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Article ; Online: Open Retromuscular Lateral Abdominal Wall Hernia Repair: Is It Possible to Optimize Results?

Blázquez Hernando, Luis / López Monclús, Javier / Robín Valle de Lersundi, Álvaro / Muñoz Rodríguez, Joaquín / García Ureña, Miguel Ángel

Journal of the American College of Surgeons

2023 Volume 237, Issue 2, Page(s) 379

MeSH term(s)	Humans ; Hernia, Ventral/surgery ; Incisional Hernia/surgery ; Surgical Mesh ; Herniorrhaphy/methods ; Abdominal Wall/surgery ; Abdominal Muscles
Language	English
Publishing date	2023-05-12
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1097/XCS.0000000000000758
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Article: Bone metaplasia in a rectal polyp.

Calcerrada Alises, Enrique / Ruiz Tovar, Jaime / García Ureña, Miguel Ángel

Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

2020 Volume 113, Issue 7, Page(s) 548

Abstract: A 77-year-old male underwent a colonoscopy because of a positive fecal occult blood test. A polyp was removed from the rectum, 12 cm from the anal margin, with a hyperplastic appearance, covered by a cap of whitish fibrinoid exudate. The pathological ... ...

Abstract	A 77-year-old male underwent a colonoscopy because of a positive fecal occult blood test. A polyp was removed from the rectum, 12 cm from the anal margin, with a hyperplastic appearance, covered by a cap of whitish fibrinoid exudate. The pathological report reported a hyperplastic polyp with foci of bone metaplasia in the lamina propria.
MeSH term(s)	Aged ; Colonoscopy ; Humans ; Male ; Metaplasia ; Polyps ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/surgery ; Rectum
Language	English
Publishing date	2020-11-26
Publishing country	Spain
Document type	Case Reports ; Journal Article
ZDB-ID	1070381-0
ISSN	1130-0108 ; 0212-7512
ISSN	1130-0108 ; 0212-7512
DOI	10.17235/reed.2020.7414/2020
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Article ; Online: Short-term outcomes of a multicentre prospective study using a "visible" polyvinylidene fluoride onlay mesh for the prevention of midline incisional hernia.

Rodicio Miravalles, José Luis / Méndez, Carlos San Miguel / Lopez-Monclus, Javier / Moreno Gijón, María / López Quindós, Patricia / Amoza Pais, Sonia / López López, Antonio / García Bear, Isabel / Menendez de Llano Ortega, Rafael / Díez Pérez de Las Vacas, María Isabel / Garcia-Urena, Miguel Angel

Langenbeck's archives of surgery

2024 Volume 409, Issue 1, Page(s) 136

Abstract: Introduction: Prophylactic meshes in high-risk patients prevent incisional hernias, although there are still some concerns about the best layer to place them in, the type of fixation, the mesh material, the significance of the level of contamination, ... ...

Abstract	Introduction: Prophylactic meshes in high-risk patients prevent incisional hernias, although there are still some concerns about the best layer to place them in, the type of fixation, the mesh material, the significance of the level of contamination, and surgical complications. We aimed to provide answers to these questions and information about how the implanted material behaves based on its visibility under magnetic resonance imaging (MRI). Method: This is a prospective multicentre observational cohort study. Preliminary results from the first 3 months are presented. We included general surgical patients who had at least two risk factors for developing an incisional hernia. Multivariate logistic regression was used. A polyvinylidene fluoride (PVDF) mesh loaded with iron particles was used in an onlay position. MRIs were performed 6 weeks after treatment. Results: Between July 2016 and June 2022, 185 patients were enrolled in the study. Surgery was emergent in 30.3% of cases, contaminated in 10.7% and dirty in 11.8%. A total of 5.6% of cases had postoperative wound infections, with the requirement of stoma being the only significant risk factor (OR = 7.59, p = 0.03). The formation of a seroma at 6 weeks detected by MRI, was associated with body mass index (OR = 1.13, p = 0.02). Conclusions: The prophylactic use of onlay PVDF mesh in midline laparotomies in high-risk patients was safe and effective in the short term, regardless of the type of surgery or the level of contamination. MRI allowed us to detect asymptomatic seromas during the early process of integration. Study registration: This protocol was registered at ClinicalTrials.gov (NCT03105895).
MeSH term(s)	Humans ; Surgical Mesh ; Prospective Studies ; Female ; Male ; Incisional Hernia/prevention & control ; Middle Aged ; Polyvinyls ; Aged ; Magnetic Resonance Imaging ; Treatment Outcome ; Risk Factors ; Adult ; Time Factors ; Fluorocarbon Polymers
Chemical Substances	polyvinylidene fluoride (24937-79-9) ; Polyvinyls ; Fluorocarbon Polymers
Language	English
Publishing date	2024-04-23
Publishing country	Germany
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-024-03307-x
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Article ; Online: Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen.

Medina Pedrique, Manuel / Robin Valle de Lersundi, Álvaro / Avilés Oliveros, Adriana / Ruiz, Sara Morejón / López-Monclús, Javier / Munoz-Rodriguez, Joaquín / Blázquez Hernando, Luis Alberto / Martinez Caballero, Javier / García-Urena, Miguel Ángel

Journal of abdominal wall surgery : JAWS

2023 Volume 2, Page(s) 11123

Abstract: Incisions performed for hepato-pancreatic-biliary (HPB) surgery are diverse, and can be a challenge both to perform correctly as well as to be properly closed. The anatomy of the region overlaps muscular layers and has a rich vascular and nervous supply. ...

Abstract	Incisions performed for hepato-pancreatic-biliary (HPB) surgery are diverse, and can be a challenge both to perform correctly as well as to be properly closed. The anatomy of the region overlaps muscular layers and has a rich vascular and nervous supply. These structures are fundamental for the correct functionality of the abdominal wall. When performing certain types of incisions, damage to the muscular or neurovascular component of the abdominal wall, as well as an inadequate closure technique may influence in the development of long-term complications as incisional hernias (IH) or bulging. Considering that both may impair quality of life and that are complex to repair, prevention becomes essential during these procedures. With the currently available evidence, there is no clear recommendation on which is the better incision or what is the best method of closure. Despite the lack of sufficient data, the following review aims to correlate the anatomical knowledge learned from posterior component separation with the incisions performed in hepato-pancreatic-biliary (HPB) surgery and their consequences on incisional hernia formation. Overall, there is data that suggests some key points to perform these incisions: avoid vertical components and very lateral extensions, subcostal should be incised at least 2 cm from costal margin, multilayered suturing using small bites technique and consider the use of a prophylactic mesh in high-risk patients. Nevertheless, the lack of evidence prevents from the possibility of making any strong recommendations.
Language	English
Publishing date	2023-03-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2813-2092
ISSN (online)	2813-2092
DOI	10.3389/jaws.2023.11123
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Article ; Online: Narbenhernien: offene Operationsverfahren und Ergebnisse einer Kohortenstudie mit 343 Patienten.

Garcia Ureña, Miguel Ángel / López-Monclús, Javier / Hernando, Luis Alberto Blázquez / Munoz-Rodriguez, Joaquín / García de León, Laura Roman / Avilés Oliveros, Adriana / Pedrique, Manuel Medina / de Luca, Marcelo / Valle de Lersundi, Alvaro Robin

Chirurgie (Heidelberg, Germany)

2023 Volume 95, Issue 1, Page(s) 10–19

Abstract: The treatment of complex midline hernias remains a particular challenge. The currently refined knowledge of the anatomy in the cadaver laboratory and advancing clinical experience have changed our present approach. The aim of this review is to present a ... ...

Title translation	Incisional hernia: open abdominal wall reconstruction. Current state of the technique and results.
Abstract	The treatment of complex midline hernias remains a particular challenge. The currently refined knowledge of the anatomy in the cadaver laboratory and advancing clinical experience have changed our present approach. The aim of this review is to present a description of the updated surgical procedures and outcomes. We favor the retromuscular or preperitoneal layer for mesh implantation, including the Rives-Stoppa procedure (sublay mesh) and posterior component separation with the Madrid modification. We operated on 334 complex midline incisional hernias: 6.3% retromuscular preperitoneal, 15% after Rives-Stoppa, 2.4% anterior component separation and 76% posterior component separation. A bridging procedure was used in 31%. A complication occurred in 35.3%, most of which were wound healing disorders (SSO). The average length of hospital stay was 7.2 days. We recorded a very low incidence of long-term complications: 3.3% recurrence, 0.9% chronic pain (daily use of pain medication), 6% bulging, 1.8% chronic seroma and 2.6% chronic mesh infection. Despite the associated morbidity, retromuscular/preperitoneal treatment offers excellent long-term results.
MeSH term(s)	Humans ; Incisional Hernia/surgery ; Incisional Hernia/complications ; Abdominal Wall/surgery ; Hernia, Ventral/surgery ; Hernia, Ventral/etiology ; Abdominal Muscles ; Surgical Mesh/adverse effects
Language	German
Publishing date	2023-12-29
Publishing country	Germany
Document type	English Abstract ; Journal Article ; Review
ISSN	2731-698X
ISSN (online)	2731-698X
DOI	10.1007/s00104-023-02005-6
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Article ; Online: Recurrence after retromuscular repair or posterior components separation: How to address them. A retrospective multicentre cohort study.

Valle de Lersundi, Alvaro Robin / López-Monclús, Javier / Blázquez Hernando, Luis Alberto / Muñoz Rodriguez, Joaquin / Medina Pedrique, Manuel / Avilés Oliveros, Adriana / Morejón Ruiz, Sara / García-Ureña, Miguel-Angel

Cirugia espanola

2023 Volume 101 Suppl 1, Page(s) S40–S45

Abstract: Abdominal wall hernias are common entities that represent important issues. Retromuscular repair and component separation for complex abdominal wall defects are considered useful treatments according to both short and long-term outcomes. However, failure ...

Abstract	Abdominal wall hernias are common entities that represent important issues. Retromuscular repair and component separation for complex abdominal wall defects are considered useful treatments according to both short and long-term outcomes. However, failure of surgical techniques may occur. The aim of this study is to analyze results of surgical treatment for hernia recurrence after prior retromuscular or posterior components separation. We have retrospectively reviewed patient charts from a prospectively maintained database. This study was conducted in three different hospitals of the Madrid region with surgical units dedicated to abdominal wall reconstruction. We have included in the database 520 patients between December 2014 and December 2021. Fifty-one patients complied with the criteria to be included in this study. We should consider offering surgical treatment for hernia recurrence after retromuscular repair or posterior components separation. However, the results might be associated to increased peri-operative complications.
MeSH term(s)	Humans ; Abdominal Muscles/surgery ; Hernia, Ventral/surgery ; Cohort Studies ; Retrospective Studies ; Herniorrhaphy/methods ; Surgical Mesh ; Recurrence
Language	English
Publishing date	2023-09-20
Publishing country	Spain
Document type	Multicenter Study ; Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.cireng.2023.01.014
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Article ; Online: Meleney's Synergic Gangrene.

Pérez-Flecha González, Marina / Muñoz Rodríguez, Joaquín Manuel / San Miguel Mendez, Carlos / García Ureña, Miguel Ángel

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2020 Volume 25, Issue 3, Page(s) 849–851

MeSH term(s)	Gangrene/etiology ; Humans ; Postoperative Complications
Language	English
Publishing date	2020-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-020-04531-8
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Article: Second Look After Retromuscular Repair With the Combination of Absorbable and Permanent Meshes.

Robin Valle de Lersundi, Alvaro / Munoz-Rodriguez, Joaquín / Lopez-Monclus, Javier / Blazquez Hernando, Luis Alberto / San Miguel, Carlos / Minaya, Ana / Perez-Flecha, Marina / Garcia-Urena, Miguel Angel

Frontiers in surgery

2021 Volume 7, Page(s) 611308

Abstract: Objective: ...

Abstract	Objective:
Language	English
Publishing date	2021-01-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2020.611308
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Article ; Online: Stepwise transversus abdominis muscle release for the treatment of complex bilateral subcostal incisional hernias.

San Miguel-Méndez, Carlos / López-Monclús, Javier / Munoz-Rodriguez, Joaquín / de Lersundi, Álvaro Robin Valle / Artes-Caselles, Mariano / Blázquez Hernando, Luis Alberto / García-Hernandez, Juan Pablo / Minaya-Bravo, Ana María / Garcia-Urena, Miguel Ángel

Surgery

2021 Volume 170, Issue 4, Page(s) 1112–1119

Abstract: Background: Management of subcostal incisional hernias is particularly complicated due to their proximity to the costochondral limits in addition to the lack of aponeurosis on the lateral side of the abdomen. We present our results of posterior ... ...

Abstract	Background: Management of subcostal incisional hernias is particularly complicated due to their proximity to the costochondral limits in addition to the lack of aponeurosis on the lateral side of the abdomen. We present our results of posterior component separation through the same previous incision as a safe and reproducible technique for these complex cases. Methods: We present a multicenter and prospective cohort of patients diagnosed with bilateral subcostal incisional hernias on either clinical examination or imaging based on computed tomography from 2014 to 2020. The aim of this investigation was to assess the outcomes of abdominal wall reconstruction for subcostal incisional hernias through a new approach. The outcomes reported were short- and long-term complications, including recurrence, pain, and bulging. Quality of life was assessed with the European Registry for Abdominal Wall Hernias Quality of Life score. Results: A total of 46 patients were identified. All patients underwent posterior component separation. Surgical site occurrences occurred in 10 patients (22%), with only 7 patients (15%) requiring procedural intervention. During a mean follow-up of 18 (range, 6-62), 1 (2%) case of clinical recurrence was registered. In addition, there were 8 (17%) patients with asymptomatic but visible bulging. The European Registry for Abdominal Wall Hernias Quality of Life score showed a statistically significant decrease in the 3 domains (pain, restriction, and cosmetic) of the postoperative compared with the preoperative scores. Conclusion: Posterior component separation technique for the repair of subcostal incisional hernias through the same incision is a safe procedure that avoids injury to the linea alba. It is associated with acceptable morbidity, low recurrence rate, and improvement in patients' reported outcomes.
MeSH term(s)	Abdominal Muscles/surgery ; Abdominoplasty/methods ; Female ; Hernia, Ventral/diagnosis ; Hernia, Ventral/etiology ; Hernia, Ventral/surgery ; Herniorrhaphy/methods ; Humans ; Incisional Hernia/complications ; Incisional Hernia/diagnosis ; Incisional Hernia/surgery ; Male ; Middle Aged ; Prospective Studies ; Recurrence ; Reoperation ; Surgical Mesh ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-05-19
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2021.04.007
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Article ; Online: High recurrence rate after posterior component separation and keyhole mesh reconstruction for complex parastomal hernia: A case series study.

Robin Valle de Lersundi, Alvaro / Rupealta, Niccolo / San Miguel Mendez, Carlos / Muñoz Rodriguez, Joaquin / Pérez Flecha, Marina / López Monclús, Javier / Blazquez Hernando, Luis / García Ureña, Miguel Angel

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 23, Issue 8, Page(s) 2137–2145

Abstract: Aim: This study aimed to describe the results of complex parastomal hernia repair after posterior component separation and keyhole reconstruction.: Method: We conducted a retrospective review of a prospectively sustained database in one single ... ...

Abstract	Aim: This study aimed to describe the results of complex parastomal hernia repair after posterior component separation and keyhole reconstruction. Method: We conducted a retrospective review of a prospectively sustained database in one single complex abdominal wall referral centre. We analysed the data of patients who underwent the posterior component separation technique using modified transversus abdominis release for complex parastomal hernia and retromuscular keyhole mesh repair from February 2014 to January 2017. Demographic data, hernia characteristics, operative details and outcomes were analysed. The primary outcome measured was the recurrence rate during the follow-up. Results: Twenty patients were included in this study. Among the patients who underwent surgery for parastomal hernia, 17 patients had a colostomy (85%) and three patients had a ureteroileostomy after the Bricker procedure (15%). The mean body mass index was 33.2 kg/m Conclusions: Although posterior component separation in the form of modified transversus abdominis muscle release allows abdominal wall reconstruction, keyhole mesh configuration at the stoma site does not offer satisfactory results in terms of long-term recurrence rate at the parastomal defect.
MeSH term(s)	Abdominal Muscles/surgery ; Hernia, Ventral/etiology ; Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Humans ; Incisional Hernia/etiology ; Incisional Hernia/surgery ; Recurrence ; Retrospective Studies ; Surgical Mesh ; Treatment Outcome
Language	English
Publishing date	2021-06-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15729
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