bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-059 FEASIBILITY OF A SMARTPHONE APPLICATION FOR INGUINAL HERNIA CARE: A PROSPECTIVE PILOT STUDY
Authors: Meuzelaar R , Den Hartog F , Verleisdonk E J , Schiphorst A , Burgmans I 
Published: May 2023

Abstract

Aim
The Inguinal Hernia Application (IHAPP) is designed to overcome current limitations of regular follow-up after inguinal hernia surgery. It has two goals: Minimizing unnecessary healthcare consumption by supplying patient information and facilitating registration of patient reported outcome measures (PROMs) by offering simple questionnaires. In this study we evaluated the usability and validity of the app.

Material & Methods
In this prospective cohort study patients (&gt;=18 years) scheduled for elective hernia repair were assessed for eligibility. Feasibility of the app was evaluated by measuring patient satisfaction about utilization. Validity (internal consistency and convergent validity) was tested by comparing answers in the app to the scores of the standardized EuraHS-Quality of Life instrument. Furthermore, test-retest reliability was analyzed correlating scores obtained at 6 weeks to outcomes after 44 days (6 weeks and 2 days).

Results
During a 3-month period, a total of 100 patients were included. Median age was 56 years and 98% were male. Most respondents (68%) valued the application as a supplementary tool to their treatment. The pre-operative information was reported as useful by 77% and the app was regarded user-friendly by 71%. Patient adherence was mediocre, 47% completed all questionnaires during follow-up. Reliability of the app was considered excellent (α &gt; 0.90) and convergent validity was significant (p = 0.01). The same applies to test-retest reliability (p = 0.01).

Conclusions
The IHAPP is a useful tool for reliable data registration and serves as patient information platform. However, further improvements are necessary to increase patient compliance in recording PROMs.
P-061 Bowel obstruction due to intraluminal migration of intraperitoneal mesh
Authors: López R , Beisani M , Comas J , Subirana H , Crusellas O , Gómez H , Castellví J 
Published: May 2023

Abstract

Aim
Report an unusual late complication after laparoscopic IPOM

Material & Methods
Description of a clinical case

Results
An 84 years old patient who had previously undergone laparoscopic IPOM with ePTFE mesh in 2012 for supraumbilical primary hernia, arrived to the emergency room in March 2022 with a small bowel obstruction due to an intraluminal foreign body impacted at the distal jejunum. In the computerized tomography scan (CT) there was no evidence in the abdominal wall of the intraperitoneal mesh present in a previous CT from 2019.
An exploratory laparotomy was warranted. A resection the affected jejunal loops was performed, without evident perforation and clear palpation of an intraluminal foreign body.
When the piece was opened, the mesh was found intraluminally, causing the patient's bowel obstruction.

Conclusions
Intra-abdominal foreign bodies usually cause a chronic inflammatory process that isolate them from neighboring structures by a fibrous capsule. In this case, however, after detaching it from the abdominal wall, the mesh migrated into the intestinal lumen, probably through slow erosion by decubitus.
Despite it being an unusual complication, its incidence could increase as the use of intra-abdominal mesh has multiplied in recent years. Given the appearance of non-specific abdominal pain in patients with intra-abdominal mesh, it may be advisable to perform a CT scan to rule out this or other complications associated with the mesh, even many years after the initial surgery.
P-064 CORRELATION BETWEEN ABDOMINAL WALL STRENGTH AND DIAMETER OF HERNIA IN PATIENTS WITH INCISIONAL HERNIA
Authors: Garcia Moriana A J , Sanchez Arteaga A , Tallon Aguilar L , Maroto Sanchez R , Gil Delgado J L , Padillo Ruiz J 
Published: May 2023

Abstract

Aim
The goal of the study was to analyse the abdominal wall strength profile in patients with incisional hernia and the relationship between the hernial defect diameter and the abdominal wall strength.

Methods
Observational cohort study of patients with incisional hernia (July-October 2022), classified as W2 according to the European Hernia Society. Collected data was demographic characteristics, clinical characteristics related with the hernia, and measure of the abdominal wall strength using an isokinetic dynamometer and a strain gauge. We analysed the relationship between hernia defect and abdominal wall strength with correlation tests to adjustment by age, sex, BMI, and body composition.

Results
53 patients were enrolled (56,6% female) with a mean age of 57,42 age (SD 10,49). Mean BMI was 30,42 (SD 5,15), mean percentage of fat mass of 36,86% (SD 7,48), mean percentage of lean mass of 60,37% (SD 7,55), and maximum diameter of hernia defect was 6,75cm (SD 2,16). The linear regression model determined age (p = 0,02) and gender (p = 0,01) as predictor variables of the abdominal wall strength measured with isokinetic dynamometer. In terms of the relation between the hernial defect diameter and abdominal wall strength, we did not found statistically signification (p = 0,17), although largest hernia defects (p90) were related with a decrease of rate of force development (p= 0,026).

Conclusions
In our study, the most statistically significant predictor variables of abdominal wall strength were age and sex. Hernia defect diameter showed a tendency to a statistically signification.
P-068 A NOVEL TECHNIQUE TO REDUCE RECURRENCE IN PATIENTS WITH DONOR SITE HERNIAS IN ILIAC CREST BONE GRAFTS
Authors: Mazumdar E , Perera D , Lloyd C , Ramanand B 
Published: May 2023

Abstract

Introduction
Iliac crest bone grafts (ICBG) are commonly used to heal non-union fractures in orthopaedic and maxillofacial surgery. The most common complications are pain, haematoma, neurovascular injury and scarring however one complication that is mentioned less frequently is herniation of abdominal contents. We emphasise the importance of this complication, and describe a technique that can be used to repair this when there is herniation.

Case
A 76 year old gentleman developed squamous cell carcinoma of the right mandible in 2019. The right mandible was resected, followed by an iliac crest free flap from the left side with a prophylactic prolene mesh which was performed in 2020. The patient then received adjuvant chemotherapy. Shortly thereafter, the patient developed a lump which became increasingly painful. The patient was referred onto the general surgical team after a CT scan showed herniation of colon and small bowel loops at the donor site. The patient underwent a hernia repair in November 2022 and is recovering well.

Discussion and conclusion
Herniation of abdominal contents following ICBG are rare and potentially dangerous complication that can lead to significant morbidity and even mortality. Here we present an open repair of a recurrent hernia, using a pre-peritoneal mesh. A pre-peritoneal plane was developed all around to ensure there is good overlap of the mesh and was anchored to a mini-plate that was fixed to the iliac bone. Pre-peritoneal meshes should be preferred to fix hernia defects caused from ICBGs, which otherwise can cause significant morbidity in patients with ICBGs.
P-075 CHRONIC INGUINAL SEROMA AFTER LAPAROSCOPIC SURGERY
Authors: Trindade M , Figueiredo J , Souto R , Branco A , Costa P 
Published: May 2023

Abstract

Aim
Chronic inguinal seroma is rare, with 80% being totally reabsorbed 3 months after surgery. Inguinal seroma after laparoscopic indirect hernia repair is presented in 3,7–70% of cases.

Material and Methods
Description of a clinical case.

Results
Male, 74 years-old. Prior bilateral inguinal herniorrhaphy. Diagnosed with recurrent right inguinal hernia, ultrasound confirmed.
The patient underwent TAPP and a L2R right inguinal hernia was observed (EHS classification). The patient was discharged on day 1.
One month after, the patient presented an irreducible tumefaction on right inguinal zone. Ultrasound describes a hydric collection measuring 5.8×5.4×4.1cm, suggesting a seroma, and excluded hernia relapse. 50mL of pure serous fluid was aspirated with clear reduction of the mass. Negative microbiology. Five months post-operatively, the tumefaction was present and 35mL of a fluid, with the same characteristics, was aspirated again. One month later, seroma was still found, and 35mL of a fluid was aspirated. After that, 100mg of Doxycycline was injected.
Two years after surgery, tumefaction was present. He was proposed for surgical intervention and underwent unroofing and scarification of the seroma. Three-month follow-up without complications.

Conclusions
Chronic seroma that needs intervention is extremely rare. It is estimated that only 0,24% need percutaneous drainage and 0,2% reoperation. Therefore, this case is relevant and should inform us for this infrequent form of presentation of a common complication of inguinal hernia.
P-076 HOW CAN WE REDUCE POSTPERATIVE PAIN IN E-TEP RIVES REPAIR?
Authors: Curado Soriano A , Infantes Ormad M , Valera Sanchez Z , Naranjo Fernandez J R 
Published: May 2023

Abstract

Aim
To show the effect on postoperative pain of direct instillation of ropivacaine into the retromuscular space.

Method
During the E-TEP Rives procedure, after mesh placement, we instilled ropivacaine into the retromuscular space via a working port. In our initial experience we compared only five patients from each group. We measured the decrease in postoperative pain with the visual analog pain scale 24 hours postoperatively.

Results
We achieved a decrease in postoperative pain, which we measured using the visual analog pain scale, with a reduction of 3 vs 5 in the control group, and which translates into a decrease in opioid consumption in the immediate postoperative period.

Conclusion
To decrease postoperative pain we implemented several actions, among the most important for us, was the technique of nerve block of the anterior abdominal wall with ropivacaine. This technique is easier and faster than ultrasound nerve localization and allows selectively blocking the nerve bundles of the rectus, having the same efficacy in our experience.
P-078 IMPLEMENTATION OF THE HOSPITAL-AT-HOME UNIT IN THE POSTOPERATIVE COMPLEX ABDOMINAL WALL
Authors: Martínez Gómez A , Molinete M , Benavent M , Homs E , Català A , Domènech J , Sánchez Marín A 
Published: May 2023

Abstract

Abreviations
EHS: European Hernia Society

Aim
Show the results of the application of a new service in our hospital, Hospital-at-Home, in the postoperative period of incisional hernias and complex abdominal wall.

Material and Methods
Retrospective analysis of operated patients in our center in 30 month period (July 2020 - December 2022) with complex abdominal wall. Patients who accept home follow-up with Hospital-at-Home unit and who corresponded to the geographical area. Patients with incisional midline hernia are included: more than two locations -M- in the classification of the EHS or width greater than 4 cm (W2). Lateral incisional hernias with more than two locations -L- are also included in the EHS classification and complex parastomal hernias.

Results
25 patients, 17 men and 8 women, underwent both elective and urgent incisional hernia surgery. The surgical techniques used were retromuscular mesh repair, posterior component separation and onlay technique (emergency cases). Mean hospital stay was 4.5 days. Later the patients were visited by Hospitalization at Home. There were 2 surgical wound infections treated with intravenous antibiotics and a need for reoperation (Grade II and IIIa of Clavien-Dindo classification of surgical complications. Recurrent incisional hernia was observed in 1 patient.

Conclusions
Benefits of Hospitalization at Home by improving the degree of patient satisfaction, reducing the hospital stay and not worsening the clinical safety of the patient with complications.
P-079 RISK FACTORS FOR BOWEL RESECTION IN PATIENTS WITH INCARCERATED INGUINAL HERNIA. RETROSPECTIVE CLINICAL STUDY
Authors: Donmez T , Karabulut M , Surek A , Ozdemir M , Hocaoglu E , Canoz O 
Published: May 2023

Abstract

Backgraund
Early recognition of the risk of bowel resection of patients with incarcerated groin hernia(IGH) will facilitate the clinical decision making of surgeons and improve the outcomes of patients. This study aimed to reveal the risk factors of bowel resection in patients with incarcerated inguinal hernia.

Materyal methods
We retrospectively collected 312 patients who underwent emergency hernia repair surgery for IGH between January 2017 and October 2022. The patients were categorized into those who received bowel resection and those who did not require bowel resection Data analysis was approved by the local ethics committee. Patient characteristics, laboratory and radiological examinations, surgery data, and postoperative outcomes were compared between patients with and without bowel resection. Risk factors for bowel resection were assessed with univariate and multivariate analysis.

Results
Univariate analysis identified 7 variables that were significantly associated with bowel resection among patients with IGH. On multivariate analysis, Charlson comorbidity index (CCI) odds ratio [OR] = 0.751, 95% confidence interval [CI] 0.592 0.953, P = .018), Gender (OR =  4.071, 95% CI 1.749/9.475, P = 0.001) and C-reactive protein(CRP) (OR =  0.321, 95% CI 0.145–0.708, P = 0.005) were identified as independent risk factors for bowel resection among patients with IGH.

Conclusion
In this study, an elavated CRP, gender and high CCI in patients with bowel obstruction due to IGH are associated with an increased risk of bowel resection. Based on our findings, surgeons should prioritize prompt emergency surgical repair for patients who present with elevated CRP and high CCI concurrent with IGH.
P-080 THE GRIP CONCEPT CONSIDERS BIOMECHANICAL PRINCIPLES FOR A DURABLE REPAIR OF INCISIONAL HERNIA – 3 YEAR FOLLOW UP
Authors: Nessel R , Löffler T , Rinn J , Kallinowski F 
Published: May 2023

Abstract

Aim
Durable hernia repair is based on specific biomechanical principles. How are the results after three years in primary and recurrent hernias?

Material and methods
The biomechanical principles were analyzed ex vivo with cyclic loading using a self-built bench test. The minimal requirements for a biomechanically durable repair were defined. The resulting GRIP concept was clinically applied.

Results
A total of 233 patients (123 males and 110 females) were treated for incisional hernia. Primary hernia was repaired in 170, recurrence in 63 patients with an average of 1.3 risk factors with most patients grouped as ASA III (n= 120). Emergency repairs were necessary in 11 patients. Hernia orifices were mostly median (N= 209) and lateral (89 patients, 59 combined). Hernia sizes were on average 9 + 6 cm wide and 13 ± 8 cm long. The mesh-defect area ratio was 7.8. Fixation was necessary (median of 60 fixation points). Recurrences required more effort for a durable repair (Primary OR duration: 165 ± 75 min; recurrence: 233 ± 89 min). A total of 138 patients were followed for three years so far. Four patients died during follow-up (Follow-up rate 100%). A second hernia in the un-repaired abdominal wall occurred three times (gunshot wound, appendectomy, cholecystectomy). Pain levels were low (median NAS = 0 at rest and under load). One recurrence was detected 8 months after primary repair in a liver transplant recipient reconstructed with a sandwich.

Conclusion
Primary and recurrent incisional hernia can be repaired durably based on biomechanical principles.
P-081 ROBOTIC RECTUS DIASTASIS AND UMBILICAL HERNIA REPAIR - INITIAL EXPERIENCE
Authors: Martins De Oliveira Neto R , Roberto Puglia C , Leal Pereira F , Roberto Corsi P , Kochi F , Derwood Mills Costa De Carvalho B 
Published: May 2023

Abstract

Aim
Rectus diastasis is typically an asymptomatic but cosmetically displeasing condition that is not usually repaired except for cosmetic purposes. However, it is been observed that hernias with a rectus diastasis tend to have a higher recurrence rate and poorer cosmetic outcome if the diastasis is not repaired at the same procedure. The authors presents the first 11 cases of rectus diastasis and umbilical hernia repair with robotic assistance.

Material & Methods
we perform the procedure on 11 patients between january and december 2022. All patients have the diagnosis os rectus diastasis and umbilical hernia. All of then underwent a primary umbilical hernia repair with closure of the rectus diastasis, performed with robotic assistance. All procedures went without complications and the patients were discharged on the day after. We evaluate parameters such as lenght of the procedure, complications, post procedure pain and recurrence.

Conclusions
The repair of a hernia within a rectus diastasis has an higher recurrence rate, as the hernia lays within the thinned weakened linea alba. We believe, if possible, the repair of the diastasis will reduce the rate of hernia recurrence. We recommend considering robotic-assisted hernia repair ans diastasis closure for optimal longer outcome and improved cosmesis.
P-085 LAPAROSCOPIC TAP BLOCK
Authors: López Farias A , Hernández Sánchez A , Lindo Canchado J J , Mateos M , Nieto Soler A 
Published: May 2023

Abstract

Aim
To test the effectiveness of the laparoscopic control-assisted TAP Block technique.

Material and methods
we performed an infiltration with 30 ml of 5% Ropivacaine, 5 ml in 3 punctures on each side of the abdomen. The transverse muscle is identified by laparoscopy, lateral to the semilunar line, 3 points are infiltrated with an intramuscular needle, visualizing the tip without crossing the peritoneum and withdrawing 2–3 mm until it is above the transverse muscle.

Results
TAP Block improves postoperative pain, requiring lower doses of opioids and allowing faster recovery. No significant differences are observed in the VAS scale compared to the ultrasound control technique, but it does take less time and avoids any type of visceral injury due to laparoscopic control.

Conclusions
Laparoscopic Block TAP is equally effective in postoperative pain control as part of multimodal analgesia as performed under ultrasound control, with the advantages of reducing anesthetic time and minimizing the potential risk of visceral injury.
P-086 NERVE IDENTIFICATION DURING OPEN MESH HERNIOPLASTY: A DESCRIPTIVE CROSS-SECTIONAL STUDY
Authors: Shettar A , Sinha M , Tripathy P 
Published: May 2023

Abstract

Background
It is recommended to identify nerves in the surgical field during open inguinal hernioplasty. This ensures proper dissection and reduces the incidence of post-operative inguinodynia. From limited surgical studies, it appears that identifying nerves may not be possible in all cases. Little is known about the factors that affect their identification.

Materials and methods
We conducted a cross-sectional study on thirty-six male patients with primary inguinal hernia. We looked for the nerves during Lichtenstein hernioplasty. We collected data on the identification & preservation of nerves for calculating the nerve identification rates. We observed the course of the nerves and evaluated the effect of BMI, height, anaesthesia type, surgical experience, ASA, type of hernia and sac contents on nerve identification.

Results
Ilioinguinal nerve (IIN), Iliohypogastric Nerve (IHN), and Genital branch of genitofemoral nerve (GBN) were identified in 86.1%, 75%, and 50% of the groin dissections. It was easier to identify the IIN when the omentum was the content of the sac. The IHN was easily identified in patients with BMI ≤ 25 kg/m2.

Conclusion
Nerve identification can be challenging during surgery. The GBN and IHN are more prone to dissection-related injuries. Identification of IHN and IIN is difficult in overweight individuals and cases where hernia contains bowel.
P-089 OBTURATOR HERNIA: A RARE CASE OF INTESTINAL OBSTRUCTION REQUIRING SEVERAL TYPES OF TREATMENT
Authors: Flores Flores C , García Galocha J L , Gómez Latorre L , Talavera Eguizabal P , Lopez Antoñanzas L , Peña Soria M J , Torres García A 
Published: May 2023

Abstract

Background
Obturator hernia is infrequent (incidence 1%). This condition usually occurs in older, multiparous women.

Case Report
We report two cases of this pathology:
The first one deals with a woman that presents insidious abdominal pain, who underwent an abdominal CT scan compatible with mechanical intestinal obstruction secondary to present the ileum trapped in a right obturator hernia. Treatment consisted of a laparoscopic approach creating a peritoneal flap, hernioplasty with polypropylene mesh and closure of the flap with V-lock 3/0.
The last one is about an elderly woman who presents nausea and vomiting accompanied by severe pain in the left lower limb. An abdominal CT scan was performed, which revealed a distal jejunal loop into the left obturator accompanied by intestinal obstruction. Open henioplasty was performed due to significant adhesive syndrome. The hernia sac was reduced, preperitoneal plug was placed and the orifice was closed with vycril suture.

Discussion
Diagnosis is complex due to the characteristics of the patients. There are 3 signs of strangulated hernia: obturator neuralgia, pain in the medial thigh due to obturator nerve compression and the absence of the adductor reflex in the thigh. The most accurate diagnostic test is the CT scan.
Three treatment techniques are described: transabdominal, extraperitoneal and laparoscopic.

Conclusion
Despite of obturator hernia is not a frequent cause of intestinal obstruction, we should consider the laparoscopic approach as an option with fewer postoperative complications, when possible.
P-096 EVALUATION OF EPIDEMIOLOGICAL PARAMETERS OF INGUINAL HERNIA IN A SPANISH RURAL AREA
Authors: Vaqué Alcázar C , Martinez E , Soria J , Álvarez E , Carvajal F , Negre D , Díaz F 
Published: May 2023

Abstract

Aim
To describe the epidemiological, clinical and surgical parameters of the population undergoing inguinal hernioplasty in a small rural hospital

Material and method
All patients who underwent an inguinal hernia repair at our Hospital in 2021 were included. A search was made in the medical records to identify epidemiological, clinical and surgical risk factors.

Results
208 patients were gathered, of which 31 (14,9%) had a bilateral hernia, 50 (24%) had previously been operated on the other side and 11 (5,2%) were recurrences. This translates into an annual incidence of 227,27/100.000, with a recurrence rate of 5%. 136 (65%) were outpatient with only 1 hospitalization.

Conclusion
In our rural hospital the incidence and recurrence rate is the same as described in the literature.