bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-066 LIRA TECHNIQUE, A NEW PROCEDURE. WHERE ARE WE NOW?. OUR RESULTS IN A MEDIUM FOLLOW-UP
Authors: Gómez Menchero J , Guerrero J L , Lara Fernandez Y , Navarro L , De La Herranz P , Gila Bohorquez A , Garcia Moreno J , Morales Conde S 
Published: October 2022

Abstract

Background
LIRA technique (Laparoscopic Intracorporeal Rectus Aponeuroplasty) was described in 2018 in order to reduce the tension in the midline as an alternative to defect closure (CD) in Laparoscopic Ventral Hernia Repair. We present our results in LIRA series in patients with a medium follow up

Methods
A prospective controlled study from January 2015 to December 2020 to evaluate (LIRA) performed on patients with midline w2 hernias (EHS Classification). Data analyzed included patient demographics, operative parameters and complications.
Tomography was performed preoperatively and postoperatively (1 month and 1 year) to evaluate recurrence, distance between rectus and seroma. Clinical examination were performed yearly.

Results
49 patients. Mean Age was 58± 10.59 years old and BMI 33.11± 6.61 kg/m2. Mean width of the defect was 6.19± 1.49 cm. Average VAS (24 h) was 5.09 ± 5, 0.38(1 month) and 0 (1 year). Mean preoperative distance between rectus was 5.55± 1.61 cm; postoperative was 2.15 ± 0.79 cm (1 month) and 2.20±0.68 cm (1 year). Radiological seroma at first month was detected in 40%. Seroma after 1 year was 4,08% Mean follow-up was 24 months. Bulging detected only in 1 case (2.04%) after 1 year follow up. No recurrence is data.

Conclusion
LIRA technique could be considered as an alternative to CD for w2 defects with a low rate of complication, and could be related to a low rate of postoperative pain with no recurrence and a low rate of bulging compared to CD, being a safe, feasible and reproducible technique.
OC-089 STANDARDIZED SUTURING OF MEDIAN INCISIONS AND DEFECTS CAN REDUCE SUTURE SLACKENING AND BURST RATES
Authors: Lesch C , Kallinowski F , Katharina U , Vollmer M , Raschidi R , Nessel R 
Published: October 2022

Abstract

Aim
Has standardization of criteria of a small-stitch-small-bite suture (SSSB) a significant influence on its durability?

Material and Methods
Porcine abdominal walls and bovine flanks were used as model tissues. We cut a median 15 cm long incision into the tissues. Then we punched an additional round (5–10 cm wide) or rhomboid (5×15 cm) defect in the middle of the incision. Monomax® and Maxon® USP 1 and 2–0 sutures were used in a running technique with a suture to incison lengths above 4:1. The mesh-tissue compounds were investigated on our self-built hydraulic bench test simulating coughs. Cyclic pressure impacts were repeatedly delivered peaking around 210 mmHg. In each of twenty experimental series, ten preparations were loaded 425 times.

Results
Standardized SSSB sutures using 2–0 Monomax® with a suture-incision-ratio of 4.5 : 1 can give a durable closure of a large defect in thin, elastic tissues. Under other conditions, suture lines can reopen. Standardization of the suturing technique significantly increased the durability (p = 0.00008). Defect shape is important since the larger rhomboid defects were easier to close compared to the smaller, 5 cm wide, round defects (SSSB: p = 0.00018; LSLB: p = 0.00906).

Discussion
After standardization, insignificant influences on the durability were exerted by the suture material and diameter, the bite and stitch size (small versus large), the surgeon, the tissue elasticity and tension and the defect size.

Conclusions
A standardized suturing technique was developed. The standardization improved the durability of a suture repair significantly.
P-007 CYANOACRYLATE IS A USEFUL TOOL TO PREVENT SEROMAS IN INCISIONAL HERNIA SURGERY
Authors: Jezieniecki Fernández C , Trujillo Díaz J , Ruiz Soriano M , Gomez Sanz T , Cabezudo Molleda G , Montes Manrique M , Rodriguez Lopez M , Herreros Rodríguez J , Beltrán De Heredia Renteria J 
Published: October 2022

Abstract

Aim
To demonstrate that the use of cyanoacrylate (Glubran®) can decrease the incidence of postoperative surgical site occurrences (SSO) in incisional hernia (IH) surgery.

Methods
Retrospective cohort analysis of SSO after elective IH repairs (November 2018 to October 2020). Group 1: mesh fixation by interrupted stitches associating cyanoacrylate (as well as spreading it in subcutaneous tissue). Group 2: without cyanoacrylate.

Results
113 patients were analyzed included (females: 50.4%, age: 70 (IQR: 59–75years)). Length of stay: 3 (IQR: 2–6days). Comorbidities: diabetes (7.1%), hypertension(29.2%), dyslipidemia(41%), smoking(38.1%), alcohol consumption(22.1%), cardiovascular disease(15.9%). ASA: I(5.3%), II(62.8%), III(31.9%). BMI: 29.14±3.63kg/m2. Hernia location: midline (89.4%), others (10.6%). Cyanoacrylate group:54.9%. Surgical technique: onlay (61.1%), sublay (38.9%).
Postoperative complications: global (29.2%), clinical seroma (25.7%), ultrasound seroma (32.7%). Surgical site infection-SSI (8.8%). Recurrence: 3.5%.
Patients with cyanoacrylate had lower overall complications, clinical and ultrasound seroma and SSI rates (17.7% vs 43.1% p=0.003; 16.1% vs 37.3% p=0.011; 27.4% vs 39.2% p=0.1; 3.2% vs 15.7% p=0.02 respectively). These findings are even more statistically significant after selecting onlay procedures (23.3% vs 51.3% p=0.018; 16.7% vs 46.2% p=0.01; 30% vs 46.2% p=0.1; 6.7% vs 20.5% p=0.04 respectively). These differences were maintained in the multivariate analysis (p &lt;0.05).

Conclusion
The cyanoacrylate (Glubran®) is a good tool in preventing postoperative seromas in patients with IH (particularly in onlay procedures), without increasing the incidence of other complications.
P-013 RESULTS OF ANATOMICAL RECONSTRUCTION OF RECTUS ABDOMINIS SHEATH AS A VARIANT OF RIVES TECHNIQUE
Authors: Díaz Pedrero R , López González L , Aguado Henche S , Hernandez Fernández M , Córdova García D , Ratia Giménez T , Bru Aparicio M , San Román Romanillos R , Allaoua Y , Gutierrez Calvo A 
Published: October 2022

Abstract

Aim
To describe our results of the anatomical reconstruction of the midline as a variant of the Rives technique.

Material and Methods
53 cases of midline incisional hernia M2, M3, M4 according to the EHS classification were treated between Jan 2016 and Jan 2022 in our Unit by the same surgeon using a modified Rives technique (reconstruct the midline by continuous sutures to create a new linea alba, where the polypropylene mesh will be fixed; the lateral region is not fixed with suture, only a tissue adhesive -Tisseel®- is used)

Results
Average duration of surgery: 132 min (113–215 min), Mean Age 57 years (32–72), 21 females and 32 males, mean BMI 29 (23–34), . The average stay was 3.7 days, the immediate postoperative pain was 3.8 according to the EVA scale, drainage was used in 7 cases (13.2%). There were 2 infectious complications in surgical site without requiring mesh explantation (3,8%), 3 seromas occurred (5,6%).

Discussion
Hernia recurrence has decreased in recent years due to the incorporation of mesh. There are other important factors when we evaluate the results of hernia repair technique. Anatomical reconstruction offers adequate results.

Conclusion
Anatomical reconstruction of rectus sheath offers good results as an option to the repair of midline hernias
P-017 A FRAMEWORK FOR MULTIDISCIPLINARY TEAM MANAGEMENT OF ABDOMINAL WALL RECONSTRUCTION
Authors: Wei R , Gilmore K , Findlay J , Sanders D , Pawlak M , Bunting D , Arain A 
Published: October 2022

Abstract

Aim
Incisional hernias are common and can significantly impact a patient's quality of life. Traditionally, abdominal wall reconstruction (AWR) has been performed by general surgeons, or those with special interest, often working in isolation. However, there is increasing awareness of pre-optimisation, risk stratification, enhanced training, and personalising treatment using a wide range of techniques.

Methods & Results
For complex and higher-risk procedures, Multidisciplinary team (MDT) management is considered the standard of care for optimising outcomes. The lack of standardised protocols and clear evidence in AWR means that surgical management can vary greatly. This makes the MDT process even more important due to the complexity of the decision-making involved. We describe a successful MDT process for complex abdominal wall reconstruction at a tertiary referral centre. Patients are reviewed at weekly AWR meetings with a multidisciplinary team, which includes consultants, advanced clinical practitioners and trainees. This is an opportunity for objective risk stratification, radiological review and assessment of the patient's goals before preoptimization and operative planning. Prospective data is collected on all patients to allow for quality improvement and service development.

Conclusion
MDT management of abdominal wall hernia is gaining popularity but remains poorly established in most regions. The involvement of surgical colleagues and other specialists is crucial in developing this growing field of surgery. We hope to expand our team to include Radiologists and Nutritionists, with the possibility of extending to regional networks, as we continue to explore new techniques and methods in managing complex abdominal wall hernias.
P-020 PERFORMANCE OF AN ATRAUMATIC AND VERSATILE LIGHT-ACTIVATED ADHESIVE FOR HERNIA MESH FIXATION
Authors: Lopes M , Bitton E , Pereira M , Dufresne A , Guilbot M 
Published: October 2022

Abstract

Aim
This study evaluates the versatility and performance of a novel adhesive for atraumatic hernia mesh fixation. The TISSIUM adhesive is a biodegradable and biocompatible viscous liquid that can be precisely applied to different tissue and mesh.1 Once in place, the surgeon utilizes a light probe to polymerize the adhesive, creating a flexible elastomeric connection that provides strong, durable and atraumatic mesh fixation.

Materials and Methods
The performance of the TISSIUM adhesive when used with a range of marketed mesh and against peritoneum (n=7) and muscle (n=3) was evaluated using a standardized lap-shear bench method using porcine tissues. The shear strength was compared to resorbable tacks (n=8) (against peritoneum as standard of care in IPOM) and self-adhesive meshes (n=4) and fibrin glue (n=3) (against muscle as classically used in the retromuscular approach).

Results
Lap-shear data revealed that the TISSIUM adhesive performance was equivalent to resorbable tacks when fixing meshes to the peritoneum. Similar testing protocol demonstrated that the TISSIUM adhesive shear strength was 6 to 13 times superior to non- penetrating fixation devices such as fibrin glue or self-adhesive mesh.

Conclusions
The use of the TISSIUM Adhesive for hernia mesh fixation is compatible with various mesh materials used in hernia repair and, in a bench model, outperforms existing non-penetrating methods in diverse tissue planes demonstrating the potential to help the surgeon achieve more effective and efficient atraumatic repair in a range of hernia procedures.
P-025 USE OF PREOPERATORY PNEUMOPERITONEUM FOR GIANT INGUINOESCROTAL HERNIA TREATMENT WITH LOSS OF DOMAIN. A GREAT RESOURSE
Authors: Gómez Torres I , Menor P D , Alcobilla E , Llorca S , Artero R , Gómez S , Tamayo A , Laguna M 
Published: October 2022

Abstract

Introduction
Recently, the use of neoadjuvant therapies such as preoperative progressive pneumoperitoneum has favored the treatment of large ventral hernias with loss of domain. Despite this, there are only few cases described in the literature.

Materials & Methods
We present a case of a 69-year-old male affected by giant inguinoescrotal hernia of years of evolution with loss of domain.
A preoperative CT scan with volumetric quantification is performed where giant left inguinal hernia with mesenteric fat content, small intestine, sigma, descending colon, as well as splenic angle of the colon, with a relationship between the volumes greater than 0.67. (VSH of 11,502cc and VABD of 17,061cc).
We decided to perform preoperative progressive pneumoperitoneum.
In the following 15 days up to 8L are administered without complications.

Results
Surgical repair of the inguinal hernia is performed according to the Lichtenstein technique modified by the size of the hernial sac with evidence of unstructured but intact structures of the inguinal canal. Placement of self-adhesive ProGrip TM retroaponeurotic mesh is performed with attachment of this to the inguinal ligament and pubis.
After surgery, the patient presented a good postoperative recovery without complications, without evidence of recurrence more than 6 months after surgery.

Discussion
The use of prehabilitating techniques in patients affected by large hernias can reduce the morbidity and mortality of patients, with the less aggression. In our case it allowed us to completely reduce all the hernia contents without visceral injury and perform an anatomical repair, which would not have been possible without this resource.
P-032 FASCIOTENS: FIRST CASE IN THE HOSPITAL OF MéRIDA
Authors: Lindo Canchado J J , Hernández Sánchez A , Marco Continente C , Lima Teixeira De Abreu P M , Moreno Ballesteros M , López Farias A , Rubio Capote L , Nieto Soler A A 
Published: October 2022

Abstract

Aim
Anterior abdominal wall incisional hernias are a problem present in approximately 11–20% of patients undergoing laparotomy. Incisional hernias with loss of right of abode are associated with many physical, physiological and psychological problems.
In order to surgically repair these incisional hernias with loss of right of abode, we need to perform a prehabilitation of the incisional hernias. Effective prehabilitation is required in order to close the aponeurotic defect without tension and to return the hernial contents to the abdominal cavity.

Material and methods
A 59-year-old female patient with a history of open cholecystectomy and incisional hernia repaired on three occasions, presenting with multisaccular midline incisional hernia (M1-M4 W3) containing colon and greater omentum.

Results
After application of botulinum toxin and Fasciotens, it is possible to perform Rives-Stoppa retrorectus repair, being able to reduce the hernial content without tension and without increasing intra-abdominal pressure.

Conclusions
Prehabilitation in complex abdominal wall surgery is essential to repair large aponeurotic defects without tension. In addition, the application of Fasciotens after administration of botulinum toxin allows closure of the aponeurotic defect using standard abdominal wall closure techniques.
P-042 POSTTRAUMATIC HERNIAS: AN UNKNOWN PATHOLOGY
Authors: Flores Flores C , García Galocha J L , Peña Soria M J , Del Campo Martín M , López Antoñanzas L , Sánchez Del Pueblo C , Pérez Jiménez A E , Ruano Campos A , Torres García A J 
Published: October 2022

Abstract

Introduction
Posttraumatic hernias are a rare pathology. The mechanism is due to increased abdominal pressure during trauma causing disruption muscle planes.

Case description
We report three cases of this patology:
One of them is a women who suffered a sigmoid perforation due to a traffic accident. After sigmoidectomy and primary abdominal wall closure the patient presented bilateral abdominal. hernias.
The second case is about an elderly woman who fell down a subway staircase. The patient presented with a fracture of the left clavicle, fractures of four ribs and left lumbar haematoma. Two months after the trauma she had a left lumbar hernia.
The latest case is about a young man who was involved in an accident while riding a motorbike, pinning the handlebars. Physical examination revealed an oedema of the abdominal wall. He had an abdominal hernia with omentum inside.
Bilateral hernioplasty was performed on the first one. Biosynthetic mesh on the second one. Laparoscopic correction of the defect with polypropylene mesh fixed with tackers in the third case.

Discussion
Traumatic abdominal hernias have a estimated incidence of 0.07 to 0.2% of all abdominal trauma. We use two diagnostic criteria: suffering a trauma and the absence of a previous hernia in the same location. In this context, it is important to confirm the presence or absence of a hernia by CT scan.

Conclusion
The treatment of choice in these cases is the use of mesh because it decreases the rate of recurrence.
P-046 LAPAROSCOPIC E-TEP APPROACH FOR VENTRAL HERNIA ASSOCIATED WITH INGUINAL HERNIA AND RECTUS DIASTASIS: IS IT A GOOD OPTION?
Authors: Trujillo Díaz J , Jezieniecki Fernandez C , Acosta Rodriguez A , Rodriguez Valenzuela N , Montes Manrique M , Saldarriaga Ospino L , Sánchez Gonzalez J , Perez Saborido B 
Published: October 2022

Abstract

Aims
Ventral hernias are a common pathology in general surgery and its association with rectus abdominis diastasis and inguinal hernias is frequent.The surgical technique for the repair of this type of hernias is ideally a retromuscular technique associated or not with a posterior separation of components (transversus abdominis muscle release-TAR).We present the utility of the e-TEP-approach to treat different types of hernias associated with rectus abdominis diastasis in the same surgical procedure.

Methods
71-year-old-man,surgical-histories:open right-hernioplasty and laparoscopic-radical prostatectomy.Physical examination:midline ventral-hernia (M3W2:6cm),left-inguinal-hernia and diastasis(5cm).We decided to perform a laparoscopic-eTEP-approach.

Results
We use 5ports(3×12mm,2×5mm).1°step is to dissect the left retromuscular-space using a dissector balloon,and continuous with the supraumbilical cross-over transecting the left posterior-sheath and then the right posterior-sheath completing the dissection of the other retromuscular-space.The dissection continues down to the pubis dissecting the midline hernial-sac and then dissecting the left-inguinal-space.Due to the tension to close the posterior-sheath,we decided to perform a right-TAR.We begin the right-TAR up-to-down using the monopolar-electrocautery, at this area we observe adhesion due to the ports of the previous surgery.Next, we continue with the closure of the posterior and anterior-sheaths using 2–0 V-lock suture.We placed a 3D-PVDF-mesh for the left-inguinal-hernia and another 30×30cm polypropylene-mesh in the retromuscular-preperitoneal space.The patient presented a satisfactory evolution,was discharged 1°POD.

Conclusions
The minimally invasive e-TEP approach is an effective and good option in cases of ventral-hernias associate with inguinal-hernias and diastasis without increasing the incidence of postoperative complications and with better postoperative recovery,less postoperative pain, shorter LOS,lower rates of recurrence and lower healthcare costs.
P-048 DOES BILATERAL REPAIR INCREASE COMPLICATION RATES COMPARED TO UNILATERAL REPAIR IN PATIENTS UNDERGOING LAPAROSCOPIC TOTALLY EXTRAPERITONEAL INGUINAL HERNIA SURGERY?
Authors: Hayward R , Smith J J , Kontovounisios C , Qiu Mbbchir S , Warren O J 
Published: October 2022

Abstract

Introduction
There is ongoing debate over whether to fix asymptomatic contralateral inguinal hernias during repair of the presenting hernia. This study reviewed the practice of one high-volume hernia surgeon, comparing unilateral and bilateral laparoscopic repairs, to establish if bilateral repair is associated with an increased risk of post-operative complications compared to unilateral repair.

Material & Methods
All patients operated on within a 5-year period were audited and subcategorised depending on whether they underwent unilateral or bilateral repair. Data was collected on complication rates, rates of recurrence, readmission within 30 days and duration of operation.

Results
186 patients underwent repair of 265 hernias. 79 patients underwent bilateral repair. 25 patients suffered a complication (13.4%). Complication rates were 11.2% and 16.5% in the unilateral group and bilateral group respectively (p=0.50). These included superficial infection (1.9% vs 1.3%, p=0.75), haematoma (5.6% vs 7.6%, p=0.59), seroma (2.8 vs 7.6%, p=0.13), and chronic pain (0% vs 2.5%, p=0.01). There were no mesh infections, persisting numbness or explantation in either arm. In both groups, median nights stayed was 0. At median length of follow-up of 1.8 years, recurrence rates were 1.9% vs 0% in the unilateral and bilateral arms respectively (p=0.22).

Conclusions
There was no significant difference in rates of complications between the bilateral and unilateral arms. Opportunistic repair may reduce risk of future surgeries and morbidity and does not appear to be associated with increased complications. Surgeons may wish to consider this when consenting patients.
P-051 TAPP IN A COMMUNITY HOSPITAL SETTING : AN EXPERIENCE OF OVER 1000 CASES
Authors: Agresta F , Licitra E , Mazzarolo G , Savino G , Pontarolo N , Montori G 
Published: October 2022

Abstract

Aim
We want to share and discuss what we have learned from our 20-year experience in TAPP procedures

Material and Methods
We use only all 5 mm trocars, instruments, and 30-degree optics and we always use low intraabdominal pressure (10mmHg).
The major technical trick is to carefully prepare the peritoneum flap all around, like a cone, just in order to let the mesh perfectly lie down on the inguinal area.

Results
Our TAPP experience is almost more than 1000 cases, elective as an emergency. We use a 10×15 cm LW macroporous monofilament polypropylene mesh. Besides the well known needed physical characteristics of the mesh, on the surgeon's side, a mesh should be smooth, stiff, wide enough to cover all the possible defects, easy to handle, and, especially for its possible use in laparoscopy, with a certain degree of and thickness just what it is needed in order to let it pass through a 5 mm trocar once rolled up. We do not use to fix the mesh anymore because we do believe in the mesh pushed versus the abdominal wall by the intra-abdominal pressure, and in the exact size of the (10×15 cm). Only in case of huge direct hernia we do “lift” without tension the transversalis fascia.

Conclusions
Most of the advantages of laparoscopy rely on the minimal access and therefore the benefits of this technique will be greater as the access becomes smaller, together with a no fixed LW mesh.
P-054 STANDARDIZATION OF HERNIA REGISTRY IN A HIGH-VOLUME LOW-COMPLEXITY CENTRE
Authors: Di Nubila F , Kaul S , Buhain R , Sarwary S , Shatkar V 
Published: October 2022

Abstract

Introduction
Our surgical department performs an average of 350 cases per year, performed by general surgeons of various seniority. These are predominantly in a post-pandemic period, where a backlog of patients are awaiting surgery in the NHS. It is not always possible for the same professional to provide continuity of care. An easy and reproducible classification of hernias is necessary to facilitate universal communication among surgeons.

Methods
We implemented a surgical proforma for the pre-assessment and operation note, based on the European Hernia Society (EHS) for inguinal and ventral hernias. The pre-assessment and operation note proforma were trialled on an elective basis on a week designated for hernia surgery. The proforma was then rolled out to both elective and emergency hernia repair surgery with the collaboration of all surgeons from our department.

Results
The use of designated hernia week was beneficial to learning and led to acceptance of the new proforma amongst all our surgeons. Hence, the reproducibility in non-dedicated elective lists and emergency cases could be achieved.

Conclusion
The adoption of a single classification accepted internationally, as proposed by the EHS, improves the continuity of patients’ care from pre-assessment to post-operative follow-up. The registry will benefit from better planning of theatre lists, improved productivity, understanding of recurrence rates, types of complications, and lead to improved quality of life. Long-term data collection and further studies can be uniformly compared inside the surgical department, and in collaboration with multinational studies with this initiative.