bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-084 OPEN PARASTOMAL HERNIA REPAIR: STOMA RELOCATION WITH CST, MODIFIED RIVES SUBLAY MESH TECHNIQUE WITH CST OR MODIFIED SUGARBAKER INTRAPERITONEAL MESH TECHNIQUE WITH CST
Authors: Zuvela M , Galun D , Bogdanovic A , Bidzic N , Zivanovic M , Bogdanovic M , Zuvela M , Zuvela M 
Published: October 2022

Abstract

Aim
To presents results of various open surgical techniques for parastomal hernia repair.

Material and Method
Between January 2014 and January 2020, 22 patients with parastomal hernias were treated by three various operative techniques: a) stoma relocation using component separation techniques (CST); b) modified Rives sublay mesh technique with CST; c) modified Sugarbaker intraperitoneal composite mesh repair with or withouth CST. Stoma relocation and CST was performed in two patients, modified Rives sublay technique and CST in 15 patients and modified Sugarbaker technique with or without CST in five patients.

Results
Hernia recurrence was developed in one of two patients treated by stoma relocation and CST and in two of 15 patients treated by modified Rives sublay mesh technique and CST. In five patients treated by modified Sugarbaker technique no complications occured. Mean follow up was 28 months.

Conclusion
Modified Rives sublay technique with CST and modified Sugarbaker technique with or withouth CST provide good results in treatment of patients with parastomal hernia.
P-097 MINIMALLY INVASIVE REPAIR IN SEVERE RECTUS DIASTASIS WITH MIDLINE HERNIA ASSOCIATED IN MALES SHOWS HIGH RECURRENCE IN MID-TERM FOLLOW-UP. CASE-CONTROL STUDY
Authors: Bellido-Luque J , Licardie E , Gomez Rosado J C , Sanchez-Matamoros I , Nogales Muñoz A , Tejada Gomez A , Bellido Luque A , Morales S 
Published: October 2022

Abstract

Aim
Endoscopic plication could develop excessive midline tension that could increase recurrence rate in patients with severe rectus diastasis (SRD). New minimally invasive endoscopic repair (FESSA technique)(FT) was proposed to corrects both pathologies. Aim: assess clinical results, postoperative pain, functional recovery and recurrence of FT compared to endoscopic anterior rectus sheaths plication and mesh (ARSP).

Patients and Methods
male patients with ventral/incisional hernia and SRD were included. 2017–2019 patient underwent to ARSP. 2019–2020 patients underwent to FT. data: Defect and diastasis width and length. Surgical results: Operation time, Intraoperative complications, Hospital stay,Postoperative complications,Pain on 1th/7th/30th days, Functional recovery, Hernia recurrence. Statistic variables were compared using nonparametric tests.

Results
53 patients were included. 28 patients underwent FT and 25 to ARSP. operative time: 70 +/-9 min in FT, 55+/- 7 min in ARSP with significant differences.Hospital stay:1.4+/- 0,5 days for FT and 2,08+/-0,5 for ARSP with significant differences. one postoperative subcutaneous hematoma, requiring surgical removal (2%) in ARSP. Pain at postoperative day 1:21+/2 in FT and 25 +/-2 in ARSP without differences. Pain after 7 and 30 days,significant improvement were shown in favor of FT. functional recovery at 1 month: 17,8 +/-2,4 in FT and 27,8 +/-3,3 in ARSP with significant improvement in FT. recurrence after 24 months: 1 patient in FT (3.6%) and 9 patient in ARSP(36.0%) with significant differences.

Conclusions
Minimally invasive endoscopic Anterior rectus sheaths plication with mesh in SRD and midline hernias, shows higher recurrence rate, postoperative pain and worse functional recovery due to probably excessive midline tension.
P-101 EVALUATION OF PATIENTS’ QUALITY OF LIFE AFTER LAPAROSCOPIC INTRAPERITONEAL ONLAY MESH (IPOM) TREATMENT OF PRIMARY AND INCISIONAL VENTRAL HERNIA
Authors: Bellino R , Giaccone M , Peirano E , Rosati S , Balestra G , Sandrucci S 
Published: October 2022

Abstract
IPOM technique is a well-established technique for the repair of primary and incisional allowing a less invasive treatment compared to open approach and improving patient satisfaction. In this retrospective observational study, we evaluated the application of IPOM technique with the use of a non-absorbable, transparent, light surgical prostheses in polypropylene, composed of a macroporous monofilament mesh and a transparent film. 82 procedures of primary and incisional hernia repair from January 2018 to January 2022 have been included in this study. All the procedures were performed through 3 abdominal trocars without dissecting the hernia sac. Mesh fixation was achieved using transparietal points and resorbable tackers. The primary outcome of the study was the evaluation of patients’ Quality of Life (QoL assessed with EHS QoL scale) in two subgroups: primitive hernias (n=34) and incisional hernias (n=48). The secondary outcomes of the study were the evaluation of recurrence rate and postoperative complications rate. In both groups we recorded a significative improvement in patients’ QoL related to pain at rest, pain during physical activity and aesthetic discomfort (p &lt;0.01). In the included cohort population, the hernia recurrence was recorded in 4 cases (4.9%, at 10, 18, 24 and 24 moths, respectively), and 3 patients experienced postoperative complications (3.7%). The recorded postoperative complications included pain (n=1, 1.2%), seroma infection (n=1, 1.2%) and intestinal obstruction (n=1, 1.2%). Our clinical experience showed that IPOM technique is a safe and effective approach, and it allows to significantly improve the patients’ QoL after surgery.
P-102 THE USEFULNESS OF EXPERIMENTAL ANIMALS IN LEARNING LAPAROENDOSCOPIC VENTRAL HERNIA SURGERY
Authors: Otegi Altolagirre I , Recreo Baquedano A , Arana Iñiguez I , Ruiz Marzo R , Ariceta López A , San José Aranda L , Rico Arrastia A , Uribazo Rodriguez M , Blázquez Lautre L 
Published: October 2022

Abstract

Aim
To study the usefulness of learning in simulation and animal model to incorporate laparoendoscopic techniques in ventral hernia in an abdominal wall unit.

Material and Methods
The training consists of 3 phases and four surgeons participate in it.
In a first phase, videos of laparoendoscopic ventral hernia surgeries are displayed.
In the second phase, 3 sessions are carried out in a simulation box to practice the zenith suture with a 5 cm diameter defect.
For the third phase, each surgeon has four sessions of surgery with swine models; In the first three, a retromuscular dissection procedure was performed, creating and suturing a midline defect of 15×4 cm (long and transverse diameter), placement of mesh in a retromuscular position, and closure of the posterior sheath (laparoscopic RIVES). In the 4th animal model, an extraperitoneal procedure was performed (eTEP) without closure of the posterior rectus sheath.
The total time of the intervention and the time used in the zenith suture are analyzed.

Results
With the first experimental animal, the average time used in suturing was 47.5 minutes, and in the fourth animal it dropped to 35 minutes. The time used to perform the laparoscopic RIVES in the first animal model was 102 minutes and was reduced to 72 minutes in the third.

Conclusions
Simulation and training models of minimally invasive ventral hernia surgery are useful and necessary in the training of surgeons and improve procedure times and skills.
P-107 DOES BARBED SUTURE REDUCE THE RATE OF EVISCERATIONS IN EMERGENCY MIDLINE LAPAROTOMIES?
Authors: López-Antoñanzas L , Jaimes León E , Ruano-Campos A , Garcí-Galocha J L , Del Campo M , Flores Flores C , Peña Soria M J , García A J 
Published: October 2022

Abstract

Introduction
Evisceration is a frequent consequence after performing midline laparotomies (ML) in urgent abdominal surgeries. The aim of this study was to compare and evaluate the results obtained after the introduction of barbed sutures in abdominal wall closure.

Materials and methods
We performed a retrospective analysis of patients undergoing emergency surgery in our hospital following a midline laparotomy approach in the last 5 years. Preoperative variables were compared between both groups and related to early surgical wound complications, depending on the type of abdominal wall closure performed.

Results
222 patients underwent surgery (Polydioxanone (P); 128; Barbed (B); 94) after ruling out exclusion factors such as neuromuscular disease, recent abdominal surgeries and whose follow-up had been lost. There were no significant differences between the two groups in terms of preoperative baseline characteristics or associated comorbidities. Furthermore, there were no statistically significant differences in type of surgery performed; the most frequent was small bowel obstruction. After data analysis, no differences were found in terms of hospital stay (P; 7.43 days vs B; 6.05 days, p=0.421) or mortality (P; 3.125% vs B; 4.25, p=0.655). Concerning immediate complications, there were no differences regarding surgical wound infection (P; 18.75% vs B; 10.63%, p=0.061) and seroma (P; 3.125% vs B; 2.12, p=0.651). Evisceration rates turned out to be more frequent in the polydioxanone group (P; 20.31% vs B; 8.51%, p=0.016).

Conclusions
The use of barbed sutures reduced the incidence of evisceration, therefore it can be considered as recommended sutures for aponeurotic closure in emergent ML.
P-114 INVESTIGATING THE ROLE OF BOTOX IN THE EMERGENCY MANAGEMENT OF COMPLEX ABDOMINAL WALL HERNIAS
Authors: Stevens J , Kostalas M , Chapman A , Prabhudesai S , Ratnasingham K 
Published: October 2022

Abstract

Aims
Botulinum toxin (Botox) has an established role in the elective management of complex abdominal wall hernia, but its role in the emergency setting has not been investigated. Clinical effects of Botox peak at 2–3 weeks after injection, but effects become apparent within 48 hours. We aimed to determine if these early effects can facilitate the acute reduction of irreducible hernia.

Materials and methods
Patients with irreducible abdominal wall hernias over a 30 month period were considered for Botox therapy. Suitable patients were given 300 units of Botox under ultrasound guidance into the anterolateral muscles bilaterally. Data were collected on outcomes.

Results
Twelve patients received Botox. All had incisional hernias and an ASA of 3 or more. Six were on antiplatelets and/or anticoagulation. All received Botox with standard conservative management. In ten patients, the hernia was reduced and symptoms resolved. One patient required surgery at 48 hours due to bowel ischaemia from inter-sac adhesions. A second patient experienced recurrent obstruction despite successful hernia reduction but was palliated due to advanced age and frailty.

Conclusions
This case series is the first study to investigate the role of Botox in the acute management of irreducible hernias. Our findings suggest that in selected patients, Botox can aid hernia reduction and avoid the morbidity of emergency repair. This is of particular value in high risk patients and those with complex defects who benefit from preoperative optimisation techniques. The accurate identification of strangulation is crucial however, as it excludes patients from this approach.
P-120 LAPAROSCOPIC REPAIR OF INCISIONAL HERNIA USING A NON-ABSORBABLE TRANSPARENT COMPOSITE PROSTHESIS TOTALLY IN POLYPROPYLENE - OUR EXPERIENCE
Authors: Pecic V , Pavlovic A , Todorovic A , Bogdanovic D , Dimitrijevic M , Bekic M , Rancic L , Rosati S , Balestra G , Jovanovic B 
Published: October 2022

Abstract

Introduction
Incisional ventral hernia is one of the most common surgical complications after laparotomy. The aim of this retrospective observational study is an evaluation of clinical outcomes after laparoscopic repair of incisional hernias with a non-absorbable and transparent composite prosthesis composed of a macro-porous monofilament polypropylene mesh and a transparent polypropylene film.

Materials and Methods
63 patients, from January 2016 to December 2021, were treated for incisional hernia at Center of minimal invasive surgery Nis, Serbia. The mesh was always positioned intraperitoneally after closing the defects and fixed with absorbable tacks and non-absorbable suture.

Results
In the considered cohort (54% female and 46% male) the median age and BMI were 54 years (range: 39–68) and 25,1 kg/m2 (range: 21.5–30.3), respectively. Concerning hernia position, 93.7% of the hernias were medial, 4.8% lumbar and 1.6% medio-lumbar. According to EHS classification, 58.7% of the hernias were W1, 36.5% W2 and 12.7% W3. The average duration of hospitalization was 2 days.
The rate of early post-operative complications was 6.3%, including 1 seroma (1.6%) and 3 patients reporting pain (4.8%). At a median follow up of 48 months (range: 6–60) we registered 2 cases of hernia recurrency (3.2%, both at 36 months follow-up) and 1 case of bowel obstruction (1.6%). All the considered variables did not result statistically significative in relation to post-operative complications.

Conclusion
Our clinical experience showed that intraperitoneal treatment of incisional hernia using a transparent composite prosthesis. The minimally invasive procedure allows a fast postoperative recovery and a consequent low economical cost.
P-144 THE ABDOMINAL BINDERS FOLLOWING ABDOMINAL WALL RECONSTRUCTIVE SURGERY: USEFUL OR USELESS? - A META-ANALYSIS
Authors: Zeb E , Pokusevski G , Sodde P , Sabri S , Ahmad S , Mihailescu A 
Published: October 2022

Abstract

Aim
Despite a recent meta-analysis published in SAGE in 2021 by a group of chinese researchers, which included 10 RCTs, the research committee for this study felt that a substantial volume of recent literature, including 7 RCTs and 3 high value non-RCT newly published articles have not been included in the latest meta-analysis and a new study is required, to understand the clinical usefulness of abdominal binders, following abdominal wall reconstructive surgery. Furthermore, no recent studies looked at the long-term impact of abdominal binders and whether their use prevent hernia recurrence, if applied from the immediate post-op period.

Material & Methods
A thorough review of all medical literature published in english language since year 2000 and to date was carried out, using the following keywords: “hernia”, “hernia repair”, “abdominal wall reconstruction” and “abdominal binder”. 17 randomised control trials and 3 non-RCT studies (systematic reviews and surveys) were included in the study. A total of 5216 patients were included in the 20 studies included. The databases searched were PubMed, Medbase, Jama and Embase.

Results/Conclusions
The use of abdominal binders following abdominal wall surgery suggests a better pain control when compared with non-users group. This contributes to earlier mobilisation and by this preventing secondary post-op complications. There is building evidence that in long term the use of abdominal binders reduces the risk of hernia recurrence and this could be in relation to decreased post-op pain and earlier return to a normal activities in the immediate post-op period.
P-149 FEASIBILITY AND SAFETY OF AMBULATORY ETEP RETRORECTUS RIVES-STOPPA REPAIR FOR VENTRAL HERNIA
Authors: Mok J , Markakis H 
Published: October 2022

Abstract

Introduction
Endoscopic totally extraperitoneal retromuscular repair (eTEP-RS) was recently introduced as a new technique for ventral hernia repair. It has been reported to have a significant reduction in analgesia need and reduce length of stay compared to laparoscopic intraperitoneal repair. We aim to evaluate the safety and feasibility of ambulatory primary ventral hernia and incisional hernia repair using eTEP technique.

Methods
Patients planned for ambulatory eTEP ventral hernia repair between October 2020 to April 2022 were retrospectively analyzed

Results
11 patients who were deemed suitable for day surgery preoperatively were included in the analysis. Median age was 48.3 years. Defect sizes ranged from 3–6 cm. 5 patients had more than 1 midline defect, 1 patient had a spigelian hernia and 1 patient had bilateral inguinal hernias which were repaired.
7 patients were successfully managed as day case eTEP-RS. 1 patient required a conversion to open RS due to additional, large defects found intraoperatively, 1 patient stayed for 1 night for urinary retention, 1 patient was drowsy and could not be discharged on the day of surgery and 1 patient was converted to IPOM repair. There were no postoperative complications or recurrences.

Conclusion
Ambulatory eTEP is feasible, safe and effective in selected patients.
P-153 COMPARING MESH RELATED SENSATION IN PATIENTS UNDERGOING AWR USING SYNTHETIC VERSUS BIOSYNTHETIC MESH USING STANDARDIZED PROMS
Authors: Kulkarni G , Elliott Z , Hammond T 
Published: October 2022

Abstract

Aim
To compare QualityOfLife (QoL) outcomes amongst patients undergoing elective Open abdominal wall reconstruction (AWR) with Synthetic Mesh versus Biosynthetic mesh, using Carolinas Comfort scale and EuraHS QOL questionnaires.

Material and Methods
This is a retrospective study with longitudinal prospective extension for serial administration of questionnaires at specific intervals, focusing on patients having undergone AWR within last 4 years by a two-operator team of same AWR surgeon and Plastic surgeon. 4 groups of patients compared based on less than / more than six months from time of surgery using either biosynthetic or synthetic mesh.
The rationale behind it is based on characteristics of the biosynthetic mesh data showing complete disappearance by 6 months time and replacement by a scaffolding tissue as a ingrown matrix and collagen. Decision of type of mesh was governed by patient characteristics.

Results
15 patients in each group (total 60 patients) included by consecutive retrospective enrollment. We excluded those who had further abdominal surgery since. Preliminary data showing reduced mesh related sensation in favour of patients with biosynthetic mesh repair more than six months ago. Since few of those patients have still not completed their six months post operative period yet, formal statistics are not included in abstract. They shall be available in time for EHS meeting, analysed to recognise differences if any regarding mesh related questions using variance, correlation and descriptive statistics.

Conclusions
This outcomes will provide a review of current surgical practises and meshes, helping surgeons & patients make better informed decisions.
V-007 LESSONS LEARNED DURING THE ABDOMINAL WALL RECONSUTRCTION FOR A MULTIRECURRENT LUMBAR HERNIA AFTER BONE GRAFT HARVESTING
Authors: Garcia Urena M A , Medina M , Aviles A , Robin A , Martinez J , Muñoz J , Lopez-Monclus J , Morejon S , Blazquez-Hernando L A 
Published: October 2022

Abstract
The best approach for lateral incisional hernia is not known. Among these difficult hernias, those arising from iliac crest harvesting can be particularly challenging. The objective of this video is to illustrate the surgical approach of a multirecurrent case with the need of adding a posterior component separation
A 70 years old woman with 2 previous attempts of repair was referred to our center. With the patient in a 45 degrees lateral decubitus, a posterior lumbar approach was initiated through the previous scar. The retromuscular preperitoneal plane was accessed with difficulty due to previous meshes in the subdiaphragmatic, iliac and posterior areas. A big tear on the medial peritoneum changed our plan to add a posterior component separation. As we did not want to enlarge the lumbar incision to denervate more the lateral abdominal wall, we decided to make an accessory midline incision. Probably, an ETEP approach could have been better even before making the posterior incision. Once the retromuscular plane was dissected, the hole in the peritoneum could be closed. The reconstructive phase consisted in making a taco configuration using the combination of a permanent and absorbable mesh.
We have learned from this case, that an eTEP dissection of the retromuscular plane could have helped to avoid the accessory midline incision. It is also important to consider the potential iatrogenic denervation we could add in case of enlargement of the incision.
V-012 LAPAROENDOSCOPIC VENTRAL HERNIA SURGERY; ANIMAL MODEL AND PATIENTS
Authors: Otegi Altolagirre I , Arana Iñiguez I , Recreo Baquedano A , Ruiz Marzo R , Ariceta López A , Ramirez Cervera J L , Piñera Díaz A , Pérez Otermin I , Talavera Utrera G , San José Aranda L , Blázquez Lautre L 
Published: October 2022

Abstract

Aim
Show the possibility of training abdominal wall laparoendoscopic techniques in the animal model.

Material and Methods
The training consists of 3 phases; in a first phase, videos of laparoendoscopic ventral hernia surgeries are displayed. In the second phase, 3 sessions are carried out in a simulation box to practice the zenith suture with a 5 cm diameter defect.
For the third phase, each surgeon has four sessions of surgery with swine models; In the first three, a retromuscular dissection procedure was performed, creating and suturing a midline defect of 15×4 cm (long and transverse diameter), placement of mesh in a retromuscular position, and closure of the posterior sheath (laparoscopic RIVES). In the 4th animal model, an extraperitoneal procedure was performed (eTEP) without closure of the posterior rectus sheath.
After training, these surgical techniques have been performed on patients

Results
The video shows the similarity of the animal model with the patient to perform the following technical steps; opening of the posterior rectus sheath, left retrorectal space dissection, midline crossover, right retrorectal space dissection, zenith suture of the anterior rectus sheaths, retrorectal mesh positioning and posterior rectus sheath suture.

Conclusion
Simulation and training models of minimally invasive ventral hernia surgery are useful and necessary in the training of surgeons.
V-017 TOTALLY ENDOSCOPIC APPROACH TO MODIFIED SUGARBAKER PARASTOMAL HERNIA REPAIR BY TRANSVERSUS ABDOMINIS RELEASE (ETEP-PAULí). ADVANTAGES OF RETROMUSCULAR/PREPERITONEAL MESH PLACEMENT
Authors: Bellido-Luque J , Licardie E , Sanchez-Matamoros I , García Reyes A , Bellido Luque A , Nogales Muñoz A , Tejada Gomez A , Morales S 
Published: October 2022

Abstract

Several studies published have shown that TAR is an effective technique for reconstructing midline hernias and lateral hernias. In 2016, Pauli et al. described a novel technique for parastomal hernioplasty using open TAR combined with a modified Sugarbaker repair.A 56-year-old woman operated on 5 years earlier due to rectum adenocarcinoma by laparoscopic resection. A parastomal hernia was diagnosed. CT revealed a 5 cm wide parastomal hernia associated with an umbilical hernia.Patient is placed in the supine position. Identification by ultrasound of the lateral junction of right rectus sheaths. incision on subcostal region 1 cm medial to said juntion. An incision is made on the anterior lamina and retromuscular space is created with a dissection balloon. With the placement of two 11–5 trocars, the medial aspect of the posterior rectus sheath muscle is incised at the epigastric level and the Crossover is carried out. Left retromuscular dissection is performed. The hernia content is reduced. the left arcuate ligament is identified and the transverse abdominis muscle is released.
Anterior defect closure with barded suture. An horizontal peritoneal incision is performed with the aim of lateralizing the colonic stump, the peritoneum and posterior aspect of the rectum sheath are closed.Placement of PPL mesh of 25×30 cms covering the dissected space.Patient was discharged on postoperative day 2. No complications or hernia recurrence were identified.

Conclusions
This technique offers some advantages; Coated mesh is unnecessary,The retromuscular positioning permits the integration on both sides.However several drawbacks; lack of long-term outcomes and technically challenge.