bluuebunny/crossref_metadata_2025_split huggingface dataset:
V-002 Robotic suprapubic eTEP retrorectus repair for incisional hernia
Authors: Vierstraete M , Muysoms F 
Published: May 2023

Abstract

Aim
A retrorectus mesh position is often considered the most suitable for the repair of a midline incisional hernia. The minimal invasive extraperitoneal approach is gaining popularity.

Material & Methods
A 56-year-old female patient, who had a laparoscopic deroofing of a bile cyst in her history, presented with an incisional midline hernia (EHS M2-M3, width 6.6 cm). Preoperative optimization via dietary instructions reduced her BMI from 40 kg/m2 to a BMI of 35 kg/m2.

Results
A robotic extraperitoneal approach via suprapubic docking was performed. The patient is positioned supine and flexed for 15° at the level of the spina iliaca. An intraperitoneal trocar is placed to explore the abdomen for adhesions. Three trocars are placed in the suprapubic position in the extraperitoneal plane whereafter the robot is docked. A dissection in the cranial direction is performed in the retrorectus plane by incising both posterior rectus fascia in a symmetric way. A preperitoneal plane behind the linea alba is created. At the level of the hernia defect the hernia sac is opened, and adhesions are freed. Once the retrorectus space is dissected up to the xyphoid, the linea alba is reconstructed with a barbed suture size 0. A self-fixating mesh is placed in the retrorectus position. The posterior layer of the peritoneum is closed. The postoperative course was uneventful.

Conclusions
We present an extraperitoneal minimal invasive approach to the retrorectus plane allowing for an adequate retrorectus dissection and mesh placement like in a classical Rives-Stoppa repair.
V-004 ROBOTIC PARASTOMAL HERNIA REPAIR WITH RETROMUSCULAR MESH (PAULI TECHNIQUE)
Authors: Rodríguez González D , Guil-Ortiz B , Tuñón-Féquant C , Casanova-Ramos R , Montes-Montero A , Arteaga-González I J 
Published: May 2023

Abstract

Aim
Parastomal hernia is a common complication of ostomy formation. We present a case of robotic parastomal hernia repair with retromuscular mesh (Pauli technique).

Material and Methods
Patient was 58 years-old man and had history of anterior resection of the rectum, terminal colostomy and onlay mesh parastomal hernia repair. After 2 months of parastomal hernia repair, the patient developed a recurrence (type III, European Hernia Society Classification).

Results
Robotic parastomal hernia repair was performed with transabdominal approach. Firstly, a small adhesiolysis of the colon to the stoma orifice was made. Then, the peritoneum and posterior sheath of the left rectus muscle was incised. The retrorectal space was dissected. The hernia sac was incised circumferentially. TAR dissection was launched lateral to the stoma. After the development of the landing zone for the mesh, the posterior retromuscular fascia was incised lateral to the stoma. The inner orifice of stoma was repositioned. A large-pore polypropylene mesh (20×28 cm) was placed in the retromuscular space and fixed it, lateral to the ostomy orifice. Finally, the retromuscular pocket was closed by suturing the posterior fascia to the linea alba. The patient was discharged on postoperative day 4 and had no complications. After 4 months of follow-up, no hernia recurrence had been recorded.

Conclusions
Robotic Pauli is a technique to repair parastomal hernias that provides wide coverage of the defect and avoids leaving mesh intraperitoneally. They could provide a secure repair and prevent postoperative complications (pain or intestinal ileus). It is technically challenging but feasible.
V-005 Robot assisted parastomal hernia repair of an ileal conduit stoma
Authors: Vierstraete M , Muysoms F 
Published: May 2023

Abstract

Aim
The optimal surgical treatment of a parastomal hernia after ileal conduit urinary division has yet to be determined. Data is scarce and reported recurrence rates after different approaches in parastomal hernia repair remain high.

Material & Methods
A 65-year-old male patient, who had a history of a radical cystectomy with an ileal conduit urinary diversion, presented with a recurrent symptomatic parastomal hernia. He had a previous repair of his parastomal hernia via an open retromuscular approach with a unilateral posterior component separation (transversus abdominis release).

Results
A robot assisted repair of the recurrent parastomal hernia was performed using a partial intraperitoneal onlay mesh technique (PIPOM). Intraoperatively, intraluminal Indocyanine green (ICG) was used to identify the ileal conduit loop. A closure of the defect was performed with a barbed suture whereafter the repair was reinforced with a PVDF IPST ‘Chimney’ parastomal mesh. The latter being partially covered by peritoneum. The postoperative course was uneventful, and the patient went home on postoperative day one. The patient had no complications and a well-functioning ileal conduit stoma 6 weeks after surgery.

Conclusions
The repair of a recurrent parastomal hernia after ileal conduit urinary division represents a surgical challenge. After a previous retromuscular approach, a robotic assisted approach using a partial intraperitoneal onlay mesh technique (PIPOM) represents a feasible technique with promising results.
V-009 Robot-Assisted Repair of a Traumatic Hernia After a Pelvic Fracture: Case Report and Literature Review
Authors: De Troyer A , Allaeys M , Eker H , Berrevoet F 
Published: May 2023

Abstract

Aim
Traumatic abdominal wall hernias (TAWH) are an uncommon clinical entity, accounting for less than 0.2% of all blunt trauma injuries. Management and operative technique are still a matter of debate and the role of the robotic surgical platform in traumatic hernias has not been reported on. We present a robot-assisted repair of a TAWH through a fracture of the left iliac wing. We aim to describe our operative approach and perform a review of the literature.

Material and methods
A 46-year-old male with a history of a high energetic trauma presented with a symptomatic swelling in the left lumbar region. Further imaging showed an important defect of the abdominal wall caused by a disruption of the iliac and gluteus muscles and non-union of a left iliac wing fracture. This caused a herniation of the descending colon. A robot-assisted transabdominal preperitoneal hernia repair (TAPP) with synthetic mesh was performed in elective setting.

Results
The postoperative course was uneventful. Discharge was possible at postoperative day one. There was no surgical site infection, seroma, or recurrence after a follow-up period of 6 months.

Conclusions
To our knowledge, we describe the first robot-assisted repair of a TAWH through a pelvic fracture. Our technique was safe and feasible. In difficult to reach areas of the abdomen, a robot-assisted repair might be a valid approach. Larger studies are needed to confirm our initial experience in traumatic abominal wall hernia surgery.
V-011 STEPWISE ABDOMINAL WALL RECONSTRUCTION OF THORACOLUMBAR HERNIA AFTER RESECTION OF CHODROSARCOMA OF X AND XI RIB
Authors: Garcia Ureña M A , Medina M , Avilés A , Morejon S , Vaello V , Martinez J , Robin Valle De Lersundi A , Cruz A , Lopez Monclus J , Blazquez Hernando L A 
Published: May 2023

Abstract

Aim
Thoracolumbar hernias may be the result of previous surgery involving costal resection or operative access. They can also develop after trauma or cough. The abdominal wall reconstruction in these defects can be a real challenge. Our aim is to present a stepwise approach for a preperitoneal mesh repair. The advantage of this video is that the previous resection of ribs allowed a complete exposition of the posterior abdominal wall.

Methods
This is a 61 years-old man, that underwent costal 2 consecutive resections for chondrocostal tumor of X and XI ribs and mesh reconstruction. The patient developed soon an incisional hernia. The patient was set in a modified decubitus position. A stepwise retromuscular preperitoneal dissection was planned: 1 subdiphragmatic, 2 iliac, 3 posterior and 4 medial. The overextended dissection reached the central tendon, linea alba, psoas, quadratum lumborum and ipsilateral Cooper ligament. After closing the peritoneum, a 50×50 mid-density polypropylene mesh was implanted in the preperitoneal retromuscular position over an absorbable mesh that helped to create the 3D dimensional configuration of the lateral and posterior abdominal wall (“taco” configuration). The ribs were approximated and fixed to the mesh with mesh-sutures. Finally, the muscle layers and skin were closed.

Results
The patient was discharged uneventfully on 5th postoperative day. Up to 6 months of follow-up the patient remains without pain and with a continent abdominal wall.

Conclusions
Applying the concept of giant reinforcement of visceral sac (Stoppa) to the posterolateral abdominal wall may help to manage these challenging situations.
V-016 TAPP APPROACH FOR A GIANT INGUINOSCROTAL HERNIA
Authors: Serrano González J , Díaz Pérez D , Román García De León L , Colao García L , Hernández Bartolomé M , Almeida Romera N , Esteban Agustí E , Galindo Jara P 
Published: May 2023

Abstract

Aim
We present the case of a patient with giant inguinoscrotal hernia and the laparoscopic approach performed.

Material & Methods
54yo Male, no medical history except for BMI41. He is evaluated in outpatient clinic for asymptomatic left inguinoscrotal hernia of ten years of evolution. He denies digestive symptoms. Difficulty in urination without symptoms of obstruction.
On examination, 20×15cm left not reducible inguinoscrotal hernia extending to the mid-thigh.
Minimally invasive approach, TransAbdominal PrePeritoneal, was performed. The content of the hernia is a long portion of sigma and a large amount of fat from the greater omentum. After returning them to the abdominal cavity with the help of pressure from the outside, the TAPP technique was performed without incident, with localization of elements of the spermatic cord. Polypropylene mesh 12×15cm fixed with tackers and cyanoacrylate is placed.

Results
the patient was discharged on the 4thPO day with no incidents. Subsequently he developed a large seroma that required percutaneous drainage and heart failure that caused large scrotal edema, resolved with diuretic treatment. Ten months later there is no recurrence.

Conclusions
Giant inguinoscrotal hernia is a surgical challenge. Anterior or posterior approach, open or minimally invasive, can be performed. Sometimes intestinal resection and/or orchiectomy is required. The need for preoperative conditioning with botulinum toxin and even pneumoperitoneum can be considered.
We presume that, when possible, the minimally invasive posterior approach is the best technique for these large defects since it provides the best surgical field in the most resistant plane for inguinal hernia repair.
V-021 MIDLINE RESTORATION VIA EMILOS TECHNIQUE
Authors: Giacone Aguiar J A , Valinoti A C , Olivero A A , Sadava E E 
Published: May 2023

Abstract

Aim
In recent years, numerous minimally invasive techniques have been developed for the repair of midline hernias associated with diastasis recti. The eMILOS technique (Endoscopic mini/less open sublay technique) allows midline repair with mesh placement in the retromuscular space through a small trans-hernial incision without entering the abdominal cavity.

Material & Methods
We present a case of a 45 year-old male who complained of umbilical bulge and pain. On physical exam, an umbilical hernia measuring 2cm was observed, associated with 5cm diastasis recti. Midline restoration via eMILOS approach was decided. In this technique, a transhernial endoscopic approach is performed with two 5mm ports on both flanks, allowing a complete dissection of the retromuscular space. First, a sublay approach of the umbilical hernia is performed. The hernial content is reduced and the posterior sheath is closed. Then, we place a homemade device (consisting of a wound protector, a surgical glove and a port) to perform the endoscopic approach. When the retromuscular space is completely dissected, both anterior and posterior sheaths are closed with barbed sutures. A large heavy polypropylene mesh is placed and fixed with absorvable tackers and glue. Afterwards, the endoscopic step is over and the ports are taked out, the umbilical fascia is closed with a running suture and the umbilicus scar is fixed.

Results
The patient presented a favorable evolution, with no recurrence a year postoperatively.

Conclusions
The eMILOS technique is a safe and effective alternative for the treatment of diastasis recti associated with midline defects.
V-023 ETEP REPAIR OF AN M2-3 W2 INCISIONAL HERNIA WITH AN ASSOCIATED SPIEGEL HERNIA. A CASE REPORT
Authors: Medina Pedrique M , Aviles Oliveros A , Morejon Ruiz S , De Robin Valle De Lersundi A , Martinez Caballero J , Vaello Jodra V , Muñoz Rodriguez J , García-Ureña M Á 
Published: May 2023

Abstract

Aim
To describe a case of an extended-view totally extraperitoneal approach for both an M2-3 W2 incisional hernia with an associated right Spiegel hernia.

Material & Methods
A 68a female with a previous medical history of a midline laparotomy after diffuse peritonitis presented with a midline bulge in the upper third of the previous surgical wound. Preoperative CT scan showed a midline hernia of 4cm and found a right-sided Spiegel hernia of 3cm. Endoscopic treatment of both defects was offered and accepted.

Results
Patient was placed in supine position. Retromuscular space was created using blunt dissection with a balloon, which helped with direct visualization. Two 5mm trocars were placed in the left pararectal region. Dissection was performed and crossover from left to right was achieved following standard eTEP procedure. Reduction of preperitoneal fat was performed, and midline defects identified. Dissection was continued to the Retzius space and Cooper's ligaments. Identification and reduction of the Spiegel hernia followed. After completing the dissection of the retro rectus and preperitoneal space, primary closure was performed. A lightweight polypropylene mesh was deployed. No complications ocurred and discharge was on the 2nd day.

Conclusions
Treatment of incisional hernias is in evolution, as minimally invasive techniques have developed greatly since their description and now have a more widespread use among surgeons. eTEP is a novel approach that can be used for the treatment of midline incisional and some primary hernias, as shown in the case, with satisfactory short-term results and similar long-term outcomes to other techniques.
V-028 HYBRID (LAPAROSCOPIC AND OPEN) REPAIR WITH REVERSE TAR TO TREAT A LATERAL INCISIONAL HERNIA WITH DENERVATION OF THE RIGHT ABDOMINAL MUSCLES
Authors: Maillo C , López-Monclús J , Sacadura Fonseca J , Oliveira G , Tavares K , Figueiredo N 
Published: May 2023

Abstract

Aim
Lateral incisional hernias with denervation of the muscles of the abdominal wall are a problem difficult to solve. The repair of the defect does not guarantee a functionality of the abdominal muscles if the lack of force of the abdominal wall is not solved.
With the technique we present there is a minimally invasive reinforcement of the mid lateral wall affected.

Material and Method
54 yo female. Previous surgeries: biliary cystadenoma 2014 by Makuuchi laparotomy (2 surgeries), Ooforectomy 2011, Hysterectomy 2013, Mamoplasty 2001, 3 vertebral surgeries. Six months after the surgery she felt a growing lump in the right side of the incision. Physical exam: right lateral incisional hernia and small umbilical hernia. Asymmetry of the abdominal wall because of flaccidity of the right abdominal muscles.

Ultrasound
Voluminous incisional hernia in the right flank dependent of the right transverse sub-costal incision with a hernia ring of 20mm and hernia sac 60mm of diameter increasing with Vasalva maneuvers.

Surgical technique
Hybrid approach laparoscopic and lateral by e-TEP to dissect the retrorectal bilateral space and lateral preperitoneal approach with reverse TAR. A macroporous polipropilene preperitoneal mesh is placed from the right psoas to left semilunar line and from top to bottom of the abdominal wall.

Result
Discharged 2nd po. day without complications. 5 months after surgery she has a symmetric abdominal wall without recurrence.

Conclusion
Hybrid technique to repair lateral hernias with denervation allows a wide repair with low morbidity and good tolerance with excellent result in abdominal functionality.
V-029 TRANSABDOMINAL LAPAROSCOPIC MANAGEMENT OF RECURRENT LUMBAR HERNIA (GRYNFELT)
Authors: Trujillo Díaz J , Martinez Moreno C , Gómez López J R , Concejo Cutoli P , Atienza Herrero J , Martin Del Olmo J C 
Published: May 2023

Abstract

Aims
Lumbar hernias are very rare defects of the posterior abdominal wall.They can be classified as Grynfelt in the upper lumbar space(it is the most frequent) and Petit in the lower lumbar triangle. Its treatment can be performed by open approach, or by laparoscopic approach(TAPP or TEP), observing a lower incidence of recurrences and postoperative pain by laparoscopy.

Methods
Video-case.

Results
78-year-old female who attended the clinic presenting a lump that had been increasing in size and was causing pain in the left upper lumbar region. Surgical histories: open lumbar hernioplasty(2018). Physical examination: recurrent left-lumbar hernia(Grynfelt).CT-scan: left-lumbar hernia(defect:45mm) with colon into the hernial sac and a large paraesophageal hiatal hernia. Since the hiatal hernia also needs to be treated, we decided to perform a laparoscopic TAPP-approach to treat the lumbar hernia.The patient was placed in the right lateral decubitus. We use 3 ports(1×12mm,2×5mm) to perform the surgery and place a 10×15cm PVDF mesh fixed with Tisseel and closed the peritoneum with V-Lock 3-0.The patient presented a satisfactory evolution without complications and was discharged in 1°POD. No recurrence.

Conclusion
Lumbar hernias are a disease with a very low incidence, so there is no clear consensus on the best surgical treatment.Our group think the laparoscopic approach in this type of hernia, whether through the transabdominal(TAPP) or extraperitoneal(TEP) approach, is the most appropriate, since it offers the advantages of minimally invasive surgery(less postoperative pain, shorter LOS) and &lt;postoperative complications related to the surgical site and a lower incidence of hernia recurrence have been reported.
V-030 LAPAROSCOPIC TAPP MCBURNEY'S INCISIONAL HERNIA REPAIR: A CASE REPORT
Authors: Vera Vasquez C A , Lupu I , Alonso V , Ye Zhou Y , Gonzalo Prats B , Solans Solerdelcoll M , Gonzalez Lopez J A , Moral Duarte A 
Published: May 2023

Abstract

Background
Lateral incisional hernia surgery represents an underappreciated challenge for general surgeons. McBurney's incisional hernia (L3) after appendectomy is rare, with an incidence between 0.1 and 0.9%. Several studies have found fewer postoperative complications with the laparoscopic approach compared with open approach.

Objective
To show a video of a transabdominal preperitoneal (TAPP) approach for McBurney's incisional hernia associated with a small right lateral inguinal hernia.

Method
We report a case of a 52 years old man, with previous open appendectomy in 2013, diagnosed with McBurney's incisional hernia (L3W2R0) and small right inguinal hernia (L1M0F0P). The patient was scheduled for laparoscopic TAPP incisional hernia repair.

Results
The patient was operated as ambulatory surgery with no intraoperative complications. No recurrence nor other complications detected during short, 4th month, follow up after surgery.

Conclusions
Minimal invasive hernia repair with preperitoneal mesh of lateral abdominal hernias cause less postoperative pain, have a short hospital stay, lower incidence of surgical site and mesh infection, and possibly can reduce recurrence as a wider mesh overlap of the defect is possible. This technique has shown to be feasible and reproducible in selected cases.
V-035 TRANSVAGINAL EVISCERATION, LAPAROSCOPIC APPROACH
Authors: Serrano González J , Román García De León L , Hernández Bartolomé M , Martínez Campos D , Zabala Salinas J , Colao García L , Gallardo Herrera A B , Galindo Jara P 
Published: May 2023

Abstract

Aim
We present the laparoscopic approach of a case of transvaginal evisceration after hysterectomy.

Material & Methods
50 yo Female, with a history of bilateral ovaric and endometrial endometroid carcinoma, for which bilateral laparoscopic anexectomy and subsequent hysterectomy and cytoreduction surgery were performed two months earlier. She consulted to emergency department for metrorrhagia and abdominal discomfort of one week's evolution. Physical examination revealed a dehisced vaginal vault with evisceration of small bowel loops. Abdominal CT scan was performed in which other intra-abdominal complications were ruled out. Urgent surgical intervention was decided and a minimally invasive approach was proposed.
During the operation, dehiscence of the vaginal vault was observed without other findings. The separated edges are refreshed and a running suture is performed with a barbed suture. As reinforcement, a titanized polypropylene mesh was placed and fixed with cyanoacrylate.

Results
The patient was discharged on the 2nd postoperative day without incident.

Conclusions
Transvaginal evisceration is a rare complication that usually occurs after hysterectomies. If it is not possible to reduce the contents, it can cause suffering of the herniated structures. The treatment consists of closing the defect and acting on the complications it may cause. The minimally invasive approach provides the already known benefits for the patient and a better vision and surgical field for the surgeon.
V-037 LAPAROSCOPIC REPAIR OF FORAMEN OF WINSLOW HERNIA CONTAINING THE RIGHT COLON
Authors: Kapsampelis P , Saunders J , Prce D , Shah I A , Gerogiannis I 
Published: May 2023

Abstract

Aim
A 74-year-old woman with hypothyroidism, dyslipidaemia and past abdominal surgeries presented with severe abdominal pain, nausea, bloating and anorexia. On clinical examination, the abdomen was soft with tenderness on palpation in the epigastrium. The laboratory workup revealed leukocytosis. Abdominal CT showed the caecum, the ascending colon, and the hepatic flexure herniated in the lesser sac through the Foramen of Winslow. Even though the initial plan was conservative management, the hernia was persistent and not resolving in the repeat CT scan. A decision was made to proceed with laparoscopic exploration. We aim to present a video of a laparoscopic repair of a Foramen of Winslow hernia.

Material and methods
Laparoscopy revealed free intrabdominal fluid and part of the right colon in the lesser sac. The hernia was reduced manually, and the colon was inspected, revealing no signs of ischemia. As the caecum was very mobile, a caecopexy was performed by suturing the cecum and the ascending colon to the lateral abdominal wall using non-absorbable interrupted sutures. The operation was performed with three ports, a 10 mm infraumbilcal port for the scope and two 5 mm ports in the right lower quadrant of the abdomen.

Results
Recovery was uneventful, and the patient was discharged the following day. In follow-up, pain and bloating had completely resolved, and her quality of life was significantly improved.

Conclusions
This was a challenging case from the technical and the decision-making point of view, with a good outcome and no complications.