 6–12% of patients experiencing chronic pain. The mesh can constitute the root of the problem. Literature concerning laparoscopic mesh removal is scarce. A recently published study has demonstrated feasibility and safety of this technique. However, little is known about hernia recurrences after laparoscopic mesh removal. This observational study aims to describe the rate of hernia recurrence following laparoscopic mesh removal in patients with chronic postoperative inguinal pain (CPIP) after preperitoneal inguinal hernia repair and reports the effect of the intervention on pain.

Methods
A retrospective study of prospectively collected questionnaires and operative findings was conducted. The patient population constitutes of eighty-nine consecutive patients undergoing a laparoscopic mesh removal for CPIP between November 2011 and July 2022. Hernia recurrence was based on anamnestic and clinical findings. Pain scores were quantified using the Numeric Pain Rating Scale (NRS).

Results
Eighty-three patients were included in the present study (median age 57 years). We noted a hernia recurrence in eighteen patients (21.7%). Intraoperative findings concerning mesh conformation were also reported. Median pain scores dropped significantly from 7 to 3 (p &lt; 0.05).

Conclusion
This retrospective study shows that laparoscopic mesh removal for CPIP following preperitoneal inguinal hernia repair results in an inguinal hernia recurrence in 1 out of 5 patients. Patients should be well-informed preoperatively about this finding. To the best of our knowledge, this is the first study describing hernia recurrence risk after laparoscopic mesh removal.
ONCOLOGICAL PATHOLOGY OF THE ABDOMINAL WALL: A CHALLENGE FOR ABDOMINAL WALL SURGEONS
Authors: Charef El Jari L , del Campo Martín M , Fra Corral D , García Galocha J L , López Antoñanzas L , Torres García A J , Soria M J 
Published: May 2024

Abstract

Introduction
Mesenchymal tumors are the tumor line that most frequently affects the abdominal wall. This pathological category includes all neoformations of mesenchymal tissues, muscle, vessels, adipose tissue, among others. They are rare tumors that require extensive extirpations and complex reconstructions.

Aim
To point out the importance of multidisciplinary units to provide patients the best oncological, functional and aesthetic results.

Material and Methods
We present a case series of patients affected by abdominal wall tumors of mesenchymal type, who have received treatment in the sarcoma unit of San Carlos Clinical Hospital in Madrid between 2015 and 2023. The sarcoma unit includes, among other specialists, abdominal wall and plastic surgeons.

Results
A total of 17 patients have received surgery, there were 9 males and 8 females. The average age was 58 years.
The inguinal region and the root of the thigh were the most affected sites (9). The most common tumor type was liposarcoma (5). The remaining cases were femoral sheath leiomyosarcoma, schwannoma, chondrosarcomas and osteosarcomas. The surgical treatment of these patients required vascular and osteoarticular reconstruction by expert surgeons in these areas.
The tumor line that most frequently involved the anterior wall of the abdomen were tumors of fibroblast origin. These cases required extensive excisions of the entire abdominal wall which was reconstructed using different types of flaps performed by plastic surgeons.

Conclusions
The treatment of abdominal wall tumor pathology should be carried out in reference units and by multidisciplinary surgical teams as different organs and systems are usually affected.
SAFETY AND EFFECTIVENESS OF A BIOSYNTHETIC, FULLY-SLOWLY RESORBABLE MESH, MADE FROM P4HB* IN VENTRAL AND INCISIONAL HERNIA REPAIR: A GREEK MULTICENTER CLINICAL STUDY
Authors: Chatzimavroudis G , Kourlaba G , Christodoulidis G , Zatagias A , Maroulis I , Chrysoheris P , Kotoreni G , Apostolidis S , Bouhagier K , Pavlidis T , Zacharoulis D , Papaziogas B , Kolovos P , Stefanou G 
Published: May 2024

Abstract

Aim
During the last decade a new type of meshes has launched, the biosynthetic slowly/fully resorbable meshes. Among them, mesh made from P4HB looks very promising due to its specific characteristics. The purpose of this study was to evaluate the safety and effectiveness of P4HB mesh in ventral/incisional hernia repair.

Material and Methods
This was a Greek multicenter retrospective clinical study including all patients who underwent ventral/incisional hernia repair with the use of P4HB mesh between May 2017 and October 2022. Patients’ demographic data and data regarding comorbidities, CDC wound classification, hernia characteristics and type of operation, were recorded. Postoperative complications and recurrence were evaluated.

Results
During study period, 85 patients (54.1% men) suffering from ventral/incisional hernias (mean age: 62.3 years and mean BMI: 30.8) underwent hernia repair with P4HB mesh. Of them, 69.5% suffered from hypertension, 42.4% from diabetes, 23.5% from COPD, 29.4% from cardiopathies, 49.6% were active smokers and 45.9% had a history of SSI. According to CDC wound classification, 47.1% of cases were non-clean. Open repair was performed in 91.8%, the defect was closed in 96.5%, while component separation was applied in 68.3% of patients. Regarding postoperative surgical site occurrences (SSOs), seroma occurred in 20%, hematoma in 4.7%, cellulitis in 7.1% and SSI in 3.5% of patients. With the exception of one case, all SSOs were successfully treated conservatively. With a mean follow-up of 40 months, only 2 (2.3%) recurrences were observed.

Conclusions
The use of P4HB mesh is safe and effective in ventral/incisional hernia repair, even in non-clean cases.
P4HB: PHASIX mesh
MESH VERSUS SUTURE FOR ELECTIVE PRIMARY UMBILICAL HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dias Rasador A C , Balthazar da Silveira C A , Lima D L , Nogueira R , Malcher F , Sreeramoju P , Cavazzola L T 
Published: May 2024

Abstract

Aim
Recent guidelines recommend the use of mesh in umbilical hernia repair (UHR) for defects &gt;1 cm. However, primary closure is still performed in UHR, especially for small defects (&lt;2 cm), for which there is no published data to determine the optimal approach. Thus, we performed a systematic review and meta-analysis comparing the use of mesh with primary closure in elective primary UHR.

Material and Methods
We searched for studies comparing mesh with suture in UHR in PubMed, Scopus, Cochrane, Scielo, and Lilacs. Studies with recurrent or emergency conditions were excluded. Outcomes were recurrence, seroma, hematoma, and wound infection. Subgroup analysis was performed for hernia defects &lt;2 cm. We used R statistics for statistical analysis.

Results
2895 studies were screened and 56 were reviewed. 12 studies were included, comprising 2926 patients (47.6% in mesh and 52.4% in the suture group). Mesh repair showed lower rates of recurrence in the overall analysis (RR 0.50; 95% CI 0.31 to 0.79; P = 0.003; I2 = 24%) and for hernia defects &lt;2 cm (RR 0.56; 95% CI 0.34 to 0.93; P = 0.03; I2 = 0%). Suture repair showed lower rates of seroma (RR 1.88; 95% CI 1.07 to 3.32; P = 0.03; I2 = 0%) and wound infection (RR 1.65; 95%CI 1.12 to 2.43; P = 0.01; I2 = 15%).

Conclusion
The use of mesh during UHR generates a higher risk for seroma and wound infection compared to primary closure. Nevertheless, mesh repair is associated with lower recurrence rates in a long-term follow-up for both small and large defects. Therefore, mesh repair should be the surgical approach for umbilical hernias.
UNILATERAL TRANSVERSUS ABDOMINIS MUSCLE RELEASE WITH RETROMUSCULAR MESH REPAIR AS A SOLUTION FOR A SECOND RECURRENCE OF LARGE MULTILOCULAR INCISIONAL HERNIA AFTER LIVER TRANSPLANTATION
Authors: Drs A , Frank J , Fronek J 
Published: May 2024

Abstract

Background
Transversus abdominis muscle release was published by Novitsky et al. in 2012. It is a posterior component separation technique allowing the closure of large abdominal wall defects and the insertion of very large retromuscular meshes without damaging the vessels and intercostal nerves.

Method
We would like to present a case of a second recurrence of a large multilocular incisional hernia after liver transplantation and its solution.

Results
We present a patient after liver transplantation in January 2021. In April 2022 retromuscular sublay mesh repair was performed for subcostal incisional hernia. In December 2022 onlay mesh repair was performed for medial recurrence of the previous incisional hernia. Four months later, unfortunately, the second recurrence appeared. At the beginning, we proceeded conservatively, but because of an increasing size of the hernia, we decided to perform a retromuscular mesh plastic. Because of the size of the defect (fascial gap 10 × 20 cm), with the transversus abdominis muscle release. Due to the violated tissue planes after previous plastics, we performed only unilateral (left) release. It was sufficient to close the posterior rectus sheath without any tension. Large retromuscular mesh was placed and covered by closure of the anterior rectus sheaths. The patient was discharged on the third postoperative day without any complications.

Conclusion
Transversus abdominis muscle release with retromuscular mesh placement provides a great solution for difficult recurrent ventral hernias.
IT’S TIME TO CHANGE THE GUIDELINES FOR RECURRENT INGUINAL HERNIA AFTER POSTERIOR REPAIR, RE POSTERIOR TEP APPROACH
Authors: Dudai M , Ganiem M 
Published: May 2024

Abstract
The guidelines are that a Recurrent Open hernia should be repaired by a Posterior approach. While recurrent Posterior is recommended to be repaired with an Open anterior approach. We'd like to discuss the recommendation and present our data for TEP repair of recurrent LAP hernia.
Since 2016, we have operated on 934 patients with Groin Hernias, 130 had a Recurrent Hernia, of which 33 was after LAP, 14 after TAPP and 19 after TEP. We started with TAPP, but quickly switched to TEP that allows the separation of all the mesh that was left attached to the peritoneum. We learned to begin separating the mesh from the lateral to medial.
The surgery lasted longer, but there was no conversion to Open. The recovery after surgeries were regular and there was no recurrence. We switched to absorbable takers and glue for avoiding pain.
There're significant advantages of TEP approach to repair a recurrent Posterior: 1. The edges of the mesh are not left exposed in the hernia defect in front of the bowel; 2. The mesh's removal completely from the posterior wall reducing pain; 3. Detecting defects that aren't visible in an Open.
Repairing recurrent hernias requires skill and experience. In our opinion, there are advantages in repairing a recurrent Posterior hernia with the TEP approach, and we've shown that the repair can be performed safely and successfully. We suggest considering changing the guidelines and allowing surgeons to choose the approach they want to repair a recurrent Posterior hernia. More data should be collected.
EFFECTIVENESS OF EMILOS SURGERY IN PATIENTS WITH DIASTASIS RECTI COMBINED WITH UMBILICAL HERNIA
Authors: Feleshtynskyi Y , Koval O , Svyrydovskyi S 
Published: May 2024

Abstract

Background
The aim of the study is to assess the effectiveness of surgical treatment of diastasis recti of the abdominal muscles combined with umbilical hernia using EMILOS and SCOLA procedure. Randomized clinical study.

Method
An analysis of the surgical treatment of 126 patients with diastasis of rectus abdominis combined with the umbilical was carried out. The age of patients is from 20 to 75 years. The average age is (42±1.3) years. There were 95 women, 31 men. In 1 group (n = 64), surgical treatment was performed according to the EMILOS method. In the 2nd group (n = 62), surgical treatment was performed according to the SCOLA method.

Results
After surgery, seroma was observed in 4 (6.3%) patients of the 1st group, in 10 (17%) of the 2nd group, there was no wound infection in the 1st group, among the patients in the 2nd group, wound infection was observed in 2 (3, 1%), chronic pain in group I in 2 (3.1%), in group II – in 6 (10%) patients. Long-term results from 1 to 36 months showed that among 35 patients of the 2nd group after SCOLA surgery, diastasis recurrences were found in 7 (13%), and among 34 patients of the 1st group after the EMILOS surgery in 1 (1.5%).

Conclusion
EMILOS alloplasty for umbilical hernias combined with diastasis of rectus abdominis muscles is more effective compared to SCOLA surgery due to retromuscular mesh placement, which reduces the frequency of postoperative complications and recurrences.
EVALUATION OF TAR AND RAMIREZ IN GIANT INCISIONAL HERNIAS
Authors: Feleshtynskyi Y , Lerchuk O , Chomiak V , Vatamaniuk V 
Published: May 2024

Abstract

Background
The aim of the study the evaluation of the effectiveness of TAR in comparison with the Ramirez operation for giant incisional hernia. Randomized clinical trial.

Method
An analysis of surgical treatment of 112 patients with giant postoperative ventral hernias was performed. The age of patients is from 30 to 80 years. The average age is 52 ± 1.3. There were 72 women, 40 men. In the first group, TAR technique was performed on 67 patients with retromuscular mesh placement. In the second group, 65 patients underwent the Ramirez procedure in combination with the "Onlay" technique.

Results
The postoperative results showed that among the patients of the 1st group. intra-abdominal hypertension was observed in 1 (1.4%) patient, in the 2nd group in 5 (7.6%). Complications of the postoperative wound, in particular, seroma among patients of the 1st group was diagnosed in 5 (7.4%), in the 2nd group in 9 (13.8%), infection observed in 1 (1.4%) patient of the 1st group and in 3 (4.6%) patients of the 2nd group. Chronic postoperative pain, respectively, in 4 (5.9%) and 6 (9.2%). Long-term results were studied in terms of 1 to 36 months in 42 patients of the 1st group and 40 patients of the 2nd group. Recurrences were found in 1 (2.3%) patient of the 1st group and in 3 (7.5%) patients of the 2nd group.

Conclusion
The obtained results showed a higher efficiency of the TAR technique compared to the Ramirez operation for giant postoperative ventral hernias.