A study to improve identification of the retroperitoneal course of iliohypogastric, ilioinguinal, femorocutaneous and genitofemoral nerves during laparoscopic triple neurectomy.

Background: Laparoscopic triple neurectomy is an available treatment option for chronic groin pain, but a poor working knowledge of the retroperitoneal neuroanatomy makes it an unsafe technique.

Object: Describe the retroperitoneal course of iliohypogastric, ilioinguinal, lateral femoral cutaneous and genitofemoral nerves, to guide the surgeon who operates in this region.

Methods: Fifty adult cadavers were dissected resulting in 100 anatomic specimens.

Does Abdominoplasty Add Morbidity to Incisional Hernia Repair? A Randomized Controlled Trial.

Background Abdominoplasty is considered an operation linked to a considerable rate of morbidity. The convenience of simultaneously performing an incisional hernia repair and an abdominoplasty remains controversial. Methods A total of 111 patients were randomized prospectively to compare isolated incisional hernia repair and hernia repair when combined with abdominoplasty.

Surgical management of postoperative chronic inguinodynia by laparoscopic transabdominal preperitoneal approach.

Background: The avoidance of postoperative chronic pain is of the foremost importance and has a deep impact on patient satisfaction. The objective of this study is to evaluate the selective transabdominal preperitoneal laparoscopic neurectomy for treatment of refractory inguinodynia.

Methods: Prospective study in a University Hernia Center included 16 consecutive patients with chronic pain.

Double Prosthetic Repair for Complex Incisional Hernia Repair: Long-term Results and Evolution of the Technique.

No single approach has emerged as the best way to close complex incisional hernias. The aim of this report is to present the long-term results with a double prosthetic repair. In this prospective observational study over 12 years (Group 1, 8 years; Group 2, 4 years), the following data were collected: age, gender, previous surgery, comorbidities, situation and size of defect, hospital stay, postoperative complications, and recurrence.

How to Prevent Trocar-site Hernia? A Totally Atraumatic Endoscopic Mini-IPOM-Plug Technique (With Extra-Lightweight Titanium-coated Mesh and Glue).

Background: The trocar-site hernia is a new complication in laparoscopic surgery, which is becoming increasingly prevalent. Thus, the search for an efficient method of prophylaxis should be prioritized.

Materials And Methods: We describe a new, totally endoscopic technique based on 2 steps, intra-abdominal and parietal: (1) a mini-IPOM with an extra-lightweight titanium-coated mesh, fixed atraumatically using glue and (2) occlusion of the parietal opening using a small plug.

Which should be the gold standard laparoscopic technique for handling Spigelian hernias?

Background: The advantages and disadvantages of both extraperitoneal and intra-abdominal laparoscopic Spigelian hernia repair are still being discussed. To our knowledge, no study has compared both techniques in terms of safety, feasibility, and cost-effectiveness.

Method: Prospective data were collected to compare the results of the extraperitoneal approach with the intra-abdominal approach in laparoscopic Spigelian hernia repair, between 2000 and 2012 (n = 16).

Is it possible to eliminate sutures in open (Lichtenstein technique) and laparoscopic (totally extraperitoneal endoscopic) inguinal hernia repair? A randomized controlled trial with tissue adhesive (n-hexyl-α-cyanoacrylate).

Background: The morbidity linked to the use of sutures in inguinal hernioplasty is well known. Tissue adhesives may be an alternative, so as to be able to improve levels of postoperative comfort, but clinical experience using them is limited. The aim of this study is to evaluate the efficiency of cyanoacrylate as a substitute for sutures in the treatment of inguinal hernias.

[Handlebar hernia. Report of 3 cases].

Background: traumatic hernias of the abdominal wall caused by handlebars are a rare type of hernia but with clinical and therapeutic connotations of great interest.

Clinical Cases: we report 3 new cases, 1 case with diagnosis on admission and emergency treatment by open approach, and 2 with a diagnostic delay of 6 months and operated on a scheduled basis using totally extraperitoneal laparoscopy. We provide here an update.

[Is sutureless hernia repair a safe option for treating abdominal wall hernias? A prospective study with a synthetic tissue adhesive (n-hexyl-alpha-cyanoacrylate)].

Introduction: The use of tissue adhesives can be an alternative to suture fixation of the mesh, but experience in their use is very limited.

Material And Methods: A prospective descriptive study was conducted on a group of 35 patients with inguinal hernias repaired by sutureless hernioplasty (20 by open and 15 by endoscopic), the prosthesis was fixed with a synthetic adhesive (n-hexyl-α-cyanoacrylate). This group was compared with another 35 patients for hernia repair with fixation sutures.

Reduction in inappropriate hospital use based on analysis of the causes.

Background: To reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement.

Methods: Pre- and post-analysis of a sample of clinical histories studied retrospectively, in which the Appropriateness Evaluation Protocol (AEP) was applied to a representative hospital sample of 1350 clinical histories in two phases.

Surgical options in lumbar hernia: laparoscopic versus open repair. A long-term prospective study.

Objective: To determine the safety and effectiveness of laparoscopic lumbar hernia repair.

Design: Prospective clinical study.

Setting: Abdominal wall unit, university hospital.

Randomized clinical trial of laparoscopic hernia repair comparing titanium-coated lightweight mesh and medium-weight composite mesh.

Background: The use of lightweight meshes in incisional hernia repair could have beneficial effects on quality of life. This study aimed to compare a new titanium-coated lightweight mesh with a standard composite mesh after laparoscopic incisional hernia repair.

Methods: A randomized controlled single-center clinical trial was designed using the basic principle of one unit, one surgeon, one technique (midline incisional hernia with a laparoscopic approach), and two meshes: a lightweight titanium-coated mesh (group 1) and a medium-weight collagen-polyester composite mesh (group 2) used in 102 patients.

Is muscular atrophy a contraindication in laparoscopic abdominal wall defect repair? A prospective study.

Laparoscopic surgery for abdominal wall hernias improves short-term results as compared with open hernia surgery. However, no evidence exists to recommend this approach for pseudohernias, which are abdominal wall defects postsurgery caused by denervation and muscular atrophy. The purpose of this study is to analyze whether the laparoscopic approach benefits patients with a pseudohernia.

Management of non-midline incisional hernia by the laparoscopic approach: results of a long-term follow-up prospective study.

Background: The role of the laparoscopic approach in the repair of non-midline incisional hernias is controversial due to the absence of adequate scientific studies. This study aimed to determine the safety and efficacy of laparoscopic repair for non-midline incisional hernias.

Methods: This prospective clinical study was conducted in an abdominal wall unit of a teaching hospital.

Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study.

Background: This study was performed to determine if defect size after laparoscopic incisional hernia repair is predictive of recurrence during the long-term follow-up evaluation.

Methods: We performed a prospective clinical study on 310 patients who underwent laparoscopic incisional hernia repair to identify predictable risk factors for hernia recurrence. Univariate and multivariate Cox regression analysis were used.

[Historic analysis of complex incisional hernia: to an understanding of the double prosthetic repair technique].

The treatment of complex incisional hernias is, on occasions, a real social and professional, and still controversial, challenge. A multitude of techniques have been described over the years in an attempt to solve this problem. The social context and technological development of each period are essential to understand the continuous changes in the way of performing these techniques.

Vascular injury by tacks during totally extraperitoneal endoscopic inguinal hernioplasty.

Totally extraperitoneal laparoscopic hernioplasty is a consolidated approach for treating recurrent and bilateral inguinal hernias. However, it may be associated, albeit very rarely, with vascular lesions that can endanger the patient's life. A proper anatomic knowledge of the posterior aspect of the inguinal region and a perfect command of the laparoscopic technique are essential for avoiding and, if necessary, treating these lesions.

Repair of complex incisional hernias using double prosthetic repair: single-surgeon experience with 50 cases.

Background: The treatment of complex incisional hernias is still difficult and controversial. With technologic developments we can modify and update the operative techniques described for treating complex abdominal wall hernias.

Methods: This is a prospective study of 50 patients with complex incisional hernias undergoing complex abdominal wall herniorrhaphy at a university hospital.

Treatment of incisional hernias adopting an intra-abdominal approach with a new low-density composite prosthetic material: proceed: our preliminary experience on 50 cases.

Introduction: The management of incisional hernias remains a challenge for the general surgeon. Repairing by using prosthetic materials has reduced the relapse rate, but intra-abdominal mesh placement continues to be a source of controversy.

Objective: An evaluation is made of the results of treating incisional hernias with a new intra-abdominal low-density composite mesh through both the open and the laparoscopic approach.