bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing safety in ventral patch repair for umbilical hernia by utilizing a hybrid technique
Authors: Jhaveri Ruchir , Kalikar Vishakha , Modi Rajan , Patankar Roy 
Published: August 2023

BACKGROUND:
Both suture and mesh repairs are used for smaller (1-3 cm) umbilical hernias. But primary repair has a higher recurrence rate in literature. The use of mesh repairs has become the way to go for small and medium sized ventral hernias. Ventral patch placement is a simple and effective procedure for the repair of umbilical hernias of 1–3 cm size. We demonstrate the safety and efficacy of the ventral patch for the same with our modification of the technique in 100 consecutive patients. We would initially insert the patch as described by the company, but had one patient presenting with intestinal obstruction, who on diagnostic laparoscopy had a small bowel loop entrapped between the patch and the anterior abdominal wall. This brought about a change in the original technique at our institute, which we adopted for all patients thereafter.

MATERIALS AND METHODS:
A single centre retrospective analysis of prospectively collected data was done. Our modified technique was done in 100 consecutive patients with umbilical hernia defect size ranging from 1 cm to 2.5 cm, from January 2017 to January 2021. Demographics, post-operative pain, duration of hospital stay, surgical site occurrences (early and late), post-operative complications and recurrences were noted.

RESULTS:
A total of 100 patients were included in the study. Two patients had superficial surgical site infection which was managed conservatively. We did not record any other major complications or recurrence. Visual analogue scale for pain was recorded at 24 hours. Majority (95%) of the patients had none to mild pain and were discharged at 24 hours. Five patients experienced moderate pain and were discharged at 36–48 hours. No patient experienced chronic pain at follow up.

CONCLUSION:
The hybrid technique of the ventral patch placement is a safe way for optimum visualization for the correct mesh placement and may improve results, decrease complications and recurrences.
Laparoscopic inguinal hernia repair: A comparison of transabdominal preperitoneal and total extraperitoneal techniques—Results of initial experiences
Authors: Ergenç Muhammer , Gülşen Taygun 
Published: August 2023

Abstract

Aims:
This study aimed to analyze the results of transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) repairs performed by two authors and to compare two laparoscopic methods.

Materials and Methods:
Patients who underwent inguinal hernia surgery in a secondary-care hospital between 2019 and 2022 were evaluated retrospectively. Demographics, hernia side and type, primary or recurrent hernia situation, size of hernia orifice, operation type, postoperative complications, duration of operation, length of hospital stay, recurrence, and follow-up time were examined. Perioperative outcomes were compared between the two groups.

Results:
One hundred and eleven patients were analyzed. The mean age was 49.4 ± 13 years, with a male/female ratio of 106/5. About 82% of hernias were unilateral, and 18% were bilateral. Sixty-four TAPP and 47 TEP repairs were performed. Follow-up time (months, mean ± standard deviation) (range) was 14.2 ± 10 (1–37). About 42.3% of the hernias were direct, 49.5% were indirect, and 8.1% were pantaloon hernias. The recurrence rate was 1.8%. The operation time was significantly lower in the TEP than in TAPP (64.4 ± 23.5, 96.7 ± 31.9, respectively, P < 0.001). TAPP was preferred in patients with larger hernia orifices (P = 0.01). The two groups had no significant difference regarding postoperative complications and recurrence rate.

Conclusion:
Our study did not detect any significant difference between TAPP and TEP repair regarding recurrence rate and postoperative complication. Laparoscopic inguinal hernia repair, which has advantages such as short hospital stay and less pain, can be safely performed in a secondary-care hospital.
De Garengeot hernia: A case report and classification
Authors: Sutedja Barlian , Rudiman Reno , Susanto Nelly , Siswanto Ardine Yew 
Published: August 2023

Abstract
Laparoscopic repair of De Garengeot hernia is recommended for its association with decreased postoperative pain and faster return to normal activities. A 65-year-old female patient presented with painful right inguinal swelling, and surgery was indicated due to suspected omentum incarceration in a femoral hernia detected via computed tomography. Laparoscopic transabdominal preperitoneal repair with appendectomy was performed, with satisfactory postoperative results and no evidence of recurrence after 2 years. Placing polypropylene mesh preperitoneally provides a natural barrier against potential sources of infection, and it is recommended to improve postoperative outcomes.
Current opinions in inguinal hernia emergencies: A comprehensive review of related evidences
Authors: Kulacoglu Hakan 
Published: August 2023

Abstract

INTRODUCTION:
Groins hernia emergencies are evaluated under two definitions: incarceration that is defined as a hernia in which its content becomes irreducible at the passage in the abdominal wall and strangulation that compromises the blood supply to the omentum and/or intestines within the hernia sac. The purpose of this paper was to determine the latest knowledge about groin hernia emergencies.

MATERIALS AND METHODS:
PubMed and Google Scholar searches were done by using combinations of “inguinal hernia” and “emergency”, and “groin hernia” and “emergency” keywords at first. More detailed searches were performed to enrich the “Surgical treatment” part of the paper by using “emergency hernia” and “mesh”, “emergency hernia,” and “laparoscopic versus open” keywords afterward.

RESULTS:
Approximately 5%–10% of all inguinal repairs are performed in emergency settings. Both lateral and medial inguinal hernias can get incarcerated or strangulated, whereas the risk for femoral hernias is higher. Manual reduction of incarcerated inguinal hernias is successful in approximately 60% of the cases. The prediction of bowel ischemia due to strangulation may be possible with some blood tests and imaging studies like ultrasound and computed tomography. It has been shown that the longer the duration of incarceration the higher the risk of bowel ischemia. Bowel resection which is more frequently necessary in patients with advanced age, female gender, and femoral hernia, is associated with an increased risk of perioperative mortality. Some surgeons still use tissue-suture repairs in an emergency setting; however, mesh repairs have been shown to be safe unless there is an overt contamination.

CONCLUSION:
Early treatment of complicated groin hernias is the key to favorable outcomes. The need for bowel resection and advanced age are the most prominent factors for morbidity and mortality. Mesh repairs are safe in most cases. Minimally invasive approaches promise good results in experienced centers.
A single-blind, randomized study comparing clinical equivalence of Trulene® polypropylene mesh to Prolene® polypropylene mesh in subjects undergoing lichtenstein open repair of primary inguinal hernia secured with sutures
Authors: Hangloo Vijay , Babu Tippana V S S Naga , Bhattacharya Sanjoy Mohan , Agarwal Nikhil , Moharana Ashok Kumar , Deepak T S 
Published: August 2023

Abstract

BACKGROUND:
Inguinal hernia is the most frequently diagnosed abdominal wall hernia. Lichtenstein open repair involving mesh fixation lowers the recurrence rate and risk of postoperative complications. This study compared the clinical equivalence of Trulene® polypropylene mesh (Healthium Medtech Limited) and Prolene® (Ethicon-Johnson & Johnson) polypropylene mesh with respect to recurrence rate of hernia in subjects undergoing Lichtenstein open repair of primary inguinal hernia, secured with sutures.

MATERIALS AND METHODS:
Between September 2020 and November 2022, this multicentric, randomized (1:1), single-blind, prospective, two-arm, parallel-group study (n = 120) was conducted. The primary study endpoint, proportion of subjects having recurrence of hernia within 6 and 12 months of index surgery, was assessed. The secondary endpoints, pain score, number of analgesics, postoperative complications, operative time, length of hospital stay, need for readmission, time to resume back to normal activities and return to work, other adverse events, subject satisfaction score, and quality of life (QOL) postoperatively were also recorded.

RESULTS:
During the 12-month follow-up period, no recurrence of hernia was recorded. In addition, no significant differences regarding intraoperative mesh parameters, pain score, number of analgesics, postoperative complications, operative time, length of hospital stay, readmission, time to resume normal activities and return to work, and subject satisfaction score and QOL were recorded between Trulene® and Prolene® mesh groups.

CONCLUSION:
Trulene® polypropylene mesh is clinically equivalent to Prolene® polypropylene mesh. Both meshes are safe and effective for Lichtenstein open repair of primary inguinal hernia with minimal risk of hernia recurrence and chronic pain.
Traumatic lumbar hernias, when should I operate? A case report
Authors: Alharmoodi Fatima , Ghabra Shadin , Chebli Ali Ahmad , Alharthi Salem , Al-Bahri Shadi 
Published: August 2023

Abstract
Traumatic lumbar hernias are a rare subset of abdominal wall hernias encountered following blunt trauma to the abdomen. These are more commonly being found due to the increased use of advanced imaging. Three cases of traumatic lumbar hernias were identified at our institution from 2021 to 2022, one of which underwent delayed repair. The second case resulted in the resolution and healing of the defect within 6 weeks of presentation, and the third was lost to follow up. Acute repair of lumbar hernias might be indicated during the repair of other intra-abdominal injuries. Delayed repair allows for a laparoscopic approach or open repair via flank incisions. Delay in asymptomatic patients may also result in fibrosis and scarring and may resolve the defect. Fixation of mesh to adjacent bony structures may be needed, and adequate sub-lay dissection for mesh placement particularly for larger defects. Consider delaying the repair of traumatic lumbar hernias in asymptomatic to minimally symptomatic patients if no other abdominal surgery was warranted at the time of presentation.
A minimally invasive approach for the treatment of encysted hydrocele of the canal of Nuck in adult female: A case report
Authors: Bilaskar Rajeev P , Thorat Santosh D , Dhaigude Balaji D 
Published: August 2023

Abstract
The canal of Nuck is the female equivalent of the patent processus vaginalis in the male. Abnormality of canal of Nuck is a rare clinical condition amendable with surgical intervention. It usually presents as a swelling in the inguinal region in pediatric age group. However, their presentation in an adult women is very rare. Intraabdominal contents including intestine, uterus, fallopian tube, and ovaries are prone to herniate though the unobliterated processus vaginalis. Hydrocele of the canal of Nuck (HCN) may develop in these patients which may be misdiagnosed with the other differential diagnosis. In this case report, we emphasize on reporting minimally invasive surgical intervention of HCN by transabdominal preperitoneal approach in a of tertiary care hospital.
Robot-assisted repair of incisional hernia of the abdominal wall: Which access is better—endoscopic totally extraperitoneal preperitoneal plasty (eTEP) or mini- or less-open sublay (e)(MILOS), some first considerations
Authors: Vogel Robert , Heinzelmann Frank , Büchler Peter , Mück Bjoern 
Published: August 2023

Abstract
Numerous metanalyses have shown that the retromuscular mesh placement is superior to other positions in terms of recurrence and complication rate. As a result, there has been a surge in novel minimally invasive retromuscular surgical techniques. We compared total extraperitoneal plasty (eTEP) and hybrid Mini/Less-open-Sublay [(e)MILOS] with respect to their adaptability to a surgical robotic system. Unfortunately, there is little to no literature regarding robotic adaptation of the (e)MILOS procedure, which made it rather difficult to juxtapose, but then again also implies that it is not commonly performed. As many benefits as the robot brings to endoscopic surgery, however, there is one major constraint when it comes to directionality. In eTEP dissection is performed in one direction and the trocars are positioned at the edge of the dissection field. The centripetal preparation of the (e)MILOS procedure is less suitable for the currently available systems and would naturally require multiple un- and re-dockings of the robot. Alternatively, the robot could only be used for a minor part of the operation. Looking at the published data concerning laparoendoscopic (e)MILOS and eTEP, there appears to be no significant difference in terms of major complications as well as reoperation and infection rates. However, a comparison to a robot-assisted eTEP cannot be done due to lack of publications. Judging from our own experience, we believe the eTEP technique to harness the advantages of the robot in addition to those of minimally invasive surgery more effectively. Within the last two decades, we have been experiencing a constant increment of endoscopic procedures in hernia surgery. This surge is nonetheless thanks to the availability of robotics in a continuously increasing number of hospitals in Europe and the United States. The combination of the advantages of minimally invasive surgery and robotic systems has been discussed and elaborated on many occasions and platforms. Hence, the goal of this analysis is to compare two broadly established minimally invasive (or less open) retromuscular methods in hernia repair surgery with regard to their adaptability to a surgical robot.
Seroma-prevention strategies in minimally invasive inguinal hernia repair
Authors: Ng Trina Priscilla , Loo Brandon Yong Kiat , Chia Clement Luck Khng 
Published: August 2023

BACKGROUND:
The rise of minimally invasive inguinal hernia repair has seen both the laparoscopic and robotic approaches increase in popularity in recent years. Despite this, seroma formation remains a common complication, and the aim of this study is to evaluate the current evidence on seroma-prevention strategies in minimally invasive inguinal hernia repair.

MATERIALS AND METHODS:
Four databases (PubMed, Scopus, Embase, and Cochrane Library) were searched from inception to November 15, 2021. All studies describing the use of intraoperative adjuncts to reduce postoperative seroma formation in patients undergoing laparoscopic or robotic inguinal and inguinoscrotal hernia repair were included. Meta-analyses were performed using Review Manager (Version 5.4).

RESULTS:
2,382 articles were identified in the initial database search, and 40 articles were included in the final analysis. In this analysis, there was a significantly lower incidence of seroma formation in the drain group when compared to the no-drain group (P < 0.00001). Other strategies aimed at reducing the dead space involving the transversalis fascia (TF) and hernia sac such as TF inversion with tacking, Endoloop closure of TF, barbed suture closure of TF, distal sac fixation, and complete dissection of the sac have shown promising results as well.

CONCLUSIONS:
While there is currently insufficient evidence to recommend the routine use of any one of the interventions analyzed, the use of drains, the management of the TF, and the hernia sac have showed potential in reducing seroma formation.
Robot-assisted repair of primary uncomplicated inguinal hernia: comparisons to conventional laparoendoscopic repair
Authors: Limper Bernhard , Kamrath Lukas 
Published: August 2023

Abstract

BACKGROUND AND METHOD:
Robotic hernia surgery is progressing more and more, so that the robotic procedure is also used in the groin. We compared our patients who were operated on laparoscopically using the TEP technique with patients who were operated on robotically using the TAPP technique.

RESULTS:
The rTAPP can be safely performed without any problems and has many advantages, but the operating time is significantly longer than the laparoscopic TEPP.

CONCLUSION:
Inguinal hernia surgery can certainly be learned quickly and effectively as an introduction to robotics. It remains to be seen whether it will prevail in terms of surgical time and economics.
Robotic transversus abdominis release for ventral hernia repairs
Authors: Nguyen Tiffany , Kunes Kristina , Crigler Christine , Ballecer Conrad 
Published: August 2023

Background:
Robotic transversus abdominis release (roboTAR) is a minimally invasive surgical approach for ventral hernia repairs that builds on the concepts developed by Rives and Stoppa. The Rives–Stoppa procedure incorporates Rives’ retromuscular repair and Stoppa’s concept of giant prosthetic reinforcement of the visceral sac (GPRVS).[1] In an effort to mitigate the limitations of the Rives–Stoppa procedure, Novitsky et al. developed the open transversus abdominis release (TAR). The TAR approach is favorable when repairing large ventral hernia defects, as it provides myofascial advancement to reconstitute linea alba, preserves the neurovascular bundles of the medial abdominal wall, and creates a large extraperitoneal space to allow for mesh reinforcement.

Methods:
The three main technical components of the roboTAR include the following: bottom-up, Novitsky method, and top-down approach. An understanding of the anatomy and technique involved in the three techniques is critical for performing roboTAR.

Results:
Within the authors’ practice, the average hernia defect size is 115 cm2. With a n = 200, approximately 1% of our patients has had a surgical site complication. Recurrences are rare and occur in very large complex hernias. The average operative time is approximately 400 min with an average length of stay being 1.2 days. This is consistent with others.

Conclusion:
Utilizing a minimally invasive approach, as seen in roboTAR, provides additional advantages, including shorter length of hospital stay, reduced wound morbidity, reduced postoperative pain, and expedited return to work and activities of daily living. This article is a comprehensive review of the pertinent anatomy, preoperative evaluation, operative technique, and the postoperative course of roboTAR.
Robot-assisted repair of complicated inguinal hernia: Advantages in comparison with conventional repair
Authors: Allaeys Mathias , Poortmans Natalie , Berrevoet Frederik 
Published: August 2023

Abstract
The adoption rate of robot-assisted surgery has skyrocketed in recent years, despite limited evidence, an unclear clinical benefit, and an increase in cost. The laparoscopic approach to inguinal hernia repair by either transabdominal or extraperitoneal approach has gradually gained traction owing to distinct advantages over traditional open repairs. Although robotic inguinal hernia repair has been established as a safe alternative to conventional laparoscopy, as of yet no superiority has been proven. We aim to give an overview of certain clinical situations, in which the robot might be advantageous. Specifically, we discuss inguinoscrotal hernia repair, inguinal hernia repair after prostatectomy, and mesh explantation. In our opinion, robotic systems are an invaluable tool in the case of mesh resection or recurrence after previous anterior and posterior repairs. With the increased expansion of the surgical tools and techniques to repair abdominal wall problems, a definitive and clear rule as to which cases should be handled robotically and which should not will be difficult and probably unattainable. We are very much proponents of a tailored approach, where every individual case deserves its surgical plan, bearing in mind all aspects of a patient, with the aim of the best surgical outcome.
Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic
Authors: Adamou Harissou , Amadou Magagi Ibrahim , Habou Oumarou , Magagi Amadou , Sani Rachid 
Published: August 2023

OBJECTIVE:
To describe epidemiological, therapeutic, and prognostic aspects of groin and ventral hernia in adults at Zinder National Hospital.

MATERIALS AND METHODS:
This was a retrospective data collected over a period of 10 years (January 2012–December 2021). All patients aged at least 18 years operated for abdominal wall hernia were included. A value of P < 0.05 was considered significant.

RESULTS:
A total of 921 patients were included. In these patients, groin hernia was present in 78.8% (n = 726), umbilical hernia in 13.25% (n = 122), linea alba hernia in 7.3% (n = 67), and Spiegel’s hernia in 6 cases (0.65%). The mean age was 48 ± 17.2 years. Men accounted for 80.9% (n = 745). Rural origin was 67% (n = 623) and poor 63.8% (n = 588). The stage of hernia strangulation represents 32% (n = 295). The median time to surgical consultation was 8 years. This delay was associated with rural origin (odds ratio [OR] = 1.42; P = 0.0142), poverty status (OR = 1.67; P = 0.0001), and inguinal location (OR = 1.75; 0.0371). General anesthesia was used in 58.7% (n = 541). Bowel necrosis was seen in 9.33% (n = 86). For all groin hernias (n = 783), 96.2% (n = 753) underwent herniorrhaphy and 3.8% (n = 30) underwent a Lichtenstein procedure. For all ventral hernias herniorrhaphy was performed in 95% (n = 245) and mesh repair in 5% (n = 13). Morbidity was 15.4% (n = 142) and mortality 1.74% (n = 16). This was associated with age over 60 years (OR = 3.06; P = 0.0341), ASAIII and ASAIV classes (OR = 5.21; P = 0.015), complicated clinical forms (OR = 4.87; P = 0.023), emergency surgery (OR = 4.51; P = 0.003), and the occurrence of bowel necrosis (OR = 4.11; P = 0.001). The median follow-up was 6 months (range: 3–36 months). Overall, hernia recurrence was recorded in 69 cases or 7.6%. This was associated with emergency surgery (OR = 6.26; P = 0.000) and age over 60 years (OR = 3.02; P = 0.000).

CONCLUSION:
In our context, the management of groin and ventral hernias is an important activity for the surgeon. Inguinal hernias predominate and hernia strangulation is an element of poor prognosis.
Robotic transabdominal preperitoneal morgagni hernia repair technique
Authors: Janowski Courtney , Sioda Natasha , Liu Siwen , Sabatino Alissa , Ballecer Conrad 
Published: August 2023

Robotic transabdominal preperitoneal Morgagni hernia repair: A step-wise approach.
Morgagni hernia (MH) is an atypical and rare type of diaphragmatic hernia that presents surgical challenges given its location and proximity to vital structures. Classically, these hernias have been repaired either open or laparoscopically with the use of an intraperitoneal onlay mesh without defect closure. Borrowing from the groups’ excellent experience in robotic transabdominal preperitoneal hernia repair (rTAPP) ventral and atypically located hernias, this approach has shown promise in repairing MHs in albeit a small cohort of patients. The rTAPP technique in our opinion overcomes many of the challenges and pitfalls associated with atypical hernias, including those of the diaphragm, providing excellent visualization and facilitating wide preperitoneal dissection with a complete reduction of the hernia sac located in the anterior mediastinum. The wide preperitoneal exposure allows for directed diaphragmatic closure, minimizing the risk of injury to mediastinal structures, placement of a large uncoated mesh sandwiched in between layers of the abdominal wall, and safely targeted fixation at cardinal points. Preperitoneal mesh allows for the use of a more cost-effective uncoated mesh that is not exposed to the viscera. It also allows for minimal and targeted fixation without the use of tacks, leading to decreased postoperative pain and complications. In this article, we are detailing the rTAPP approach in managing MHs.