bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-020 REACTIVATION OF SURGICAL CAMPAIGNS AFTER THE COVID PANDEMIC: SURGEONS IN ACTION WITH HERNIA INTERNATIONAL FOUNDATIONS IN 2022
Authors: Butrón T , Ramirez C , Perea E , De La Torre C , Mora J , Murga P , Fdez Luengas D , Bustos M , Moreno J , Revuelta B , Kingsnorth A , Catot L 
Published: May 2023

Abstract

Aim
The Cirujanos en Acción and Hernia International foundations carried out their own and collaborative surgical campaigns in developing countries. In 2020 and 2021 the programme had to be suspended due to Covid. In 2022 we restarted our actions, analysed the difficulties of reactivation and described the campaigns that had been carried out and those that had to be delayed.

Material/ Methods
We describe the 9 campaigns of Surgeons in Action, our own and in collaboration with Hernia International and our own campaign to the region of Naborno Karabakh, planned for September and cancelled 24 hours before departure due to the resurgence of armed conflict. An analysis is made of volunteers, places, type (adults or children or mixed), collaborations with other foundations, patients operated and procedures done according to pathologies, integration with local staff with exchange of knowledge.

Results
Made in 8 countries (Benin, Camerun, Gambia (2), Kenya, Liberia, Mozambique, Tanzania, Sierra Leone) and postponed in one country, the Naborno Karabakh region of Armenia. 85 volunteers (25 general and 10 paediatric surgeons, 19 anaesthetists, 3 intensivists, 23 nurses, 5 audiovisuals); local staff; 1144 patients (473 children, 671 adults), 1325 procedures for various pathologies (hernias, goitres, hydroceles, undescendend testis, soft tissue tumours, etc.)

Conclusion
9 campaigns have been carried out successfully and new locations have been opened with a good projection for the coming years, and we have experienced difficulties with the cancellation of a mega-campaign in an area with geopolitical conflicts - to be taken into account in the future
P-022 A RARE CASE OF APPENDICITIS IN A FEMORAL HERNIA, DE GARENGOUT'S HERNIA- A CASE REPORT AND LITERATURE REVIEW
Authors: Kazi A , Kazi F , Perthiani H K 
Published: May 2023

Abstract
Acute appendicitis within a femoral hernia, also known as a De Garengout's hernia (DGH) is a rare condition, occurring in approximately 0.08–0.15% of all femoral hernia cases. It was first described by Renee in 1731. We present the rare case of a young male with acute uncomplicated appendicitis within a femoral hernia, known as a De Garengout's hernia (DGH). Prompt recognition and diagnosis followed by early surgical intervention in the form of femoral hernia repair followed by laparascopic appendicectomy, allowed for timely and appropriate management for satisfactory post operative outcomes of this condition. Our case is unique due to the rarity of this pathology, along with the lack of international standardised guidelines on current management. This can make diagnosis challenging and may present a management dilemma to the surgeon, while also highlighting the importance of a skilled general surgeon along with early involvement of a senior radiologist to aid in an accurate diagnosis.
P-023 PATIENT SATISFACTION AFTER INGUINAL HERNIA SURGERY: LITERATURE REVIEW OF AN OVERLOOKED PATIENT-REPORTED OUTCOME MEASURE
Authors: Nijs J , Miserez M , Meylemans D , Tollens T 
Published: May 2023

Abstract

Aim
Patient satisfaction after inguinal hernia surgery is currently underappreciated and not as well studied as other patient reported outcome measures (PROMs) on this topic. Our study aims to review the literature and summarize available data.

Materials & Methods
A literature review was conducted using Medline focusing on patient reported satisfaction after elective, inguinal hernia surgery in adults (&gt;18 years old). All inguinal hernia repair techniques were considered, but small sample sizes (&lt;100 patients) and short follow-up periods (&lt;6 months) were excluded. The methodology and results of the remaining articles were reviewed. Due to heterogeneity of reporting between articles, only a descriptive analysis was performed.

Results
The available data from 15 out of 358 articles was withheld for further analysis. Unfortunately it has become apparent patient reported outcome measures regarding satisfaction lack validation and yield considerable heterogeneity, as 53% of all included studies used an asymmetrical response questionnaire. Resulting in an overwhelmingly positive patient satisfaction, be it with wide ranges (78–100% more than averagely satisfied, compared to 0–15% less than averagely satisfied). The number of patients not willing to undergo inguinal hernia repair again ranges from 1–16.

Conclusion
Our study demonstrates patient reported satisfaction is not uniformly surveyed and remains unvalidated. Further research on patient reported satisfaction would benefit from standardization and validation, while using a symmetrical and balanced 5-point Likert or 11-point NRS scale at regular post-operative intervals with addition of open questions to evaluate patient satisfaction after inguinal hernia surgery.
P-025 TREATMENT OF UMBILICAL HERNIA IN A COOPERATION PROJECT IN TANZANIA
Authors: Garcia Garcia L , González Sánchez L , Cordero Rojas A , Kimaro J , Antonini G , Hernández Hernández J R 
Published: May 2023

Abstract

Aim
Adult umbilical hernia accounts for between 3% and 14% of abdominal wall hernias, second only to inguinal hernias in frequency. The current prevalence of umbilical hernias in Africa is currently unknown, but it is estimated that about 50,000 patients die each year in Africa as a result of umbilical hernias. We describe below the number of interventions performed in 2022 by European aid workers in a third level Hospital in Tanzania using local anesthesia and the available material.

Material and Methods
We performed a retrospective observational study of the number of umbilical hernias operated in a Third level Hospital in Tanzania

Results
Throughout 2022, 2818 surgical interventions were performed in men and women by european aid workers: 114 interventions (4.04%) were umbilical hernia repairs. The age range of the operated patients was 12–18 years. No mesh was used in any case. The techniques used consisted of edge-to-edge closure. Patients were discharged after 24–48 hours without complications and no follow-up was obtained due to the fact that it was a rural hospital.

Conclusions
Umbilical hernia repair with mesh is the gold standard of treatment in our environment, however its practice in collaborative projects of this type requires a thorough knowledge of non-prosthetic repair options due to the scarcity of material.
P-028 SHORT-TERM RESULTS OF LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY (LIRA). OUR FIRST EXPERIENCES
Authors: Marrero Marrero P , Delgado Plasencia L J , Lorenzo Rocha N , Rodríguez Castellano D , Fernández Hernández L , Bravo Gutiérrez A F 
Published: May 2023

Abstract

Aim
Closing the defect (CD) during laparoscopic ventral hernia repair began to be performed in order to decrease seroma, to improve the functionality of the abdominal wall, and to decrease the bulging effect. However, tension at the incision after CD in large defects is related to an increased rate of pain and recurrence. We present our preliminary results of this recent technique for midline hernias as an alternative to conventional CD emphasizing the evaluation of postoperative pain.

Material and Methods
A retrospective study was conducted from March 2021 to July 2022 to evaluate the elective procedure (LIRA) performed on patients with midline ventral hernias (3–4 cm width). The posterior rectus aponeurosis was opened lengthwise around the hernia defect using a laparoscopic approach to create two flaps and was then sutured. An on-lay mesh was placed intraperitoneal overlapping the fascia defect. The data analyzed included postoperative pain and recurrence rate.

Results
Fourteen patients were included. Mean width of the defect was 3,5 cm. Average VAS (24 h) was 7, 2–3 (1 month), and 0 (6 month). Clinical seroma vas detected at first month in 50% (Clavien-Dindos-I). Recurrence rate was 14% at the expense of the first cases (Clavien-Dindos IIIb). Mean follow-up was 6 months.

Conclusions
Despite the fact that this technique obtained a “no tension” effect that could be related to a lower rate of postoperative pain, we have detected an elevated early postoperative VAS which is probably due to the fixing system with tackers which counteracts the beneficial effect.
P-034 ROBOTIC TAPP FOR RE-RECURRENT INGUINAL HERNIA: OUR EARLY EXPERIENCE
Authors: Chatzimavroudis G , Kotoreni G , Pavlidis T , Papaziogas V 
Published: May 2023

Abstract

Aim
Undoubtedly, the use of meshes has dramatically reduced recurrence rates following primary inguinal hernia repair; however, recurrences still occur with an incidence ranging from 0.5 to more than 20%, depending upon various factors that include hernia and patient characteristics, applied surgical technique and mesh characteristics, and surgeon's experience. The repair of a recurrent inguinal hernia sets a challenge for the hernia surgeon to prevent not only new recurrence, but also other complications. The challenge becomes even bigger in cases of re-recurrent inguinal hernias. The aim of this study is to present our early experience with the application of robotic system in the repair of re-recurrent inguinal hernias.

Material and Methods
From January to December 2022, five male patients with re-recurrent inguinal hernias (two patients with two previous repairs, one with three and one with four previous repairs) were operated in our Center using the robotic system Da Vinci X. In all cases robotic TAPP was performed and an extra-large (measuring 12×17cm) heavy-weight polypropylene mesh was implanted.

Results
All patients were discharged from the hospital on the first post-operative day. Their postoperative course has been uneventful, without any evidence of early or late complications, including recurrence.

Conclusion
Robotic-assisted repair of re-recurrent inguinal hernia is safe and feasible. The advantages of the surgical robotic system and more specifically, the magnified and three-dimensional view of the surgical field, as well as the increased maneuverability of the instruments permit the efficient treatment of this demanding subtype of inguinal hernias.
P-036 SUTURING OF THE INTERNAL INGUINAL ORIFICE DURING THE LAPAROSCOPIC TRANSABDOMINAL REPAIR OF A LARGE INDIRECT INGUINAL HERNIA
Authors: Chamzin A , Galyfos G , Theodoropoulos C , Triantafyllou A , Toutouzas K , Theodorou D , Zografos G 
Published: May 2023

Abstract

Aim
To present the rationale and surgical technique of the internal inguinal orifice suturing during transabdominal preperitoneal hernia repair of large inguinal hernias.

Methods
The surgical steps of a laparoscopic transabdominal preperitoneal hernia repair (TAPP) with the addition of the suturing reconstruction of the internal orifice are presented.

Results
A 52-year-old man presented with a large symptomatic right inguinal hernia. A TAPP repair was performed. Due to a significantly widened internal inguinal orifice, reconstruction of the deep ring was performed by suturing the transversalis fascia arc to the iliopubic tract with a self-locking 2-0 stitch in a continuous fashion. Accordingly, a medium-weighted polyester mesh was applied. The patient had an uneventful postoperative period, without symptoms of chronic pain or discomfort at a 6-month follow-up.

Conclusions
During the laparoscopic repair of large indirect inguinal hernias, suturing reconstruction of the internal orifice, similar to the common practice for open inguinal hernia repair, may reduce mesh eventration and recurrence.
P-039 INITIAL EXPERIENCE IN ROBOTIC APPROACH IN ABDOMINAL WALL SURGERY
Authors: Hinojosa Ramírez F , Tallón Aguilar L , Tinoco González J , Moreno Suero F , Alarcón Del Agua I , Morales Conde S 
Published: May 2023

Abstract

Aim
To evaluate the results of our robotic hernia repair case series.

Material and Methods
Prospective and observational study on hernia repair cases operated with a robotic approach. We have performed a descriptive analysis of demographic and surgical variables and short-term complications.

Results
From October 2021 to January 2023, 64 robotic interventions, including 39 men (60.1%) and 25 women (39.1%). Mean age is 60,66 years (+/- 11,72). Mean Body Mass Index (BMI) is 30,70kg/m2 (+/- 5.58).
Interventions: 3 unilateral inguinal hernia (2 recurrents), 16 bilateral inguinal hernia (9 recurrents), 13 primary ventral hernias, 23 incisional hernia, 8 mixed hernias and 1 parastomal hernias. Conversion rate is 1,6% (one case).
Techniques in inguinal hernia: 22 rTAPP (Transabdominal Preperitoneal) (85,91min +/- 31.90). In unilateral hernia the mean of intervention time is 50min +/- 25,98 and in bilateral hernia is 95,31min +/- 28,83.
Techniques in abdominal hernia: 2 iPOM+ (Laparoscopic Intraperitoneal Onlay Mesh) (127.50 min +/- 3.54), 1 rTAPP (90min), 1 rRives (260min), 28 TARUP (Robotic Transabdominal Retromuscular Umbilical Prosthetic) (135.50 min +/- 54.02), 2 eTEP (Enhanced-view Total Extraperitoneal) (165 min +/- 49.48), 4 rTAR (Transversus Abdominis Muscle Release) (122.50 min +/- 51.07), 2 rLIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) (147.50 min +/- 74.25) and 1 Pauli (155 min).
Complications: 21 SSO (surgical site occurrence) (32,81%), 2 SSI (surgical site infection) (3.1%), 1 recurrence (1.6%).

Conclusions
Robotic surgery facilitates the approach of complex incisional hernias and the performance or retromuscular techniques. It doesn`t provide clear benefits in inguinal hernia.
P-043 QUALITY OF LIFE SURVEY IN PATIENTS WITH COMPLEX ABDOMINAL WALL RECONSTRUCTION BY TAR
Authors: López Farias A , Flores Flores G , Lindo Canchado J J , Nieto Soler A 
Published: May 2023

Abstract

Aim
Interest in complex abdominal wall repair has been on the rise in recent times, perhaps motivated by the significant challenge they are despite the number of surgical techniques available. The objective is to verify if the TAR technique fulfills its function in the reconstruction of the complex abdominal wall and improves the quality of life of patients.

Material and methods
We performed a systematized Madrid modification of TAR with double mesh (absorbable synthetic and permanent polypropylene), applying the EuraHS QoL quality of life scale pre and postoperatively as well as an analysis of the results.

Results
Of the first 30 patients with complex incisional hernia submitted to the study, 60% were recurrent cases. After a 22-month follow-up (range 10–32), two recurrences (6.6%) have been reported. The EuraHS QoL analysis shows a statistically significant improvement in quality of life in the 3 spheres: pain (p=0.03), restriction of activities (p=0.05) and aesthetic discomfort (p=0.03).

Conclusions
TAR should be considered a first-line technique in complex abdominal wall reconstruction, demonstrating good postoperative results with low morbidity and mortality and recurrence rates and improving the quality of life of patients.
P-046 NOVEL TECHNIQUE TO DISSECT RETRORECTAL SPACE DURING ETEP APPROACH FOR SUPRAUMBILICAL HERNIAS
Authors: Sabatella L , Marti Cruchaga P , Aliseda Jover D , Almeida Vargas A , Blanco Asensio N , Uriz Pagola A , Zozaya Larequi G N , Sanchez Justicia C , Rotellar Sastre F 
Published: May 2023

Abstract

Aim
Present a modification for the retrorectal dissection during the performance of enhanced view totally extraperitoneal (eTEP) approach for the treatment of supraumbilical hernia associated with rectus diastasis.

Material and methods
During eTEP, a new approach to access both retrorectal spaces was performed through an infraumbilical incision. First, we made a 2 cm section in the anterior fascia spanning both sides of the linea alba. Therefore, both retrorectal spaces were dissected with the assistance of a balloon trocar. After this maneuver, a structural trocar was inserted, and CO2 was inssuflated. Then 3 suprapubic trocars were inserted: one at the midline, and the other two medial to both semilunaris lines. After trocar placement, and prior to the inferior crossover the anterior rectus fascia of the infraumbilical incision was closed. The surgery was then performed according to the technique described by Daes and Belyansky.

Results
We have performed this approach in 2 consecutive patients with supraumbilical hernia (M3W1 and M3W2) associated with rectus diastasis. We achieve a complete dissection of the retro-muscular spaces in only one step and from the same location, facilitating the crossover. There were no associated intraoperative or postoperative complications.

Conclusion
The presented modification of the retrorectal dissection during laparoscopic eTEP for supraumbilical hernias represents a time-saver, safe and feasible alternative for the dissection of retrorectal space during eTEP.
P-048 UTILITY OF PRE-OPERATIVE ELECTROMYOGRAPHY AFTER CHEMICAL SEPARATION OF COMPONENTS WITH BOTULINUM TOXIN
Authors: Domínguez Bastante M , Santidrian Zurbano M , Viclhez Rabelo A , Salmeron Ruiz A , Medina Benitez A , Mansilla Rosello A 
Published: May 2023

Abstract

Aim
To describe and analyze the effectiveness of preconditioning complex abdominal wall with botulinum toxin type A (BTA) demonstrated by a preoperative electromyography.

Material and methods
Descriptive and prospective study from September 2018 to November 2020 of our patients who received neoadjuvant BTA and an electromyographic study prior to complex eventroplasty surgery. The patients signed a specific informed consent and 500 U of BTA were administered on an outpatient regimen at 10 different points under ultrasound control. The BTA was administered ecoguide by the radiologist approximately one month (33.8 days) before surgery. The electromyographic study was performed 35 days after the administration. Demographic, pre-surgical, intra-surgical and post-surgical variables were studied.

Results
57 received neoadjuvant BTA, 24 (42.1%) underwent an electromyographic study. The mean age were 64.8 years. The mean BMI was 29.3. The 24 patients (100%) had a W3 eventration of the EHS classification.
Moderate (grade II) denervation was found in 7 patients (29.2%) and intense (grade III) in 17 patients (70.8%), according to neurophysiology criteria. No significant complications occurred in any patient. No complications were register. Eventroplasty was performed according to the Rives-Stoppa technique in 3 patients (12.5%) and according to the transversus abdominis release (TAR) technique in 21 (87.5%). The mean stay was 7.9 days.

Conclusions
The electromyographic study in patients who have received BTA as neoadjuvant therapy for complex eventroplasties confirms the effectiveness of this therapy (100% presented denervation, &gt;70% intense denervation), which clinically translates into less extensive dissections and better fascial closures with no significant complications.
P-055 COMPLEX ABDOMINAL WALL RECONSTRUCTION AFTER THE RESECTION OF ADVANCED OVARIAN CANCER SPREAD TO ABDOMINAL WALL AND ILIAC VESSELS
Authors: Garcia Garcia L , De La Cruz Cuadrado C , Larrubia Loring J , López-Tomassety E , Caballero Diaz Y , Hernández Hernández J R 
Published: May 2023

Abstract

Aim
We present the case of an advanced ovarian cancer spread to the abdominal wall and iliac vessels where a complete resection was performed with immediatly reconstruction of the abdominal wall to achieve a complete R0 resection.

Material and Methods
A 66-year-old woman with history of hysterectomy, double adnexectomy and adjuvant chemotherapy for ovarian cancer 36 years ago. The CT scan showed an 8×7 cm lesion involving the anterior rectus muscle with compression of the ipsilateral iliac vessels. A biopsy was positive for adenocarcinoma with gynecological origin. She received neoadjuvant treatment with chemotherapy. In the control CT scan persisted a mass the abdominal wall mass with slight reduction in size and compressing the iliac vessels.

Results
Following a karakousys incision, an anterior abdominal wall tumor intimately attached to the pubic symphysis was observed. The tumor measured 6 cm, it infiltrated the femoral vein but there was not invasion of the artery. A completed resection of the anterior abdominal wall musculature up to the pubic symphysis was performed, disconnecting the inguinal ligament and leaving a 10×10 cm wall defect. This defect was repaired with the placement of a preperitoneal biological mesh to provide a reinforcement plane and a polypropylene mesh above the previous one.

Conclusions
Wide abdominal wall resections may be necessary to obtain R0 resections. Numerous studies have shown that morbidity rates associated with these procedures are not high. In fact, in our case, an immediate abdominal wall reconstruction achieved good functional and aesthetic results in a single surgical procedure.
P-057 EFFECTS ON SURGICAL QUALITY, TRAINING, AND RESEARCH ON INGUINAL HERNIA AFTER CENTRALIZATION OF PLANNED INGUINAL HERNIA SURGERY IN A REGION
Authors: Ruiz Jasbon F , Ticehurst K , Ölund M , Kroon L , Ahonen J , Norrby J 
Published: May 2023

Abstract

Aims
Evaluate the effects of centralization of inguinal hernia surgery in Region Halland in Sweden on surgical quality, training and research on inguinal hernia.

Methods
Comparison of outcomes for Region Halland in relation to the national average in the Swedish Hernia Register before and after centralization. Review of how training and research on inguinal hernia changed after centralization.

Results
The percentage of patients operated on by “inguinal hernia specialists” increased from nearly 40% in 2008 to 90% in 2019. 20% of the surgeons operating &gt; 90 hernias/year in Sweden are active in Region Halland, even though Region Halland only performs 4% of all inguinal hernia operations in Sweden.
The risk of reoperation 3 years after inguinal hernia decreased from nearly 100% greater to 30% less than the national average (4% to 1.7%).
The percentage of women that underwent the recommended posterior mesh surgeries increased from 5% (2007) to 90% (2019). The percentage of patients with bilateral hernias operated with TEP-TAPP increased from 5% (2007) to 98% (2020).
After centralization residents’ training was formalized including at least 30 operation/resident. Halland runs one of the two national courses on TEP/TAPP. Peer-review publications on inguinal hernias increased from 2 to 6 articles.

Conclusion
The quality of inguinal hernia surgery and training of residents became better after centralization. The number of region-conducted research projects on inguinal hernia increased after centralization.