bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-058 IMMEDIATE USE OF PERITONEAL DIALYSIS AFTER SIMULTANEOUS LAPAROSCOPIC PLACEMENT OF PERITONEAL DIALYSIS CATHETER AND INGUINAL HERNIA REPAIR
Authors: Alshammari S , Binjaloud A , Aldohayan A 
Published: October 2022

Abstract

Background
Peritoneal dialysis is accepted renal placement therapy for end-stage renal disease (ESRD). Managing inguinal hernia in peritoneal dialysis (PD) patient is not standardized. Moreover, the occurrence of occult hernia post PD placement needs surgical planning. This work aims to report the outcome of simultaneous laparoscopic placement od PD catheter and transabdominal preperitoneal (TAPP) repair of inguinal hernia.

Methods
All patients underwent laparoscopic PD catheter placement for ESRD from September 2016 to July 2021 were reviewed. Patients who underwent Concurrent Laparoscopic Inguinal Herniorraphy and Laparoscopic PD catheter placement were involved. PD with inflow measurement of the amount and should be below the incised peritoneum by 1 inch and smooth inflow and outflow without leakage. The amount raised gradually in two weeks to reach the targeted PD.

Results
Laparoscopic PD catheter placement was inserted for 13 patients with inguinal hernia. Two patients had bilateral inguinal hernia, one patient with umbilical hernia, and one patient diagnosed with hernia intraoperatively. The safe amount of dialysate fluid was from 400 to 600ml. There was no mortality, intraoperative complications or fluid dialysis leak. One patient had catheter displacement which was repositioned laparoscopically. Three catheters were removed due to non-compliance. No hernia recurrence observed.

Conclusion
Simultaneous laparoscopic PD catheter placement and TAPP repair herniorrhaphy with immediate use of PD is safe and effective. Our surgical approach allows using minimal invasive technique in the management of both PD catheter placement and inguinal hernia repair without delaying PD.
P-066 ABDOMINAL WALL RECONSTRUCTION FOLLOWING FULL THICKNESS BILATERAL RUPTURE OF THE RECTUS ABDOMINIS
Authors: Suhail D , Smith O , Lim P , Chintapatla S 
Published: October 2022

Abstract

Introduction
Rupture of the rectus abdominis is rare injury with no consensus on management. Previous reported cases have been due to exercise-related injuries and blunt abdominal trauma. We report the case of a 20-year-old male trainee paratrooper who presented with severe lower abdominal pain that occurred during military training. MRI revealed full-thickness bilateral rupture of the rectus abdominis. Abdominal wall reconstruction involved bilateral rectus muscle repair and placement of a biosynthetic mesh in the retrorectus plane. Postoperatively, our patient could walk pain-free at 3 weeks, jog pain-free at 10 weeks, and run up to 2 miles at 25 weeks.

Methods
Pubmed, Medline and Embase were searched to identify relevant studies using the MeSH terms, “rectus abdominis” and “rupture”, as well as their free text counterparts and synonyms. Texts were restricted to publications in English and publications after the year 2000. The search resulted in 391 articles. Manual cross-referencing was performed, limiting the included articles to 8 for review.

Results
6 out of the 8 selected articles discussed management using conservative means, while only 2 cases were managed surgically. Interestingly, no other exercise-related cases in the literature were managed surgically. Instead, all exercise related cases were managed conservatively, while only cases of traumatic aetiology were managed surgically. Among both surgically and conservatively treated patients, none suffered any treatment related complications, and all patients returned to normal levels of activity.

Conclusion
Full-thickness, bilateral rupture of the rectus abdominis can occur during exercise. Surgical and conservative treatment yield similar results.
P-078 LAPAROSCOPIC TREATMENT OF UMBILICAL HERNIA IN A COMMUNITY HOSPITAL SETTING
Authors: Agresta F , Mazzarolo G , Licitra E , Pontarolo N , Savino G , Montori G 
Published: October 2022

Abstract

Introduction
Umbilical Hernia is a common ventral hernia in the adult population. The classical approach was represented by open repair, but in recent years laparoscopic treatment is increasingly adopted and it can present some intraoperative and post-operative advantages.

Materials and methods
We prospectively analyzed a case series of 50 laparoscopic primary and incisional umbilical hernia repairs performed between January 1st, 2020, and December 31st, 2021. We collected data concerning age, sex, hernia defect size, operative time, and complications according to Clavien-DindoClassification, recurrence at 6 months, and 1-year follow-up.

Results
We performed laparoscopic umbilical hernia repairs in 50 patients (32males,18females);mean age52.1year-old(range30–82y.o.).Mean defect size was4.5cm(3–6.8cm).All procedures were performed under general anesthesia and with 5mm trocars and optic and under pneumoperitoneum pressure set until 10 mmHg as the maximum value. In all cases we applied a transparent, lightweight, ultra-thin, nonabsorbable surgical prosthesis in polypropylene, made by a monofilament macroporous mesh and a transparent film. and we performed closure of fascia with adsorbable stitches. Mean Operative time:40minutes(30–65min.).No complications and recurrences were reported.

Conclusions
Laparoscopic treatment of umbilical hernia is a safe and feasible procedure; indeed, we consider reducing hernia from the abdominal cavity generally better than the open approach and composite mesh positioning with direct fascial closure usually allows a satisfying repair of the defect.
P-082 INNOVATION IN INGUINAL HERNIA REPAIR
Authors: Santilli O , Santilli H , Nardelli N , Scaravonati R 
Published: October 2022

Abstract

Aim
Innovation is to efficiently use knowledge to improve an existing process for the benefit of users and their environment.
The aim is to show different innovations that we are applying in inguinal hernia repair.

Material & Methods
We present: 1. data from the first 500 procedures using 5mm articulated instruments. 2. Postoperative sports rehabilitation protocol designed to improve quality of life. 3. Virtual interactive visits (VIV) to teach and learn at a distance allows interaction in the operating room between a specialist and the surgeon in training.

Results
The articulated forceps allow angulations in order to reach areas with less pulling force and movements. The accepted benefits of robotics have been achieved without significant cost impact.
The sport rehabilitation protocol after laparoscopic hernioplasty does not increase recurrence rate or complications. It probably accelerates the return to regular physical activity, improving the quality of life in the postoperative period.
The (VIV) allows us to carry out the training process of specialists from Buenos Aires to Latin America and Spain, ​​modifying and improving the education and training of the new generations.

Conclusions
The articulated graspers, the sports rehabilitation protocol, and the virtual interactive visits allow us to innovate in tools, quality of life, and education.
P-086 MINIMALLY INVASIVE TREATMENT OF PARASTOMAL HERNIA: FROM THE LAPAROSCOPIC SANDWICH TECHNIQUE TO THE ROBOTIC RETROMUSCULAR TECHNIQUE
Authors: Barranquero A G , Villalobos Mori R , Maestre González Y , Protti G P , Gutiérrez E , Kissler J O 
Published: October 2022

Abstract

Aim
Parastomal hernias are frequent and highly recurrent. The sandwich technique (ST) (Berger et al. [2007]) uses a double intraperitoneal mesh, whereas the retromuscular technique (RMT) (Pauli et al. [2016]) dissects the retromuscular space, releases the transversus muscle, and lateralizes the stoma to place a retromuscular mesh. The aim was to evaluate the results of these interventions.

Matherial & Methods
Observational retrospective study of patients with parastomal hernia intervened by our Abdominal Wall Unit in a tertiary referral centre. The intervention performed was the ST from February 2016 to September 2020, and the RMT from September 2020 to March 2022.

Results
A total of 12 patients were intervened with the ST, eight laparoscopically and four robotically, and 7 patients were intervened with the RMT, all robotically. There were no statistically significant differences in basal characteristics between groups. According to the European Hernia Society classification, the parastomal hernias intervened in the ST were 16.7% type I, 33.3% type II, 16.7% type III, 33.3% type IV, while in the RMT most were type II (85.7%). The surgical time was more prolonged in the RMT.
There were no statistically significant differences in early complications. Long term follow-up was longer in the ST (median: 24 months vs. 1.6 months), and the recurrences observed were 25% (3/12) for ST and 14.3% (1/7) for RMT (p:1.000).

Conclusions
RMT is a challenging procedure with similar rate of early complications and promising relapse results despite a shorter follow-up. It is currently our procedure of choice for parastomal hernia.
P-093 GASTROINTESTINAL PROCEDURES AND ANASTOMOSES CAN BE SAFELY PERFORMED DURING COMPLEX ABDOMINAL WALL RECONSTRUCTION
Authors: Wallace A , Houlton S , Garner J 
Published: October 2022

Abstract

Aim
The literature regarding combined abdominal wall reconstruction and gastrointestinal surgery is limited and largely suggests staged procedures due to a reported increased incidence of surgical site infections (SSIs), hernia recurrence and anastomotic leak, but this exposes patients to the risks of two substantial procedures. This study aimed to evaluate outcomes of single-stage GI surgery with complex abdominal wall reconstructions (CAWR) by a single surgeon.

Materials & Methods
Analysis of 10 years of a prospectively maintained single surgeon CAWR database compared those who had CAWR-alone with those having concomitant gastrointestinal surgery (CAWR-GI) such as stoma reversal or bowel resection but excluding cholecystectomy, gynaecological surgery and adhesiolysis alone. Groups were compared using the paired t-test (continuous data) and Fisher's exact test (nominal data).

Results
Overall, 62 elective cases (42 CAWR alone v 20 CAWR-GI) were analysed. Baseline demographics (age, BMI, co-morbidities, smoking status and hernia size) showed no differences; CAWR-GI mean operating time was significantly longer compared to the CAWR-alone group (5.4hrs vs 4.1hrs) with an increased incidence of post-operative ileus in the intestinal group (40% vs 11.9%, p&lt;0.05). Post-operative complications were common (chest infection (32.3%) and SSI (41.9%)), but similar between groups. There were no anastomotic leaks and the hernia recurrence rate at almost 4 years follow up was 10% in both groups.

Conclusion
Performing simultaneous intestinal surgery during complex abdominal wall repair can be performed safely without increasing the risk of hernia recurrence, mesh infections or anastomotic leak.
P-094 LAPAROSCOPIC VS OPEN VENTRAL HERNIA REPAIR: AN OBSERVATIONAL SINGLE CENTRE STUDY
Authors: Badkur M , Sharma N , Lodha M , Meena S 
Published: October 2022

Abstract

Background
Various surgical techniques are practised to provide best possible outcome for ventral hernia patients. This study was conducted to understand the patient's perspective regarding the choice and outcome of treatment.

Aim
To determine the level of satisfaction 1 month after ventral hernia repair. To analysed various factors which affects the patient's decision regarding the choice of surgery. To compare post operative outcomes between laparoscopic and open ventral hernia repair.

Material & Methods
An observational study was conducted between January 2020 and December 2021. Total 70 patients with ventral hernia were included. Relevant data was collected and analysed using SPSS version 28.

Results
39 patients underwent open repair and 31 patients underwent laparoscopic repair. 40% patients thought that their choice is better than the other option. 18.5% patients who preferred laparoscopic surgery were scared of big incision and 5% patients opted for open surgery because of unaffordability of mesh. 11.4% patient's decision was affected by the advice from other doctors whom they may have consulted before, 2.8% patients took advise from friends and family. Almost 20% patients left the decision on the treating team. The incidence of complications was significantly less in laparoscopic repair. However, there was no significant difference in the postoperative pain, duration of hospital stay, return to activity and satisfaction at discharge. level of satisfaction at 1 month was significantly higher in the laparoscopic group compared to open group.

Conclusion
laparoscopic ventral hernia repairs should be preferred in view of fewer complications and higher satisfaction.
P-096 ASSESSMENT OF THE FASCIA HEALING PROCESS AFTER SUTURE PLICATION OF RECTUS DIASTASIS – MEASURED WITH ULTRASOUND AT ONE, TWO, THREE AND FOUR MONTHS FOLLOWING SURGERY
Authors: Olsson A , Woxnerud K 
Published: October 2022

Abstract

Aim
Surgical repair of postpartum rectus diastasis (RD) has proven to provide functional improvements. Several different repair techniques have been described. There is no consensus regarding postoperative management and rehabilitation regimes varies. The purpose of this observational prospective cohort study was to follow and to better understand the healing process of the reconstructed linea alba with the aim to optimize the postoperative rehabilitation.

Material and method
Forty-five patients with RD operated with a standardized plication using absorbable suture material were included consecutively. All participants underwent a standardized postoperative rehabilitation program and were followed with ultrasonography examinations of the healing abdominal wall midline at one, two, three and four months after surgery. Interpretation of the ultrasound findings were defined by a specialist radiologist. The diameter of the duplicate was measured until it was totally contracted. The linea alba was considered totally regenerated when the anterior and the posterior lining were observed parallel.

Results
Early results showed that the duplicate had shrunk and the linea alba was totally recreated in 82.2% at the four-month examination. Corresponding numbers for the three, two and one-month examinations were 15.6%, 0%, and 0%. A preoperative inter-recti distance exceeding five centimeters showed a tendency to prolong the healing process.

Conclusion
The fascia healing time following a standardized suture repair was completed within four months in 4/5 of this cohort of postpartum women undergoing a RD repair. The findings can contribute to design an optimized rehabilitation regime following RD repair.
P-110 SURGICAL MESH INFECTION SECONDARY TO SKIN NECROSIS MANAGED WITH NEGATIVE PRESSURE THERAPY IN A PATIENT UNDERGOING TAR (TRANSVERSUS ABDOMINIS MUSCLE RELEASE)
Authors: Serrano Yébenes E , Diaz Pedrero R , Lasa Unzue I , Córdova García D M , Ovejero Merino E , Allaoua Moussasi Y , Laguna Hernandez P , Bru Aparicio M , Mañes Jimenez F , Jimenez Martin R , Medina Reinoso C , San Roman Romanillos M R , Ratia Gimenez T , Gutierrez Calvo A 
Published: October 2022

Abstract

Aim
To Show the management of skin necrosis, wound dehiscence and mesh infection in a patient undergoing TAR (Transversus Abdominis Muscle Release) through NPT (Negative Pressure Therapy)

Material and Methods
A 55-year-old man underwent elective surgery in 2017 for a giant hydatid cyst with portal rupture during the intervention, making a subcostal incision and subsequently midline laparotomy. Subsequently, he developed portal cavernomatosis and portal hypertension. In 2018, he underwent surgery for incisional hernia in a patient with a complex abdominal wall (extended subcostal incision + median laparotomy) performing a RIVES-type hernia repair. Develops chronic wall infection, mesh rejection and hernia recurrence that required reoperation with TAR (polypropylene mesh). One month after the intervention, he presents skin necrosis, wound infection and mesh infection in the upper third of the wound, which was managed through TPN cures for a year and a half.

Results
Given the dehiscence in the upper third of about 15×7 cm, conservative management was decided with cures and debridement of non-viable tissue. In contact with the polypropylene mesh, a silver dressing was applied, as well as treatment with negative pressure therapy. This cure was carried out for a year and a half every 3–4 days, being able to cover the mesh with granulation tissue and close it by secondary intention, thus avoiding a reintervention with mesh explant.

Conclusions
TPN is a useful tool in the management of mesh infections in patients with complex abdominal wall, thus avoiding reintervention and mesh explantation.
P-112 PRE-OPERATIVE PAIN AND REDUCED QUALITY OF LIFE SCORES IN PATIENTS THAT REPORT PERSISTENT PAIN AT 365 DAYS FOLLOWING LAPAROSCOPIC INCISIONAL HERNIA REPAIR
Authors: Dave M , Pilkington J , Fullwood C , Sheen A J 
Published: October 2022

Abstract

Background
​The use of patient reported outcome measures (PROMs) for incisional hernia has been established. This study aims to explore relationships between persistent pain at Day365 post laparoscopic-IPOM repair and other clinical and patient-reported data for patients within the TACKoMESH randomised trial.

Methods
Clinical, operative and PROMs data were collected pre-operatively and at four post-operative time points up to one year. Pain scores were measured using a visual analogue scale (VAS). Quality of life (QoL) data were measured using the short-form 36 (SF-36) and Carolina Comfort Score (CCS). Patients reporting pain ‘at rest’ at Day365 were compared with those reporting no pain. Statistical analysis was undertaken in R studio.

Results
54/63 trial participants attended followed up at Day365; 36 were male, and mean age was 59.1.
10 patients reported persistent pain at Day365 ranging from 1–9 on VAS. Patients were found to have reported higher pre-operative pain scores ‘at rest’ (5 [2–7] vs 0 [0–3] p=0.0181) and ‘on activity’ (8.5 [5–10] vs 4 [2–8] p=0.0181). They reported lower QoL scores in every domain on the SF-36, with significantly lower score for social function (50 [31–50] vs 75 [63–100] p=0.006).
Those reporting persistent pain at Day365 were more likely to have developed hernia recurrence (4 vs 3 p=0.0171). There were no significant differences in baseline characteristics, operative variables, and other complication rates between the groups.

Conclusion
Patients that report persistent pain at Day365 following laparoscopic-IPOM repair are more likely to have reported higher pain and lower QoL scores at pre-operative assessment.
P-113 IMPACT ANALYSIS OF DIASTASIS RECTI ASSOCIATION IN PRIMARY VENTRAL HERNIA REPAIR. OUR EXPERIENCE
Authors: Bravo Salva A , Bosch Silvela G , Perez Guitart M , Pereira Rodriguez J A 
Published: October 2022

Abstract

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

Material and methods
An observational single centre retrospective analysis of our Abdominal Wall Surgery prospective data base was performed.
We analysed primary ventral hernia repairs in our Hospital during 2020 and 2021. Two groups were performed according to presence of concomitant diastasis recti or not. We performed a descriptive analysis; comparative univariate analysis and a complication risk factors analysis.

Results
A total of 194 patients were included. 16 (8.2%) associated diastasis recti. Preperitoneal open hernia repair was performed in 180 (86.1%). 141 (72.7%) patients were operated as day case surgery. There were 28 (13.4%) patients with surgical complications. There were no reoperations, 4 readmission (1.9%) and 1 death (0.5%) Diastasis recti group had no statistically significative difference with control group except for study group was more frequently repaired by an abdominal wall surgeon specialist 15.2 vs 6.1%; p= 0.049) In complications risk factors analysis only presence of preoperative comorbidities was related to worst outcomes OR 7.32 (IC 2.68–20.21; p=0.001)

Conclusions
In our series 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.
P-115 HYBRID REPAIR OF RECURRENT COMPLEX GROIN HERNIA - CHALLENGES AND LESSONS LEARNT
Authors: Bandyopadhyay S , Iqbal A , Sheen A J 
Published: October 2022

Abstract
A 45 year old lady presented with a recurrent swelling over the right groin that had gradually turned tense and tender over the last 48 hours. Having undergone an urgent right femoral hernia repair in 2002, she underwent an inguinal hernioplasty in 2004 and amesh repair of a recurrent inguinal hernia in 2008. She developed a third recurrence that slowly increased in size and needed an urgent repair. At assessment, she was found to have a large complete recurrent irreducible right inguinal hernia containing loops of bowel.
At laparoscopy, multiple loops of bowel and omentum were reduced from a large multiloculated hernial sac. In view of the large sac which had incorporated the previously placed meshes in the wall, a decision was made to abandon laparoscopic approach. The myopectineal orifice was approached through a groin incision and the hernial sac with it's locules, including a prevascular component, was defined. The posterior sheath was defined and the rigt rectus muscle, displaced by the hernia, was repositioned. The dissection was carried upto the Space of Bogros to ensure that no component of the hernia was missed out. After completing a formal herniotomy, a sandwich prosthesis, created by stitching a biomesh and a polypropylene mesh, was utilised for hernia repair.
The patient had an uneventful recovery.
The presentation is aimed at discussing the challenges of repairing a complex recurrent hernia, the possible pitfalls and lessons learnt.
P-119 A MODIFIED CHEVREL AS AN ALTERNATIVE WALL CLOSURE TECHNIQUE FOR PATIENTS WITH ABDOMINAL HYPERTENSION
Authors: Vega Novillo V , Chacón F , Suárez A , Marcacuzco A , Caso O , Loinaz C , Jiménez C , Rivas Duarte C , Justo I 
Published: October 2022

Abstract

Abdominal compartment syndrome is a pontentially life-threatening condition seen in critically ill patients, and most often caused by acute pancreatitis, postoperative abdominal vacular thrombosis or mesenteric ischemia. A descompressive laparotomy is sometimes required, often resulting in hernias, and subsequent definitive wall closure is challenging.

Aim
This study aims to describe short term results after a modified Chevrel technique for midline incisional repair in patients witch abdominal hypertension.

Materials & Methods
We performed a modified Chevrel as an abdominal closure technique in 9 patients between January 2016 and January 2022. All patients presented varying degrees of abdominal hypertension.

Results
Nine patients were treated with new technique (6 male and 3 female), all of whom had conditions that precluded unfolding the contralateral side as a means for closure. The reasons for this were diverse, including presence of ileostomies, intra-abdominal drainages, Kher tubes or an inverted T scar from previous transplant. The use of mesh was initially dismissed in 6 of the patients (66.7%) because they required subsequent abdominal surgeries. None of the patients developed a hernia, although two died 6 months after the procedure. Only one patient developed buldging. A decrease in intrabdominal pressure was achieved in all patients.

Conclusion
The modified Chevrel technique can be used as a closure option for midline ventral hernias in cases where the entire abdominal wall cannot be used.