bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-054 IMPLEMENTATION OF A SATISFACTION SURVERY IN HERNIA INTERNATIONAL COOPERATION CAMPAIGN
Authors: García Sánchez C J , Perea Del Pozo E , Alarcón Del Agua I , Butrón Vila T , Kingsnorth A , Padillo Ruíz F J 
Published: May 2023

Abstract

Aim
To assess the feasibility of implementing a survey in a surgical cooperation campaign to know about patients' demographics and satisfaction with service provided.

Material and methods
A survey was designed to collect data about demographics and satisfaction of each patient during our 5 days campaign in The Gambia. Satisfaction items were ranged from 1 to 5. Local nurses were trained to carry out the survey. We encouraged every patient to perform the survey before discharge.

Results
48 patients with hernia were operated. Groin hernioplasty was the most common procedure (45, 93,8%). 45 (93,8%) were men. Mean age was 52,2 years. Only 4 patients (8,3%) did not fill in the survey.
10 (23,8%) patients that filled in the survey were local. Between the foreign ones, median travel distance and time were 103 km (IQR 52–149 km) and 2 hours (IQR 1–3 hours), respectively. The most frequent means of transport was public transport (22, 75,9%). The most frequent job occupation was farmer (15, 31,3%), followed by local businesses (8, 16,7%).
About satisfaction items, all the mean punctuations were over 4,4. All the surveyed patients would recommend the campaign program, and only 2 patients (4,5%) didn't perceived a quality of care according to the cost of the public health services.

Conclusions
A satisfaction survey is a feasible way to study the target population of future cooperation campaigns in a specific destination. It allows to know if the campaign meets the standards of care according to the patient's opinion.
P-060 PREFORMED PATCH VS. FLAT PREPERITONEAL MESH FOR PRIMARY AND INCISIONAL HERNIA: A PROPENSITY-SCORE MATCHED ANALYSIS
Authors: Barranquero A G , Villalobos Mori R , Maestre González Y , López Soler G , Soto Pasamar J , Protti G P , Olsina Kissler J J 
Published: May 2023

Abstract

Aim
The MORPHEUS trial (Ponten et al. [2018]) reported better outcomes with a flat preperitoneal polypropylene mesh compared with a preformed patch for primary midline hernia repair. The aim was to evaluate our results with these meshes and to explore the recurrence factors.

Material & Methods
Observational retrospective study of patients undergoing hernia repair in a tertiary referral center. The preformed patch (PP) was used since April 2013, and the flat preperitoneal mesh (FPM) since March 2016. Recruitment finished in December 2021. A 3:1 Propensity-Score matching was performed to select cases for analysis.

Results
A total of 156 patients were analysed, 117 with PP and 39 with FPM. There were no differences in baseline characteristics, patients’ comorbidities, rates of midline (96.6% vs. 71.4%) or lateral hernias (3.4% vs. 28.6%) or in the proportion of primary (70.9% vs. 69.2%) and incisional hernias (29.1% vs. 30.8%) in PP and FPM groups, respectively. The median hernia defect was 2.5 cm (IQR: 2–3.22). There was a higher rate of defect closure in FPM (100%; 39/39) compared with PP group (12.8%; 15/117).
The recurrence rate was higher in the PP group, with 16.2% (19/117), compared to 2.6% (1/39) in the FPM group (p: 0.027) with a median follow-up of 33.6 months (IQR: 14.2–48.7). In logistic regression, there were no statistically significant differences between meshes (OR: 0.136 [CI95%: 0.018-1.050]), while BMI was a risk factor for recurrence and the defect closure was a protective factor.

Conclusion
Mesh choice did not influence hernia recurrence.
P-062 SEVERE COMPLICATION AFTER EVENTROPLASTY: NECROSIS OF RECTUS ABDOMINIS MUSCLES
Authors: Casanova-Ramos R , Rodríguez-González D , Tuñón-Fequant C , Guil-Ortiz B , Montes-Montero A , Arteaga-González I J 
Published: May 2023

Abstract

Aim
Rectus abdominis muscles are supplied mainly by superior and inferior epigastric arteries, forming an arcade between them. The ligation of one of them during a surgical intervention usually has no clinical repercussions. However, when both arteries flow are interrupted, there is another clinical scenario.

Material and Methods
We describe the case of a 74 years-old woman who was admitted for an elective surgery of fourth recurrence of a midline eventration (M2-5W3 European Hernia Society Classification). We treated using preoperative botulinum toxin and Rives-Stoppa surgical technique. On the second postoperative day, the patient suffered a cardiorespiratory arrest due to a pulmonary embolism, therefore anticoagulation was necessary. After anticoagulation the patient showed severe anemia (Hemoglobin 5 g/dL) and tomography computed scan images revealed a big hematoma of the abdominal wall with active bleeding.

Results
Embolization of both epigastric, right mammary and left pectoral arteries was performed by interventional radiologists. After 12 days, the patient showed cutaneous surgical wound dehiscence and serohematic foul-smelling fluid. We detected necrosis of the rectus muscles when we debrided the wound. It was treated with daily cures and vacuum therapy without mesh removal, achieving a progressive closure. After six months of follow-up, there are no signs of recurrence.

Conclusions
Ischemia of the rectus muscles is a severe complication after eventroplasty that can be treated with debridament of necrotic muscle and vacuum therapy, without removal of mesh if it is sufficiently extended along the healthy abdominal wall and cover the necrotic defect.
P-065 SYNTHETIC MESH VERSUS BIOLOGICAL MESH TO PREVENT INCISIONAL HERNIA AFTER LOOP-ILEOSTOMY CLOSURE: A RANDOMIZED FEASIBILITY TRIAL
Authors: Mäkäräinen E , Wiik H , Kössi J , Pinta T , Mäntymäki L M , Mattila A , Kairaluoma M , Ohtonen P , Rautio T 
Published: May 2023

Abstract

Aim
Up to one third of patients experience incisional hernia after loop-ileostomy closure. Biological meshes have been commonly used in contaminated surgical sites instead of synthetic ones due to complication concerns, previous data on the subject does not support this practice. The aim of this study was to evaluate the safety and efficacy of synthetic mesh compared to a biological mesh in incisional hernia prevention after loop-ileostomy closure.

Materials & Methods
A randomized, controlled, multi-center non-inferior feasibility trial was conducted from April 2018 – November 2021. Patients (n=102) were randomized 1:1 to receive either a light-weight synthetic polypropylene mesh (Parietene MacroTM, Medtronic) (SM) or a biological mesh (PermacolTM, Medtronic) (BM) to the retrorectus space at loop-ileostomy closure after anterior resection for rectal adenocarcinoma. The primary outcome was rate of surgical site infections (SSI) at 30-day follow-up and rate of incisional hernias at 10 months follow-up.

Results
In total, 102 patients were randomized, of which 97 received the intended allocation. Of patients in the SM group, 1/46 (2%) had SSI and in the BM group 2/48 (4%) had SSI (p&gt;0.90) at 30 days follow-up. One patient from each group underwent reoperation requiring mesh removal (p&gt;0.90). At 10 months follow-up, one patient (2%) in both groups had an incisional hernia on clinical examination (p&gt;0.90) at 10 months follow-up. None of the patients had underwent reoperation due to mesh or wound-related complications.

Conclusions
Both a synthetic mesh and biological mesh were safe and effective in incisional hernia prevention after loop-ileostomy closure.
P-066 SURGICAL TREATMENT OF RECTUS DIASTASIS WITH ASSOCIATED HERNIA: INITIAL EXPERIENCE IN A TERTIARY HOSPITAL
Authors: Rodríguez-González D , Tuñón-Féquant C , Casanova-Ramos R , Guil-Ortiz B , Montes-Montero A , Arteaga-González I J 
Published: May 2023

Abstract

Aim
Rectus diastasis (RD) is frequent and may be associated with abdominal wall hernias. Although a plication of the línea alba and mesh placement has been suggested to repair a RD associated with small hernias, numerous surgical techniques have been reported. We present our inicial experience in the treatment of RD and associated hernia (RDAH).

Material and Methods
We reviewed patients with RDAH treated surgically at our hospital from June 2021 to July 2022. The minimum follow-up time was 6 months.

Results
Forty one patients with RDAH were operated in our hospital with an average age of 59.3 years (range 27–83 years), 53.7% female, and 46.3% male. Mean BMI was 29.8 Kg/m2 (range 18.6–40.0 Kg/m2). Fourteen women (34.3%) had a mean of 1.9 previous pregnancies (range 0–4 pregnancies). The most common types of associated hernia with RD were primary midline hernia (51.2%), incisional hernia (26.8%), and recurrent midline hernia (19.5%). Most of the RD was M1-3 (90%) and W1-W2 (80.5%). The mean diameter of associated hernia was 3,1 cm (range 1–8 cm). We performed Rives (43.9%), midline plication with preperitoneal mesh (34.1%), midline plication with onlay mesh (19.5%) and Bezama-Murray technique (2.4%). Hematoma and respiratory failure (7.3%) were found in the first 30 postoperative days. No reccurence was recorded in the follow-up time.

Conclusions
Surgical treatment of RD in patients with RDAH could be recommended to prevent hernia recurrence. The choice of surgical technique should be adapted to the characteristics of the RD, the hernia and the patient.
P-069 TOTAL EXTRAPERITONEAL (TEP) APPROACH FOR THE TREATMENT OF SPIGELIAN HERNIAS: SINGLE-CENTRE EXPERIENCE
Authors: Ruano-Campos A , Pérez-Jiménez A E , García-Galocha J L , Sánchez Del Pueblo C , Gómez Latorre L , Peña Soria M J , Torres García A 
Published: May 2023

Abstract

Aim
Spigelian hernias are rare. Surgical treatment is often recommended. Different minimally invasive techniques are available by means of intraperitoneal or extraperitoneal mesh placement, either by IPOM, transabdominal preperitoneal (TAPP) or total extraperitoneal (TEP) approach. TEP approach is seldom reported in the literature. We present a short series of TEP repair of Spigelian hernias.

Materials and Methods
Between February and October 2022, TEP repair was performed in two patients with unilateral Spigelian hernia, one case of bilateral hernia, and one combined unilateral Spigelian and inguinal hernia, ensuing the following technique. Preperitoneal access was achieved placing a contralateral 11mm trocar, a few centimetres above the umbilicus, posterior to the rectus muscle toward Retzius space. A 5mm trocar was placed suprapubic and another 11mm trocar at the flank. Working space is developed by blunt dissection. Spigelian hernia sac is dissected and reduced. At this point other inguinal or femoral hernias are explored, performing simultaneous repair if necessary. Sufficient preperitoneal space is ensured to allow correct overlap of a polypropylene self-gripping mesh, prior to closing the defect with barbed-polydioxanone suture.

Results
Median age was 72 years. Three cases were right hernias and two left, all diagnosed by imaging test due to symptoms. Latest discharge was 24 hours after surgery. No complications or recurrences were encountered at a median follow-up of 4 months.

Conclusions
Comparative studies between minimally invasive approaches of Spigelian hernias are scarce. In the presented experience, TEP approach proved to be an efficient and reproducible technique with favourable results.
P-070 ROLE OF MESH AUGMENTATION IN TRAM FLAP DEFECTS AFTER BREAST RECONSTRUCTION: LITERATURE REVIEW
Authors: Alabbasi I , Cocciolo F , Birch A , Pawlak M 
Published: May 2023

Abstract

Aim
The aim of this study was to assess the problem of hernia occurrence in patients after transverse rectus abdominis flap in breast reconstructive surgery and the influence of using donor site reinforcement with mesh to prevent bulging and hernia.

Method
Literature searches were performed using databases, using key terms to include related articles in the last ten years.

Results
Out of 65 articles found by the research, 7 articles included in this review, risk factors were identified as obesity, smoking, unipedicule vs bipedicle, mesh vs non-mesh repair. 5 of the included articles involved retrospective study with 6 to 160 patients and follow up period 6 to 48 months, one double blinded study and one was cost utility study retrospective. it is showed that TRAM reconstruction associated with hernia in 18% and 63% had abdominal bulging. using mesh reinforcement reducing bulging 2% to 6% and hernia to 1% to 2%, Consideration should be given particularly in high-risk populations.

Conclusion
Although the literature about the best way to deal with TRAM defect has not been published yet, this review shows the important of mesh augmentation, it magnified the effect of that on patient with high risk for hernia or bulging.
P-072 INCIDENCE OF TROCAR SITE HERNIA AFTER LAPAROSCOPIC BARIATRIC SURGERY, A LONG TERM FOLLOW UP
Authors: López-Negrete E , Rodicio J , Suárez A , Amoza S , Moreno M , Noriega P , Montes A , Sanz L 
Published: May 2023

Abstract

Aim
Given the increased use of laparoscopic surgery, the possible complications associated with it must be considered. Trocar site hernias (TSH) are one of them, being more frequent in obese patients. With this study we want to know the importance of the problem and evaluate our own results.

Methods
We made an observational, descriptive, longitudinal and retrospective study in patients undergoing laparoscopic bariatric surgery with 12mm bladeless trocars without fascial closure between January 2015 and July 2016. They were interrogated about symptoms and postoperative infection in the ports, and an abdominal wall ultrasound were performed by an expert radiologist in December 2022.

Results
45 patients were included. The average age was 49.9 years-old (77.8% women) with a mean initial BMI of 45.5kg/m2 and actual BMI of 30.2 kg/m2. Among risk factors we found 31.1% of smokers, 46.7% of diabetes and 64.4% of respiratory pathology. The main surgery was gastric bypass (88.9%). 7 patients presented TSH (15.6%) and 6 patients presented symptomatology in any trocar site (13.3%), although only 2 (4.4%) showed hernia ecographically at the symptomatic port. We studied 189 ports and detected a 3.7% TSH in the control echography 6–7 years after surgery, all of them in the epigastric trocar.

Conclusions
The incidence of TSH after bariatric surgery with 12mm bladeless trocars is low considering patient´s characteristics. All the THS were in the midline port, which raises the possibility of systematic closure, change its position or contemplate this low incidence as acceptable considering its difficulty of closing.
P-074 SAILING ROUGH SEAS – MANAGING THE COMPLEX RECURRENT INCISIONAL HERNIA PATIENT WITH ADJUVANT TECHNIQUES – CASE REPORT
Authors: Santos G , Taré F , Costa C , Mogne T , Andrade N , Cordeiro B , Pinto F , Capote H 
Published: May 2023

Abstract

Aim
Case report regarding the repair of a complex incisional hernia, with loss of domain (LoD), where adjuvant techniques were used.

Materials and methods
Data from the patient's electronic chart and literature review.

Results
A 77-year-old female patient is referred for evaluation. She had a multi-recurrent incisional hernia, symptomatic with pain and recurrent episodes of intestinal occlusion. Clinical and imaging evaluation confirmed a complex incisional hernia with LoD, located in the left iliac and flank regions.
Abdominal wall muscle blockade was done with botulinum toxin. A progressive pneumoperitoneum catheter was placed laparoscopically, and 11 liters of air were instilled over 13 days. Imaging showed lengthening of the AW muscles.
Posterior component separation and transversus abdominis release was performed on the left side, and a retrorectus dissection the right side. A macroporous polypropylene mesh was attached on the left to the twelfth rib, psoas muscle, transverse process of lumbar vertebrae, iliac crest, Cooper's ligament and pubis, and on the right with transfascial sutures. A seroma developed on the post operative period. No other complications occurred.

Discussion
If a patient never had an AW reconstruction surgery, with a mesh on the retromuscular plane, this option should be offered, by a specialized hernia surgeon, regardless of the number of recurrences. Progressive pneumoperitoneum has existed for many years, but is seldom used. Likewise, botulinum toxin is emerging as a powerful tool to prepare AW reconstruction, but much is still unknow. Heterogeneity in the data is a hinderance to the wide adoption of these techniques.
P-077 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL HERNIA REPAIR (TAPP): OUR EXPERIENCE IN 200 PATIENTS
Authors: Rodríguez Haro C , García-Sancho L , García Virosta M , Hernández O'reilly M , Mellado Sánchez I , Gajda J , Ferrero Celemín E , Martínez Alegre J , Vaquero Pérez M A , Sánchez López J D , Picardo Nieto A L 
Published: May 2023

Abstract

Aim
To review and report our experience in the laparoscopic hernia treatment.

Material & Methods
It's a retrospective observational study including all patients who underwent a laparoscopic transabdominal preperitoneal hernia repair (TAPP) in our hospital between January 2016 to April 2022.

Results
From a total of 190 patients, 92% were male with a median age of 55,7 years old. Most of the cases were a primary hernia repair (81%) and 51,6% had bilateral presentation.
Regarding the type of mesh employed, 89,1% were Adhesix®, 7,5% were Progrip® and 3,2% were flat polypropylen meshes. Tackers were used to fix the mesh only in a 11,2% of the patients.
To close the peritoneum flap an absorbable barbed suture was used in a 94% of the cases, while tackers in a 5,9%.
No intra-operative complications were described and 91,5% of surgeries were performed on an outpatioent basis.
Concerning complications on the first fllow-up month: 7 patients suffered pain (3,4%) and 7 hematoma/seroma.
Long-term complications were: chronic pain in 4 patients (2 with Adhesix®, 1 Progrip®, the forth one unknown; in none of them tackers were used); recurrence happened in 14 patients (7,6%) (11 Adhesix®, 2 Progrip®, 1 flat polypropylen mesh; tackers were used in three of these patients to fix the mesh).

Conclusions
Adhesix® mesh was the most employed (89,1%) and the one with the lowest recurrence rate (6,6%). According to our experience, tackers aren't necessary when an auto-adhesive mesh is used. Although they weren't related with postoperative pain, they didn't seem to prevent recurrence eiher.
P-083 LAPAROSCOPIC APPROACH TO RECURRENCE OF URETEROINGUINAL HERNIA: A CASE REPORT
Authors: Gajda Escudero J , Sánchez López J D , García-Sancho Téllez L , Picardo Nieto A L 
Published: May 2023

Abstract

Aim
The aim of this communication is to present an exceptionally rare type of hernia and its surgical management.

Material and methods
We report the case of a 66-year-old male with recurrence of inguinal hernia. A routine Computed Tomography scan revealed as an incidental finding the ureter forming a loop within the hernia sac. Additional findings included pyelocaliceal duplicity and ureteropelvic dilatation.

Results
An attempted transabdominal peritoneal repair (TAPP) was performed, with dissection of the ureter. To prevent adhesion formation with the ureter, no mesh was placed. An inguinal incision and suture of the deep inguinal ring was performed. The patient was discharged the same day, with no associated complications.

Conclusions
Ureteroinguinal hernia is a rare presentation, but with potentially serious complications. Knowledge of its existence is important in view of the possibility of its incidental finding. There are approximately 140 cases described in the literature, the vast majority of which involve ectopic kidney. Our case presented an inguinoureteral hernia on native kidneys and obstructive voiding symptoms. The laparoscopic TAPP approach allows identification and safe dissection of the ureter. Due to the low frequency of this pathology, there is no consensus on the placement of the mesh in the peritoneal space due to the risk of adhesion of the ureter. Therefore, in our case we opted for an open repair of the hernia.
P-087 LAPAROSCOPIC TREATMENT OF TROCAR SITE HERNIA: A SINGLE-CENTER EXPERIENCE
Authors: Chiari D , Ricchitelli S , Moroni M R , Sorrentino M , Frascarelli A , Platto M , Rovagnati M , Zuliani W 
Published: May 2023

Abstract

Introduction
Trocar site hernia (TSH) is a complication of minimally invasive surgery that is often underestimated. These lesions cause patient discomfort and require surgery for their correction. Although there are some case reports for laparoscopic repair of TSH, there is data missing in the literature about this specific topic. The aim of this study is to evaluate safety and efficacy of the laparoscopic repair of TSH.

Methods
We collected data regarding 213 patients submitted to incisional hernia repair in the Department of General Surgery at Humanitas Mater Domini Clinical Institute in Italy since 2011 and 2019.
We selected the patients submitted to laparoscopic repair of a TSH with an intraperitoenal mesh. We evaluated the clinical and surgical characteristics of the patients and the following outcomes: post-operative hospitalization, complications and long-term recurrences.

Discussion
Forty-two out of 213 patients were operated for a TSH. Forty out of 42 patients (95.2%) were treated with a laparoscopic approach. Follow up: 60 months. Study group: females (62.5%), mean BMI 29.1. According to EHS (European Hernia Society) classification, 35 patients had a midline defect. In 77.5% of cases a ePTFE/PP mesh was implanted. Mean hospitalization: 2 nights. The complication rate was low (1 surgical site infection, 1 seroma and 1 hematoma), without re-intervention. We observed 2 cases of recurrence (5%) developed after 5 months and 36 months, respectively.

Conclusions
Laparoscopic repair of TSH is a safe approach, in absence of specific contraindications. Our experience suggest that a laparoscopic approach could obtain satisfying results.
P-088 OMENTUM PROTECTED IPOM (OPIPOM) – NOVEL TECHNIQUE OF VENTRAL HERNIA REPAIR
Authors: Skach J , Blecher V , Verner T 
Published: May 2023

Abstract

Aim
It is known from experience that adhesions of the small intestine and bands forming adhesions of the omentum are especially potentially dangerous (ileus, fistulas, chronic pain). Therefore, with this technique, we create a space where the mesh and the small intestine come into no contact and the omentum adhesion is controlled to form flat. The aim of our work was to verify this assumption and include this method as safe and effective.

Materials and methods
We perform this by fixind the omentum to the abdominal wall in a line below the hernia defect. The next step is to perform a standard IPOM, but with the use of a lightweight large-pore mesh without anti-adhesive surface treatment and fixing it with stitches. We called it omentum protected IPOM (OpIPOM). We included three departments in the initial multicenter comparative study. From 2017 to 2020, we selected a group of 80 patients originály indicated for retromuscular hernioplasty according to Rives-Stoppa(RS). For comparison of RS and OpIPOM, the method of surgery was dedicated by lot just before the operation in a ratio 1:1.

Results
The average operating time, duration of postoperative drainage,the length of hospitalization, occurence of surgical site infection and complicated seroma favor OpIPOM. Hernia recurrence within two years was for the both methods the same.

Conclusion
The technique is simple, safe, cheaper then IPOM, faster then RS and with a shorter recovery. From our experience controlled adhesion is also not a technical problem of redo laparotomy.