Full endoscopic minimally invasive extraperitoneal modified Sugarbaker approach for para-colostomy hernia repair: Technical aspects and 2-year follow-up results of a prospective cohort.

AIM: This study aimed to assess technical aspects and clinical results of a new minimally invasive technique in parastomal hernia (PSH) repair, full endoscopic retromuscular access, after 2 years of follow-up. METHODS: Data from consecutive patients requiring minimally invasive ventral PSH repair were collected from 2019 to 2022. The inclusion criteria were patients aged between 18 and 80 years old with symptomatic PSH. Demographics and perioperative and postoperative data were collected. Postoperative pain and functional recovery were compared with preoperative data. RESULTS: Twelve patients with symptomatic PSH were included. The mean PSH defect area was 16.2 cm2 and the mean midline defect was 8.7 cm2 . No intra-operative complications or conversion to open surgery were detected. One patient (8%) required postoperative readmission due to partial bowel obstruction symptoms that required catheterization of the stoma. Pain significantly worsened after the first postoperative day compared to preoperative data but improved after the first postoperative month compared to the first postoperative week and after the 90th postoperative day compared to the first postoperative month, with significant differences. Significant restriction improvement was identified when 30 days after surgery data were compared to preoperative data and when the 180th postoperative day results were compared to 30 days after surgery. The average follow-up was 29 months. During the follow-up no clinical or radiological recurrence was observed. CONCLUSION: This paper shows low rate of intra- and postoperative complications with significant improvement in terms of pain activities restriction compared to preoperatory. After 29 months follow-up, no recurrence was identified, confirming that this approach offers good mid-term results.

Safety and effectiveness of self-adhesive mesh in laparoscopic ventral hernia repair using transabdominal preperitoneal route.

BACKGROUND: Laparoscopic ventral or incisional hernia repair requires intraperitoneal mesh placement. This is associated with an increase in adhesions, bowel obstruction and enterocutaneous fistula. Intraabdominal meshes are laparoscopically fixed using traumatic fixation methods that increase acute, chronic pain and adhesions to bowel loops. The aim was to check the safety and effectiveness of the laparoscopic approach in ventral or incisional hernia, using a self-adhesive mesh in the preperitoneal space without tacks or transfascial sutures, and to objectively assess its benefits and complications. METHODS: Patients aged between 18 and 67 years old with medial, lateral ventral and incisional hernias between 3 and 8 cm in size were included in this study. Fifty patients were included in the study, which was conducted between January 2013 and March 2015. RESULTS: The average length of surgery was 57.3 ± 18 min. The average hospital stay was 1.1 ± 0.3 days. The average time taken to return to work was 9.2 ± 2.4 days. The most common post-operative complication was seroma, which was observed in 13 patients (26 %). The average follow-up was 15.4 ± 5.5 months. Three patients were lost to follow-up during this period. There was no hernia recurrence during examination nor on CT scan during the follow-up period. The average score on the visual analogue scale before surgery was 4 ± 1. After surgery, the score was as follows: 3 ± 0.8 on the first day after surgery, 0.9 ± 0.5 after the first week, 0.4 ± 0.4 after the first month and 0 after 90 days. No patient showed chronic pain. Overall satisfaction (VAS for surgery) was 8.3 ± 0.6. CONCLUSIONS: The use of self-adhesive meshes during the laparoscopic transabdominal preperitoneal approach in small- and medium-sized ventral or incisional hernias is safe and effective, with low post-operative pain, quick functional recovery and high overall satisfaction after surgery with no increase in recurrence in the short term.

Correction to: Safety and effectiveness of self-adhesive mesh in laparoscopic ventral hernia repair using transabdominal preperitoneal route.

The metadata listed the wrong given names and family names.

[Quality of life measurement in the postoperative period in general and gastrointestinal surgery]. / Evaluación de la calidad de vida en el periodo postoperatorio inmediato en cirugía general.

INTRODUCTION: Health related quality of life measurement (HRQL) is widely accepted as an appropriate outcome of surgical care for assessing effectiveness and for risk adjusted outcomes. Nevertheless its use in the immediate postoperative period has show limitations. The aim of this study is to prove that is possible, with a specific new tool, to assess the HRQL during this period. PATIENTS AND METHODS: The study is designed to create a specific close questionnaire related to the patient's condition after surgery, structured in domains, with the subsequent use of: literature searches, patient interviews (n=30), and a Delphi survey with health care providers. Finally the tool was validated using a pre-test (n=36) and a prospective observational cohort trial (n=250), to assess the discriminant validity for different cohorts of patients, reliability, responsiveness, and convergent validity, and to compare with the widely used generic tool, Short Form 36 (SF-36). RESULTS: The questionnaire was shown to have good sensitivity to change (single index and domains score), as well as good sensitivity to distinguish cohorts of patients, a high internal consistency (Cronbach's alpha 0.88), absence of redundancy between domains (Spearman's rho range, 0.29-0.84), and good convergent validity with patient opinion. The SF-36 questionnaire showed poor discriminant validity, and lack of convergent validity with patient opinion. CONCLUSIONS: These results support that the created questionnaire is appropriate to assess HRQL in the immediate postoperative period; and was more specific than SF-36.

Totally endoscopic suprabupic approach to ventral hernia repair: Advantages of a new minimally invasive procedure. / Abordaje totalmente endoscópico suprapúbico de la hernia ventral. Ventajas de un nuevo procedimiento mínimamente invasivo.

Laparoscopic ventral hernia repair is in full development with the appearance of surgical techniques that try to diminish the disadvantages associated with this procedure. Totally endoscopic subcutaneous ventral hernia surgery with suprapubic access is a new minimally invasive surgical technique that surgically corrects the hernia defect associated or not with diastasis recti with the advantages of not penetrating the intra-abdominal space, thereby avoiding placement of the prosthesis in contact with the viscera and consequent complications (appearance of adhesions or fistulae).

Abordaje totalmente endoscópico suprapúbico de la hernia ventral. Ventajas de un nuevo procedimiento mínimamente invasivo / Totally endoscopic suprabupic approach to ventral hernia repair: Advantages of a new minimally invasive procedure

El abordaje mínimamente invasivo de la hernia ventral se encuentra en pleno desarrollo con la aparición de técnicas quirúrgicas que intentan disminuir las críticas asociadas al abordaje laparoscópico tradicional. La cirugía totalmente endoscópica subcutánea de acceso suprapúbico de la hernia ventral es una nueva técnica quirúrgica mínimamente invasiva que corrige quirúrgicamente el defecto herniario asociado o no a diástasis de rectos, con las ventajas de no penetrar en el espacio intraabdominal y evitando la colocación de la prótesis en contacto con las vísceras, con las consiguientes complicaciones derivadas de ello (aparición de adherencias o fístulas)

Laparoscopic ventral hernia repair is in full development with the appearance of surgical techniques that try to diminish the disadvantages associated with this procedure. Totally endoscopic subcutaneous ventral hernia surgery with suprapubic access is a new minimally invasive surgical technique that surgically corrects the hernia defect associated or not with diastasis recti with the advantages of not penetrating the intra-abdominal space, thereby avoiding placement of the prosthesis in contact with the viscera and consequent complications (appearance of adhesions or fistulae)

Evaluación de la calidad de vida en el periodo postoperatorio inmediato en cirugía general / Quality of life measurement in the postoperative period in general and gastrointestinal surgery

Introducción: La calidad de vida relacionada con la salud es un resultado aceptado en cirugía para medir efectividad y para ajuste de riesgos, si bien su medición en el postoperatorio precoz ha presentado limitaciones. El propósito de este estudio es probar que es posible medir la calidad de vida relacionada con la salud en dicho periodo mediante un instrumento específico. Material y método: Se obtuvo un cuestionario específico estructurado en dominios con el uso consecutivo de 3 fuentes: la revisión bibliográfica, la entrevista con pacientes (n=30) y métodos de consenso Delphi con profesionales. Finalmente el instrumento es validado sometiéndolo a preprueba (n=36) y mediante un estudio clínico observacional prospectivo (n=250) analizando su capacidad de discriminar cohortes de pacientes por tipo de intervención, complicaciones, estado clínico, su evolución temporal y sus propiedades como medida, comparándolo con el short form-36. Resultados: El instrumento mostró buena sensibilidad al cambio y capacidad de discriminación para las diferentes cohortes de pacientes, además de facilidad de uso, alta coherencia interna (alfa de Cronbach 0,88), ausencia de redundancia entre dominios (rho de Spearman entre 0,29–0,84) y adecuada convergencia con la opinión de los pacientes. En cambio el short form-36 no mostró adecuada capacidad de discriminación, ni idoneidad para su uso en dicho periodo. Conclusiones: Estos resultados sugieren que el cuestionario elaborado es válido para evaluar la calidad de vida relacionada con la salud en el periodo postoperatorio inmediato, siendo más sensible y específico que el short form-36 (AU)

Introduction: Health related quality of life measurement (HRQL) is widely accepted as an appropriate outcome of surgical care for assessing effectiveness and for risk adjusted outcomes. Nevertheless its use in the immediate postoperative period has show limitations. The aim of this study is to prove that is possible, with a specific new tool, to assess the HRQL during this period. Patients and Methods: The study is designed to create a specific close questionnaire related to the patient's condition after surgery, structured in domains, with the subsequent use of: literature searches, patient interviews (n=30), and a Delphi survey with health care providers. Finally the tool was validated using a pre-test (n=36) and a prospective observational cohort trial (n=250), to assess the discriminant validity for different cohorts of patients, reliability, responsiveness, and convergent validity, and to compare with the widely used generic tool, Short Form 36 (SF-36). Results: The questionnaire was shown to have good sensitivity to change (single index and domains score), as well as good sensitivity to distinguish cohorts of patients, a high internal consistency (Cronbach's alpha 0.88), absence of redundancy between domains (Spearman's rho range, 0.29–0.84), and good convergent validity with patient opinion. The SF-36 questionnaire showed poor discriminant validity, and lack of convergent validity with patient opinion. Conclusions: These results support that the created questionnaire is appropriate to assess HRQL in the immediate postoperative period; and was more specific than SF-36 (AU)