bluuebunny/crossref_metadata_2025_split huggingface dataset:
V-035 EXTERNAL OBLIQUE MUSCLE´S RETROFASCIAL APPROACH: IS THAT AN OPTION?
Authors: Osorio Capitán M , Novo Sukia I , Rufo Crespo E , Arruabarrena Oyarbide A , Clemares De La Lama M , Aramendia García I , Busto Vicente M J , Erro Azcarate J M 
Published: October 2022

Abstract

Background
The evolution of Abdominal Wall Surgery has led to increased knowledge of the abdominal wall anatomy and new dissection spaces. New surgical resources have promoted a scenario that advocates the individualization of the patient and the surgical technique. We present a new technique based on a dissection of the anterior rectus muscle´s retrofascial space and the space between oblique muscles from an anterior anatomical approach.

Material & Methods
We present you a case of a 80 years old patient with a reherniation of a right Spiegel hernia and a possible right groin hernia. The patient had a surgical history of both Retzius and right Bogros space intervened. We decided to performe a modified surgical approach dissecting anterior rectus muscle´s retrofascial space and the space between oblique muscles.

Results
The immediate postoperative period was favorable and the patient was discharged after 24 hours of the surgery. The successive reviewes were satisfactory.

Conclusion
Through this video we present an interesting case in which a modified new surgical approach has been performed. Waiting for further results, the External Oblique Muscle´s Retrofascial Approach could be a surgical resource that would facilitate hernia repair when other spaces have been previously intervened.
V-036 LAPAROSCOPIC MANAGEMENT OF ATYPICAL PRESENTATION OF PRIMARY GRYNFELTT HERNIA
Authors: Sarvani M , Lokendra Venkata Prasad M , Kalyan Chakravati K 
Published: October 2022

Abstract

The rarest posterior abdominal wall defect with retro and intra peritoneal contents through the upper lumbar posterolateral wall associated with weakening of the triangle is grynfeltt -lesshaft hernia. Lumbar hernia is initially small and asymptomatic and expands over time and may lead to mild symptoms gradually leading definitely grave complications. Grenynfeltt –lesshaft triangle is quite often missed due to unfamiliar nature . Correcting surgically is the only treatment option. Performing early elective management preferred to avoid grave complications. Lumbar hernia presentations are very limited in number and its laparoscopic hernioplasty was shown in very minimal series. Laparoscopic lumbar hernioplasty with principle similarity to inguinal hernioplasty is undoubtedly the best treatment modality with minimal complications.

Presentation of case
A 50 yrs healthy male without any past surgical history and nil comorbidities presented with a swelling in the right loin region gradually progressive swelling and is more prominent on the cough. Diagnosis confirmed by ultrasonography. The hernia was repaired by laparoscopic Trans abdominal pre-peritoneal approach. It was successfully completed laparoscopically and no conventional method was used. On follow up patient doing well without any signs of infection or any seroma formation noted.

Discussion
Laparoscopic approach is far more advanced and superior to the open approach with adequate long-term results.
V-037 PARASTOMAL MESH INFECTIONS WITH INTESTINAL FISTULA: 2 RARE SURGICAL CASES AND HOW WE FIXED THEM
Authors: Bertoglio C L , Quagli O , Grimaldi S , Alampi B , Morini L , Ferrari G 
Published: October 2022

Abstract
Parastomal hernias (PSH) occur in 50–80% after stoma formation and its treatment is considered a real challenge. According to the recent literature, the use of prophylactic mesh at the time of primary stoma should decrease the odds of hernia formation. The most common occurrences after PSH surgery are: recurrence, seroma and wound complications.
In this video, we report 2 cases of mesh infection with fistula necessitated removal after 10 and 4 years of mesh placement.
The first patient was a 66 years-old male.
In 2007 he underwent radical prostatectomy and pelvic lymphadenectomy following radiotherapy. He underwent a radical cystectomy and Bricker's cutaneous uretero-ileostomy for stenosis of the vesicourethral anastomosis. In 2012 for PSH he underwent laparo-alloplasty with a placement of an intraperitoneal mesh. In February 2022, with fever and dyspnoea, at the CT-scan of the abdomen we found air bubbles near the mesh and a suspected sigmoid-to-mesh fistula.
The second patient was a 66 years old male.
In 2018 the patient underwent neoadjuvant radiotherapy, then Miles’ procedure and prophylactic 3D intraperitoneal mesh, subsequent adjuvant therapy. During the oncological follow-up an abdominal CT-scan showed air bubbles around the stoma and suspicion of fistula on the adjacent intestinal loops.
In both cases there was an infection of the area around the stoma due to a fistula between the mesh and the intestine. We proceeded, in laparoscopy, to remove the infected mesh. We converted in open surgery with the resection of the fistulized intestine tract and we did a new ostomy.
V-039 EXPANDED INDICATION FOR LAPAROSCOPIC INTRACORPOREAL RECTUS MUSCLE APONEUROPLASTY (LIRA) IN PARASTOMAL HERNIA
Authors: Navarro-Morales L , Licardie E , Gómez-Menchero J , Suárez-Grau J , Bellido J , Morales-Conde S 
Published: October 2022

Abstract

Aims
Laparoscopic intracorporeal rectus aponeuroplasty (LIRA) is a minimally invasive technique for the repair of incisional hernias from M2 to M4, but using the basic concepts of the technique, it allows an extended indication for other types of hernias such as suprapubic, lateral, or as in our case, the parastomal.
The aim is to present step by step the larparoscopic aponeuroplasty technique as an alternative for parastomal hernia repair, as a modification of the original LIRA-technique.

Material & Methods
We present a 56-year-old patient with a history of abdominoperineal resection in 2012, who presented a symptomatic parastomal hernia. Clinical examination and computed tomography (CT) showed a partially reducible type I parastomal hernia, 8×11cm.

Results
We begin by releasing adhesions and reducing the hernial sac, always with control of the vascular axis, avoiding ischemic events. We opened the peritoneum and the transversus muscle 1–2 cm from the edge of the defect. We closed the defect using the transversus muscle as well as the posterior rectus sheath. We reduce the pneumoperitoneum to adapt the mesh and fix it using non-absorbable tackers and fibrin glue coating.

Conclusions
The LIRA technique guarantees a reconstruction of the midline, reinforcing this area without tension in ventral hernias. Based on this condition, we apply the concepts in a parastomal hernia, the original technique being equally reproducible, providing the advantages of laparoscopic surgery in terms of less pain. and morbidity, and betting on the minimization of tension compared to primary closure, as well as less appearance of seroma.
V-041 ENTEROCUTANEOUS FISTULA TAKEDOWN AND VENTRAL HERNIA REPAIR WITH PREPERITONEAL MESH
Authors: Wilson H , Sacco J , Tawkaliyar R , Augenstein V 
Published: October 2022

Abstract
In this video, we present a 48-year-old otherwise healthy man with a history of perforated appendicitis status post exploratory laparotomy and appendectomy, complicated by an intraabdominal abscess requiring re-exploration and subsequent midline wound dehiscence, incisional ventral hernia, and enterocutaneous fistula managed with a drain. Plastic surgery performed a split thickness skin graft of his midline wound, and his drain was kept in place until surgery. The patient was taken to the operating room for a takedown of his enterocutaneous fistula and an open repair of his incisional ventral hernia. We entered the abdomen in the midline, far away from the fistula. After lysing omental and bowel adhesions, we identified the patient's drain entering the small bowel and exiting about 10 cm distally. We removed the drain from the small bowel and performed a small bowel resection, including the entry and exit points of the drain, and a stapled side-to-side antiperistaltic anastomosis. Preperitoneal planes were developed bilaterally, and the peritoneum was rearranged over the bowel and partially closed to the omentum. We placed a biologic mesh into the preperitoneal plane and secured it in place with transfascial sutures. We then performed a multilayer closure of the fascia and dermis and an incisional negative pressure dressing was placed over the wound. The patient was discharged on postoperative day 4 after tolerating a regular diet and having full return of bowel function. In summary, this video demonstrates several important operative techniques in our approach to this complex case.
V-047 LAPAROSCOPIC TEP- RECURRENT MASSIVE REDUCICLE COMPLETE SCROTAL HERNIA
Authors: Bhowate P 
Published: October 2022

Abstract
The patient was 67 yrs old gentlemen. Swelling over the Left groin for the last one and half year with recent onset discomfort. He was operated on same side 2 years back with open suregry. On clinical examination - large scrotal reducile hernia was observed, another reducible herinia primary was obseved on right side. He was also having symptoms of bladder outlet obstruction for which tablet. silodosin was started. A complete workup was done and patiemt was told about need for folys post operative. He underwent surgery for same under general anesthesia. (video enclosed). The post operative period was eneventful and on follow up of 8 months there is no recurrence. Why laparoscopy - Hernia was reducible, recurrence was on medial aspect. Less tone of abdominal was musculature. Challaanges in laparoscopy - Hernia sac reduction. Opening of sac may happen loss of TEP space, Management of sac, Large mesh covering all defects, post operative seroma, Mesh fixation mutiple places and surggical mangement of contrallaetral hernia in same setting.
V-048 EXPANDING INDICATION OF LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY (LIRA) TO SUPRAPUBIC AREA: LIRA & TAPE
Authors: Licardie E , Jerí-Mcfarlane S , Navarro L , Bellido J , Gómez-Menchero J , Morales-Conde S 
Published: October 2022

Abstract

Aim
LIRA-technique is a minimally invasive technique described to repair M2–M4 primary and incisional hernias. Defects below this area (M5 –Suprapubic area) could be treated using the concept associated to LIRA, expanding the indication of this technique in combination with a transabdominal partially extraperitoneal (TAPE) repair. The aim of this video is to show the surgical steps combining LIRA & TAPE for M2–M5 ventral hernias.

Material & Methods
75-years-old-female patient with clinical examination and CT-scan showed a 9 cm width incisional hernia(W2), including the supraumbilical(M3), infraumbilical(M4) and suprapubic area(M5) with a total longitudinal length of 18 cm.

Results
The first step of the procedure is to open the peritoneum and posterior rectus sheath at 1–2 cm from the edge of the defect over the arcuate line. This flap allows following the dissection below arcuate line. At the suprapubic area, a bilateral peritoneal flap was done as indicated during the TAPE-repair until both Cooper ligaments are identified. Loop sutures were used for closing the defect, using the rectus muscle below the arcuate line, as well as the posterior rectus sheath above this line. A double-layer mesh is used in this case, being placed intraperitoneally.

Conclusions
The combination of LIRA & TAPE techniques provides an extension of the indication of concept associated to the LIRA for the repair of M5/W2 hernias, which could not be achieved using a conventional technique. Our initial experience with this technique, expanding the concept of LIRA to the suprapubic area, shows no recurrences and no postoperative morbidity.
V-055 LAPAROSCOPIC FUNDOPLICATION WITH HANDXTM HOOK AND NEEDLE HOLDER
Authors: Szold A , Ortenzi M 
Published: October 2022

Abstract

Aim
HandX™ is a handheld, powered laparoscopic device with interchanging single-patient fully articulating instruments. It is electromechanically controlled, and, as the manual interface is handled by the surgeon, beside the patient's bed, the movements of the surgeon's wrist and fingers are translated to the instrument-articulating tip.This report is to show the feasibility and safety of this technology implemented with a monopolar dissecting hook in a complex abdominal procedure.

Materials and Methods
We report the case of the laparoscopic repair of a large hiatal hernia using HandXTM instruments.

Results
The index case was a 69-year-old female with symptomatic large paraesophageal hiatal hernia. Three 5 mm trocars were used: 1 in the left midclavicular line, 1 in on the right of the midline close to the costal arch and 1 assistant on the right midclavicular line, one 11 mm umbilical. The sac was dissected with the HandXTM monopolar hook and the stomach was fully reduced into the abdomen with the hernia sac. The hiatus was closed with three separated stiches handled with the articulating needle holder. A Nissen funduplication was performed. Three separated stiches were used to secure the wrap, using the HandX needle holder. At the end of the operation a mesh was used to reinforce the hiatus. The operative time was 80 minutes, no blood loss nor intraoperative or post-operative complications were recorded

Conclusions
The report showed how the HandX technology could be safely adopted to obtain both a safe dissection and an ergonomically advantageous suture in laparoscopic Nissen fundoplication.
V-056 LAPAROSCOPIC VENTRAL HERNIA REPAIR WITH GORE SINECOR INTRAPERITONEAL BIOMATERIAL: OUR CENTER EXPERIENCE
Authors: Monti E , Latham L , Gianazza S , Zullo A , Odeh M , Colombo E M , Marzorati A , Fanelli M , Costa J , Inversini D , Ietto G , Carcano G 
Published: October 2022

Abstract

Aim
Ventral hernias including incisional ones are very common in our population. Mesh reinforcement options for ventral/incisional hernia repair continue to evolve with advances in polymer science and better understanding of the extracellular matrix. Consensus on the safety and efficacy of these various types of synthetic and biologic mesh has yet to be reached.
Intraperitoneal onlay mesh (IPOM) is the laparoscopic technique most frequently used in our center to treat umbilical and abdominal ventral defects sized 3 cm to 8 cm. Our equipe built an expertise with Gore DualMesh prosthesis (2% recurrence ratio in our center); we used the Gore Sinecor Intraperitoneal Biomaterial for the first time here.

Methods
Symptomatic supraumbilical incisional hernia in a 74 years old man; parietal defect sized 7×8 cm. We performed an Ipom repair procedure using a 20×25 cm Gore Sinecor Intraperitoneal Biomaterial, trimmed to 18×20 cm. Follow-up at one and six months from surgery.

Results
The patient was discharged the day after surgery. He did not complain severe pain in the first week after surgery and he only use Paracetamolo 1g die as antalgic therapy. After seven days he resumed his daily activities.
He did not experience any short-term sieroma nor long-term complication at follow up.

Conclusions
The Gore Sinecor Intraperitoneal Biomaterial, while maintaining a firm peritoneal adhesivity, has a better handling and feels lighter than the Gore DualMesh we routinely use. The transparency makes it possible to visualize the overlying abdominal wall, allowing a safer tacs positioning.
V-057 INTRAPERITONEAL ONLAY MESH (IPOM) TECHNIQUE FOR THE LAPAROSCOPIC TREATMENT OF INGUINAL HERNIA
Authors: Bellino R , Giaccone M , Sandrucci S 
Published: October 2022

Abstract
Laparoscopic treatment of inguinal hernia is a widely accepted technique, especially in the case of bilateral or recurrent inguinal hernias. The evolution of materials has led to the successful use of double layer prostheses for the intraperitoneal treatment of wall defects, significantly reducing the mesh-related complications.
In this regard, the literature data and the availability of non-absorbable, transparent, light surgical prostheses in polypropylene, composed of a macroporous monofilament mesh and a transparent film, have led to the re-proposal of the IPOM technique also for the treatment of primary inguinal hernias.
After the laparoscopic access in the abdomen using a 10 mm trocar in the umbilical region and two 5 mm trocars operating in the Iliac fossae, the hernia is reduced by returning the hernial contents to their original compartments and the hernial sac is closed with the possible lipoma using purse-string suture. Subsequently, a polypropylene composite prosthesis is then inserted into the abdomen, centered on the defect and fixed to the wall by tack and chemical glue.
To date we have performed 10 procedures on 6 patients (4 with bilateral hernia). The longest follow-up is one year. The patients were all discharged the day after the surgery, reporting a mean postoperative pain score (assessed with EHS QoL scale) equal to 2 (range: 0–4), and the work resumption after a week in average.
This technique, which is easy to perform and reproducible, can significantly reduce operating times and minimize complications related to the preparation of the peritoneal pocket.
Teaching Social Work Practice Skills: A Collaborative Autoethnography Identifying Key Practice Skills and Modes of Delivery in the Art of Social Work Practice
Authors: Turner George W , Round Rohena , Chhetry Dibya Shree 
Published: October 2022

Abstract
Social work students must advance their social work skills gaining practice competencies. And, whilst practice learning takes place in field education placements, social work students often also enrol in a dedicated unit/ course whereby the teaching of practice skills is facilitated in class. A practice skills class is another learning space to imbue practice wisdom. Adjunct teaching staff are often employed on short-term university contracts to teach social work students in the area of practice skills. Whilst these practitioners can bring a wealth of experience and expertise to the under-graduate classroom, it cannot be assumed that adjunct teaching staff have formal training in curricula development nor pedagogical delivery. The goal of this article is to identify the critical elements of teaching practice skills and to examine the ways in which teaching content is delivered. This article presents the ‘teaching the teacher’ experience of three social work educators at an Australian university. A collaborative autoethnography identified three themes from the inductive analysis: (i) teaching best practices, (ii) teaching role and (iii) teaching practice skills. Finally, implications for social work are discussed and recommendations shared.
Parallel in-depth analysis of repeat expansions in ataxia patients by long-read sequencing
Authors: Erdmann Hannes , Schöberl Florian , Giurgiu Mădălina , Leal Silva Rafaela Magalhaes , Scholz Veronika , Scharf Florentine , Wendlandt Martin , Kleinle Stephanie , Deschauer Marcus , Nübling Georg , Heide Wolfgang , Babacan Sait Seymen , Schneider Christine , Neuhann Teresa , Hahn Katrin , Schoser Benedikt , Holinski-Feder Elke , Wolf Dieter A , Abicht Angela 
Published: October 2022

Abstract
Instability of simple DNA repeats has been known as a common cause of hereditary ataxias for over 20 years. Routine genetic diagnostics of these phenotypically similar diseases still rely on an iterative workflow for quantification of repeat units by PCR-based methods of limited precision.
We established and validated clinical nanopore Cas9-targeted sequencing, an amplification-free method for simultaneous analysis of 10 repeat loci associated with clinically overlapping hereditary ataxias. The method combines target enrichment by CRISPR–Cas9, Oxford Nanopore long-read sequencing and a bioinformatics pipeline using the tools STRique and Megalodon for parallel detection of length, sequence, methylation and composition of the repeat loci.
Clinical nanopore Cas9-targeted sequencing allowed for the precise and parallel analysis of 10 repeat loci associated with adult-onset ataxia and revealed additional parameter such as FMR1 promotor methylation and repeat sequence required for diagnosis at the same time. Using clinical nanopore Cas9-targeted sequencing we analysed 100 clinical samples of undiagnosed ataxia patients and identified causative repeat expansions in 28 patients. Parallel repeat analysis enabled a molecular diagnosis of ataxias independent of preconceptions on the basis of clinical presentation. Biallelic expansions within RFC1 were identified as the most frequent cause of ataxia. We characterized the RFC1 repeat composition of all patients and identified a novel repeat motif, AGGGG.
Our results highlight the power of clinical nanopore Cas9-targeted sequencing as a readily expandable workflow for the in-depth analysis and diagnosis of phenotypically overlapping repeat expansion disorders.
Mutant huntingtin messenger RNA forms neuronal nuclear clusters in rodent and human brains
Authors: Ly Socheata , Didiot Marie-Cécile , Ferguson Chantal M , Coles Andrew H , Miller Rachael , Chase Kathryn , Echeverria Dimas , Wang Feng , Sadri-Vakili Ghazaleh , Aronin Neil , Khvorova Anastasia 
Published: October 2022

ABSTRACT
Mutant mRNA and protein contribute to the clinical manifestation of many repeat-associated neurological disorders, with the presence of nuclear RNA clusters being a common pathological feature. Yet, investigations into Huntington's disease – caused by a CAG repeat expansion in exon 1 of the huntingtin (HTT) gene – have primarily focused on toxic protein gain-of-function as the primary disease-causing feature. To date, mutant HTT mRNA has not been identified as an in vivo hallmark of Huntington’s disease. Here, we report that, in two Huntington’s disease mouse models (YAC128 and BACHD-97Q-ΔN17), mutant HTT mRNA is retained in the nucleus. Widespread formation of large mRNA clusters (∼0.6 to 5 µm3) occurred in 50-75% of striatal and cortical neurons. Cluster formation was independent of age and driven by expanded repeats. Clusters associate with chromosomal transcriptional sites and quantitatively co-localize with the aberrantly-processed N-terminal exon 1-intron 1 mRNA isoform, HTT1a. HTT1a mRNA clusters are observed in a subset of neurons from human Huntington’s disease post-mortem brain and are likely caused by somatic expansion of repeats. In YAC128 mice, clusters, but not individual HTT mRNA, are resistant to antisense oligonucleotide treatment. Our findings identify mutant HTT/HTT1a mRNA clustering as an early, robust molecular signature of Huntington’s disease, providing in vivo evidence that Huntington’s disease is a repeat expansion disease with mRNA involvement.
Brain structure in autoimmune Addison’s disease
Authors: van’t Westeinde Annelies , Padilla Nelly , Siqueiros Sanchez Monica , Fletcher-Sandersjöö Sara , Kämpe Olle , Bensing Sophie , Lajic Svetlana 
Published: October 2022

AbstractLong-term disturbances in cortisol levels might affect brain structure in individuals with autoimmune Addison’s disease (AAD). This study investigated gray and white matter brain structure in a cohort of young adults with AAD. T1- and diffusion-weighted images were acquired for 52 individuals with AAD and 70 healthy controls, aged 19–43 years, using magnetic resonance imaging. Groups were compared on cortical thickness, surface area, cortical gray matter volume, subcortical volume (FreeSurfer), and white matter microstructure (FSL tract-based spatial statistics). Individuals with AAD had 4.3% smaller total brain volume. Correcting for head size, we did not find any regional structural differences, apart from reduced volume of the right superior parietal cortex in males with AAD. Within the patient group, a higher glucocorticoid (GC) replacement dose was associated with smaller total brain volume and smaller volume of the left lingual gyrus, left rostral anterior cingulate cortex, and right supramarginal gyrus. With the exception of smaller total brain volume and potential sensitivity of the parietal cortex to GC disturbances in men, brain structure seems relatively unaffected in young adults with AAD. However, the association between GC replacement dose and reduced brain volume may be reason for concern and requires follow-up study.