bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-074 A NEW THREE-DIMENSIONAL MODEL OF THE INGUINAL REGION FOR ANATOMY TEACHING
Authors: Blazquez Lautre L , Yarnoz Irazabal C , Insausti Serrano A 
Published: May 2023

Abstract

Aim
The inguinal anatomy is difficult, but a correct anatomical base prevents clinical errors. We present a three-dimensional paper model the student made by himself to improve knowledge of the setup of layers and structures from the inguinal region.

Material and methods
It is a paper model that is made from a printed document, that is distributed in PDF format supported by a video tutorial. This model contains the layers of the inguinal region and other structures. Its usefulness has been tested with Medicine students in the Anatomy course.
In a practical class, before starting, the students answer a questionnaire with questions about inguinal anatomy and the self-perception of their knowledge. The individual construction of the model is carried out and at the end of the class they answer the questionnaire again.

Results
The results of the 2022–23 academic year show an improvement in the self-perception of their knowledge going from an average grade of 2.54/5 before the practice to 3.42/5 and an improvement in the correct answers going from 57.5% of correct answers to 71.42% after the construction of the model.

Conclusions
This method has the following advantages: it is built by the student, very low cost, reproducible and it is three-dimensional. Based on the preliminary results of the past academic year, we hope that students will significantly improve their theoretical knowledge about the inguinal region, and they will have improved their confidence about the knowledge of this subject.
OC-075 RADIOLOGIC TRANSVERSUS ABDOMINIS MUSCLE RETRACTION AFTER UNILATERAL TRANSVERSUS ABDOMINIS RELEASE VIA ETEP
Authors: Guevara-Martínez J , Hernández S , Gutiérrez E , Zapata C , Chavarrías N , Vicario M , Fondevila C , Salido S 
Published: May 2023

Abstract

Aim
Our principal aim is to determine the retraction distance (RD) of the transverse abdominis muscle after unilateral endoscopic transversus abdominis release (eTAR) for the treatment of midline and lateral hernias, and compare it with the same patient contralateral unreleased side.

Material and Methods
We performed a retrospective analysis of a prospective database collection. We defined the RD as the measure between the lateral edge of the rectus abdominis muscle and the medial edge of the transversus abdominis muscle at the level of L3-L4 and at the defect´s maximum diameter. RD was measured pre and postoperatively and compared in the eTAR side with the contralateral (non- eTAR) side.

Results
94 midline and 63 lateral hernias underwent hernia repair via endoscopic totally extraperitoneal (eTEP). Thirtyfive patients required unilateral TAR, including 1 primary and 34 incisional hernias. Lateral (65,7%) and medial (34,3%) defects were both included. The mean hernia defect was 49mm transverse diameter and 52mm longitudinal. We compared the postoperative RD at L4, obtaining 45,8mm on the eTAR side and 42,2mm on the non-eTAR side (p=0,284). At the defect site a mean of 38,3mm on the eTAR side was compared with 35,5mm (p=0.363). In our series we didn't find any statistically significant differences in the transversus muscle retraction after unilateral eTAR when compared with the unreleased side.

Conclusions
eTAR is a safe technique especially during the treatment of lateral hernias, allowing a proper mesh placement without significant transverse muscle retraction.
OC-085 APPROACH AND SURGICAL REPAIR OF RECURRENT COMPLEX PARASTOMAL HERNIA IN AN ADVANCED ABDOMINAL WALL UNIT
Authors: Castaño J C , Crusellas O , Subirana H , Comas J 
Published: May 2023

Abstract

Aim
We present a case of a recurrent parastomal hernia with enterocutaneous fistula and subcutaneous abscesses and their management.

Material & Methods
79-year-old patient with history of pT4b low rectal cancer treated with an abdominoperineal resection with adjuvant chemo-radiotherapy in 2000.
Parastomal hernia repair was performed in 2016 with PTFEe mesh according to the Sugarbaker technique and closing midline with double-sided inlay mesh. A plastic peritonitis was found at this moment
In July 2021 presented episodes of fever with spontaneous parastomal purulent drainage, deciding initially conservative treatment.
Due to persistence of soft tissue infection local surgical drainage was performed in September 2021, removing previous parastomal PTFEe mesh.
The patient presented multiple infectious relapses from January to March 2022, debridement was carried out combined with negative pressure therapy. During follow-up intestinal fluid was seen through the negative therapy what put on show an enterocutaneous fistula.
Finally, we decided radical surgery in May 2022 performing an in-block resection of end colostomy, 30 cm of ileum and abdominal wall area affected of chronic infection and previous meshes. A 20×20cm defect was left. Reconstruction with double-sided inlay mesh and new colostomy in the right iliac fossa was performed. Skin closure required cutaneous plastia.

Conclusions
The use of suitable prosthetic material for the repair of parastomal hernia doesn't exclude the developing of severe complications.
An early and decisive surgical approach is recommended in cases of chronic prosthetic material infection to avoid redundant and non-cost-effective treatments.
OC-090 MESH FIXATION IN LAPAROENDSOCOPIC REPAIR OF LARGE M3 INGUINAL HERNIAS – MULTICENTER, DOUBLE-BLINDED, RANDOMIZED TRIAL -&gt; MEFI TRIAL
Authors: Zamkowski M , Śmietański M 
Published: May 2023

Abstract

Introduction
Guidelines of groin hernia treatment strongly recommends to fixate the mesh in large M3 medial defects during TAPP / TEP. In 2022 team consisting of hernia surgeons and scientists from universities of technology conducted an experimental study with the use of 3d groin model to verify the hypothesis that fixation is not necessary in above cases. Experiment showed that rigid and anatomically shaped meshes are able to maintain its position in groin without fixation. To confirm experimental results we decided to conduct RCT.

Study Hypothesis
Non-fixation of spatial, standard polypropylene meshes is non-inferior as compared to fixation of flat, polypropylene lightweight meshes in m3 hernias.

Materials and Methods
11 large surgery centres in poland were recruited for this study. recurrence in 12-month follow-up was set as a primary endpoint. pain sensation (vas scale) was made secondary endpoint. minimal sample sizes were established 82–103 in each arm. first arm (control): patients repaired with the use of flat, macroporous mesh with fixation. second arm (experimental): patients repaired with the use of anatomically shaped, standard mesh without fixation. after dissection of preperitoneal space, surgeon will find out the technique he will have to perform. patients won't be aware of the method. pain and reccurence will be measured during the hospital stay and then up to 12-months after surgery.

Predicted Outcomes
Based on experimental study and own experience, we believe that recurrence rate in both groups (control and experimental) would be on the same level givingba strong argument for amending the guidelines.
OC-092 Giant inguinoscrotal hernia treated with botulinum toxin, pneumoperitoneum and scrotoplasty associated to hernia repair
Authors: Tuñón-Féquant C , Rodríguez-González D , Ortega-González M Y , Casanova-Ramos R , Guil-Ortiz B , Montes-Montero A , Arteaga-González I 
Published: May 2023

Abstract

Aim
Inguinal hernias are the most frequent hernias of the abdominal wall, but giant hernias are a rare entity in developed countries. The surgical repair of these hernias is a challenge for surgeons, with high rates of postoperative morbi-mortality and recurrence. There are limited reports of cases of giant inguinal hernia treated with preoperative botulinum toxin and pneumoperitoneum and hernia repair associated with scrotoplasty.

Material & Methods
We present the case of a male patient of 68 years-old suffering from a giant inguinoscrotal bilateral hernia with loss of domain that was causing an extreme limitation to ambulate. The index of Sabbagh measured by images of computed tomography was 48,8%.

Results
We administrated preoperative botulinum toxin and progressive pneumoperitoneum (14100cc of air) before surgery. We realized a Rives-Stoppa technique with partial transverse abdominis release and scrotoplasty. Intra-abdominal pressures were measured during the early postoperative period. Seven days after surgery a restrictive respiratory failure was diagnosed needing non-invasive mechanical ventilation. Nevertheless, the evolution was satisfactory, and the patient was discharged on postoperative day 20. After a follow-up of 1 year neither hernia recurrence and no chronic pain were recorded. His quality of life improved notably.

Conclusions
In order to avoid the development of an abdominal compartment syndrome, the preoperative administration of pneumoperitoneum and botulinum toxin is suggested as a therapeutic option in giant hernias. Furthermore, adding scrotoplasty to hernia repair can improve functional and aesthetic results.
OC-116 IMPACT ANALYSIS OF DIASTASIS RECTI ASSOCIATION IN PRIMARY VENTRAL HERNIA REPAIR. OUR EXPERIENCE
Authors: Bravo Salva A , Bosch Silvela G , Perez Guitart M , Gimeno Lopez M , Pera Roman M , Pereira Rodriguez J A , Lorente Poch L 
Published: May 2023

Abstract

Aim
The aim of the study is to analyze concomitant diastasis recti impact in ventral hernia repair in our experience.

Material and methods
An observational single-center retrospective analysis was performed. We analyzed primary ventral hernia preperitoneal repairs in our Hospital from 2019 to 2021. Two groups were compared according to the presence of concomitant diastasis recti or not. We performed a descriptive analysis; comparative univariate analysis for complication and recurrence and risk factors analysis.

Results
From 312 ventral hernia repairs a total of 279 (89%) preperitoneal open hernia repairs were performed. 18 (6.5%) patients had diastasis recti. 236 (84.6%%) were day case surgery. 7 (13.4%) patients had surgical complications. There were no reoperations, 4 readmissions (1.4%%), and 1 death (0.3%) Diastasis recti group had no statistically significative difference with the control group except that more frequently were repaired by an abdominal wall surgeon specialist 1.2 vs 5.9%; p= 0.009) In complications risk factors univariate analysis higher size of mesh and hernia defect and lower mesh/defect ratio were associated with more complications. Recurrence was significatively lower in patients with chronic renal failure. No risk factors for recurrence were found.

Conclusions
In our ventral hernia repair serie small or medium size diastasis recti associated to ventral hernia repair seem not to impact in hernia repair outcomes. Diastasis repair should carefully take it into account when repairing an associated ventral hernia repair in order to not increase surgery complications. And mesh/hernia defect size ratio is related to complications.
OC-117 LIRA (LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY) TECHNIQUE FOR MIDLINE VENTRAL AND INCISIONAL HERNIAS: PRELIMINARY ANALYSIS OF A PROSPECTIVE SERIES
Authors: Hoyuela C , Pierres M , Caballero D , Navarro J , Cubel M , Rovira M , Martínez F , González I , Urdaneta G , Astete S 
Published: May 2023

Abstract

Objective
To analyze the safety and efficacy of the LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) technique by evaluating postoperative pain, complications (seroma, infection, etc.), bulging, and recurrence rate.

Methods
Prospective analysis of patients who underwent elective laparoscopic repair of midline ventral and incisional hernias with defects 4 to 8 cm wide (W2, EHS classification). Endpoints: Recurrence rate (primary endpoint). Secondary objectives: acute pain, postoperative seroma, infection, chronic pain, bulging and patient satisfaction.

Results
From 2020 to 2021, LIRA repair was performed in 12 patients (mean age 51-y, mean BMI: 33.5 kg/m2). Mean defect width: 5.9 cm. Rectus diastasis&gt;5cm. was present in 6 patients. No intraoperative complications were observed. Tension-free closure was achieved in all patients. Mean operative time: 79 minutes. Postop clinical seroma: 4/12 patients (No intervention needed).
Postoperative pain (VAS): 4 at 24h, 0.6 at one month, and 0 in those patients who have completed one year of follow-up. No clinical or radiological recurrences, nor trocar hernias have been observed. The degree of patient satisfaction is 9/10. No one complained of bulging.

Conclusions
Despite being a technically demanding procedure, the LIRA technique allowed a tension-free midline reconstruction of patients suffering from hernia defects smaller than 8 cm without relevant complications. Although the follow-up time is short, no recurrences or trocar hernias have been observed to date. Therefore, LIRA should be considered a safe and efficient therapeutic alternative in patients with ventral and incisional hernias type W2.
OC-122 CHARACTERISATION OF HUMAN POSTERIOR RECTUS SHEATH REVEALS MECHANICAL AND STRUCTURAL ANISOTROPY
Authors: Whitehead-Clarke T , Brown C , Ali G , Mudera V , Smith C , Kureshi A 
Published: May 2023

Abstract

Background
Our work investigated the mechanical properties of the posterior rectus sheath (PRS) in terms of its ultimate tensile stress (UTS), stiffness, thickness and anisotropy as well as assess the collagen fibre organisation of the PRS using Second-Harmonic Generation (SHG) microscopy.

Methods
For mechanical analysis, twenty-five fresh-frozen PRS samples of were taken from six different cadaveric donors. They underwent uniaxial tensile stress testing until rupture either in the transverse (n=15) or longitudinal (n=10) plane. The thickness of each sample was also recorded using digital callipers. On a separate occasion, ten PRS samples and three anterior rectus sheath samples underwent SHG microscopy and photography to assess collagen fibre organisation.

Results
PRS samples had a mean UTS of 7.7MPa (SD 4.9) in the transverse plane and 1.2 MPa (SD 0.8) in the longitudinal plane (P&lt;0.01). The same samples had a mean Youngs modulus of 11.1 MPa (SD 5.0) in the transverse plane and 1.7 MPa (SD 1.3) in the longitudinal plane (P&lt;0.01). The mean thickness of the posterior rectus sheath was 0.51mm (SD 0.13). Collagen fibres within the tissue could be identified with SHG microscopy, generally aligned transversely.

Conclusion
The PRS displayed mechanical and structural anisotropy with greater tensile stress and stiffness in the transverse plane compared to the longitudinal plane. The mean thickness of this layer is around 0.51mm – consistent with other studies. The tissue is constructed of transversely aligned collagen fibres that are visible using SHG microscopy.
OC-126 PRESERVATION OF DEEP EPIGASTRIC PERFORATORS DURING ANTERIOR COMPONENT SEPARATION TECHNIQUE (ACST) RESULTS IN EQUIVALENT WOUND COMPLICATIONS COMPARED TO TRANSVERSUS ABDOMINIS RELEASE (TAR)
Authors: Ayuso S , Sacco J , Salvino M , Scarola G , Ku D , Tawkaliyar R , Brown K , Colavita P , Kercher K , Augenstein V , Heniford B T 
Published: May 2023

Abstract

Aim
The use of component separation results in myofascial release and increased rates of fascial closure in abdominal wall reconstruction (AWR). These complex dissections have been associated with increased rates of wound complications with anterior component separation having the greatest wound morbidity. The aim of this paper was to compare the wound complication rate between PS-ACST and TAR.

Material & Methods
Patients were identified from a prospective, single institution hernia center database who underwent PS-ACST and TAR from 2015–2021. The primary outcome was wound complication rate. Standard statistical methods were used, univariate analysis and multivariable logistic regression were performed.

Results
A total of 172 patients met criteria, 39 had PS-ACST and 133 had TAR performed. The PS-ACST and TAR groups were similar in terms of diabetes (15.4% vs 28.6%, p=0.097), but the PS-ACST group had a greater percentage of smokers (46.2% vs 14.3%, p&lt;0.001). The PS-ACST group had a larger hernia defect size (375.2±156.7 vs 234.4±126.9cm2, p&lt;0.001) and more patients who underwent preoperative Botulinum toxin A (BTA) injections (43.6% vs 6.0%, p&lt;0.001). The overall wound complication rate was not significantly different (23.1% vs 36.1%, p=0.129) nor was the mesh infection rate (0% vs 1.6%, p=0.438). Using logistic regression, none of the factors that were significantly different in the univariate analysis were associated with wound complication rate (all p&gt;0.05).

Conclusion
PS-ACST and TAR are comparable in terms of wound complication rates. PS-ACST can be used for large hernia defects and promote fascial closure with low overall wound morbidity and perioperative complications.
P-006 OUR EXPERIENCE WITH TAR FOR COMPLEX INCISIONAL HERNIA REPAIR
Authors: Santidrián Zurbano M , Domínguez Bastante M , Vilchez Rabelo A , Turiño Luque J D , Díaz Ríos P , Mansilla Roselló A 
Published: May 2023

Abstract

Aim
Transverse abdominis muscle release (TAR) enables dissection of the preperitoneal space and the placement of large meshes. We present our experience with TAR in the treatment of complex incisional hernias (IH).

Material and Methods
Retrospective, descriptive study of patients operated with the TAR technique (October 2019-July 2022). Epidemiological characteristics, comorbidity, prehabilitation, type of IH, bridging, surgical time, hospital stay, morbidity, mortality and recurrence were studied.

Results
69 TAR (30 females/39 males); age 64.9 years (24–85), body mass index 31 (19–49), CeDAR 35% (4–92). 66 cases (96%) treated preoperatively with Botulinum Toxin A, 31 (45%), with preoperative progressive pneumoperitoneum and 29 (42%) with both. Classification (EHS): M 52 (46%), L 7 (10%), ML 9 (13%), parastomal 1 (1%), tumour 1 (1%). 36 cases R0 (52%), R1 22 (32%), R2 4 (10%) and R3 6 (9%). Median size 17.8 cm(3–30) x13.7 cm (6–25), area 694.3 cm2. Primary fascial closure was achieved in 26 cases (38%), remaining 43 (62%) with bridging (8.7 cm (2–19)x5 cm (1–16)), postoperative area 125.6 cm2 (82% reduction). Surgical time was 242 minutes (140–450). Hospital stay 9 days (3–45). Wound-related complications 35 (50%): infection 15 (21%), seroma 17 (24%), haematoma 15 (7%), skin necrosis 1 (1%). General complications 7 (10%): 2 urinary tract infection, 1 intestinal perforation, 1 pneumonia, 1 haematoma, 1 haemorrhagic shock, 1 heart failure. Mortality 2 (3%). Recurrences 0 (0%).

Conclusions
TAR is a very useful and effective technique for resolving complex eventrations. It is not exempt from morbidity, therefore adequate patient selection is recommended.
P-008 PRE-OPERATIVE PREPARATION IN HERNIAS WITH LOSS OF DOMAIN
Authors: Ribeiro Dias R , Miguel Almeida N , Fonseca T , Barbosa E , Barbosa E 
Published: May 2023

Abstract

Aim
Incisional hernia with loss of domain remains a surgical challenge. Its management requires complex approaches and pre-operative optimization is essential for the success of the surgical repair.

Material and Methods
We describe a case of a 59-year-old woman with a BMI of 35,4 with a recurrent hernia with significant loss of domain. The transverse hernia defect was 12cm and a Tanaka of 40%. Previous to the abdominal wall surgery, the patient had a gastric sleeve in order to lose weight. She lost 27 kilos and was proposed to surgery with a BMI of 25,2. She was also submitted to injection of 300U in six points of the abdominal wall of botulinum toxin and a progressive pneumoperitoneum with insufflation of 8000 cc of filtered air.

Results
The hernia was treated with a Rives-Stoppa-Wantz technique with placement of a macroporous polypropylene mesh with 48mg/m2 density in a retromuscular position and extensive panniculectomy was done. The postoperative course was uneventful.

Conclusions
The combination of preoperative progressive pneumoperitoneum and botulinum toxin decrease the risk of postoperative complications like abdominal compartment syndrome. Both procedures, as well as the bariatric surgery, facilitates the management the patient, allowing it to be possible to correct this type of hernias with less invasive techniques like a Rives Stoppa Wantz repair.
P-010 IS THE ONSTEP METHOD FOR INGUINAL HERNIA SIMPLE AND SAFE?-STUDY OF SHORT-MIDDLE TERM RESULTS OF THE ONSTEP METHOD IN OUR DEPARTMENT
Authors: Tsuchiya Y , Kimura D , Omura T , Ota N , Shimada K , Hojo S , Matsui K , Yoshioka I , Okumura T , Fujii T 
Published: May 2023

Abstract

Aim
The ONSTEP (Open New Simplified Totally Extraperitoneal) method is a new surgical procedure for inguinal hernia reported by Lourenço and da Costa from Portugal in 2013. We investigated the operative results and post operative course of the ONSTEP method in our department.

Material & Methods
Since January 2021, we performed the ONSTEP method for 36 patients who classified except for female and European Hernia Society (EHS) classification for inguinal hernia L3, and investigated patient's background, surgical procedure, and postoperative course. In addition, to investigate whether there were any differences in the simplicity and safety of this procedure between operators, we compared these points of the patients operated by Board Certified Surgeon in Gastroenterology (group A) or beginner (group B).

Results
The average height, weight and Body Mass Index of the patients was 165.9 cm, 60.6 kg, 22.1 respectively. The average operating time was 55.1 minutes, and the average blood loss was 7.0 g. 16 cases (44.4%) planned day surgery and performed it as planned, and the remaining 20 cases were discharged on the day after surgery as planned. Local swelling was observed in 19 patients (52.8%) one week after the operation, but all of them improved one month after the operation. All patients had no chronic pain or infection. There was no statistical difference between group A and B except for the average operating time (A: 50.3minutes, B: 69.4 minutes, p = 0.001).

Conclusions
The ONSTEP method is simple, highly safe, and expected to reduce chronic pain.
P-012 GARENGEOT'S HERNIA WITH ACUTE APPENDICITIS: A RARE CASE
Authors: Lourenço R , Matos D , Lopes A , Santos A , Peixoto I , Longras C , Oliveira M , Pinto R , Alpoim C 
Published: May 2023

Abstract
Garengeot's hernia is a rare entity that refers to the herniation of the vermiform appendix through the femoral canal, being even rarer the presence of acute appendicitis in a Garengeot hernia as presented in the clinical case, with an overall incidence of 0,08%-0,13%.
A 52 years old female patient, attended the Emergency Service complaining of abdominal pain in the right lower quadrant and fever for the last 2 days.
As pathological background, she had bilateral tubal ligation, right crural hernioplasty and iatrogenic uterine perforation after placement of a intrauterine device (IUD).
On physical examination, she complained of pain in iliac fossa/right inguinal region showing a positive Blumberg sign. Abdominal ultrasonography revealed acute appendicitis. In the laparoscopic approach, we identified the ileocecal appendix contained in a right crural hernia with abscessed acute appendicitis. We proceeded with appendectomy and, given the soiling of operative field, we chose not to correct the hernia at that moment.
Empirical antibiotic therapy with Amoxicillin/Clavulanic acid was performed and patient was discharged after 3 days.
Diagnosis of Garengeot hernia with acute appendicitis is difficult, being more frequently diagnosed intraoperatively.
There's no standard therapeutic approach regarding hernia repair simultaneously, being licit not to do it due to the risk of postoperative infection.