bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-048 LONG TERM OUTCOMES AND QUALITY OF LIFE AFTER OPEN ABDOMEN TREATMENT
Authors: Theodorou A , Von Websky M 
Published: May 2023

Abstract

Aim
Open abdomen treatment (OAT) can manage severe abdominal conditions but is associated with high morbidity and mortality. Main risks are entero-atmospheric fistula (EAF), failure of primary fascial closure, and incisional hernias. In this study, we assessed long-term functional outcomes after OAT to understand which factors impacted most on quality of life (QoL).

Methods
After a retrospective analysis of 165 consecutive OAT patients treated in our center over a 10 years period, before the implantation of a structured mesh mediated fascial traction concept, a prospective follow-up was initiated. All survivors were invited for a follow-up. 40 datasets including clinical and social follow-up with SF-36 scores were analysed.

Results
Primary closure (PC) was achieved in 23% of patients. 3/4 of the others underwent a secondary-stage abdominal wall reconstruction (SSR), but 2/3 of them developed recurrent hernias. 55% percent of the patients with PC developed an incisional hernia, while 20% of all patients developed significant scarring. Scar pain was described by 15% of the patients as “moderate” and by 10% as “severe”. While hernia presence and scarring showed no impact, male sex and EAF formation significantly reduced QoL.

Discussion
Despite advantages, OAT is associated with high mortality and morbidity, especially in early era before the implementation of a structured concept. Follow-up revealed that hernia is high and that 25% of patients qualifying for a secondary reconstruction did not want surgery or were unfit. Sex and EAF formation impacted significantly on QoL, which was lower than in the general population.
OC-050 FULL ENDOSCOPIC RETROMUSCULAR ACCESS (ETEP) ASSOCIATED WITH TRANSVERSUS ABDOMINIS RELEASE (TAR) IN INCISIONAL HERNIA AFTER LIVER TRANSPLANTATION. CASE-CONTROL STUDY
Authors: Bellido-Luque J , Licardie E , Tejada A , Bellido-Luque A , Gomez Menchero J , Suarez Grau J M , Sanchez-Matamoros I , Nogales Muñoz A 
Published: May 2023

Abstract

eTEP is a new technique that minimizes the possibility of intraperitoneal lesions or adhesions formation.

Methods
From January 2018 to January 2023, patients with symptomatic right subcostal incisional hernia after liver transplantation were underwent to eTEP - TAR. The results were compared to those operated on using IPOM + from 2016 to 2018 in a prospectively maintained database. Variables: type of scar -Defect length/width-mesh area-surgical time- complications-conversion rate-Length of stay- Pain at 1°-7°-30–90 days- recurrence rate.

Results
21 patients were included in eTEP and 14 in IPOM groups. No differences were seen in preoperative measurements/type of scar.
defect length 6,3+/- 1 cm width 4,2+/- 0,3 cm in eTEP and 8,7+/-1,5 and 5,1+/-0,7 cm respectively in IPOM. Surgical time was longer in eTEP with significant differences (115+/- 16 vs 65+/- 7,1 minutes). Seromav11% in eTEP and 13% in IPOM. Length of stay 1,2 +/- 0,7 and 2,1+/-0,6 days in eTEP and IPOM groups respectively with significant improvement in favor of eTEP. Operative time was higher in eTEP (106,8 +/- 20,5 minutes) than IPOM+ group (61,4 +/- 18 minutes) with significant differences. Postoperative pain in eTEP showed significantly less pain on 1st, 7th and 30th than IPOM+. No differences when 90th day pain was compared. follow-up 20,9 +/- 6,5 months in eTEP group and 38,3 +/- 4,8 months in IPOM+ group. No recurrences were identified.

Conclusions
eTEP-TAR for incisional hernia after liver transplantation is an optimal approach due the benefits of the extraperitoneal approach.. Postoperative pain and surgical stay are improved.
OC-062 15-YEAR FOLLOW-UP AFTER INCISIONAL HERNIA REPAIR: DYNAMICS OF RECURRENCE, RISK FACTORS, HEALTH CARE UTILIZATION AND PATIENT-REPORTED SATISFACTION
Authors: Cengiz Y , Karlsson S , Bjorklund I , Israelsson L 
Published: May 2023

Abstract

Aim
Long-time results after Incisional hernia (IH) repair including recurrence rates with possible risk factors, long-term patient reported outcome (PROM) and health care utilization related.

Methods
Medical records and additional clinical/radiological examinations of IH repairs performed 2002–2013 . Time to recurrence, risk factors, and hazard ratios were calculated. A questionnaire was used for PROM.

Results
299 IH repairs were performed. 260 (87%) with a sublay mesh, 15 (5%) with other mesh techniques and 24 (8%) with other techniques. The recurrence rates at 2, 5, 10, and 15 years were 7%, 9%, 11%, and 12%, respectively. Suture repair, obesity, small mesh size and wound infection were risk factors while a non-closed anterior aponeurosis was not. 9 out of 10 patients were satisfied, and 3 out of four were free of any discomfort. Risk factors identified for discomfort were women and patients younger than 65 years while mesh size was not. 7,1% hospital visits and 21,4% readmissions occurred and the reoperation rate was 7,2%.

Conclusions
The recurrence rate within 15 years was quite low and did not increase substantially with time. The larger the mesh, the lower the rate of recurrence. Closure of the anterior aponeurosis did not correlate to the rate of recurrence. Patient-satisfaction was high with low rates of long-term discomfort. Health care utilization mostly occurred within 2 months. Sublay mesh repairs were performed by applying a standardized regime. Based on current findings the regime now includes always aiming at placing a largest mesh possible.
OC-068 PORTUGUESE NATIONAL TRAINING IN HERNIA AND ABDOMINAL WALL SURGERY – THE RESIDENTS’ PERSPECTIVE
Authors: Pais D , Bolota J , Barreira A L , Rolo Santos C , Alves R , Botelho P 
Published: May 2023

Abstract
Abdominal Wall surgery is often considered the initial step in the training of General Surgery residents. However, that training is not standardized.
The resident committee of the Portuguese Society of Hernia and Abdominal Wall (SPHPA) conducted a survey to the general surgery community, addressing training in inguinal and incisional hernia surgery. Its aim was to analyze the reality of training in abdominal wall surgery in Portugal.
100 answers were validated - 43 from specialists and 57 from residents; 56 from district hospitals and 44 from central hospitals. 57 had a formal unit dedicated to the abdominal wall in their institution.
On the treatment of inguinal hernia, 99% responded that most corrections are open although 80% answered that laparoscopic corrections were performed in their institution. 65.7% answered that laparoscopic correction was reserved for specialists but 36% considered that it was appropriate to start perfoming it in the 3rd year of residency.
As for incisional hernia, 90% answered that most procedures were open corrections, although 88% stated that laparoscopic corrections were also performed. 52% answered that residents operate laparoscopically and 19% only started in the specialty; 34% consider it appropriate to start this training in the 3rd year of residency.
In conclusion, the abdominal wall is a focus of interest in General Surgery departments in Portugal, most of them having dedicated units. There is a disparity between the laparoscopic practice and the general opinion of when it should start, exposing the need for greater standardization of the surgical training.
OC-076 LAPAROSCOPIC TAPP REPAIR FOR A LUMBAR HERNIA. STEP-BY-STEP SYSTEMATIZATION
Authors: Santilli O , Santilli H , Nardelli N 
Published: May 2023

Abstract

Aim
Lumbar hernias are a rare clinical entity and surgical treatment is constantly evolving and changing. We propose a systematization step-by-step guiding a safe and effective repair with similar conditions to the inguinal region.

Material & Methods
The patient lies down in a dorsal decubitus position with a 45° elevation of the hernia side. The first port is in the umbilicus access, and the accessory ports are along the middle line. Start the dissection by marking the anatomical limits that involve the semilunar lines, epigastric vessels, spine, and imaginary line between the iliac crest and 11 th rib. Releasing the peritoneal flat until visualizing the psoas iliacus and quadratus muscles until the 11 th ribs, preserving the avascular plane avoids nerves and vascular damage. Hernia sac reduction. Placement of a polypropylene mesh (24×22 cm) covering all the dissected areas. Mesh fixation using absorbable sutures. Closure of the peritoneum.Vacuum maneuver and bulge compression.

Results
Systematic standardization was applied to all patients. The mean operative time was 90 min. Outpatient surgery was achieved with a fast return to usual activity. The procedures were performed without intraoperative complications, mortality, or conversion to open surgery.

Conclusions
The step-by-step guide for landmarks and tips provides a safe and effective repair of this rare entity. Finally, clinical studies are needed to measure the impact of this technique's implementation in lumbar hernia repair.
OC-077 ONE STOP MULTI-SPECIALTY CHRONIC POSTOPERATIVE INGUINAL PAIN CLINIC - IMPLEMENTATION OUTCOMES
Authors: Cocciolo F , Birch A , Al-Abbasi I , Pawlak M 
Published: May 2023

Abstract

Aim/Objective
The aim on this presentation is to assess patients’ feedback as well as the outcomes of individualised treatment plans for patients assessed in the multidisciplinary team (MDT) clinic. The primary endpoint was quality of life and pain improvement 3 months after receiving treatment.

Material and methods
All patients reviewed in MDT CPIP clinic in the Comprehensive Hernia Centre between July 2021 and July 2022 were included in the study. Patients feedback as well as MDT individualised treatment plans were assessed. The outcomes, Visual Analogue Scale (VAS) and modified Activity Assessment Scale (mAAS) 3 months post intervention have been audited against data collected prior to intervention.

Results
We have received 57 referrals during the investigated period. 40 patients underwent MDT assessment with 55% receiving treatment and entering follow-up stage. In that group 26% had surgery, 35% had invasive non-surgical treatment (local injections and radiofrequency ablation), 39% were qualified for pharmacological treatment, together with physiotherapy and psychological support. Follow up data was collected for 19/22 patients. All patients had reported moderate to significant pain (VAS 4–10) on initial assessment and a significant reduction in pain (&gt; 50% improvement in VAS) after treatment. Mean baseline mAAS score was 20.3± 7.3 (range 8 to 40). Mean change was - 10.6±2.6 with all patients reporting significant improvement (&gt; 50%). Moreover, on a scale from 0 to 5, the average satisfaction score was 4.5.

Conclusion
Developing a multidisciplinary clinic to assess patients presenting with CPIP improved patients’ experiences and outcomes. Enhancing patient-centred care.
OC-099 ROBOTICALLY-ASSISTED ENHANCED-VIEW TOTALLY EXTRAPERITONEAL (R-ETEP) TECHNIQUE FOR ENDOSCOPIC RETROMUSCULAR HERNIA REPAIR. A RETROSPECTIVE ANALYSIS OF OUR FIRST 99 CASES
Authors: Vogel R , Heinzelmann F , Buechler P , Mueck B 
Published: May 2023

Abstract

Introduction
The availability of robotics has marked the beginning of a new era in hernia surgery. Due to its tiltable instruments the robot grants a dexterity which is not comparable to any conventional minimally invasive approach. In 2019 we have established r-eTEP-repair in our hospital.
The objective of this analysis is to share our experience of the first ninety-nine cases.

Materials and Methods
A retrospective analysis was carried out of all patients who underwent a r-eTEP repair in our hospital from September 2019 to January 2023 using gathered data out of our hospital information system (ORBIS Dedalus).

Results
Within the study period, we operated on a total of 99 patients. In 27 patients an extraperitoneal transversus abdominis release (eTAR) was performed. Complete closure of the hernia defect was possible in all cases and an uncoated synthetic mesh was placed in the retromuscular plane. In 3 cases a partial open hybrid procedure with robotic transversus abdominis release was performed. The median defect size was 25cm2 (2,25–375 cm2). The median mesh size was 540 cm2 (260–1350 cm2). The postoperative complication rate was 6.06%. There was one intraoperative complication and no abdominal reoperations. Median length of hospital stay was 3 days (2–10).

Conclusion
eTEP is a safe and minimally invasive procedure for a retromuscular mesh placement. In combination with a transversus abdominis release, even complex findings can comfortably be treated endoscopically.
OC-105 PARASTOMAL HERNIA REPAIRS: A RETROSPECTIVE NATIONAL COHORT STUDY IN THE REPUBLIC OF IRELAND
Authors: Chan K Y , Raftery N , Abdelhafiz T , Rayis A , Johnston S 
Published: May 2023

Abstract

Aim
In the context of improving colorectal cancer outcomes, post-survivorship quality of life has become an important outcome measure. Parastomal hernias and their associated morbidity remain largely under-reported and under-appreciated. Despite their burden, conservative management is common. This study aims to provide a national overview on the current trends in parastomal hernia repairs (PHRs).

Material and Methods
All PHRs performed in the country between 1/2017 to 7/2022 were identified retrospectively from the National Quality Assurance and Improvement System (NQAIS) database. Anonymised patient characteristics and quality indices were extracted for statistical analysis.

Results
A total of 565 PHRs, 64.1% elective and the remainder emergent, were identified across 27 hospitals. The 8 national colorectal units performed 67.3% of all repairs. While 42.3% of PHRs were standalone procedures, reversal of Hartmann's procedure was the commonest simultaneous procedure in the remainder. The median age, ASA and Charlson Co-Morbidity Index were 64 years (24–97), 3(1–5) and 3(0–48) respectively. Mean length of stay (LOS) was 16.2 days (SD=29.8). 29.0% of patients had at least 1 emergency readmission in 12 months, with a corresponding 12% 30-day readmission rate. Linear regression analysis associated ASA (95% CI 0.58–16.1, p&lt;0.035) and emergency admissions (95% CI 5.9–25.5, P&lt;0.002) with a significantly longer LOS, with the latter also associated with more frequent emergency re-admissions (95% CI 0.18–0.82, p&lt;0.002).

Conclusion
Patients undergoing emergency PHR are subjected to longer stays and more frequent readmissions. A dedicated parastomal hernia registry will facilitate timely elective intervention, negating the undue morbidity and costs associated with emergency
OC-120 ROBOTIC TRANSABDOMINAL RETROMUSCULAR RECTUS DIASTASIS (R-TARRD) REPAIR - A NEW APPROACH
Authors: Tartaglia E , Cuccurullo D , Sagnelli C , Guerriero L 
Published: May 2023

Abstract

Aim
To present our innovative robotic approach for the treatment of rectus diastasis with concurrent primary or incisional ventral hernias.

Material & Methods
We performed 45 r-TARRD repairs for symptomatic rectus diastasis with concomitant associated ventral/incisional umbilical and/or epigastric hernias. Data on patient demographics, type of hernia, operative time, complications, recurrence rate and hospital stay were retrospectively analyzed. Follow-up was scheduled at 1 month, 6 months and 1 year after surgery.

Results
45 patients (13 M, 32 F) underwent r-TARRD repair. Mean age was 54,8 years (range 31–68) and mean BMI was 26,74 Kg/m2 (range 21,1–31). Mean ASA was 2,2 (range 1–3). In all patients we used a polypropylene mesh 25×15 cm, properly shaped. Mean operative time was 192 min (range115–260). Mean hospital stay 4,2 days (range 2–7). No conversion to laparoscopy or open surgery and no major complications occurred. At 1 month follow up one mesh infection (2,22%) was observed and it was treated conservatively. Four recurrences (8,88%) were reported at 1 year follow up.

Conclusions
Robot-assisted TARRD repair is conceived as a novel alternative minimally invasive procedure for RD with concurrent midline defects ensuring a primary fascial defect closure and mesh implantation in a sublay position with a wide overlap. It is important to better evaluate the suture that should be used to perform the repair and multicenter studies with standardization of patient's demographics, RD characteristics and long-term follow-up outcomes are mandatory to assess the effectiveness and durability of r-TARDD repair.
OC-125 PARASTOMAL HERNIA REPAIR WITH THE MODIFIED RETROMUSCULAR SUGARBAKER TECHNIQUE (PAULI PROCEDURE)
Authors: Gröger C , Kundel L , Adam U , Köckerling F , Riediger H 
Published: May 2023

Abstract

Aim
Parastomal hernia can be treated by retromuscular mesh placement with transversus abdominis release (Pauli procedure). Since then, we established it as our standard procedure and report on our perioperative results and initial follow-up data.

Material & Methods
During a 4-year period (1/2019–12/2022), 20 consecutive patients were treated by Pauli procedure. All patients were prospectively registered in the Herniamed database. Follow up was performed by patient interview or patient review.

Results
Pauli Procedures were mainly (75%, n=15) performed by minimal-invasive techniques (Laparoscopic n=14, open n=4, robotic n=1). Thirteen patients had a urostomy and seven had a colostomy. Median hernia diameter was 5 cm (3–13 cm, EHS classification for parastomal hernia: 9×I, 6×III and 5×IV). Median Mesh size was 310 cm2 (150–750). Perioperative morbidity was 15% (n=3, Clavien Dindo Grade II). Median hospital stay was 4 days (range: 3–17). Median follow up was 13 months (range 6–43) with a recurrence rate of 20% (urostomy n=3, colostomy n=1).

Conclusion
Pauli repair of parastomal hernia can be performed routinely by minimal-invasive techniques. The perioperative risk is low. Further studies are necessary to reduce the recurrence rate.
P-056 ADOPTING ROBOTICS IN A PRIVATE PRACTICE: FIRST EXPERIENCE AND PITFALLS
Authors: Serebrennikov A 
Published: May 2023

Abstract

Aim
Description of the adoption process, first experiences and pitfalls with a surgical robot for hernia surgery in a private practice.

Material & Methods
consecutive experience with the first 30 cases including redo cases for inguinal hernias with previous preperitoneal mesh placemen, previous prostate surgery and incional hernias.

Results
There were no complications. The usage of pain medication was significantly lower in comparison to “conventional” hernia surgery techniques. The preparations of the operating theatre for a robot adoption in a small day case unit was complex and required thorough planning and a talent for improvisation.

Conclusion
Robotic approach to hernia surgery is feasible and safe in a private practice setting with day cases. Using a robot potentially allows to minimize risks and complication rates and raise patient comfort. There are several pitfalls which can be avoided if known in advance.
P-063 Comparison of isokinetic dynamometer and strain gauge as measurement methods of abdominal wall strength in patients with abdominal hernia
Authors: Garcia Moriana A J , Sanchez Arteaga A , Tallon Aguilar L , Tinoco Gonzalez J , Feria Madueño A , Sañudo Corrales B 
Published: May 2023

Abstract

Aim
The goal was to analyse trunk flexion strength in patients undergoing incisional hernia surgery, obtaining the data using both isokinetic dynamometer (gold standard for the measurement of the abdominal wall strenght) and strain gauge.

Methods
Observational cohort study, including patients with incisional hernia (July-December 2022). Collected data were demographic characteristics, clinical characteristics related with the hernia, and measures of the abdominal wall strength using an isokinetic dynamometer and a strain gauge. Comparative analysis was performed using Pearson correlation test adjusted for body composition parameters.

Results
53 patients were enrolled (56,6% female) with a mean age of 57,42 age (SD 10,49). Mean BMI was 30,42 (SD 5,15), and mean maximum diameter of hernia defect was 6,75cm (SD 2,16). Bending force moment measurement was 80,23 N/m (SD 38,17). Results obtained with the strain gauge were: force peak with hip and knee flexion at 90° 171,1 N (SD 52,98), rate of force development (RFD) 523,29 N/s (SD 410,04). Adding 45° trunk rotation, peak force was 158,4 N (SD 42,76) and RFD 376,72 N/s (SD 288,74). Significant Pearson correlation indexes were found exceeding r= 0,641 for peak force and r= 0,305 for RFD (both at 90°), and r= 0,6 for peak force and r= 0,315 for RFD (both at 45°) when compared to isokinetic moment values.

Conclusions
In our group of study, we found a correlation between data obtained using isokinetic dynamometer and strain gauge. Further studies should analyze these associations controlling for other variables such as gender, age or hernia defect size.
P-067 PREHABILITATION IN A LOSS OF DOMAIN BILATERAL INGUINOSCROTAL HERNIA: USE OF BOTULINUM TOXIN AND PREOPERATIVE PROGRESSIVE PNEUMOPERITONEUM
Authors: Orellana León M , Lorenzo Mañas S , Vázquez Beltrán P , Vega Novillo V , Justo Alonso I , Butrón Vila T , Fernández Nöel S , Lavin Montoro L , Bernaldo De Quirós Fernández M , Falcón Bonilla K , Martínez Pozuelo A , Otero Torrón B 
Published: May 2023

Abstract

Aim
Describe the use of botulinum toxin A (BT) and preoperative progressive pneumoperitoneum (PPP) in a loss of domain inguinoscrotal hernia following our hospital's protocol.

Material and methods
Single case report of a 60-year-old male, with loss of domain bilateral inguinoscrotal hernia. We performed prehabilitation with respiratory physiotherapy (RP), BT and PPP. We applied BT 30 days before surgery, injecting a total of 500U in 12 sites of abdominal wall: 4 in the lateral abdominal muscle and 2 of them in each rectus abdominis. We calculated, using the Tanaka index, the ratio between the abdominal cavity volume (ACV) and the hernia volume (HV), which was 32%, as well as the amount of pneumoperitoneum to insufflate, which according to our protocol is HV x3 + 100cc.
The PPP catheter was placed 10 days before repair, insufflating a total of 6.900cc within seven consecutive days of catheter placement.

Results
With the application of prehabilitation (BT, RP, PPP) we achieve a lengthening of 18.5 cm and a decrease of 27 mm of the thickness as well as an increase in the volume of the abdominal cavity of×4.200cc.
Afterwards, a hernioplasty with Stoppa and bilateral Litchenstein technique was performed. as well as a scrotoplasty and circumcision for the patient's phimosis in collaboration with Plastic and Urology services.
The surgical procedure was performed without complications. After 7 months there is no hernia recurrence.

Conclusions
BT and PPP help to repair the inguinoscrotal hernia, avoiding the mayor surgical techniques like component separation diminishing morbidity.