bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-005 SINGLE-PORT VS. MULTI-PORT TOTALLY EXTRAPERITONEAL (TEP) INGUINAL HERNIA REPAIR: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Prassas D , Knoefel W T , Krieg A 
Published: May 2023

Abstract

Objective
The value of single-port totally extraperitoneal inguinal hernia repair (STEP) when compared to the conventional multi-port approach (TEP) is still a matter of controversy. We conducted a meta-analysis of randomized controlled trials comparing the feasibility and safety of the above-mentioned techniques.

Materials and Methods
A systematic literature search for randomized controlled trials (RCTs) comparing the outcome STEP and TEP in patients with inguinal hernia was conducted. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The Odds Ratio and Standardized Mean Differences with 95% Confidence Intervals (CI) were calculated.

Results
Six RCTs were identified, involving a total of 636 cases (STEP: n=328, TEP: n=308). There was a statistically significant difference noted between the two groups regarding return to everyday activities favoring the STEP group (SMD=-0.23; 95% CI [-0.41, -0.06]; p=0.009; 4 studies; I2=9). For the remaining primary and secondary endpoints, intra- and postoperative morbidity, conversion rate, peritoneal tears, major intraoperative bleeding, postoperative haematoseroma, operative time, postoperative pain, chronic pain, cosmetic satisfaction, hernia recurrence and in-hospital length of stay no statistically significant difference was noted between the two study groups.

Conclusions
Current evidence suggests that patients who underwent STEP had similar outcomes to the traditional TEP technique with the exception of time to return to everyday activities, which was reported to be shorter in the STEP group.
P-011 OPEN PREPERITONEAL APPROACH IN AN INCARCERATED ABSCESSIFIED GARENGEOT HERNIA
Authors: Fernandes N , Verdaguer M , Rodrigues V , Martínez P , Bergamini S , Cirera A , López P , López Cano M 
Published: May 2023

Abstract

Aim
The Garengeot hernia is a a rare entity (incidence 0.15–5%) that appears more frequently in elderly women and contents the vermiform appendix. Different surgical approaches are available but the most appropriate one is unknown. Association or conversion to laparotomy may be needed in complicated cases entailing higher morbimortality.

Results
82-year-old female with hypertension, dyslipidemia and left inguinal hernioplasty. She presented acute right inguinal pain with a 1 month of evolution mass associated extended to the limb. Blood tests were normal but CT scan was performed reporting a right incarcerated inguinal hernia with acute perforated and abscessified appendicitis. Besides antibiotics, an open preperitoneal approach was performed. An incarcerated crural hernia was found: the sac was opened, the perforated appendix was reduced and the abscess was debrided. Appendicectomy was performed and after aseptic measures and critical view, a 15×15cm gentamicin impregnated large-pore light-weight polypropylene mesh was placed in the preperitoneal space covering the myopectineal orifice. Patient was successfully discharged 4 days after surgery with no complications after two years of follow-up.

Conclusion
The treatment of a complicated crural hernia in a septic environment in the emergency room represents a challenge. In an incarcerated and abscessified Garangeot hernia, an open preperitoneal approach (modified Nyhus technique) can be safely performed to confront both pathologies. Not only it allows access to the abdominal cavity through a small incision, avoiding the need for a laparotomy, but also favours an optimal exploration and repair of the myopectineal orifice.
P-021 DELAYED ENTEROCUTANEOUS FISTULA AND ENCAPSULATING MESH INFECTION AFTER COMPOSITE MESH REPAIR OF AN ABDOMINAL MIDLINE INCISIONAL HERNIA - COMPLICATIONS 12 YEARS LATER
Authors: Rajaretnam N , Christopoulos P , Sinha S 
Published: May 2023

Abstract

Aim
Mesh infection is a well-recognised complication of incisional hernia repair, however, is usually encountered within months after mesh insertion. Only a few cases have been published where an enterocutaneous fistula has presented many years after mesh repair of an incisional hernia. Here we describe a complicated case of enterocutaneous fistula and mesh infection 12 years after the primary surgery.

Material & Methods
A 44 year-old gentleman presented acutely with a worsening 4 month history of an umbilical discharging sinus with associated fever, intermittent abdominal pain and nausea. There was also an associated hard lump and skin erythema. He previously had a laparotomy, small bowel resection for tuberculosis and ileostomy formation 13 years ago, followed by ileostomy reversal and intraperitoneal incisional hernia repair with composite mesh 1 year later.

Results
Cross-sectional imaging showed a large volume of gas within the mesh with underlying small bowel and collection within anterior abdominal wall, suggesting an enterocutaneous fistula. The patient initially underwent ultrasound guided aspiration of the collection followed by nutritional optimisation prior to another laparotomy, mesh excision and small bowel resection. The mesh was found to have a thick biofilm initially thought to be encased in mycobacterium but further testing was negative for this.

Conclusions
Delayed mesh infection over more than a decade after mesh insertion is rare. It is likely that pre-existing risk factors such as previous TB and small bowel resection with adhesions increased the risk of enterocutaneous fistulation.
P-026 FASCIAL TRACTION WITH EPTFE MESH FOR DEFINITIVE CLOSURE OF CATASTROPHIC ADBOMEN
Authors: Esmailli Ramos M , Gómez Ruiz L , Santiago Peña J C , Cruz Romero P , Arriero Ollero L , Cano Pecharromán E M , Martin Paniagua L , Mesa Ruiz M I , Ortiz González M , Balsa Marín T 
Published: May 2023

Abstract

Aim
Show the benefits of temporary closure with expanded polytetrafluoroethylene (ePTFE) mesh associated with negative pressure therapy (NPT) in the management of catastrophic abdomen.

Material & methods
We present the case of a 74-year-old female who underwent emergency surgery for necrotising fasciitis of the abdominal wall and tertiary peritonitis after a vaginal hysterectomy and anterior colpoplasty, where the use of NPT combined with ePTFE mesh allowed gradual fascial traction until its complete closure (after ten days), restoring the functionality of the abdominal wall.

Results
Temporary abdominal wall closure using NPT with ePTFE mesh allows progressive fascial traction and early closure of the abdominal wall in cases of catastrophic abdomen with low complication rate.

Conclusion
Techniques for temporary abdominal wall closure have led to a significant mortality reduction in cases of complex abdomen. There are several techniques with unclear evidence as to which is optimal. The combined use of NPT with ePTFE mesh is a riveting alternative as it does not adhere to bowel serosa and the risk of eventrations and fistulas are less common.
P-027 Enhanced view totally extraperitoneal technique (e-TEP) for laparoscopic retromuscular inguinal hernia repair- our experience
Authors: Prodan A , Matei M , Cancea B , Turculet C , Beuran M 
Published: May 2023

Abstract

The best approaches to repair inguinoscrotal hernias are still debated. Extended totally extraperitoneal repair technique (e-TEP) represents a modification of the traditional TEP method. The role of this technique is to overcome the limitations of the classical technique (limited dissection space), while still keeping the main advantages.
The e-TEP technique allows an additional dissection space, a large surgical field and a very flexible trocarization, adaptable to many clinical situations and also good tolerance to pneumoperitobeum
Our team uses the e-TEP technique to repair most cases of inguinal hernias.
Between May 2017 and January 2023, we performed 102 operations, using the e-TEP technique. I used macroporous polypropylene mesh 15/12, fixed with cyanoacrylate.
For a total of 102 cases, we registered a total of 6 self-limiting seromas, two cases were converted to open surgery, one wound infection and three recurrences. Patients were followed up one week, three months and one year, postoperatively.
One patient presented with chronic pain one year postoperatively. The operating time was about 60–90 minutes.

Conclusions
Our experience with the e-TEP procedure has been satisfactory. We had no major complications, neither intra, or post-operatively, and the functional results were excellent. The operating time was found to be longer than usual at the beginning of the use of this technique, attributed to the novelty of the technique, the longer laryngeal curve and the complexity of the cases.
P-031 TREATMENT OF A VOLUMINOUS INGUINOSCROTAL HERNIA AFTER A PREOPERATIVE PNEUMOPERITONEUM PREPARATION
Authors: Hammami Y , Fteriche F S 
Published: May 2023

Abstract
Voluminous inguinoscrotal hernias that have lost their “right of domain”, are usually hard to repair, and need preoperative preparations to reduce the risk of complications after the treatment, such as compartment syndrome, intestinal ischemia, and respiratory problems.
In this e-poster, we present a case report of a patient who had a voluminous inguinoscrotal hernia containing most of the small intestine and the entire right colon, which we treated after a preoperative pneumoperitoneum preparation (PPP).
The preparation was conducted 20 days before the surgery and the pneumoperitoneum was created through a percutaneous catheter that we inserted in the epigastric region after a radiologic control.
We injected 1000 ml of air per day, and the dose was adapted to the clinical tolerance of the patient.
We performed a reintegration of the hernia's volume, a resection of the hernial sac, and a reduction of the size othe profound inguinal ring via a Raphia, no intestinal resections were made, and the postoperative course was uneventful.
We plan a second intervention that consists of a hernia repair by a mesh insertion and a resection of the extra skin developed as a result of the voluminous hernia.
PPP is an interesting way to prepare the abdominal cavity to receive the component of a voluminous hernia after its reduction. The patient should be closely monitored during the preparation and after the surgery in order. Sometimes a second operation is necessary for definitive cure or aesthetic needs.
P-033 COMPLICATIONS IN E-TEP RIVES:OUR SERIE
Authors: Curado Soriano A , Infantes Ormad M , Sanchez Ramirez M , Valera Sanchez Z , Naranjo Fernandez J R 
Published: May 2023

Abstract

Aim
To study complications in our e-TEP series in ventral and incisional hernias.

Methods
We reviewed all patients undergoing e-TEP for ventral or incisional hernias. We included 33 patients (14 M2 or M3W2 incisional hernias and 11 medium ventral hernias with rectus diastasis), in whom polypropylene mesh was used. Follow-up at least 6 months.

Results
We found 2 patients with interstitial hernia below the mesh, one of them in the acute postoperative period with intestinal obstruction. One patient with recurrence of incisional hernia in the subxiphoid area, one patient with asymmetry of the right hypochondrium, and one patient with a seroma requiring drainage and a hematoma in another (using drainage). Intensive postoperative pain in 6 patients with delayed discharge.

Conclusion
In our series, E-TEP is safe but not free of complications.We started the procedure very ambitiously with M3W2 incisional hernias, but we soon realized that this technique did not allow us to revise the cavity and perform adhesiolysis, so we changed the way we managed these patients, and became more selective, only indicating E-TEP in medium-sized primary hernias associated with rectus diastasis. We managed to improve surgical skill with the cases, reducing postoperative pain, surgical time and hospital stay.
P-035 THE IMPORTANCE OF THE VALSALVA MANEUVER IN IMAGING DIAGNOSIS USING COMPUTER TOMOGRAPHY IN PATIENTS WITH INGUINAL HERNIAS
Authors: Fodor D , Biris P , Suciu B A 
Published: May 2023

Abstract

Aim
Recently, more and more studies have demonstrated the importance of practicing the Valsalva maneuver during the abdominal computer tomography investigation, for bettering the accuracy of the imagistic diagnosis in these patients.

Material and Methods
In this study we introduce 118 patients with inguinal hernias (110 men - 93.22% and 8 women - 6.78%).
The patients were divided into two groups. Group A was comprised of 92 patients with bilateral inguinal hernias. Group B was comprised of 26 patients with unilateral inguinal hernias. The Valsalva maneuver was performed on all the patients included in the study, during the abdominal computer tomography investigation.
The diagnostic confirmation of the hernia was done intraoperatively.

Results
Of the 92 patients studied in group A, 60 patients were confirmed to have bilateral inguinal hernias during the abdominal CT exam - 65%, while for 31 patients the diagnosis was confirmed after the applying the Valsalva maneuver - 34%. In one of the cases, the diagnosis of bilateral inguinal hernia was only established intraoperatively - 1%. Of the 26 patients studied in group B, 23 cases had an established diagnosis of unilateral inguinal hernia due to the abdominal CT exam - 88.5% while in 3 patients the diagnosis was only established after practicing the Valsalva maneuver - 11.5%.

Conclusions
In cases of patients with inguinal hernias, practicing the Valsalva maneuver during the abdominal CT exam, can be considered very useful in the diagnostic accuracy for these types of patients.
P-037 Zinc oxide/collagen (ZnOC) biocomposites for the development of novel meshes
Authors: Prodan A , Cancea B , Matei M , Turculet C , Beuran M 
Published: May 2023

Abstract
When we talk about abdominal wall hernias, we are talking about a complex surgical approach. In recent years there is a special interest in the use and development of meshes with antimicrobial properties. Doctors are making efforts to continue progress in this area.
We propose the development of meshes covered with Zinc Oxide in a collagen matrix. They have biomedical applications and antimicrobial properties.
The objectives of the study are to highlight the major contributions that Zinc Oxide in collagen matrices could make, in the development of new antimicrobial properties. The research will test both the synthesis method of Zinc Oxide in collagen matrix, as well as its ability to inhibit the bacterial activity of different species of bacteria.
We demonstrate the significant contributions that could be made by using composites based on Zinc Oxide in collagen matrices for the development of new biocompatible medical devices with antimicrobial properties.
This will lead to important advances in the development of new networks based on Zinc Oxide in collagen matrix (ZnOC).
Physicochemical characterization of ZnOC composites was performed, using appropriate techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM and EDS) and transmission electron microscopy (TEM), infrared spectroscopy (FTIR). The antimicrobial properties of ZnOC biocomposites was investigated using clinical and reference microorganisms belonging to Gram positive, Gram negative and fungal families.
P-040 MERY'S SIGN IN LARGE INGUINO-VESICAL HERNIAS – A CASE REPORT AND REVIEW
Authors: Ungureanu C , Ginghina O , Iordache N 
Published: May 2023

Abstract
Inguinal bladder hernia (IBH) is a variety of inguinal hernia rarely found: the urinary bladder is involved in no more than 5% of all groin hernias. Usually asymptomatic and occuring in men aged over 50 years, it can be incidentally encountered during hernia repair. Herein we report a case of a 68 years-old obese patient with a large symptomatic IBH, containing almost whole urinary bladder and successfully treated via open hernia repair using a properitoneal mesh technique, as described by Celdran. This entity of hernia should be suspected when inguinoscrotal hernia is associated with urinary symptoms. We evoke this specific clinical sign: Mery's sign, that implies two-stage micturition, i.e. initial manual compression of hernia is followed by bladder voiding. We emphasize the importance of preoperative diagnosis in order to reduce inadvertent lesions of the bladder or ureters during hernia surgery. Diagnosis is based on ultrasound, CT, cystography, but we also stress the idea of preoperative cystoscopy. Also, uretheral catheterization is an important aspect in diagnosis – intraoperative bladder filling/insufflation with saline fluid/methylene blue. Also it is important to emphasize that postoperative diagnosis can be exerted on bladder injury and leakage occuring after surgery in at least 10%, as literature reports. Treatment of IBH is based on reducing the bladder to its native position and hernia cure: open, laparoscopic or robotic approach.
P-041 3-YEAR RETROSPECTIVE ANALYSIS OF USE OF ONLAY PROPHYLACTIC MESH IN MIDLINE LAPAROTOMY FOR GASTRIC CANCER
Authors: Julià-Verdaguer E , Olona C , Vadillo J , Jorba R 
Published: May 2023

Abstract

Background
Incisional hernias are a frequent complication of abdominal wall incisions, ranging from 12.8% to 69% in long-time series. Recent literature supports the use of prophylactic mesh placement to avoid long-term incisional hernias.
Gastric surgery in our center is performed via midline laparotomy and prophylactic mesh placement is carried out as a usual practice.
The objective of our study is to evaluate long-term results of prophylactic mesh in midline laparotomies for gastric cancer.

Methods
Observational retrospective analysis of all patients undergoing gastric cancer sugery via midline incision with use of a polypropliene autoadhesive prophylactic mesh, between the years 2019–2021.
Outcome measures included demographics, comorbidities, wound complications, reinterventions, neoplastic recurrences and incisional hernias (diagnosed by CT scan).

Results
A cohort of 55 patients (80% male). Mean age 68.1 years old (41–86), BMI 25,75 kg/m2 (18.73–33).
All patients operated for gastric cancer, abdominal wall closure with small bite technique (monofilament absorbable 2/0 suture) and autoadhesive onlay mesh. 72.7% distal subtotal gastrectomies. 89% elective surgery. Mean albumin in preoperative analytic 40.5 g/L.
Postoperative complications: 72% Clavien-Dindo grade II, mean CCI 29 (including 4 reinterventions and 1 exitus). Mean follow-up 24.9 months: 8 (14.5%) neoplastic recurrences, 4 (7.3%) exitus for cancer progression and 3 (5.4%) incisional hernias diagnosed by CT Scan (none of them reoperated). No meshes have been removed.
In a comparative study no risk factors for incisional hernia have been found.

Conclusions
In our setting, the use of polypropylene autoadhesive prophylactic meshes in midline incision for gastric cancer is safe and durable.
P-044 FEASIBILITY AND SAFETY OF A NEW ‘ON-DEMAND ROBOTICS' PLATFORM FOR INGUINAL HERNIA REPAIR
Authors: Mignot H , Capitaine J , Diack B 
Published: May 2023

Abstract

Aim
To assess the feasibility, safety, and efficiency of a novel ‘on-demand robotics' platform for inguinal hernia repair.

Materials & Methods
A robotic system consisting in a sterile surgeon console, two robotic instrument arms, and one robotic endoscope arm, was evaluated. This ‘on-demand robotics' platform allows surgeons to remain sterile and combine work at the surgeon console and at the patient bed, e.g. in case of emergency management. This open platform also integrates with existing operating room (OR) equipment such as 3D laparoscopic camera, insufflator, energy devices and trocars.
We present the first series of 16 transabdominal preperitoneal inguinal hernia repair procedures (9 unilateral, 7 bilateral) performed with the robotic system. Safety outcomes and skin-to-skin procedure times were documented. All procedures were performed by one surgeon with extensive laparoscopic surgery experience.

Results
All 16 patients were successfully treated with no device-related adverse events. Most patients were discharged on the same day. 14 patients had reached 30 day follow-up with no morbidity and maintained outcome. Skin-to-skin procedure time was 64 and 84 minutes for unilateral and bilateral procedures respectively. Unilateral mean robotic times transitioned from 73 to 54 minutes between the 5 first and the last 4 cases, indicative of a fast learning curve.

Conclusions
“On-demand” robotic repair of inguinal hernia is feasible and safe. The described platform provides direct patient access to the sterile surgeon, and uses existing OR equipment. Surgeon's prior laparoscopic experience may also shorten learning curve.
P-050 A CASE OF EPIGASTRIC HERNIA WITH INCARCERATION OF THE LEFT HEPATIC LOBE AND REVIEW OF THE LITERATURE
Authors: Hashim D 
Published: May 2023

Abstract

Abstract
An epigastrishe hernias with hepatic herniation are extremely rare. This is the first case of epigastric hernie with leber left lobe incaceration in the literatur. The other seven cases are cases with incisional hernia which have been reported so far in the literature. . We report a case of an epigastrishe hernia with incacerated hepatic left lobe along with a review of the literature. A 71-year-old female patient was admitted to our hospital with acute pain and complain of epigastric swelling. On examination, she had a tender 5 cm×5 cm epigastric lump and was diagnosed as incacerated epigastric hernia. Contrast-enhanced CT of the abdomen revealed a ventral hernia with herniation of omentum and left hepatic lobe. The patient underwent open IPOM mesh repair and is asymptomatic at 1-month follow-up.

Background
Ventral hernias with hepatic herniation are extremely rare. Hepatic herniation through congenital defects such as diaphragmatic hernia or omphaloceles are known to occur, but subcutaneous hepatic herniation through a ventral hernia is rarely encountered. We report a case of epigastric hernia with hepatic herniation, and its clinical and radiological findings, along with a review of the literature.
P-051 OPEN ABDOMEN MANAGEMENT IN PATIENT WITH ECMO THERAPY
Authors: Déniz Ramírez A M , González Sánchez L , Tejera Hernández A A , Hernández Hernández J R , Ocampo Pérez J G 
Published: May 2023

Abstract
Management of negative pressure therapy with fascial traction mediated by inlay mesh, in the context of a patient with multiple organ failure (MOF) secondary to sepsis of abdominal origin in treatment with extracorporeal membrane oxygenation therapy (ECMO)
We present the case of a 15-year-old female patient, referred to a hospital after continuous consultations in a primary care center. She refers abdominal pain located in the right iliac fossa of 72 hours of evolution. Blood analysis with high infectious parameters, abdomen on a table and scanner compatible with acute appendicitis complicated by perforation. Urgent surgical intervention, where purulent peritonitis was observed in the four quadrants, the abdomen was kept open with NPT.
In a situation of MOF, the need for high-dose noradrenaline and acute respiratory failure. During intubation, 2nd pneumothorax due to barotrauma. Given early deterioration, ECMO therapy was started. After completion of treatment, decreased intra-abdominal pressure and no restrictive respiratory compromise. Progressive fascial traction, using inlay mesh for 18 days until complete closure, using 2/0 monofilament suture, small bites technique, 4:1 ratio and placement of wide-pore, onlay polypropylene mesh. Partial dehiscence of the surgical wound as the only complication, NPT at 80mm Hg with definitive closure was prescribed. Satisfactory evolution one year after the intervention.
After our experience with this case, we can conclude that NTP in the open abdomen with the help of facial traction mesh, in patients with ECMO therapy in a situation of septic shock, may be an adequate alternative for definitive closure of the abdominal wall.