bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-091 Primary intestinal lymphoma associated with enteric fistula to an intraperitoneal mesh: what came first?
Authors: Gómez Latorre L , Ruano Campos A , Peña Soria M J , Sajonia-Coburgo M J , Otero De Pablos J , Diez Valladares L I , Fernández Aceñero M J , Torres García A J 
Published: May 2023

Abstract

Aim
To present the possible association between the use of intraperitoneal mesh and the appearance of primary intestinal lymphoma.

Material and Methods
We present the case of a 67-year-old woman with a history of multiple abdominal surgeries (appendectomy, Hartmann's procedure for perforated diverticulitis and reoperation due to hemoperitoneum). Ventral hernia repair was performed placing intraperitoneal composite mesh in 2013. Eight years later, the patient consulted with abdominal pain and bulging located on previous laparotomy scar. Abdominal CT was carried out, demonstrating an intestinal fistula from the jejunum to the mesh with an adjacent 5 cm intraabdominal abscess.

Results
Elective surgery was decided on. An enteric fistula from the jejunum to the previous mesh was observed, as well as pathologic lymph nodes adhered to the mesh. Intestinal resection was performed prior mesh excision. Histopathological analysis was compatible with extranodal B-cell lymphoma of the marginal zone.

Conclusions
Enteric fistula rate associated with the use of intraperitoneal mesh is 0.3–4%. There are no published cases of intestinal lymphoma correlated with the use of intraperitoneal mesh. Primary intestinal lymphoma constitutes 1–4% of bowel malignancies. The most common type is extranodal marginal zone MALT B lymphoma. Typical locations are: gastric (50%), small bowel (33–40%) and colon (10–15%). Situations of chronic inflammation such as celiac disease, inflammatory bowel disease, Campylobacter jejuni infection or inflammatory reactions are known to cause this entity. In this particular case, an excessive inflammatory response to an intraperitoneal mesh resulting in enteric fistula could be the source of malignancy, or vice versa.
P-092 EARLY OUTCOMES OF ROBOTIC-ASSISTED TRANSABDOMINAL PREPERITONEAL INGUINAL HERNIA REPAIR: A SINGLE-INSTITUTION EXPERIENCE
Authors: Jung S , Lee J H , Lee S Y , Lee H S 
Published: May 2023

Abstract

Purpose
Since the introduction of the Da Vinci robot, robot-assisted hernia repairs have become more common. We aim to report our initial experience of robotic transabdominal preperitoneal (R-TAPP) inguinal hernia repair.

Methods
A retrospective chart review was performed in patients who underwent R-TAPP inguinal hernia repair with a prosthetic mesh using the Da Vinci platform (Intuitive Surgical Inc). Data were collected for patient characteristics and surgical outcomes.

Results
A total of 21 patients underwent R-TAPP repair consecutively. The mean age was 54.1 ±16.4 years. Twenty patients (95.2%) were male, and the mean body mass index was 23.8 ± 1.9. Bilateral hernia repairs were performed on 2 (9.5%) patients. Six cases (28.5%) of huge scrotal hernias were performed by R-TAPP. The operation time was 91.8 ± 20.4 min for unilateral inguinal hernia and 154.5 ± 26.2 min for bilateral inguinal hernia. The mean console operative time was 61.4 ± 16.9 min for unilateral inguinal hernia and 128 ± 25.5 min for bilateral inguinal hernia. Scrotal vein injury was identified in one patient intraoperatively. Two minor postoperative complications were reported: one with postoperative ileus and the other with umbilical wound seroma. The length of hospital stay was 3.8 ± 0.9 days. Neither mortality nor conversion to open surgery occurred.

Conclusion
Our early experience has demonstrated that the R-TAPP inguinal hernia repair is a safe and feasible approach. Cost-effectiveness, optimal procedural steps, and indications for the robotic approach remain to be further investigated.
P-093 THE NEED FOR STANDARDIZATION IN EMERGENCY FEMORAL HERNIA TREATMENT
Authors: Noditi G , Negrau A , Valean C , Duta C , Tarta C , Brebu D , Al-Hajjar H , Hajjar R 
Published: May 2023

Abstract

Aim
Evaluating the need for a standardized surgical technique in emergency femoral hernia cases
Material & methods: There were 69 femoral hernia cases admitted in our surgical department during 01.01.2012–22.12.2022, of which 43 cases were admitted to the Emergency Department, and 26 were elective cases. We have retrospectively evaluated the medical files of all the patients who underwent surgery with a diagnosis of femoral hernia. Moreover, demographic data, surgical technique, sex, length of hospital stay, intraoperative and postoperative complications were retrospectively analyzed.

Results
The sex distribution among the cases was as follows: 56 of the patients were female while the other 13 were male. The patients age was between 26 and 92 years old, with most cases between 70–79 years old (n=18). Of all the patients admitted through emergency department only one was operated using laparoscopic technique while the rest were operated using multiple open surgical techniques, 16 cases were incarcerated, 10 cases were strangulated femoral hernia, out of which 3 required small bowel resections. Amid elective cases, only 4 of them were operated using laparoscopic technique (TAPP).

Conclusions
The standardization of emergency surgical techniques in cases of femoral hernia could lead to a lower number of post-operative complications, and therefore could lead to a safer strategy in the treatment of femoral hernia patients.
P-095 EXPERIENCE IN COOPERATION PROJECT IN TANZANIA
Authors: Garcia Garcia L , González Sánchez L , Álvaro Roures M , Antonini G , Kimaro J , Hernández Hernández J R 
Published: May 2023

Abstract

Objectives
In rural África, hernia and caesarean section are the most common elective procedures with a very high burden of morbidity and mortality in inguinal hernias. We present the interventions carried out during 2022 by European aid workers in a referral and third level hospital in Tanzania and the techniques performed from the scarce material available.

Material and Methods
A retrospective observational study of the number of inguinal hernias operated in a Hospital in Tanzania by European aid workers.

Results
Throughout 2022 the hospital performed 2818 surgical interventions (1445 men and 1373 women) of which 155 were inguinal hernias (5.5% of total interventions). Of this total, only 5 were repaired with mesh using the Lietchenstein technique (3% of operations). The remaining cases were repaired by herniorrhaphy using the Shouldice technique. The postoperative period was between 24 and 48 hours. Follow-up is carried out in less than 5% due to the fact that this is a rural hospital, with 17 reoperations.

Conclusions
Treatment of inguinal hernia in cooperative projects are challenging to the surgeon's skills and require a thorough understanding of the anatomy of the inguinal region and nonprosthetic repair options.
V-003 Parastomal & ileal conduit hernia: Top docking robotic eTEP approach
Authors: Villalobos R , Maestre Y , González-Barranquero A , Escartin A , Olsina J 
Published: May 2023

Abstract

Aim
Parastomal hernias are frequent in patients with end colostomy. Recently, the robotic approach for the treatment of this pathology had spread abroad. On the other hand, patients with an ileal conduit urinary diversion after a radical cystoprostatectomy have a high risk of incisional hernia development. The combination of both parastomal hernia and ileal conduit hernia is rare. The aim of this video is to describe a top docking robotic eTEP approach combining a modified retromuscular Sugarbaker technique (Pauli) with a retromuscular keyhole for the parastomal and ileal conduit hernias respectively.

Material and Methods
The case is a 71 years old man patient with a BMI of 36 who presented a progressive 2-year discomfort bulging around the end colostomy that turned in an intermittent constipation. Additionally, a progressive bulging started the last 6 months on the ileal conduit. An abdominal CT scan was made showing a bilateral ostomal defect with small bowel parastomal content and fat tissue in the ileal conduit. Once the patient was assessed, a top docking robotic eTEP approach was planned with a Xi Da Vinci robotic platform. The patient was in a hyperextended supine position.

Result
The patient was discharged 3 days after the operation with a mild pain controlled by oral medication.

Conclusion
The Pauli technique and retromuscular keyhole for combined parastomal and ileal conduit hernia performed by a top docking robotic approach is feasible, but a long follow-up is needed to demonstrate its effectiveness.
V-007 Robotic repair of a bilateral recurrent groin hernia in a kidney transplant patient
Authors: Vierstraete M , Muysoms F 
Published: May 2023

Abstract

Aim
Due to the increased frequency of kidney transplantations and the high incidence of inguinal hernia in men, the coincidence of both features is not uncommon.

Material & Methods
A 58-year-old male patient with a history of a kidney transplantation in the right fossa due to bilateral shrivel kidneys, presented with a bilateral recurrent incisional hernia. Two years before he had an anterior bilateral groin hernia repair; a Liechtenstein repair on the left side and a partial preperitoneal repair with mesh reinforcement on the right side.

Results
The case was approached via a robot assisted TAPP (transabdominal preperitoneal) procedure to perform the preperitoneal dissection of the myopectineal orifices. At the region of the right inguinal hernia, the normal anatomy was distorted, due to the extraperitoneal course of the donor ureter which was freed accordingly. A partial mesh excision of the previous mesh was performed. The preperitoneal dissection area was covered with a self-gripping mesh. The postoperative course was uneventful.

Conclusions
The extraperitoneal course of the ureter in a kidney transplant patient challenges the surgical repair of an inguinal hernia. In primary groin hernias an anterior approach seems best suited, but in case of a recurrence after a previous anterior approach, a laparoscopic approach is a possible though challenging surgical option.
V-012 MADRID-PCS. STEP BY STEP E-TEP APPROACH
Authors: Román García De León L , Muñoz Rodriguez J M , Blazquez Hernando L , Robin Valle De Lersundi Á , Serrano González J , Artés Caselles M , García Ureña M Á , López Monclús J 
Published: May 2023

Abstract

Aim
To show the steps involved in the Madrid Modification of posterior component separation (PCS) by e-TEP approach.

Material and Methods
We present a case of a patient with a lateral incisional hernia (L3W1) associated with primary umbilical hernia and ipsilateral groin hernia. The repair that allows treatment of all defects and wide prosthetic coverage with wall reinforcement is PCS, performed in this case according to the Madrid modification. Due to the presence of risk factors for surgical site occurrences such as obesity, we decided to perform a totally extraperitoneal minimally invasive approach (e-TEP) and the step-by-step procedure is shown.

Conclusions
Minimally invasive surgery has become the standard approach in many abdominal wall pathologies. Since the description of the e-TEP technique in 2017, its growth and development has been exponential, progressively expanding for large defects and other locations; being especially indicated versus open surgery for patients with risk factors for surgical site events.
Likewise, the technique of PCS described in 2012 by Novitsky has been extended in recent years and is now the gold standard in the treatment of complex abdominal wall hernias. From the Madrid group, modifications to this technique have been proposed. We present a video that combines this modification with minimally invasive surgery, visualizing the steps of this technique using the e-TEP approach.
V-014 TIPS AND TRICKS OF INGUINAL HERNIA SURGICAL MANAGEMENT IN SUB-SAHARAN AFRICA COOPERATION CAMPAIGNS
Authors: Roldón Golet M , Muriel Alvarez P , Butron T , Ramírez Plaza C P 
Published: May 2023

Abstract

Introduction and Aim
Inguinal hernia is the most prevalent surgical pathology in every surgery department. However, in the African continent (especially the Sub-Saharan region), the shortage of surgeons and the population's difficulty in accessing medical care have made herniary pathology a very frequent cause of disability in the young population. That is why foundations such as “Hernia International” and “Cirujanos en acción” carry out numerous cooperation campaigns each year, in which surgical treatment of inguinal hernia is the key as it meets the four ideal requirements: high prevalence, high impact of surgical treatment, few serious postoperative complications and the possibility of operating on many patients with few resources.The standard surgery in this setting is the Lichtenstein type hernioplasty with sac ligation for L3EHS type hernias.But we believe that the preperitoneal approach through the anterior access (Berliner technique)also has an indication that the general surgeon should know.

Material and Methods
We present the two surgical approaches that we use in cooperation campaigns, analyzing the technical tricks for the management.
1.They are mostly L3 hernias with large chronic scrotal sacs due to persistent peritoneo-vaginal processes of long evolution; 2.High sac ligation is a resource that will reduce the risk of recurrence; 3.The Lichtenstein technique is the standard approach used when the posterior wall is acceptable and the deep inguinal orifice is less than 3cm; 4.In the rest of the cases,the Berliner technique is a technique with excellent long-term results and that the surgeon who operates hernias on the African continent should master.
V-015 ENDOSCOPIC MANAGEMENT OF AN INCARCERATED SPIGELIAN HERNIA
Authors: Iqbal A , Sarian A , Apthorp C , Sheen A 
Published: May 2023

Abstract

Introduction
Spigelian hernias are abdominal wall hernias (incidence 0.12% to 2%). It is more common in women over the age of 60 years and occurs in individuals with raised intraabdominal pressure or weakening of the abdominal fascial layers. Several studies suggest that about 27% of Spigelian hernia will incarcerate and this will require immediate surgical intervention depending on the presentation.

Presentation
A 76-year-old lady presented with a painful lump at the right lower abdomen since a few days. No other constitutional symptoms were reported.
She denied any comorbidities and was on no medication that would contraindicate a general anaesthetic. On Examination she had a 2cm tender non reducible lump at the right Spigelian line.
A CT scan revealed a break in the right side of the abdominal wall consistent with a Spigelian Hernia.
She underwent a repair using a laparoscopic, totally extraperitoneal technique (TEP). This was undertaken as a day case surgery with the hernia containing extraperitoneal fat only. The video demonstrates surgery with balloon dissection, medial to lateral dissection displaying the ilio-pectineal (cooper's) ligament and reduction of the hernia. The defect was covered with a mesh and fixated with Tisseel fibrin sealant. On her 4th week outpatient follow up she recovered well with only a small seroma at the previous site of the Spigelian hernia.

Conclusion
Our video demonstrates an efficient way to perform a Laparoscopic totally extraperitoneal (TEP) technique for an incarcerated Spigelian Hernia.
V-025 ETEP-RS: EXTENDED TOTALLY EXTRAPERITONEAL RIVES-STOPPA TECHNIQUE FOR SMALL VENTRAL HERNIA
Authors: Avilés Oliveros A , Medina Pedrique M , Morejón Ruiz S , Martínez Caballero J , Cruz Cidoncha A , García Ureña M Á 
Published: May 2023

Abstract

Aim
The aim is to describe the laparoscopic surgical technique of eTEP with 3 trocars from the upper port in a 52-year-old male patient who presented 3 small ventral hernias

Material & Methods
Recently, the surgical technique of ventral hernia repair, Rives-Stoppa e-TEP eventroplasty (eTEP-RS) has been introduced. First, 2 subcostal incisions are made. By introducing the dissector balloon through both retromuscular spaces up to the linea arcuata, the retromuscular space is exposed. Great care must be taken to preserve the neurovascular bundles at semilunar line. A 5mm trocar is placed on the right flank to perfom the epigastric crossover maniobre by incising the medial aspect of rigth posterior sheath. The dissection of the left retromuscular space is performed. The midline dissection is progressed to the retzius, completing the Rives retromuscular space. The hernia sacs are dissected and reduced. Finally, posterior rectus sheaths and the linea alba are sutured with 2/0 absorbable self-locking continuous barb suture and a mesh is placed in the retromuscular space.

Results
The patient was discharged the next postoperative day with good pain control. To date, he does not present data on hernia recurrence.

Conclusions
The repair of abdominal wall defects via endoscopic eTEP Rives-Stoppa with three trocars is a feasible and reproducible technique that meets the criteria of ideal open surgery and is safe for the patient.
In addition, it offers advantages such as less postoperative pain, less need for analgesia, favors rapid and safe recovery, added to an excellent aesthetic result.
V-026 LAPAROSCOPIC TAPP REPAIR: IS IT REALLY FEASIBLE IN A RE-RECURRENT HERNIA?
Authors: Alves D G , Ribas S , Oliveira F 
Published: May 2023

Abstract

Aim
Describe a step by step laparoscopic transabdominal preperitoneal (TAPP) repair of a re-recurrent incisional lumbar hernia.

Material & Methods
This is the case of a 72-year-old man who had a previous traumatic right lumbar hernia initially approached by laparoscopic intra-peritoneal onlay mesh repair (IPOM) and its recurrence approached by open onlay mesh repair. CT-scan revealed a lumbar hernia on the right with a neck size of 40 mm. The hernia sac measured 65 mm and contained part of the right colon inside, without signs of incarceration nor dilated intestinal loops. According to the European Hernia Society classification for incisional abdominal wall hernias, the patient had a lateral hernia (L4 W2).

Results
Lateral incisional hernias are limited by the inguinal region inferiorly, the costal margin superiorly, the lateral margin of the rectal sheath medially and the lumbar region laterally. Due to their low incidence and the resulting lack of expertise in the treatment of this abdominal wall defect, surgical treatment poses a challenge-

Conclusion
The repair of a recurrent hernia is a daunting task, even more so of a re-recurrent one. By choosing to perform a TAPP repair, we were able to prove a laparoscopic re-do repair is feasible even faced with weakened tissues and distorted anatomy.
V-033 MINIMAL INCISION REPAIR OF RECTUS ABDOMINIS MUSCLE DIASTASIS (MIRRAD) AS DAY CASE SURGERY: A PILOT STUDY
Authors: Katawazai A 
Published: May 2023

Abstract

Rectus abdominis muscle diastasis (RAD) is a common condition where the rectus muscles are separated by an abnormal distance causing widening of the linea-alba. This condition usually occurs due to increased abdominal cavity pressure. The most common causes are pregnancy and truncal obesity. There is also an increased risk of hernia in the linea-alba. Some of the patients with RAD can increase the stability with the abdominal wall muscle-training program, while others do not benefit from this type of exercise. There is no consensus yet regarding the preferred surgical treatment. The need for a minimal invasive surgical procedure as a day case surgery in RAD in selected cases is obvious.
The aim of this study is to evaluate the safety and effectiveness of MIRRAD as a day case surgery.
All patients are planned as elective day case surgery. Through a small skin incision on one side of the umbilicus, the subcutaneous fat is undermined and dissected from the external aponeurosis 7–9 cm above and 5 cm below the umbilicus to expose the diastasis. The umbilicus is de-attached from the external fascia. The abdominal rectus muscle diastasis is then plicated with double layer barbed suture. The umbilicus re-attached and skin sutured.

Results
20 patients are repaired with this method, all as a day case surgery, without any immediate complication.

Conclusion
This new, relative simple, method is cost effective and may minimize the postoperative morbidity. The method may preferably appropriate for patients without excessive skin.
V-044 CASE REPORT: RECURRENT AND INCARCERATED VENTRAL HERNIA. ETEP APPROACH
Authors: Zárate Gómez J , Peinado Iríbar B , Álvarez De Sierra Hernández P , Supelano Eslait G , Gil López J M , Fernández Luengas D , Conde Someso S , Merello Godino J 
Published: May 2023

Abstract

Aim
The eTEP approach for ventral hernia is becoming a promising treatment option for obese patients as a scheduled procedure, in specialized high volumen centers. Is it feasible also in emergency surgey?

M&M
We present a case of a 73 year old female patient with an incarcerated ventral hernia, presenting itself as a bowel obstruction on the early postoperative period after a prosthetic knee surgery. The patient had a previous midline laparotomy (Cesarian), two onlay ventral hernia repairs, and body mass index of 32. The CT imaging findings revealed a bowel obstruction close to incarcerated ventral hernia. We performed an endoscopic retromuscular sac exploration, reduced the incarcerated hernia, ruled out bowel damage, completed intraperitoneal adhesiolysis and followed through with an eTEP procedure, closing anterior and posterior rectus sheat running sutures. We began closing supraumbilical abdominal wall using inferior trocars and finished closing infraumbilical part using superior trocars. Then we introduced and deployed a polypropylene 26×15 cm mesh. No mesh fixation or drains were used.

Results
Bowel obstruction was solved after surgery. Oral liquids intake started on the second postoperative day. Despite of knee pain, sedentary lifestyle, depressive disorder and obesity, the patient started walking, assisted by physiotherapist also on second postoperative day. Intravenous naproxen and acetaminophen were used as painkillers. Discharged on postoperative day 10 because of knee wound celulitis.

Conclusions
eTEP approach seams feasible also in emergency surgeries in specialized centers.
V-047 VIDEO OF A LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL(TAPP) REPAIR FOR GIANT INGUINOSCROTAL HERNIA
Authors: Caruso R , Ferri V , Vicente E , Quijano Y , Duran H , Diaz E , Fabra I , Malave L , Ruiz P , Pizzuti G , Naldini C 
Published: May 2023

Abstract

Giant inguinoscrotal (GIS) hernias are rarely encountered in clinical settings and are oftenassociated with mental neglect for many years. This type of hernia is defined as “giant” if it descends belowthe mid-point of the inner thigh of a patient in an upright position. The laparoscopic repair approach of aGIS hernia is technically challenging. It has been claimed that laparoscopic surgery has several advantagesover the open surgical approach, with less pain and an earlier recovery. The aim of this video is to evaluatethe efficacy of TAPP (laparoscopic transabdominal preperitoneal) in order to treat a GIS hernia. A 65-year-old male without a relevant past medical history was admitted to theemergency service with abdominal pain, belching and nausea. He denied any other symptoms, and noprevious surgical operations were recorded. Physical examination showed a large mass in the left scrotumbelow the mid-point of the inner thigh of the patient in an upright position. A CT scan confirmed thediagnosis of a GIS. A laparoscopic TAPP procedure was decided upon as the best course of treatment.

Results
The patient underwent a successful repair procedure. The operation time was 150 min. Nointraoperative blood transfusion was necessary. The patient's diet was resumed on the first day postsurgery, and the postoperative hospital stay was three days. Laparoscopic TAPP repair is a safe and feasible method for surgically managing GIS hernias.