bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-021 TRANSVERSUS ABDOMINIS MUSCLE RELEASE FOR THE TREATMENT OF COMPLEX BILATERAL SUBCOSTAL INCISIONAL HERNIAS
Authors: Medina Pedrique M , Avilés Oliveros A , Morejon Ruiz S , San Miguel Méndez C , Muñoz Rodriguez J , López Monclus J , De Robin Valle De Lersundi A , García-Ureña M Á 
Published: May 2023

Abstract

Aim
To assess the outcomes of abdominal wall reconstruction for subcostal incisional hernias through a new approach. We present our results of posterior component separation through the previous incision as a safe and reproducible technique for complex cases.

Material & Methods
A multicenter and prospective cohort of patients diagnosed with bilateral subcostal incisional hernias on either clinical examination or imaging based on computed tomography from 2014 to 2020 was gathered. The outcomes reported were short and long-term complications, including recurrence, pain, and bulging. Quality of life was assessed with the European Registry for Abdominal Wall Hernias Quality of Life score.

Results
A total of 46 patients were identified. All patients underwent posterior component separation. Surgical site occurrences occurred in 10 patients (22%), with only 7 (15%) requiring procedural intervention. During a mean follow-up of 18 months (range, 6–62 months), 1 (2%) case of clinical recurrence was registered. Also, there were 8 (17%) patients with asymptomatic but visible bulging. The European Registry for Abdominal Wall Hernias Quality of Life score showed a statistically significant decrease in the 3 variables (pain, restriction, and cosmetic) of the postoperative scores compared with the preoperative score.

Conclusion
Posterior component separation technique for the repair of subcostal incisional hernias through the same incision is a safe procedure that avoids injury to the linea alba. It is associated with acceptable morbidity, low recurrence rate, and improvement in patient's reported outcomes.
OC-022 Quality and Quantity Matter - Incidence of Incisional Hernia Following Common Abdominal Surgeries by Abdominal Surgical History: A United States Population-based Analysis of 945,262 Patients
Authors: Habarth-Morales T , Rios-Diaz A , Davis H , Broach R , Serletti J , Fischer J 
Published: May 2023

Abstract

Objective
Patients with prior abdominal surgery (prior-AS) may have increased risk of developing incisional hernia (IH) at the time of subsequent abdominal surgery (AS). We hypothesized that prior-AS history is associated with increased incisional hernia (IH) formation and that the risk is higher for prior IH repair (prior-IHR).

Methods
Patients undergoing common AS operations (bariatric, cholecystectomy, small/large bowel resection, prostatectomy, and gynecologic) were identified and followed-up for 1-year using Statewide Inpatient/Ambulatory Databases (2009–2016; FL, IA, NE, NY, UT). Prior-AS history was ascertained within 3-year period preceding the index operation. Risk-adjusted Cox regression examined the association of surgical history with IH.

Results
Of 945,262 patients, 8.55% had prior-AS. Median age was 49 years, most patients were female (68.95%), undergoing open (80.5%) elective (74.5%) AS. Risk-adjusted revealed increased IH risk by surgical history: prior-AS (HR 1.36 [95%CI 1.25–1.48]), multiple prior-AS (2.0 [1.67–2.46]), prior-IHR (3.4 [2.99–3.66]), and multiple prior-IHR (3.56 [2.5–4.28]; Figure). For every additional prior-AS and prior-IHR there was an increase in IH by 9.7% (95%CI 1%-18.6%) and 22.5% (15.6%-29.9%), respectively.

Conclusion
Both the type and number of previous AS are associated with increased risk for IH, particularly in patients with prior-IHR, and multiple prior operations. These findings demonstrate that reoperation through a previously-disrupted abdominal wall poses technical challenges that impact long-term morbidity, and underscore the need to consider preventive measures at the time of subsequent AS.
OC-024 THE IMPACT OF THE INTRODUCTION OF ROBOT-ASSISTED SURGERY ON A DEDICATED VENTRAL HERNIA PROGRAM
Authors: Marckmann M , Willaume M , Jensen K K 
Published: May 2023

Abstract

Aim
The role of a robot-assisted approach in hernia surgery remains controversial due to the high costs associated with robotic surgery and the proposed equal outcomes compared to open surgery. In the current study, we report the 30-day results of the introduction of robot-assisted approach in a dedicated regional ventral hernia repair center.

Material & Methods
This was a retrospective single-center cohort study, including consecutive patients undergoing ventral hernia repair from 2017 to 2022. To reduce the risk of bias, patients undergoing robotic and open repair were matched by propensity scores in a 1:2 ratio on the variables age, type of hernia (primary/ventral) and horizontal fascial defect size. Multivariable logistic regression was performed.

Results
A total of 109 patients undergoing robotic repair were compared to 231 undergoing open repair, of which 61.2% were incisional and 38.8% primary hernias. Mean hernia defect size was 4.9×6.5 cm (horizontal x vertical). The mean length of stay was lower after robotic repair (0.1 vs. 1.9 days, P &lt; 0.001) as was the incidence of readmission (3.7% vs. 15.2%, P &lt; 0.001). The incidence of reoperation was insignificantly lower after robotic repair (0.9% vs. 4.8%, P = 0.139), however after adjusting for confounders there was a significantly reduced risk of reoperation after robotic compared to open repair (OR 0.08, CI 0.01–0.92, P = 0.043).

Conclusions
The introduction of a robotic approach was associated with significantly improved postoperative outcomes.
OC-025 PROSPECTIVE STUDY OF THE ANALGESIC EFFICACY OF A CYCLOMESH™ PARIETAL REINFORCEMENT IMPLANT SOAKED IN ROPIVACAINE IN THE TREATMENT FOR UNCOMPLICATED INGUINAL HERNIA
Authors: Regimbeau J M , Study Group H 
Published: May 2023

Abstract

Background
The objective of this study was to evaluate the interest of a parietal prosthesis (Cyclomesh ™) soaked with ropivacaine in the management of early postoperative pain.

Materials and Methods
This is a randomized, phase III, comparative superiority, double-blind, international multicentre study. 290 patients (October 2019 February 2022) underwent surgery for inguinal hernia, by Liechtenstein technique, under general anaesthesia, and with placement of a ropivacaine or saline soaked parietal prosthesis. The primary endpoint was the coughing pain assessment (EVA) at H6. The secondary endpoints were the overall pain assessment at H2, H4 and H6 and the evaluation of the painkillers consumption.

Results
The prosthesis type had no significant effect on the coughing pain at H6, either for the ITT population (3.3 vs 3.2, p=0.12) or for the PP population (3.3 vs 3.7, p=0.15). The ropivaciane soaked prosthesis resulted in a decrease in the overall pain at H2 (2.3 vs 3.2, p&lt;0.0001), H4 (2.3 vs 3.1, p&lt;0.0001) and H6 (2.3 vs 2.7, p=0.0039). Regarding the painkillers consumption, the postoperative complications and the number of ambulatory conversions, there was no difference between the two groups.

Conclusion
The placement of a parietal prosthesis (Cyclomesh ™) soaked with ropivacaine did not reduce the coughing pain at H6 but allowed a decrease in the overall pain over the first 6 hours after the surgery and could simplify the management of patients.
OC-027 RANDOMISED CONTROLLED TRIAL OF THE DESARDA TECHNIQUE AND SUTURE REPAIR FOR OBSTRUCTED INGUINAL HERNIA
Authors: Awan Z N , Hanif M 
Published: May 2023

Abstract

Aim
Open inguinal hernia repair remains one of the most commonly performed operations worldwide. For elective surgery, mesh implantation is an established global ‘gold standard’. However, for emergency repair of obstructed hernia, non-mesh techniques may be utilised. We designed a randomised controlled trial to compare the open, non-mesh ‘Desarda’ against non-mesh suture darn repair in the treatment of obstructed inguinal hernias.

Materials & Methods
A prospective randomized controlled trial was undertaken between Feb and Aug 2020 at the Emergency Unit, of a busy hospital in a resource-constrained setting. To identify a true difference in operating time, a sample size of 100 patients was calculated using WHO calculator. Exclusion criteria were patients ASA 3+ or with recurrent or strangulated intestine; ethical approval was obtained from the hospital Ethics’ Committee and informed consent obtained from all participants. Randomisation was by the sealed opaque envelope method. Data analysis by SPSS version 25 using Student t-test; p-value ≤0.05 was considered significant.

Results
Total 100 patients were included (71 male and 29 female). Mean age of patients: 39.1 years±6.1SD. Mean operative time was significantly lower in Desarda group (50.5±1.7) compared to sutured repair (58.8±2.1SD) p=0.000. Intra-operative and immediately postoperative complications were not identified in any of the patients. Patient reported outcomes will be reviewed at the 2-year point.

Conclusion
In this RCT of emergency repair of obstructed inguinal hernia, Desarda's repair was safe and effective and took significantly less surgical time compared to a standard sutured darn repair. Longer term, patient reported outcomes are awaited.
OC-029 E- MILOS EXTRAPERITONEAL MESH REPAIR OF UMBILICAL HERNIAS WITH COMBINED RECTUSDIASTASIS
Authors: Pokorny H , Koo P S , Hofmann M , Schlögl M , Reznicek K 
Published: May 2023

Abstract

Aim
Umbilical hernias with combined rectusdiastasis have a higher risk für recurrence after single repair of the umbilical hernia. The E- MILOS concept enables the minimal invasive sublay mesh repair realizing the benefits of minimally invasive surgery and placing the mesh in the retromuscular position.

Materials & Methods
All E- MILOS operations were documented prospectively. For 1 year follow-up all patients received a questionnaire.

Results
From January 2019 to December 2022, 89 patients (24 female/65 male) with umbilical hernia and a coexisting rectus diastasis (median hernia size 2 cm/diastasis recti 5,5 cm) and median age of 61 yrs were operated by 3 experienced surgeons. In all cases a polypropylene mesh (median size 40×12 cm) was implanted in the retromuscular space without any fixation and continuous suture (V-Loc 2–0) of the anterior and posterior rectus sheet was achieved for reconstructing the midline. The average skin incision was 4,5 cm; median operation time was 125 min. The median hospital stay was 5 days, the postoperative median pain score (VAS) was 2. Two patients needed reoperation due to a retromuscular haematoma. Chronic pain was reported by 13 patients, no postoperative infection and 4 recurrences were observed. Not satisfied with the cosmetic result (subcutaneous bulging) were 4 female patients.

Conclusions
The E- MILOS technique allows minimally invasive transhernial repair of umbilical hernias with combined rectusdiastasis using large retromuscular meshes with low morbidity. The technique is reliable and easy to standardize and shows mostly good cosmetic results.
OC-030 COMPARISON OF OUTCOMES OF THE EXTENDED-VIEW TOTALLY EXTRAPERITONEAL RIVES-STOPPA (ETEP-RS) AND THE INTRAPERITONEAL ONLAY MESH WITH DEFECT CLOSURE (IPOM-PLUS) FOR W1-W2 MIDLINE INCISIONAL HERNIA REPAIR
Authors: Taşdelen H A 
Published: May 2023

Abstract

Aim
This study aimed to compare the outcomes of the eTEP-RS and IPOM-plus procedures in W1 and W2 midline incisional abdominal wall hernia (IAWH) repairs performed by the same surgeon.

Material and Methods
Prospectively collected data of laparoscopic abdominal wall repairs performed on 61 patients with eTEP between November 2018 and April 2022 and on 67 patients with IPOM-plus between January 2016 and April 2022 were retrospectively analyzed. A total of 74 out of 128 patients, 30 in the eTEP-RS group and 44 in the IPOM-plus group, who underwent W1-W2 midline incisional hernia repair were included in the study. The mean follow-up was 24 months in the eTEP-RS group and 45 months in the IPOM-plus group.

Results
There was no statistically significant difference between the groups regarding age, sex, BMI, ASA score, or active smoking. The mean mesh area (MMA) and mesh/defect (M/D) ratio were higher in the eTEP-RS group (p &lt;0.001 and p =0.004). In the eTEP-RS group, the hospital length of stay (LOS) (1.48 days vs. 2.58 days, p &lt;0.001) and pain on the first and 10th postoperative days were significantly lower (p &lt;0.001), while the operative time was significantly longer (p &lt;0.001). There was no significant difference in terms of intraoperative complications (p =0.56), seroma formation (p =0.83), or recurrence (p =0.83).

Conclusions
The eTEP-RS technique has advantages over the IPOM-plus approach, such as a shorter LOS and less early postoperative pain with W1-W2 midline IAWH repair. However, the eTEP technique has a longer operative time.
OC-033 SHORT-TERM OUTCOMES OF MINIMALLY INVASIVE RETROMUSCULAR VENTRAL HERNIA REPAIR USING AN ENHANCED VIEW TOTALLY EXTRAPERITONEAL (ETEP) APPROACH: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Aliseda D , Sanchez-Justicia C , Zozaya G , Almeida A , Blanco N , Sabatella L , Uriz A , Martí-Cruchaga P , Rotellar F 
Published: May 2023

Abstract

Background
The enhanced view totally extraperitoneal (eTEP) approach is becoming increasingly more widely accepted as a promising technique in the treatment of ventral hernia. However, evidence is still lacking regarding the perioperative, postoperative and long-term outcomes of this technique. The aim of this meta-analysis is to summarize the current available evidence regarding the perioperative and short-term outcomes of ventral hernia repair using eTEP.

Study Design
A systematic search was performed of PubMed, EMBASE, Cochrane Library and Web of Science electronic databases to identify studies on the laparoscopic or robotic enhanced view totally extraperitoneal (eTEP) approach for the treatment of ventral hernia. A pooled meta-analysis was performed. The primary endpoint was focused on short-term outcomes regarding perioperative characteristics and postoperative parameters.

Results
A total of 13 studies were identified involving 918 patients. Minimally invasive eTEP resulted in a rate of surgical site infection of 0% [95% CI 0.0–1.0%], a rate of seroma of 5% [95% CI 2.0–8.0%] and a rate of major complications (Clavien-Dindo III-IV) of 1% [95% CI 0.0–3.0%]. The rate of intraoperative complications was 2% [95% CI 0.0–4.0%] with a conversion rate of 1.0% [95% CI 0.0–3.0%]. The mean hospital length of stay was 1.77 days [95% CI 1.21–2.24]. After a median follow-up of 6.6 months (1–24), the rate of recurrence was of 1% [95% CI 0.0–1.0%].

Conclusion
Minimally invasive eTEP is a safe and effective approach for ventral hernia repair, with low reported intraoperative complications and good outcomes.
OC-035 AUTOMATION OF HERNIA VOLUMES - SAC DETECTION AND HERNIA VOLUMETRY USING COMPUTER VISION AND DEEP LEARNING - PUSHING FRONTIERS
Authors: Rengan V , Sundaram P M , Arora E , Bawa A , Alexander N , Balasubramanian R 
Published: May 2023

Abstract

Aim
To identify the sac and defect using deep learning algorithms and to compute hernial sac volume in an automated fashion.

Materials and methods
70 ventral hernia CT scans were used. Slices with hernia defect and sac were annotated using computer vision tools. 80% of the data was used for training and validation. 20% data was used for testing. We used a combination of 3D reconstruction algorithms and deep learning to train the models. The model output was compared to manual annotation by experts.

Results
The testing data showed that our novel algorithm was able tp estimate the defect with an accuracy of 90%. The mean IOU for detection of hernia sac was 88% and volume estimation accuracy was 85%.

Conclusion
A combination of supervised deep learning and 3D volumetry will increase the accuracy of volumetric indices and shorten the volume estimation time. In most parts of the world, the hernia sac volume is not calculated by the radiologist and the surgeon is left to estimate it using rudimentary means such as visual estimation. Automated hernia volumetry will play a major role in standardising hernia reports. We believe this is a pivotal step in creating actionable radiology reports that will help the surgeon assess the complexity and plan surgery.
OC-036 SİNGLE SURGEON EXPERİENCE WİTH MONOTYPE MESH FOR İNGUİNAL HERNİA REPAİR
Authors: Gumus T , Girgin T , Temel R , Ersin S 
Published: May 2023

Abstract

Summary
Complex inguinal anatomy, mesh variety, surgeon's use of mesh, surgical technique preference made it inevitable to examine the recurrence of inguinal hernia. Unlike the literature, we examined the recurrence rates of a single experienced general surgeon using a single type of mesh, separately for laparoscopy and open surgery.

Method
Uniform mesh (ProgripTM self-fixating in open, Polipropilen mesh in laparoscopic) was applied. A total of 314 patients who underwent hernia surgery for the first time performed by a single expert general surgeon between 2013–2022 were included in the study. Demographic data, perioperative data, body mass indexes, co-morbidities and recurrence status were documented.

Results
The mean follow-up period was 75.2 months(3–158). Recurrence developed in a total of 24 patients(7.6%). Recurrence developed in 14 patients(7.3%) who underwent open hernia repair, while recurrence was found in 10(8.2%) of laparoscopic repairs(p=0.77).
Diabetes mellitus was diagnosed in 8 patients(33.3%) in the group with recurrence, while diabetes was diagnosed in 14 patients(4.8%) in the group without recurrence(p&lt;0.001).
While there was cardiovascular disease in 16 patients(66.7%) in the group with recurrence, cardiovascular disease was observed in 99 patients(34.1%) in the group without recurrence(p=0.001).

Discussion
Recurrence rates after inguinal hernia repair were found to be compatible with the literature. We found that all patients with recurrence had high ASA scores, heavy lifting, chronic constipation, diabetes mellitus, and cardiovascular disease problems. Especially if we take into account the early return to work in the post-operative period, it doesn't seem easy to reduce the recurrence rate, which is dependent on many factors.
OC-037 Triclosan-coated sutures decrease the risk of surgical site infection in abdominal surgery. A systematic review and meta-analysis
Authors: Depuyt M , Van Egmond S , Petersen S M , Muysoms F , Henriksen N , Deerenberg E 
Published: May 2023

Abstract

Aim
Surgical site infection (SSI) occurs in 2–10% of the patients after abdominal surgery and has an impact on morbidity, mortality and medical costs. The aim of this systematic review and meta-analysis was to evaluate whether the use of triclosan-coated sutures for fascial closure in adominal surgery decrease the rate of SSI compared to uncoated sutures.

Methods
A systematic review and meta-analysis was conducted using the PRISMA guidelines. A literature search was performed in Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials and Embase. The latest search was performed on January, 21th, 2023. Risk of bias was assessed using the Cochrane RoB 2 tool. A pooled meta-analysis was performed using RevMan.

Results
Out of 1356 records, ten Randomized Controlled Trials, with a total of 9432 patients were included: 4763 in the Triclosan-coated group and 4660 in the uncoated group. The overall SSI rate was significantly reduced in the Triclosan-coated group with an Odds Ratio (OR) of 0.84 (95% CI [0.76; 0.94] p = 0.002). If PDS was evaluated separately (PDS Plus = 3999, PDS = 3900), triclosan-coating reduced SSI with an OR of 0.86 (95% CI [0.77; 0.96], p = 0.008). When Vicryl was evaluated (Vicryl Plus = 764, Vicryl = 760), the OR was 0.71 (95% CI [0.48; 1.04], p = 0.08) and was not significant.

Conclusions
In this current meta-analysis, it was found that the incidence of SSIs decreases when triclosan-coated sutures are used for fascial closure, compared to the uncoated sutures group.
OC-039 PROPHYLACTIC NEGATIVE PRESSURE WOUND THERAPY FOR COMPLEX VENTRAL HERNIA REPAIR, A CASE SERIES
Authors: Trebol J , Sánchez-Casado A B , García-Plaza A , González-Muñoz I , Muñoz-Bellvís L 
Published: May 2023

Abstract

Aims
Presenting our 1-month results in 20 patients with prophylactic negative pressure (pNPWT) applied in complex ventral hernia repairs.

Material & Methods
pNPWT was applied when high surgical site occurrences (SSO) risk factors and when colorectal procedures, huge panniculectomies, active cutaneous/mesh infections or loss of domain are associated.
Our results are compared with SSO incidence calculated with HW-RAT score.

Results
10 men and 10 women with 67.55 (43–84) year-old. BMI 32.01 kg/m2 (24–55). 55% ASA III, 35% II, 10% I.
Most relevant risk factors: 3 stoma closures, 3 loss of domain, 2 paraestomal, 2 peritonitis, 2 W3, 2 multi-recurrences, 1 infected mesh, 1 synchronic colonic fistula.
HW-RAT SSO score (1-less risk- to 5 -maximum-): 3 II, 3 III, 12 IV and 2 V.
pNPWT was applied to 17 midline wounds, 1 bilateral subcostal, 1 colostomy site and 1 midline+colostomy for 6–10 days (mode 7).
12 patients (60%) had 19 complications, 3 grade IIIB and one IVa.
Only 1 patient (5%) had surgical site infection (SSI): 1 infected seroma presenting at 16th postoperative day requiring readmission, drainage, and negative pressure (grade IIIA). Global HW-RAT estimated SSI incidence: 15.76%.
Two patients had other causes postoperative peritonitis, none of which affected the wound.
At 1 month another 2 seromas (1 grade I, 1 grade III) and one 3cm haematoma appeared.

Conclusions
pNPWT in high-risk patients is safe and can significantly reduce SSI and SSO (in our series from 15% to 5%).
Estimated NNT for preventing 1 SSI in the literature is 9 patients.
OC-040 FULL ENDOSCOPIC MINIMALLY INVASIVE MODIFIED SUGARBAKER APPROACH PARASTOMAL HERNIA REPAIR (E-TEP PAULI). MID-TERM RESULTS
Authors: Bellido-Luque J , Licardie E , Bellido-Luque A , Navarro L , Tejada A , Gomez Menchero J , Suarez Grau J M , Sanchez-Matamoros I , Nogales Muñoz A , Morales Conde S 
Published: May 2023

Abstract

Introduction
In 2016, E. Pauli described a novel technique for PSH using TAR combined with a modified “Sugarbaker” repair.
The present study aimed to assess clinical results of this technique performed by minimally invasive access

Methods
Data from patients requiring minimally invasive PSH repair were collected.
Inclusion criteria: Symptomatic PSH
Exclusion criteria: Recurrences with previous retromuscular/intraperitoneal mesh, Incarcerated/strangulated PSH
Data collected:

Results
Between January 2020 and May 2022, 11 patients were included. 5 patients had a type I PSH, 5 patients a type II and 1 patient a type IV hernia. Mean BMI: 28 kg/m2. Mean width defect: 4.5 cm, length: 4.4 cm. Mean width in cases of midline hernia: 4.3 cm, length: 4 cm. Mean mesh area: 749 cm2.No intraoperative complications were detected. Mean operative time was 180+/-13 minutes.Average stay:2.2 days.
Postoperative complications:
After follow-up of 16 months, no clinical/radiological recurrence were observed.

Conclusions
e-TEP Paulí for PSH is a promising surgical technique with different advantages. No intraperitoneal mesh or traumatic fixation are needed.