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Article ; Online: Economic analysis of the robotic approach to inguinal hernia versus laparoscopic: is it sustainable for the healthcare system?

Hinojosa-Ramirez, F / Tallon-Aguilar, L / Tinoco-Gonzalez, J / Sanchez-Arteaga, A / Aguilar-Del Castillo, F / Alarcon-Del Agua, I / Morales-Conde, S

Hernia : the journal of hernias and abdominal wall surgery

2024

Abstract: Introduction: There has been a rapid proliferation of the robotic approach to inguinal hernia, mainly in the United States, as it has shown similar outcomes to the laparoscopic approach but with a significant increase in associated costs. Our objective ... ...

Abstract	Introduction: There has been a rapid proliferation of the robotic approach to inguinal hernia, mainly in the United States, as it has shown similar outcomes to the laparoscopic approach but with a significant increase in associated costs. Our objective is to conduct a cost analysis in our setting (Spanish National Health System). Materials and methods: A retrospective single-center comparative study on inguinal hernia repair using a robotic approach versus laparoscopic approach. Results: A total of 98 patients who underwent either robotic or laparoscopic TAPP inguinal hernia repair between October 2021 and July 2023 were analyzed. Out of these 98 patients, 20 (20.4%) were treated with the robotic approach, while 78 (79.6%) underwent the laparoscopic approach. When comparing both approaches, no significant differences were found in terms of complications, recurrences, or readmissions. However, the robotic group exhibited a longer surgical time (86 ± 33.07 min vs. 40 ± 14.46 min, p < 0.001), an extended hospital stays (1.6 ± 0.503 days vs. 1.13 ± 0.727 days, p < 0.007), as well as higher procedural costs (2318.63 ± 205.15 € vs. 356.81 ± 110.14 €, p < 0.001) and total hospitalization costs (3272.48 ± 408.49 € vs. 1048.61 ± 460.06 €, p < 0.001). These results were consistent when performing subgroup analysis for unilateral and bilateral hernias. Conclusions: The benefits observed in terms of recurrence rates and post-surgical complications do not justify the additional costs incurred by the robotic approach to inguinal hernia within the national public healthcare system. Nevertheless, it represents a simpler way to initiate the robotic learning curve, justifying its use in a training context.
Language	English
Publishing date	2024-03-20
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-024-03006-y
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Article ; Online: Neuromuscular Response during Different Side-Cutting Maneuvers and Its Influence on the Risk of Knee Injuries.

Feria-Madueño, Adrián / Hewett, Timothy E / Sánchez-Arteaga, Alejandro / Sañudo, Borja

Sports (Basel, Switzerland)

2023 Volume 11, Issue 10

Abstract: Background: The objective of this study was to investigate the impact of a customized exercise program on electromyographic (EMG) variables during side-cutting maneuvers.: Methods: Fifty-seven physically active volunteers were recruited and ... ...

Abstract	Background: The objective of this study was to investigate the impact of a customized exercise program on electromyographic (EMG) variables during side-cutting maneuvers. Methods: Fifty-seven physically active volunteers were recruited and randomized into two groups: a control group (CG) and an experimental group (EG). The CG maintained their regular physical activity, while the EG followed an individualized, integrated exercise regimen that included strength, neuromuscular, proprioceptive, eccentric training, and whole-body vibration (WBV) exercises, lasting for 12 weeks. EMG-Root Means Square (RMS) values for the quadriceps (Q) and hamstrings (H) were measured immediately following initial foot contact at 50, 100, 150, and 200 milliseconds. Changes in EMG activity were evaluated before and after a twelve-week intervention, and the effect size (ES, 90% confidence limit [90%CL]) was calculated. Results: The results showed that the EG participants exhibited enhanced co-contraction as measured by the hamstring/quadriceps ratio (H/Q ratio) during both open and cross-cutting side maneuvers after the twelve-week intervention. Conclusion: Furthermore, the customized, integrated exercise program that combined strength, neuromuscular, proprioceptive, eccentric training, and WBV exercises were could potentially serve as a beneficial neuromuscular and biomechanical strategy for addressing knee injury risk in non-professional, physically active populations at high risk for such injuries.
Language	English
Publishing date	2023-10-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704239-X
ISSN	2075-4663 ; 2075-4663
ISSN (online)	2075-4663
ISSN	2075-4663
DOI	10.3390/sports11100190
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Article ; Online: Growth, survival, digestive activity and respiratory metabolism of Octopus maya juveniles fed with prepared diets.

Santiago, Israel / Rosas, Carlos / Cruz-López, Honorio / Domingues, Pedro / Pascual, Cristina / Mascaro, Maite / Sanchez-Arteaga, Ariadna / Caamal, Claudia / Gallardo, Pedro

Journal of animal physiology and animal nutrition

2024

Abstract: The effects of two prepared feeds were tested on growth, survival, enzymatic activity, nutritive reserves in the digestive gland and oxygen consumption of Octopus maya juveniles. For the first time, a semihumid paste (HD, control) and a dry diet, in ... ...

Abstract	The effects of two prepared feeds were tested on growth, survival, enzymatic activity, nutritive reserves in the digestive gland and oxygen consumption of Octopus maya juveniles. For the first time, a semihumid paste (HD, control) and a dry diet, in pelleted form (PD, experimental) with the same formulation were used for this species. The experiment lasted for 42 days. Results indicate that growth rates were similar for both diets (p > 0.05); however, survival (70%) was higher with the PD compared to the HD (48%) (p < 0.05). The performance index was higher for octopuses fed the PD (p < 0.05). No differences in acid proteases activity were observed. However, a higher activity of alkaline proteases in the octopuses fed the PD was observed (p < 0.05). Ingestion rate was higher for octopuses fed the PD. Routine energy inversion was similar in both treatments (p > 0.05). A greater energy inversion was observed in octopuses fed the PD, whose active metabolism was double compared to the octopuses fed the HD. Results showed that the PD promoted similar growth compared to the HD diet but favored survival, and a greater investment in the active metabolism, reflected in the apparent heat increase.
Language	English
Publishing date	2024-05-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	232729-6
ISSN	1439-0396 ; 0044-3565 ; 0931-2439
ISSN (online)	1439-0396
ISSN	0044-3565 ; 0931-2439
DOI	10.1111/jpn.13976
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Article ; Online: Evaluation of rectus abdominis muscle strength and width of hernia defect in patients undergoing incisional hernia surgery.

García Moriana, A J / Sánchez Arteaga, A / Gil Delgado, J L / Maroto Sánchez, R / Feria Madueño, A / Tallón Aguilar, L / Padillo Ruiz, J / Sañudo, B

Hernia : the journal of hernias and abdominal wall surgery

2023 Volume 27, Issue 4, Page(s) 919–926

Abstract: Background: The aim of this study was to analyze the strength status of the rectus abdominis muscle in patients with incisional hernia and the relationship between the width of the hernia defect and the strength of the rectus abdominis muscle.: ... ...

Abstract	Background: The aim of this study was to analyze the strength status of the rectus abdominis muscle in patients with incisional hernia and the relationship between the width of the hernia defect and the strength of the rectus abdominis muscle. Methods: This is a observational cohort study of patients with medial line incisional hernia (July-October 2022), classified as W2 according to the European Hernia Society (EHS). The data collected were demographic and clinical characteristics related to hernia, and measure of the rectus abdominis muscle strength using an isokinetic dynamometer and a strain gauge. We analyzed the relationship between hernia width and rectus abdominis muscle strength with correlation tests to adjustment by age, sex, BMI, and body composition. Results: A total of 40 patients (64% female) with a mean age of 57.62 years (SD 11) were enrolled in the study. The mean BMI was 29.18 (SD 5.06), with a mean percentage of fat mass of 37.8% (SD 8.47) and a mean percentage of muscle mass of 60.33% (SD 6.43). The maximum width of the hernia defect was 6.59 cm (SD 1.54). In the male group, the mean bending force moment (ISOK_PT) was 94.01 Nw m (SD 34.58), bending force moment relative to body weight (ISOK_PT_Weight) was 103.32 Nw m (SD 37.48), and peak force (PK_90) was 184.71 N (SD 47.01). In the female group, these values were 58.11 Nw m (SD 29.41), 66.48 Nw m (SD 32.44), and 152.50 N (SD 48.49), respectively. Statistically significant differences were observed in the relationship between the data obtained with the isokinetic dynamometer and sex (p = 0.002), as well as between the data obtained with the isokinetic dynamometer and age (p = 0.006). Patients in the 90th percentile (P90) of rectus abdominis muscle strength also had smaller hernia defect widths (p = 0.048). Conclusions: In this study, age and sex were identified as the most statistically significant predictor variables for rectus abdominis muscle strength. The width of the hernia defect exhibited a trend towards statistical significance.
MeSH term(s)	Humans ; Male ; Female ; Middle Aged ; Incisional Hernia/etiology ; Incisional Hernia/surgery ; Rectus Abdominis ; Herniorrhaphy/adverse effects ; Muscle Strength
Language	English
Publishing date	2023-07-13
Publishing country	France
Document type	Observational Study ; Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-023-02834-8
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Article ; Online: Implementing an outpatient surgical management in moderated-high risk patients with groin hernia repair.

Álvarez-Aguilera, M / DeJesús-Gil, Á / Sánchez-Arteaga, A / Tinoco-González, J / Suárez-Grau, J M / Tallón-Aguilar, L / Padillo-Ruiz, J

Hernia : the journal of hernias and abdominal wall surgery

2023 Volume 27, Issue 5, Page(s) 1307–1313

Abstract: Purpose: There is a growing trend to expand Ambulatory Surgery (AS) criteria in abdominal wall surgery. No Admission (NOADS) circuit. The present study aimed to assess the impact of classification criteria on postoperative results and hospital stays in ... ...

Abstract	Purpose: There is a growing trend to expand Ambulatory Surgery (AS) criteria in abdominal wall surgery. No Admission (NOADS) circuit. The present study aimed to assess the impact of classification criteria on postoperative results and hospital stays in a NOADS versus a conventional admission circuit to throw some light on surgical circuit inclusion. Methods: A retrospective analysis of a prospective;y maintained database was performed comparing groin hernia's interventions in a NOADS vs Admission circuit in our center in 2018-2021. A multiple regression predictive model followed by a retrospective retest were dessigned to assess the impact of each criterion on hospital stay. In total, 743 patients were included, 399 in the Admission circuit (ADC) and 344 in NOADS circuit (NOADS). Results: There were no statistical differences in complication or readmission rates (p = 0.343 and p = 0.563), nevertheless, a shorter hospital stay was observed in NOADS (p = 0.000). A hierarchical multiple regression predictive model proposed two opposite scenarios. The best scenario, not likely to need admission, was a female patient operated via the laparoscopic approach of a unilateral primary hernia (Estimated Postoperative Stay: 0.049 days). The worst scenario, likely to need admission, was a male patient operated via the open approach of a bilateral and recurrent hernia (Estimated Postoperative Stay: 1.505 Days). Conclusion: Groin hernia patients could safely benefit from a No Admission (NOADS) circuit. Our model could be useful for surgical circuit decision-making, especially for best/worst scenarios.
MeSH term(s)	Humans ; Male ; Female ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods ; Outpatients ; Groin/surgery ; Retrospective Studies ; Prospective Studies ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Hernia, Inguinal/surgery
Language	English
Publishing date	2023-06-01
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-023-02813-z
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Article ; Online: Use of polyvinylidene fluoride (PVDF) meshes for ventral hernia repair in emergency surgery.

Sánchez-Arteaga, A / Tallón-Aguilar, L / Tinoco-González, J / Perea Del-Pozo, E / Navas-Cuellar, A / Padillo-Ruíz, J

Hernia : the journal of hernias and abdominal wall surgery

2020 Volume 25, Issue 1, Page(s) 99–106

Abstract: Purpose: The implantation of non-absorbable meshes is the gold standard technique for ventral hernia (VH) repairs. However, emergency surgeries are often related to contaminated/infected fields, where the implantation of prosthetic materials may not be ... ...

Abstract	Purpose: The implantation of non-absorbable meshes is the gold standard technique for ventral hernia (VH) repairs. However, emergency surgeries are often related to contaminated/infected fields, where the implantation of prosthetic materials may not be recommendable. Our aim was to evaluate the results of polyvinylidene fluoride (PVDF) meshes used for contaminated and/or complicated VH repairs in the acute setting. Methods: We conducted a retrospective analysis of patients with VH who underwent emergency surgery involving PVDF meshes, in a tertiary hospital (from November 2013 to September 2019). We analyzed postoperative complications and 1-year recurrence rates. We evaluated the relationships between contamination grade, mesh placement, infectious complications, and recurrences. Results: We gathered data on 123 patients; their mean age was 62.3 years, their mean BMI was 31.1 kg/m Conclusion: The use of PVDF meshes for emergency VH repairs in contaminated surgeries seems safe and useful, with reasonable recurrence rates, and acceptable infectious complication rates, similar to those published in the literature.
MeSH term(s)	Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Humans ; Middle Aged ; Polyvinyls ; Recurrence ; Retrospective Studies ; Surgical Mesh ; Treatment Outcome
Chemical Substances	Polyvinyls ; polyvinylidene fluoride (24937-79-9)
Language	English
Publishing date	2020-05-22
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-020-02209-3
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Article ; Online: Response to «Management of splenic injuries utilizing a multidisciplinary protocol in 110 consecutive patients at a level II hospital».

Sánchez Arteaga, Alejandro / Beltrán Miranda, Pablo / Gómez Bravo, Miguel Ángel / Pareja Ciuro, Felipe

Cirugia espanola

2020 Volume 98, Issue 8, Page(s) 498–499

Title translation	Respuesta a «Resultados en el tratamiento de traumatismos esplénicos utilizando un protocolo multidisciplinar en 110 pacientes consecutivos en un hospital de nivel II».
MeSH term(s)	Abdominal Injuries ; Humans ; Wounds, Nonpenetrating
Language	Spanish
Publishing date	2020-04-24
Publishing country	Spain
Document type	Letter ; Comment
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.ciresp.2020.03.003
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Article ; Online: Laparoscopic vs. Open Approach in Emergent Inguinal Hernia: Our Experience and Review of Literature.

Moreno-Suero, Francisco / Tallon-Aguilar, Luis / Tinoco-González, José / Sánchez-Arteaga, Alejandro / Suárez-Grau, Juan Manuel / Alvarez-Aguilera, Miriam / Morales-Conde, Salvador / Padillo-Ruiz, Javier

Journal of abdominal wall surgery : JAWS

2023 Volume 2, Page(s) 11242

Abstract: There is currently no consensus or homogeneous recommendation about the role of the laparoscopic approach in emergent inguinal hernia surgery. The aim of this manuscript is showing our experience and results of laparoscopic approach for emergent groin ... ...

Abstract	There is currently no consensus or homogeneous recommendation about the role of the laparoscopic approach in emergent inguinal hernia surgery. The aim of this manuscript is showing our experience and results of laparoscopic approach for emergent groin hernia repair comparing with open approach. A retrospective review of a prospectively maintained database between January 2011 and December 2021 of acute incarcerated groin hernia that were operated at Virgen del Rocio University Hospital. In this period, they were identified 463 patients with groin hernia that required an emergency repair. 454 patients underwent open surgery (group 1) and 36 patients underwent laparoscopic approach (TAPP procedure) (group 2). Median length stay was 1 day in lap group and 2 days in open approach. Reintervention was necessary in 20 cases (4.40%) from group 1 and one (2.27%) from group 2. In laparoscopic approach, no mortality was described but in open approach, 10 patients (2.20%) died. Globally, 58 cases (12.77%) from group 1 and six patients (16.66%) from group 2 presented any complication. Wound infection was higher in group of open repairs (5.94% vs. 2.77%). Non-surgical complications were higher in open approach (19 vs. 0). There is no statistical significance in any of these items. Laparoscopic approach is a safe, feasible and effective therapeutic option for the treatment of incarcerated groin hernia that require emergency surgery, but prospective and randomized comparative studies are needed to establish the best approach.
Language	English
Publishing date	2023-06-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2813-2092
ISSN (online)	2813-2092
DOI	10.3389/jaws.2023.11242
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Article ; Online: Fasciotomy wound secondary to necrotizing fasciitis closure using combination of negative pressure wound therapy and progressive primary closure.

Pintor-Tortolero, José / Sánchez-Arteaga, Alejandro / Tallón-Aguilar, Luis / Padillo-Ruiz, Francisco Javier

ANZ journal of surgery

2019 Volume 89, Issue 1-2, Page(s) E49

MeSH term(s)	Adult ; Debridement/methods ; Fasciitis, Necrotizing/complications ; Fasciitis, Necrotizing/therapy ; Fasciotomy/adverse effects ; Humans ; Male ; Negative-Pressure Wound Therapy/methods ; Surgical Wound Infection/etiology ; Surgical Wound Infection/therapy
Language	English
Publishing date	2019-03-28
Publishing country	Australia
Document type	Case Reports ; Letter
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.14959
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Article ; Online: Is the use of endoloops safe and efficient for the closure of the appendicular stump in complicated and uncomplicated acute appendicitis?

Durán Muñoz-Cruzado, Virginia / Anguiano-Diaz, Gregorio / Tallón Aguilar, Luis / Tinoco González, José / Sánchez Arteaga, Alejandro / Aparicio Sánchez, Daniel / Pareja Ciuró, Felipe / Padillo Ruiz, Javier

Langenbeck's archives of surgery

2021 Volume 406, Issue 5, Page(s) 1581–1589

Abstract: Introduction: There is still controversy regarding the ideal technique to close the appendicular stump in laparoscopic appendectomy (LA). The objective of this study was to determine the safety and efficiency of the use of an endoloop (EL) and ... ...

Abstract	Introduction: There is still controversy regarding the ideal technique to close the appendicular stump in laparoscopic appendectomy (LA). The objective of this study was to determine the safety and efficiency of the use of an endoloop (EL) and endostapler (ES) in complicated and uncomplicated acute appendicitis. Methods: Retrospective cohort study of patients undergoing LA from February 2013 to December 2019. Acute uncomplicated and complicated appendicitis were analysed separately, establishing two groups according to the stump closure technique: EL or ES. Seven hundred-nine patients were included (535 uncomplicated and 174 complicated). In uncomplicated appendicitis, an EL was used in 447 of the patients (83.55%) and an ES was used in 88 patients (16.45%). In complicated appendicitis, an EL was used in 85 patients (48.85%) and an ES was used in 89 patients (51.15%). An analysis of effectiveness and a cost analysis of each technique were performed. Results: In uncomplicated appendicitis, we found no differences with respect to global complications, although there were significant differences in the total mean hospital stay (EL group 1.55 (SD 1.48) days; ES group 2.21 (SD 1.69) days; p = 0.046). This meant a savings of 514.12€ per patient using the EL p < 0.001). In complicated appendicitis, the reoperations classified as Clavien-Dindo IIIB in the EL group (6.4%) were greater than in the ES group (0%) (p = 0.012), although the rate of postoperative abscesses (p = 0.788) and the mean volume of abscesses (p = 0.891) were similar. Conclusion: The systematic use of an EL could reduce costs in uncomplicated appendicitis, while in complicated cases, both options are valid. Prospective studies with a greater number of patients are needed to observe differences in postoperative complications.
MeSH term(s)	Appendectomy/adverse effects ; Appendicitis/surgery ; Humans ; Laparoscopy ; Length of Stay ; Postoperative Complications/epidemiology ; Prospective Studies ; Retrospective Studies
Language	English
Publishing date	2021-01-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-020-02050-3
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