bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-065 PROSPECTIVE STUDY OF QUALITY OF LIFE OUTCOMES OF TOTALLY TRANSFASCIAL SUTURE FIXATION OF MESH WITH CLOSURE OF DEFECT IN LAPAROSCOPIC VENTRAL HERNIA REPAIR
Authors: Agrawal M K , Kumar A , Fanai M H , Pal A , Anand A , Pahwa H S , Sonkar A A 
Published: October 2022

Abstract

Aim
To study the Quality of life Outcome in totally transfacial suture fixation of mesh with primary closure of defect in laparoscopic ventral hernia repair with regards to:

Materials & Methods
Patients who visited the OPD of General Surgery, KGMU, Lucknow, UP and was diagnosed as a case of symptomatic ventral and incisional hernia fulfilling the inclusion and exclusion criteria were enrolled.

Results
A total of 40 patients from OPD department of General Surgery were enrolled. Maximum numbers of patients in the study i.e. 14(35%) belong to M4. Mean BMI is 28.6. Mean defect size was 3.25 cm (Range- 2cm to 5 cm). Mean duration of hospital stay was 2.85 days. With this procedure the patients were able to resume his/her daily routines very early and a mean of 4.65 days was recorded among the 40 patients involved in the study. Also a mean of 11.6 days was recorded as the time taken to return to office works which was all within two weeks after the operation. Carolina's comfort scale measure quality of life score in pre-op and post-op period on sensation of mesh,pain sensation and limitation of movement . where the scores were added and the mean sensation of mesh at post-operative period was 0.30.

Conclusion
There was significant improvement in dimensions of body pain, physical function, vitality, emotional role, mental health and sensation of mesh in small and medium size hernia, with totally transfascial suture fixation of mesh.
P-067 FORMATION IN MINIMAL INVASIVE SURGERY IN INGUINAL HERNIA REPAIR IN GENERAL SURGERY RESIDENCY TRAINING: RESULTS OF A NATIONAL SURVEY
Authors: Gonzalez-Prado C , Cabriada García G , Reoyo Pascual J F , Valero Cerrato X , León Miranda R , Muñoz Plaza N , Otero Rondón M , Álvarez Rico M Á , Polanco Perez L , López Rodríguez B , Casaval Cornejo L , Dominguez Arroyo I 
Published: October 2022

Abstract

Aim
To describe and assess how minimal invasive surgery in inguinal hernia repair is in spanish general surgery residency.

Material & Methonds
An anonymus survey with 26 questions was sent to all Surgery Residents in Spain by email by Spanish Surgeons Association. Responses were analysed using both qualitative and quantitative methods.

Results
161 answers were recieved. Residents of each year and each hospital answered that survey. 83.2% performed minimal invasive abdominal wall surgery. But in 78.2% of hospital this surgery was conducted by 1 or 2 senior surgeon. 55.1% performed less than 30 surgeries per year. TEP was preferred than TAPP in most cases. 51.2% of residents did not rotate in an abdominal wall surgery unit. At least 48% of residents did not performed any minimal invasive surgery during their residency training, but 71.4% performed their first open inguinal hernia repair at their first year of residency. Those who performed minimal invasive surgery, just 6% performed more than 20 surgeries. 91.9% of residents percieved gaps in their minimal invasive inguinal hernia repair surgery training.

Conclusion
Abdominal wall surgery is infraestimated. This survey findings highlighted the gaps and the callenges encouterd by Spanish General Surgery residents in acquiring satisfactory minimal invasive inguinal hernia surgery skills during their residency. An improvement in our formation is needed.
P-076 PROSPECTIVE COHORT STUDY ON MESH SHRINKAGE MEASURED WITH MRI AFTER ROBOT ASSISTED MINIMAL INVASIVE RETRORECTUS VENTRAL HERNIA REPAIR USING AN IRON OXIDE LOADED PVDF MESH
Authors: Vierstraete M , Beckers R , Vangeel L , Foriers B , Pletinckx P , Muysoms F 
Published: October 2022

Abstract

Aim
Mesh-reinforced ventral hernia repair is considered the gold standard treatment for all but the smallest of hernias. Human data on mesh shrinkage in the retrorectus mesh position is lacking. A prospective observational cohort study was performed to measure mesh shrinkage in robot assisted minimal invasive retrorectus repair of ventral hernias.

Methods
A cohort of 20 patients underwent a robot assisted minimal invasive retrorectus repair of their ventral hernia. Magnetic resonance imaging (MRI) imaging was performed one month and thirteen months after implantation of an iron-oxide-impregnated polyvinylidene fluoride (PVDF) mesh to assess the decrease in mesh surface area. Inter-rater reliability among three radiologists regarding measurement of the mesh dimensions was analyzed. Quality of Life scoring was evaluated.

Results
The inter-rater reliability between the radiologists reported as the intra-class correlations proved to be excellent for mesh width (ICC 0.95), length (ICC 0.98) and surface area (ICC 0.99). Between MRI measurements at one month and thirteen months postoperatively, there was a significant increase in mesh surface area (+12.0 cm2, p=0.0013) and mesh width (+0.8 cm, p&lt;0.001), while the length of the mesh remained unchanged (-0.1 cm, p=0.754). Quality of Life Scoring showed a significant improvement in Quality of Life after one month and a further improvement at thirteen months (p&lt;0.001).

Conclusion
There was an excellent inter-rater reliability between three radiologists when measuring width, length and surface area of an iron-oxide-impregnated PVDF mesh using MRI visualization. Mesh shrinkage was not observed, instead the effective mesh surface area and width of the mesh increased.
P-087 ANALYSIS OF COMPLICATIONS AND QUALITY OF LIFE IN PATIENTS AFTER 5 YEARS OF ANTERIOR SEPARATION HERNIOPLASTY
Authors: Kulakova A L , Protasov A V , Kuliev S , Evsukova I , Borsuk A 
Published: October 2022

Abstract

Aim
To assess the treatment results, complications and the quality of life of patients after anterior separation hernioplasty.

Material & Methods
comparative analysis of complications and quality of life of 96 patients with giant postoperative ventral hernias after anterior separation plastic by using polypropylene mesh endoprosthesis. Description of method of implant fixation is given, analysis of complications and quality of life of patients is given. The Clavien-Dindo scale and the EuroHS QoL score by EHS were used to investigate complications in the first 30 days.

Results
wound complications were observed in 11.4% (p &lt; 0.01), general complications 4.2% (0.05), hernia recurrence rate1.0% (p &lt; 0.01), death 1.0% (p &lt; 0.05). Most patients (n = 71, 74%) experienced a significant reduction in pain intensity, increased physical activity, and satisfaction with appearance at 3 months post-surgery.

Conclusions
study results showed low percentage of wound complications, relapses, and the significant improvement of the quality of patient's life.
P-100 ANATOMICAL STUDY ON THE PREPERITONEAL FAT DISTRIBUTION IN EXTENDED RETROMUSCULAR PREPERITONEAL DISSECTION: FROM THE FATTY TRIANGLE TO THE FATTY TRIDENT
Authors: Garcia-Urena M A , Lopez-Monclus J , Medina M , Aviles A , Blazquez Hernando L A , Robin Valle De Lersundi A , Munoz-Rodriguez J , Rial X , Minaya A , Sanchez A 
Published: October 2022

Abstract

Aim
Extended retromuscular dissection performed for abdominal wall reconstruction in complex abdominal wall repair has progressively exposed the anatomy between the peritoneal layer and abdominal wall muscles. This study aimed to assess the morphology and distribution of preperitoneal fat in a cadaveric model.

Material and methods
Thirty frozen cadaver torsos were dissected by posterior component separation. The shape of the preperitoneal fat was identified, and the dimensions and more significant distances were calculated.

Results
The results showed that the preperitoneal fat resembles a trident, exists along the midline under the linea alba, and expands in the epigastric area into a rhomboid shape. The fatty triangle was found to be a part of this rhomboid. The mean rhomboid area was 35 cm2. Caudally, the midline preperitoneal fat widened under the arcuate line to reach the Retzius space. Laterally, the Bogros space communicated the root of the trident with the paracolic gutters, Toldt's fascia, and pararenal fats, forming the lateral prong of the trident. The mean width of the midline prong at the umbilicus was 2.8 cm. It was easier to tear the peritoneum outside the area reinforced by the fatty trident.

Conclusions
The concept of preperitoneal fatty trident may be of practical assistance to perform various hernia procedures, from the simple ventral hernia repair to the more complex preperitoneal ventral repair or posterior component separation techniques. The consistency of this layer allows us to follow our plane between the peritoneum and muscle layers to extend the preperitoneal dissection.
P-105 A UNIQUE AND MULTIDISCIPLINARY APPROACH TO ABDOMINAL DEFECT CORRECTION AFTER TRAM FLAP
Authors: Fonseca T , Andrade Almeida M , Campos E , Barbosa E , Barbosa E 
Published: October 2022

Abstract

Aim
The Transverse Rectus Myocutaneous (TRAM) flap is a valid option in autologous breast reconstruction with acceptable aesthetic results, but the absence of the rectus muscle can be responsible for the discomfort and functional lost caused be the asymmetry of the abdominal wall with a slight bulge. It's also described that incisional hernias can develop following TRAM, and the management is often challenging. We want to present a case of a multidisciplinary surgery with immediate correction of the abdominal defect after the TRAM flap.

Material and Methods
We describe a case of a woman who, at the same surgical time, underwent skin-sparing mastectomy with immediate reconstruction with a TRAM flap and correction of the muscle defect of the abdominal wall with transverse abdominis release (TAR) with placement of a wide, macroporous polypropylene mesh with 48mg/m2 density in a retromuscular position.

Results
The association of the TAR with the placement of a wide mesh retromuscular allows a greater containment of intraabdominal force, with less bulging and better aesthetic results at the muscle donor site.

Conclusion
The correction of the muscle defect should be considered at the same time of the TRAM flap. The multidisciplinary approach in these cases can reduce the patient's surgical morbidity and allow better aesthetic and functional outcomes.
Note: we use a DIPROMED®, BULEVB5050 mesh
P-106 CAN POOR ORAL HYGIENE BE RESPONSIBLE FOR MESH INFECTION FOLLOWING HERNIA REPAIR? A SYSTEMATIC REVIEW AND SUGGESTION FOR NEW PRACTICE
Authors: East B , Podda M , Beznosková-Seydlová M , de Beaux A C 
Published: October 2022

Abstract

Background
There is a reasonable evidence around oral/dental health and implant infection in orthopaedic and cardiovascular surgery. Mesh hernia repair is another area of surgical practice associated with a permanent implant. The aim of this SR was to review the evidence around oral/dental health and mesh infection.

Mehods
The study was registered at Prospero. A systematic review of the literature was undertaken according to the PRISMA2020 statement. The initial search identified 520 publications. After a review by title and abstract, 40 papers were read in full text. A further 4 papers were identified from references and searching.15 publications were included in the final review.

Results
There is no published evidence investigating the state of oral hygiene/health and the risk of mesh infection. Improvement in oral hygiene/health can reduce surgical site infection and implant infection in colorectal, gastric, liver, orthopaedic and cardiovascular surgery. Poor oral hygiene/health is associated with a large increase in oral bacteria and bacteraemia on everyday activities such as when chewing or brushing teeth. Antibiotic prophylaxis does not appear to be necessary before invasive dental care in patients with an implant.

Conclusion
Good oral hygiene and oral health is a strong public health message. The effect of poor oral hygiene on mesh infection and other complications of mesh hernia repair is unknown. While research is clearly needed in this area, extrapolating from evidence in other areas of surgery where implants are used, good oral hygiene/health should be encouraged amongst hernia patients both prior and after their surgery.
P-109 A RETROSPECTIVE AUDIT OF THE DEPARTMENTAL USE OF PROPHYLACTIC ANTIBIOTICS IN ELECTIVE VENTRAL HERNIA SURGERY AS COMPARED TO NATIONAL AND INTERNATIONAL GUIDELINES
Authors: Islam R , Sriskanthanathan A , Maynard O , Abdalla S 
Published: October 2022

Abstract
The routine use of prophylactic antibiotics for the prevention of surgical site infection is no longer recommended in all types of elective ventral hernia repairs, according to national and international guidelines.NICE recommends that prophylactic antibiotics are given only in clean surgeries that involve the use of a prothesis or implant. The British Hernia Society and European Hernia Society state that there is no indication for antibiotic prophylaxis in both open and laparoscopic elective groin hernia repairs with mesh in patients that are healthy and considered low risk for surgical site infection.
This is a retrospective audit of patients who underwent elective ventral hernia repairs at Ealing Hospital between June 2021 and December 2021 to assess the compliance of antibiotic prophylaxis with the current guidelines.
Forty-nine patients underwent elective ventral hernia repair, of which 44 was with the use of a mesh.Thirty-five of these cases (79.5%) received prophylactic antibiotics. All cases that underwent laparoscopic hernia repair received prophylactic antibiotics. Five cases underwent an elective open ventral hernia repair without a mesh.Three cases who were considered low risk received prophylactic antibiotics.
In conclusion, majority of patients along with those who were considered high risk received prophylactic antibiotics, which is compliant with guidelines. However, patients who did not have a mesh repair, or were not considered high risk also received prophylactic antibiotics.It would be useful to improve the awareness of the guidelines by creating clear local guidelines and improving documentation of reasons to give antibiotics against the recommendations.
P-111 TAR (TRANSVERSUS ABDOMINIS MUSCLE RELEASE) AS AN ALTERNATIVE IN PATIENTS WITH INCISIONAL HERNIA AND COMPLEX ABDOMINAL WALL. ANALYSIS OF OUR EXPERIENCE
Authors: Serrano Yébenes E , Diaz Pedrero R , Ovejero Merino E , Córdova García D M , Ratia Gimenez T , Allaoua Moussasi Y , Laguna Hernandez P , Bru Aparicio M , Manes Jimenez F , Jimenez Martín R , Medina Reinoso C , San Román Romanillos M R , Gutierrez Calvo A 
Published: October 2022

Abstract

Aim
To analyze the results of patients with complex abdominal wall surgery using TAR(transversus abdominis muscle release) technique in our center.

Material and Methods
An observational, descriptive, retrospective study of patients operated using TAR technique in a second level hospital in the last three years was carried out. Demographic variables, classification of incisional hernias according to the EHS(European Hernia Society), and complications after the intervention were recorded. Statistical analysis was performed with IBMSPSS-Statistics-25.

Results
13 patients were operated using TAR. Medium age was 56 years. 54% of patients were men and 46% women. Median BMI was 30. According to the EHS classification, the most frequent incisional hernia was M3(84.6%), followed by M4(61.5%) and M2(53.8%). W2(61.5%) and W3(30.8%). Median distance between the rectus in the CT prior the intervention was 85 mm. 100% had median laparotomy. 53.8% subcostal or stomal incision. 46% of the patients suffered some type of complication, 38.5% surgical. The complications were wound dehiscence secondary to skin necrosis(23%), abscess(15%), mesh infection(7%), hematoma(7%). Recurrence(7%).
Subcostal or other laparotomy showed higher risk of complications of any type(p 0,048). Distance between rectums was associated with high risk of skin necrosis and wound dehiscence(p 0,015). No ileus, UTI, pneumonia, stroke or DVT.

Conclusions
TAR is a technique used in complex abdominal wall with good results in relation to closure of hernia defect. However, in our cohort some postoperative complications were observed with a low rate of hernia recurrence. This highlights the effectiveness of TAR as a technique for complex abdominal wall closure.
P-124 UMBILICAL HERNIAS IN ADULTS: WHICH PROCEDURE? A RETROSPECTIVE STUDY OF OUTCOMES
Authors: Oprea V , Buia F , Toma M , Bucuri C , Pavel P , Grad O 
Published: October 2022

Abstract

Goal
To evaluate the outcomes of three procedures for adult umbilical hernias larger than 2.5 cm.

Patients and methods
all adult patients with umbilical hernias larger than 2.5 cm admitted between 01 January 2018 and 30 December 2019 were included in the study. According to the surgeon's preference, three mesh procedures were performed: open Rives-Stoppa (o-RS), IPOM (with composite polypropylene mesh with polypropylene transparent film), and endoscopic Rives-Stoppa (e-RS). Demographics were included. The evaluated outcomes were duration of surgery, postoperative pain (on the VAS scale), local complications (seroma, hematoma, infections), and recurrence.

Results
57 patients fulfilled inclusion criteria and were distributed according to the operative procedure as follows: 28 patients with o-RS, 18 with IPOM, and 11 with e-RS. The mean age was 39.3 ± 8.2 years. Operative time was significantly shorter for o-RS patients compared with the other procedures (28.2 ± 12.7 min versus 41.7 ± 18.3 min for IPOM versus 124.3 ± 43.1 min for e-RS). No infection rate was reported. Equal rates of wound events were described. The pain was slightly increased in o-RS patients but only for the first 24 hours (4.1 ± 0.8) compared to 3.1 ± 0.2 for IPOM and 2.8 ± 0.5 for e-RS. An early recurrence rate was detected for each group of patients.

Conclusions
According to our data o-RS, repair for umbilical hernia in adults is a valid and un-expensive procedure with similar immediate outcomes in terms of pain and wound events.
P-125 INCIDENCE OF DIASTASIS RECTI ABDOMINIS SEEMS TO BE HIGHER IN PATIENTS WITH INGUINAL HERNIAS
Authors: Ugurlu C , Gok H , Sahin A , Bayar B , Olcucuoglu E , Kulacoglu H 
Published: October 2022

Abstract

Aim
To find the incidence of Diastasis Recti Abdominis (DRA) in patients with inguinal hernias.

Materials and Methods
Prospective, multicenter, cross-sectional study. Patients with inguinal hernias constitues the study group (IH), and patients with proctological disorders in the control group (PC). Investigated parameters: age, gender, BMI, family history, systemic comorbidities, alcohol consumption, tobacco use, constipation, malignancies, chemotherapy, number of births, multiple pregnancies, prostate hypertrophy. The measurements were done at 3 cm above the umbilicus. Any separation ≥20 mm was accepted as DRA. The existence of paraumbilical hernia (PUH)was also recorded.

Results
36 female and 212 male patients with a mean age of 51.3± 1.4 in IH, whereas 137 women and 305 men with a mean age of 44.5±15.9 in PC. 48.0% of IH and 21.1% of PC were diagnosed with DRA (p=0.001). Incidences of PU were 16.5% and %5.2 respectively (p=0.01). BMI ≥25, chronic pulmonary disease, multiple pregnancies and prostatic enlargement were associated with DRA. Multivariate analysis revealed that inguinal hernia and multiple pregnancies were independent factors for DRA.

Conclusions
Incidences of DRA and PUH seem to be higher in patients with inguinal hernias in comparison with control subjects.
P-127 E-TEP ASSISTED REVERSE-TAR FOR THE TREATMENT OF LARGE LUMBAR INCISIONAL HERNIAS ASSOCIATED TO MIDLINE DEFECTS
Authors: Lopez-Monclus J , Roman Garcia De Leon L , Muñoz Rodriguez J , Blazquez Hernando L , Robin A , Polaino Moreno V , Rial Justo X , Lucena De La Poza J L , Iglesias Garcia E , Garcia Ureña M A 
Published: October 2022

Abstract

Aim
To describe a new hybrid surgical approach of large lumbar incisional hernias (IH) associated to synchronic midline defects.

Material and Methods
Prospective multicentric study including patients with large lumbar hernias (L4W3) associated to midline abdominal wall defects. Surgical intervention starts with a bilateral retrorectus dissection performed through a minimally invasive extraperitoneal endoscopic approach (eTEP). Once this space has been dissected, the lumbar IH is treated with an overextended centrifugal preperitoneal open approach through the previous lumbar incision. Afterwards the dissected spaces are communicated performing a reverse transversus abdominis release (TAR) from lateral to medial. A prosthetic preperitoneal repair is performed with an absorbable and permantent meshes that cover the space dissected.

Results
Five patients were included in the study. All patients had lumbar hernias L4W3 associated to primary or incisional midline hernias M1–5 W1–2. Eighty percent of the patients were women, with a mean age of 62 years. Mean BMI was 32 (range 30–34), with a 60% of diabetic patients, and 80% of recurrent lumbar hernias (between 1 and 3 previous repair attempts). Mean surgical time was 198 minutes (range 160–250). Mean hospital stay was 5 days (range 4–8 days). Two lumbar hematomas which didn't required any interventional procedure took place as the only surgical site occurrences, without any systemic complications. No recurrence has taken place after 5 months mean follow up (range 2–9 months)

Conclusion
Hybrid eTEP and open approach of large lumbar hernias associated with small midline defects seem to be an efficient and safe approach.
P-129 TRAUMATIC HERNIA, URGENT REPAIR?
Authors: Infantes Ormad M , Curado Soriano A , Montemuiño Chulian N , Valera Sanchez Z , Naranjo Fernandez J R 
Published: October 2022

Abstract

Aim
We present our clinical experience in the urgent repair of traumatic hernias through two clinical cases.

Material and Methods
Case 1: A 45-year-old man suffering thoraco-abdominal trauma due to running over. Thoracoabdominal CT scan and surgical examination shows a meso tear of terminal ileum and traumatic section of the right lateral musculature.
Case 2: A 19-year-old man suffering abdominal trauma due to a traffic accident. CT abdomen is performed which reports large traumatic hernia of the left anterior abdominal wall including intestinal loops, with pneumo and retroneumoperitoneum.

Results
Case 1: We close the mesenteric gap and repair musculature by associating a polypropylene mesh in the preperitoneal space. The patient is discharged after 13 days. During the two-year follow-up, no hernia recurrence was detected.
Case 2: A reconstruction of the wall is performed associating posterior separation of left components, in addition to ileocecal and sigma resection with anastomosis. As a complication presents seroma and chronic sinus, without hernia recurrence during follow-up for 5 years.

Conclusions
The tendency in traumatic hernias is their repair in a second time attending first to injuries that compromise the survival of the patient, but larger defect can lead to irreversible sequelae since enlargement of hernia, atrophy and muscle retraction, resulting in a more complex repair. If the patient requires urgent surgical intervention for visceral injury, some authors defend the simultaneous repair of the hernia in stable patients. Our group thinks that patients requires individualized management and its urgent repair will depend on the clinical situation.