bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-072 COMPARATIVE STUDY OF THE TROCAR SITE INCISIONAL HERNIA INCIDENCE ACCORDING TO SLOW VS RAPID ABSORPTION SUTURES
Authors: Ferreres Serafini J , Olona Casas C , Julià Verdaguer E , Vadillo Bargalló J , Varona Mancilla A , Rodrigo Rodrigo M , Diaz Martín Á , Jorba Martín R 
Published: May 2023

Abstract

Aim
Abdominal wall closure guidelines recommend the utilization of slow absorption sutures. However, fast absorption sutures are still used for laparoscopic trocar site closure, mainly due to ease of handling and availability.
We planned a retrospective cohort study, analysing the incidence of trocar site hernia (TSH) depending on the suture used for the fascial closure.

Materials & Methods
A retrospective cohort study is carried out including a sample of 200 patients operated in our centre by any elective laparoscopic procedure, by Hasson access technique at the umbilical trocar site.
Patients were distributed in 2 groups, according to the suture used: Group-1 Polyglactin, Group-2 Polydioxanone. In both groups the needle that was employed had a J-shape.
Patients that had open or robotic surgery, reinterventions, and previous diagnosis of umbilical hernia were excluded.

Results
100 patients were included in Group-1, and 100 patients in Group-2. The average age was 57.34 and 63.39 years respectively. The incidence of TSH in Group-1 was 20% with an average follow up of 22.3 months, compared to an 15% TSH incidence in Group-2, with an average follow-up of 20.3 months. These differences were not statistically significant. 80% of TSH were diagnosed in the first 24 months after the surgery.

Conclusions
Likewise the existing evidence in open surgery wall closure, the use of slow absorption sutures in trocar site closure probably reduces the TSH incidence, without repercussion in comorbidity, however, in our study, the sample was not enough to prove statistical significance.
These results should be contrasted with further randomized Control Trials.
OC-083 THE REACH OF THE HERNIA BASECAMP LEARNING PLATFORM SINCE ITS LAUNCH JUNE 2021
Authors: de Beaux A , Becker S , Temporal G , Parent T , Kummer R , Allouard C , East B 
Published: May 2023

Abstract

Aim
Hernia Basecamp is an online learning platform hosted within the WebSurg website. One of the drivers of its development was to cover the syllabus of the UEMS AWS examination, but it is a learning resource in its own right. There are currently 205 video lectures, with a number of them selected to create 10 modules of 3 hours each with UEMS CME accreditation. The aim of this study was to review the Hernia Basecamp usage since launch in June 2021.

Methods
The Hernia Basecamp WebSurg platform was interrogated using Matomo Analytics in January 2023 (19 month period since launch). Data on the number of visits, pages looked at and time spent on the platform per visit, along with the number of CME modules taken and passed were collected.

Results
Users from 146 countries visited the Hernia Basecamp site 17,171 times (6586 times, 38.4% in first 9 months). The top 5 countries by visitors were the UK, Mexico, Spain, USA and Germany (accounting for 29.4% of the visits). The average time spent per visit was 11 min 37 sec (range: 47 sec to 49 min 4 sec), and the number of pages/videos viewed per visit was 8.1 (range: 2–21). The number of UEMS CME modules taken was 675, and 326 (48%) of these tests were passed.

Conclusions
In the first 19 months from launch, Hernia Basecamp provided over 3,000 hours of hernia education to users around the world. The UEMS approved CME accreditation tests were commonly used.
OC-084 PATIENT-REPORTED OUTCOMES ON INCISIONAL VENTRAL HERNIA: SINGLE CENTER REPORT
Authors: Trindade M , Figueiredo J , Souto R , Branco A , Costa P 
Published: May 2023

Abstract

Aim
The impact of incisional hernia repair on quality of life is poor. Patient-reported outcomes (PROs) self-report one's health status and imply an impact on daily life. This study presents PROs in incisional ventral hernia repair from a single hernia center.

Material and Methods
55 consecutive patients undergoing incisional hernia repair between 2019 and 2022 were selected. Pain and restrictions on daily life were evaluated. They were asked 3 questions by phone call: 1. Compared to how you were before surgery, do you consider yourself better/same/worse?; 2. Do you still have any symptoms? (If so, explain them); 3. If you had to have another ventral hernia surgery, would you do it again?

Results
Study's population median follow-up was 16,5 months. Ventral hernias were mostly W2 or M2, according to EHS classification. 54% underwent laparoscopic surgery. 49 patients (89%) answered they were better than before surgery. 19 patients (34,5%) stated they still have some symptom, pain being the most common. 41 patients (75%) said they would accept surgery again if they had to. 9 patients (16%) would undergo surgery again whether same team and hospital were available. Only 4 patients said they would deny another ventral hernia repair.

Conclusions
This study suggests that the majority of patients improved their self-reported symptoms. Nonetheless there are still patients with persistent postoperative symptoms, especially those with pain and daily life restrictions pre-operatively. Expectation management is therefore determinant to improve decision-making in incisional ventral hernia treatment.
OC-088 NOT ALL SYMPTOMS MAY BE THE HERNIA!
Authors: Wolesky J , East B 
Published: May 2023

Abstract

Introduction
Ventral hernias are common and operations for ventral hernias are some of the most commonly performed procedures in general surgery. These operations are often motivated also by symptoms such as back pain, the bulge growing and abdominal wall pain or inability to exercise.

Material and methods
We have run a retrospective trial looking at our cohort of patients with large ventral hernias that have successfully completed a prehabilitation programme. We have specifically focused at symptoms of back pain, size of their hernias and other general symptoms like ability to exercise.

Results
78 patients have successfully completed the programme and 45 have decided against an operation as the symptoms that have originally motivated them to seek surgical help have diminished. Their abdominal circumference (measured over the hernia) has not increased in any of them.

Conclusion
Individual physiotherapy can lead to improvement in patient symptoms and can prevent a hernia from getting bigger.
OC-089 A CHALLENGING REPAIR OF RECURRENT VENTRAL HERNIA IN A PATIENT WITH A PREVIOUS INTRAPERITONEAL MESH AND ABDOMINOPLASTY
Authors: Prce D , Gaber M , Gerogiannis I 
Published: May 2023

Abstract

Aim
To understand the challenges faced in repair of recurrent ventral hernia in a patient with a previous intraperitoneal mesh and abdominoplasty.

Introduction
Ventral hernias still represent a great challenge for surgeons, especially if they are recurrent.
We present a 54-year-old overweight female with complex surgical history and a recurrent incisional hernia. She had a laparoscopic cholecystectomy and port site hernia which was repaired without a mesh. She later underwent a Roux-en-Y Gastric bypass for obesity and developed another port site hernia in lower epigastrium. The incisional hernia was repaired with an intraperitoneal mesh. Finally, she had an abdominoplasty for cosmetic reasons. She presented to our surgical clinic with a clinically palpable recurrent large incisional hernia.

Methods
The repair was carefully planned with a CT abdomen confirming a 6 cm defect in the upper midline and a large intraperitoneal mesh with multiple metallic tacks.
The surgical procedure was as follows:
Midline incision and careful dissection of the sac. The intraperitoneal mesh was identified and removed carefully keeping the posterior rectus sheath and peritoneum intact. A posterior component separation technique was performed. Posterior rectus sheath was closed with interrupted absorbable sutures. A tailored polypropylene mesh was placed in retro-rectus space. The anterior rectus sheath was closed with non-absorbable interrupted sutures. Patient had an uneventful postoperative period and was discharged on the third postoperative day.

Conclusion
Careful patient selection, detailed preoperative planning and expertise in abdominal wall reconstruction result in a successful repair of complex ventral hernias.
OC-094 LESSONS LEARNT FROM DEVELOPING AN ABDOMINAL WALL RECONSTRUCTION (AWR) MULTIDISCIPLINARY TEAM (MDT) IN A COMPREHENSIVE HERNIA CENTRE
Authors: Gilmore K , Birch A , Cocciolo F , Bunting D , Findlay J , Sanders D , Pawlak M 
Published: May 2023

Abstract
We present our experience of developing a successful AWR MDT in a Tertiary Referral Centre, which aimed to optimise the management of complex AWR patients.
The weekly AWR MDT was established in August 2020. Cases are discussed with a hollistic approach. A comprehensive individualised plan is agreed regarding appropriateness of surgery, pre-operative risk factors requiring optimisation and operative specific decisions.
151 patients have been discussed to date (118 incisional hernias, 33 primary). In 65% of patients, at least one risk factor for adverse surgical outcomes was identified that required pre-optimisation, most commonly the need for weight loss (93%), glycemic control (22%), & smoking cessation (22%). 50 patients have been operated on to date. Retrorectus repair was the most commonly used technique (86%). Adjuvant techniques such as peritoneal flaps were suggested in 36% of patients.
23 patients are currently on waiting list for surgery, 45 remain in their prehabilitation period. 20 patients did not undergo surgery after combined patient and MDT decision. 8 patients await further investigation and 5 patients have been transferred to other centres due to specialist input requirement.
MDT management of abdominal wall hernias remains poorly established in most regions. Our experience highlights how vital it is. We have proven that it is feasible to run MDTs and that it has improved pre-operative planning and focus on modifiable risk factors in our centre. We would encourage other centres to establish this for complex cases, so that the most appropriate decisions can be made for this surgically challenging group.
OC-100 CORRELATION BETWEEN DIASTASIS RECTI AND RECURRENCE AFTER UMBILICAL HERNIA REPAIR
Authors: Ruiz García B D L Á , Sánchez Arteaga A , Hinojosa Ramirez F , Moreno Suero F , Tinoco González J , Tallón Aguilar L 
Published: May 2023

Abstract

Aim
Evaluate whether diastasis recti is an independent risk factor for recurrence after umbilical hernia repair.

Material and Methods
Retrospective cohort study based on patients operated on for primary umbilical hernia between 2015–2017. Inclusion criteria were umbilical hernia repair with previous computed tomography scan, without diastasis repair and follow-up of at least two years.
Rectus diastasis was defined as a separation &gt;2,5 cm.
Different variables were analyzed to assess their influence on hernia recurrence, with diastasis recti being our main factor to evaluate. Demographic characteristics, hernia size, type of hernia repair, postoperative complications and long-term recurrence were recorded.

Results
458 patients underwent umbilical hernia repair during the study period, 70 patients (15,28%) met the inclusion criteria and were selected.
The mean age was 57.08 years and 42.9% were women. The mean diameter of the hernia defect was 2.26 cm. 67.1% of the sample presented diastasis with a mean size of 3.78 cm.
Female sex(p=0.04), diabetes(p=0.16) and diastasis recti(p=0.05) present a statistically significant relationship with the development of recurrence after umbilical hernia repair.
We obtained that female sex(p=0,029) and diabetes(p=0,16) significantly increase the recurrence development. Meanwhile, we cannot affirm that diastasis acts as an independently risk factor(p=0,058),since it has been influenced by these variables.

Conclusions
We obtained that diabetes and female sex independently influence the development of recurrence after umbilical hernia. We have not been able to demonstrate that diastasis is a risk factor by itself for the appearance of recurrence, although we did find a trend towards statistical significance.
OC-106 #SOME4SURGERY
Authors: López Farias A 
Published: May 2023

Abstract

Aim
Digital transformation of society is now a reality, as is the incessant increase in the use of social networks. The aim is to present digital platforms for surgeons, how they are used, what impact they have and their roles in research and communication.

Material and methods
We carried out a narrative review based on bibliographic searches on the use of social networks in health professionals, as well as studies of impact and repercussion in the field of surgical communication and research.

Results
There are different social networks that can be used by surgeons, Twitter being preferred for its easy use and speed of diffusion, with the ability to group specific topics and amplify them through the use of hashtags such as #SoMe4Surgery (Social Media for Surgery). It is possible to spread knowledge in specific areas, facilitate conversation, collaboration and support between professionals with common interests anywhere in the world.

Conclusions
Social networks have been described as a necessary component in the usual practice of surgery and as an obligation for surgeons to know how to recognize their power and potential and to be used in the preparation of guides or expert panels, as well as the dissemination of information and interaction between professionals in the face of the growing difficulty in the resources available to access continuing education programs or attendance at face-to-face events. All this through responsible use (even requiring the publication of a guide for the ethical use of social networks by the American College of Surgeons).
OC-108 THE EFFECT OF COMBINED SPINAL EPIDURAL ANESTHESIA ON SHOULDER PAIN IN LAPAROSCOPIC EXTRAPERITONEAL HERNIA SURGERY
Authors: Donmez T , Cayirci C E , Surek A , Guzey D , Ferahman S , Kones O , Karabulut M 
Published: May 2023

Abstract

Background
Shoulder pain is a condition that seriously discomforts patients which develops due to peritoneal tear in laparoscopic extra peritoneal hernia repair (TEP) surgeries. Although surgeons generally prefer general anesthesia for the TEP technique, many studies have been carried out for the use of regional anesthesia in recent years. In our study, we aimed to investigate the efficacy and safety of the combined spinal/epidural anesthesia (CSEA) method in order to prevent shoulder pain in the TEP technique.

Method
The patients which operated with TEP procedure were divided into two groups; SA (Group 1) and CSEA (Group 2). The two patient groups were compared in terms of sex, age, body mass index, duration of surgery, total operation time, patient satisfaction, pain scores, length of hospital stay, adverse effect, intra operative and postoperative complications.

Results
The number of patients in group 1 was 42 and the group 2 was 40. The mean operation time was recorded as 55.9 and 80.2 minutes in groups 1 and 2 respectively, which was statistically significantly shorter in group 1 (p&lt;0.001). Postoperative pain was significantly less in group 2 for the 4th hour (p&lt;0.0001) and the 12th hour (p: 0.047). There was no difference between the two groups in terms of peritoneal tear (p:0.860). Intra operative and postoperative shoulder pain was significantly less in group 2 (p: 0.038, p:0015 respectively).

Conclusion
CSEA is an effective and safe anesthesia method in preventing shoulder pain that develops after TEP surgeries.
OC-111 FIVE YEARS OUTCOME OF LAPAROSCOPIC VENTRAL HERNIA REPAIR WITH PHASIX ST
Authors: Altowaijeri A , Aljomah N , Alshammari S , Binjaloud A , Aldohayan N , Aldohayan A 
Published: May 2023

Abstract

Background
Repair of ventral and incisional hernias (VIHR) is a standard procedure; newly introduced resorbable mesh biomaterials provide an attractive option to reduce the use of permanent synthetic mesh in hernia surgery and reduce its complications. Indeed the data of Phasix resorption started to occur post-maturation of the wound tissue. However, data on the use of slowly resorbable mesh materials remain scarce, and this study aims to evaluate the use of Phasix ST in the laparoscopic repair of VIHR.

Methods
This is a retrospective study of a sequential cohort of patients undergoing laparoscopic VIHR utilizing a Phasix ST mesh. Perioperative characteristics and clinical outcomes were collected.

Results
In total, 26 patients, including 19 females and 7 males, underwent laparoscopic VIHR using Phasix ST from April 2016 to January 2023. All surgeries were performed in a single institution by the same surgeon. The average patient age was 52.6, and the mean BMI was 35.5. All patients had a clean wound classification. The average defect size was 136.4 cm2. All patients were seen in the clinic with a median follow-up of 48 months. We observed four wound seromas, no wound infections, and three recurrences during the five years follow-up period. All occurred in the center of the mesh with severe adhesions to the mesh and tacker

Conclusion
Five years of follow-ups showed 11% recurrence in the same site note, which needs to be reviewed. Further, ten years of follow-up results need to be assessed.
OC-129 A new surgical technique for repair of rectus diastasis and associated hernia: description and initial experience
Authors: Rodríguez-González D , Casanova-Ramos R , Tuñón-Féquant C , Guil-Ortiz B , Montes-Montero A , Arteaga-González I J 
Published: May 2023

Abstract

Aim
Rectus diastasis (RD) is a common pathology, usually associated with midline hernias. Preaponeurotic surgical repairs have been described with complications derived from extensive subcutaneous dissection or suprafascial mesh placement. Other techniques place preperitoneal mesh but midline plication is not performed, with aesthetic disadvantages. We describe a new technique for the correction of ventral hernias associated with RD with midline plication and preperitoneal mesh (MPPM) and report our initial experience.

Material and Methods
We reviewed patients with RD and associated hernia surgically treated using the MPPM technique at our hospital from June 2021 to July 2022. The minimum follow-up time was 6 months.

Results
Forteen patients with RD and associated hernia were surgically treated with MPPM technique, with an average age of 64.1 years (range 38–82 years), 71.4% male and 28.6% female. The mean BMI was 28.8 Kg/m2 (range 18.6–40.0 Kg/m2). Three women (21.3%) had a mean of 1,3 previous pregnancies (range 0–2 pregnancies). The most common types of associated hernia with RD were primary midline hernia (50%), incisional hernia (21.4%), and recurrent midline hernia (28.6%). Half of the RD (50%) were M1-3 and the other half M2-3 (50%) as well as W1 (50%) and W2 (50%). The mean diameter of associated hernia was 3,2 cm (range 1–6 cm). Hematoma was observed in one patient (7,1%) in the first 30 postoperative days. No reccurence was recorded in the follow-up time.

Conclusions
The MPPM technique is a safe, reproducible and effective alternative for patients with abdominal wall hernia associated with RD.
P-003 ASSESSMENT OF UROSTOMY PARASTOMAL HERNIATION FORCES
Authors: Kanabolo D , Kumar Y , Maxwell A , Schade G 
Published: May 2023

Abstract

Introduction
Approximately 10,000 patients undergo cystectomy with ileal conduit diversion annually in the USA, of which ∼ 50% will subsequently develop a parastomal hernia (PSH) at 2 years. Due to the knowledge gap between urostomy surgical factors and abdominal wall forces, we developed a silicone and ex-vivo human cadaver fascia-based model for study. Our objective was to measure the relationship between incision size/type/material and axial tension force (ATF) as a surrogate for herniation force.

Methods
Using incisions (linear, cruciate, circular) ranging 1 to 3 cm (0.5cm increments) in clamped 3″x3″x0.020″ silicone or cadaveric sheets, a dynamometer was hooked to a Foley catheter at the drainage aperture and pulled using a motorized positioning system at 20 millimeters/minute. Balloons were hydrated to 125% incision dimension. Upward ATF was recorded until balloon herniation and repeated up to N=5 membranes/size. As limited cadaveric fascia was available, a single incision size was used.

Results
Controlling for silicone incision size, linear incision ATF was highest. With an average 3cm incision herniation force of 18.58, 8.48, and 2.36 Newtons (linear, cruciate, and circular respectively), linear was greater than cruciate herniation force (p&lt;0.0001), and cruciate was greater than circular (p=0.0039). This was true in cadaveric fascia for linear vs cruciate (p=0.0001) and cruciate vs circular (p=0.0024).

Conclusion
This ex-vivo study suggests incision type/size have predictable influences on ATF for herniation. En-bloc human studies are underway to assess these factors in more clinically optimized models. If confirmed, these data can help to standardize urostomy creation, reducing PSH risk.
P-004 APPENDICITIS CAUSING CHRONIC MESH INFECTION: A CASE SERIES OF TWO PATIENTS
Authors: Willis K A , Pawlak M 
Published: May 2023

Abstract

Aim
To discuss appendicitis as a cause of chronic mesh infection.

Methods
This study reports two patients with previous inguinal hernia repair who presented with recurrent groin infections resulting from appendicitis.

Results
Patient 1 had a history of laparoscopic bilateral inguinal hernia repair, followed by an open repair of a unilateral recurrence. He presented twice with groin pain and discharge. Sinugram demonstrated a superficial tract, but intra-operatively the sinus tract extended to the deep ring where the appendix was adherent and inflamed. There was also a meshoma of the preperitoneal mesh. He underwent appendicectomy and excision of meshoma.
Patient 2 presented with perforated appendicitis with a large pelvic collection extending into the anterior abdominal wall. This was treated with percutaneous drainage and antibiotics. Further presentations with recurrent abscesses prompted a laparoscopy where an inflamed appendix was found adherent to the previous mesh through a hole in the peritoneum in a pre-peritoneal abscess cavity. He underwent appendicectomy and washout without mesh removal.
Both patients remain symptom free at 10 months and 1 month respectively.

Conclusion
Literature review found reports of mesh-related appendicitis but no cases of appendicitis causing chronic mesh infection. Whilst rare, appendicitis causing chronic mesh infection should be considered in patients presenting with recurrent groin pain and abscesses having previously undergone inguinal hernia repair. Whilst we do not have long term follow up data, our experience indicates that these patients can be managed with or without mesh removal, providing the appendix is removed and the source of sepsis controlled.