The Experts below are selected from a list of 273 Experts worldwide ranked by ideXlab platform
A J Torres - One of the best experts on this subject based on the ideXlab platform.
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Umbilical hernia repair with Composite Prosthesis: a single-centre experience
Hernia, 2019Co-Authors: Jose L Porrero, Sol Villar, Beatriz Ramos, B Porrero, M Cendrero, Oscar Bonachia, O. Cano-valderrama, C. Sánchez-cabezudo, A J TorresAbstract:Purpose Since 2004, Composite Prosthesis repair is the preferred procedure for umbilical hernia repair in our centre, although long-term results of this technique are lacking. The aim of this study was to analyze the long-term results of a cohort of patients who underwent umbilical hernia repair with this procedure. Methods A retrospective cohort study of patients who underwent umbilical hernia repair with Composite Prosthesis was conducted. Data were obtained from electronic medical records. Univariate and multivariate analyses were performed to analyze the factors associated with postoperative complications and hernia recurrence. Results Between March 2004 and December 2015, 2135 patients underwent umbilical hernia repair and Composite Prosthesis (Ventralex or Ventralex ST^®) was used in 1538 patients. 179 patients were lost during the follow-up. Finally, 1359 patients were included in the study. The Prosthesis was placed in the preperitoneal space in 93.4% of the patients. 86.3% of the patients underwent same-day surgery. Only 2.1% of the patients developed a complication during the follow-up, and 1.8% of the patients required a new surgery. After a mean follow-up of 4.1 years, hernia recurrence rate was 3.9%. Multivariate analysis showed that hernia recurrence was associated with female gender, recurrent hernia, and postoperative complication. Postoperative complications were related to follow-up time and smoking patients. Conclusions Long-term results after umbilical hernia repair with Composite Prosthesis are satisfactory, with a low percentage of complications and recurrences.
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umbilical hernia repair with Composite Prosthesis a single centre experience
Hernia, 2019Co-Authors: Jose L Porrero, Oscar Canovalderrama, Sol Villar, Carlos Sanchezcabezudo, Beatriz Ramos, B Porrero, M Cendrero, Oscar Bonachia, A J TorresAbstract:Purpose Since 2004, Composite Prosthesis repair is the preferred procedure for umbilical hernia repair in our centre, although long-term results of this technique are lacking. The aim of this study was to analyze the long-term results of a cohort of patients who underwent umbilical hernia repair with this procedure.
E. Croce - One of the best experts on this subject based on the ideXlab platform.
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Use of fibrin glue (Tissucol^®) in laparoscopic repair of abdominal wall defects: preliminary experience
Surgical Endoscopy, 2007Co-Authors: S. Olmi, A. Scaini, L. Erba, E. CroceAbstract:Introduction The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol^®) for the nontraumatic fixation of a Composite Prosthesis (Parietex^®) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall. Materials and methods From October 2003 to October 2005, 40 patients underwent laparoscopic repair at the hands of one surgeon with expertise in laparoscopic surgery; all meshes were implanted in an intraperitoneal position. Follow-up visits were scheduled for 7 days and 1, 6, and 12 months. These included assessments for pain and postoperative complications. Results Forty patients (24 females, 16 males) with a mean age of 50 years (range, 26–65 years) and a mean Body Mass Index (BMI) of 27 (range 25 to 30) were included in the study. Sixteen patients had incisional hernias, and 24 had primary defects. The size of the defects varied from 2 to 7 cm. Adhesiolysis was necessary in 92.5% of cases (25/40). There were no intraoperative complications or conversions. After a mean follow-up of 16 months (range, 3–24 months), no postoperative complications were observed. The mean surgical intervention time was 36 min (range, 12–40 min), with an average hospitalization time of 1 day. Conclusions The use of fibrin glue in the present study provided stable and uniform fixation of the Prosthesis and minimized intraoperative and postoperative complications. Consequently, laparoscopic treatment of small to medium-sized abdominal defects using this approach is our therapeutic option of choice.
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Use of fibrin glue (Tissucol) in laparoscopic repair of abdominal wall defects: preliminary experience.
Surgical endoscopy, 2006Co-Authors: S. Olmi, A. Scaini, L. Erba, E. CroceAbstract:Introduction The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol®) for the nontraumatic fixation of a Composite Prosthesis (Parietex®) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall.
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Prospective clinical study of laparoscopic treatment of incisional and ventral hernia using a Composite mesh: indications, complications and results
Hernia, 2006Co-Authors: S. Olmi, L. Erba, S. Magnone, A. Bertolini, E. CroceAbstract:The aim of this study is to establish the indications, safety, efficacy, feasibility and reproducibility of the laparoscopic technique in treating defects in the abdominal wall, including those of large dimensions, to standardise the surgical technique and to confirm the performance of the Composite Prosthesis used (Parietex, Sofradim). The study encompassed the period from January 2001 to December 2004 and included 178 nonselected patients (108 women and 70 men), with an average age of 56 years (range: 26–77 years) and an average body mass index (BMI) of 30 (range: 26–40). These patients were treated for either abdominal hernia (156 patients; 89.7%) or a primary defect (22 patients; 10.3%). The dimensions of the abdominal hernias treated varied from 4 to 26 cm (average: 12.1 cm). All patients were treated using the laparoscopic technique, and all meshes were placed in the intraperitoneal position. Eleven (7%) postoperative complications arose after an average follow-up period of 29 months (range: 1–48 months): seven seromas (4.4%) lasting for 4 weeks, with one becoming infected after being punctured repeatedly; we removed the infected Prosthesis by laparoscopy; three (1.9%) patients with persistent neuralgia, which were resolved after 2 months with a prescription for FANS; one patient with a haematoma at the trocar site. There were also four recurrences (2.5%), all of which occurred between 1 and 3 months postsurgery: one in the 'small' group of abdominal hernias (less than 9 cm) and three in the 'large' group of abdominal hernias. With the exclusion of any primary defects, an adhesiolysis was carried out in 99.3% of the patients. In seven cases (4.4%) we carried out a raphe for speritonealisations of loops in the small intestine; in four patients (2.5%), following tenacious adhesion (one patient) and loops fixed to the previous scar by stitches (three patients), we carried out an intestinal perforation (ileus) which was sutured by laparoscopy. The average operating time was 65.6 min (range: 28–130 min), with an average postoperative period in the hospital of 2.1 days (range: 1–5 days). No conversion was observed, and mortality was zero. The results obtained during the clinical trial demonstrate the safety and efficacy of the laparoscopic technique and of the mesh used as well as the reproducibility of the technique in the intraperitoneal treatment of congenital and postincision defects in the abdominal wall, including those of large dimensions.
Jose L Porrero - One of the best experts on this subject based on the ideXlab platform.
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Umbilical hernia repair with Composite Prosthesis: a single-centre experience
Hernia, 2019Co-Authors: Jose L Porrero, Sol Villar, Beatriz Ramos, B Porrero, M Cendrero, Oscar Bonachia, O. Cano-valderrama, C. Sánchez-cabezudo, A J TorresAbstract:Purpose Since 2004, Composite Prosthesis repair is the preferred procedure for umbilical hernia repair in our centre, although long-term results of this technique are lacking. The aim of this study was to analyze the long-term results of a cohort of patients who underwent umbilical hernia repair with this procedure. Methods A retrospective cohort study of patients who underwent umbilical hernia repair with Composite Prosthesis was conducted. Data were obtained from electronic medical records. Univariate and multivariate analyses were performed to analyze the factors associated with postoperative complications and hernia recurrence. Results Between March 2004 and December 2015, 2135 patients underwent umbilical hernia repair and Composite Prosthesis (Ventralex or Ventralex ST^®) was used in 1538 patients. 179 patients were lost during the follow-up. Finally, 1359 patients were included in the study. The Prosthesis was placed in the preperitoneal space in 93.4% of the patients. 86.3% of the patients underwent same-day surgery. Only 2.1% of the patients developed a complication during the follow-up, and 1.8% of the patients required a new surgery. After a mean follow-up of 4.1 years, hernia recurrence rate was 3.9%. Multivariate analysis showed that hernia recurrence was associated with female gender, recurrent hernia, and postoperative complication. Postoperative complications were related to follow-up time and smoking patients. Conclusions Long-term results after umbilical hernia repair with Composite Prosthesis are satisfactory, with a low percentage of complications and recurrences.
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umbilical hernia repair with Composite Prosthesis a single centre experience
Hernia, 2019Co-Authors: Jose L Porrero, Oscar Canovalderrama, Sol Villar, Carlos Sanchezcabezudo, Beatriz Ramos, B Porrero, M Cendrero, Oscar Bonachia, A J TorresAbstract:Purpose Since 2004, Composite Prosthesis repair is the preferred procedure for umbilical hernia repair in our centre, although long-term results of this technique are lacking. The aim of this study was to analyze the long-term results of a cohort of patients who underwent umbilical hernia repair with this procedure.
Julia Buján - One of the best experts on this subject based on the ideXlab platform.
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Composite prostheses used to repair abdominal wall defects: physical or chemical adhesion barriers?
Journal of biomedical materials research. Part B Applied biomaterials, 2005Co-Authors: J. M. Bellón, Natalia Serrano, Marta Rodríguez, N. García-honduvilla, G. Pascual, Julia BujánAbstract:In a Composite Prosthesis, the component placed at the peritoneal interface takes the form of a physical or chemical barrier. In this experimental study performed on the white New Zealand rabbit, several Composites were examined to establish the effectiveness of these barriers at impeding adhesion formation. The biomaterials tested were two polypropylene prostheses (PP) with the physical barriers of expanded polytetrafluoroethylene or polyurethane (PP + ePTFE and PP + PU) and two prostheses (one polyester and the other PP) with the absorbable chemical barriers of polyethylene glycol/glycerol and hyaluronate, respectively (PO + gl and PP + hy). The Composites were used to repair 7 × 5 cm defects created in the abdominal wall of the animals by placing the implant in contact with the visceral peritoneum and the subcutaneous tissue and fixing it to recipient tissue by 4/0 polypropylene running suture. Fourteen days after surgery the animals were sacrificed and specimens were taken for light microscopy and scanning electron microscopy. Adhesions developing at the Prosthesis/visceral peritoneal interface were quantified. All the prostheses induced optimal mesothelialization. Composites with physical barriers behaved similarly in terms of provoking adhesions. However, the prostheses with chemical barriers differed in their effectiveness at preventing adhesions. Overall, the best results were obtained with the PP + PU Composite. © 2005 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2005
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Improved Biomechanical Resistance Using an Expanded Polytetrafluoroethylene Composite-Structure Prosthesis
World Journal of Surgery, 2004Co-Authors: Juan M. Bellón, Natalia Serrano, Marta Rodríguez, Antonio Carrera San-martín, Julia BujánAbstract:We designed a Composite-structure (laminar-reticular) Prosthesis using expanded polytetrafluoroethylene (ePTFE) as the biomaterial in an attempt to improve the biomechanical resistance of the same biomaterial in the form of a single lamina. Defects (7 × 5 cm) were created in the abdominal wall of male white New Zealand rabbits ( n = 24). The defects, which comprised all the wall layers except the skin, were then repaired with one of two types of ePTFE Prosthesis. One was a latest generation laminar Prosthesis (DualMesh, or Gore-Tex) and the other was a Composite of in-house design (CV-4 mesh Composite) made by suturing a mesh woven out of ePTFE thread to an ePTFE lamina. After sacrificing the animals at 14 or 90 days after surgery, implant specimens were subjected to morphologic analysis (light microscopy and scanning electron microscopy); and adhesion formation, neoperitoneal thickness, and biomechanical strength were evaluated. No significant differences were recorded between the two Prosthesis regarding the consistency of adhesions or the area occupied by adhesions (DM 0.17 ± 0.06; CV-4 mesh Composite 0.18 ± 0.08 cm^2) ( p > 0.05). Notably, improved tissue integration was achieved using the Composite Prosthesis; its reticular side became infiltrated by dense connective tissue that enveloped the mesh filaments. In contrast, the DM Prosthesis became encapsulated by host tissue. The neoperitoneum induced by both prostheses was homogeneous and orderly, with a layer of typical mesothelial cells lining its inner surface. The thickness of the neoperitoneum was similar ( p > 0.05) for the two implants (385.0 ± 3.4 vs. 390 ± 3.1 μm), although significantly higher ( p < 0.05) mechanical resistance values were recorded for the Composite Prosthesis (26.75 ± 3.71 vs. 14.11 ± 3.71 N). Our findings suggest that the use of a reticular and a laminar ePTFE layer in the same Prosthesis leads to better repair and biomechanical behavior compared to the use of a single-structure laminar implant.
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Temporary closure of the abdomen using a new Composite Prosthesis (PL-PU99).
American journal of surgery, 2004Co-Authors: Juan M. Bellón, Natalio García-honduvilla, Esmeralda Carnicer, Natalia Serrano, Marta Rodríguez, Julia BujánAbstract:Abstract Background Temporary abdominal wound closure is sometimes desirable when tension-free approximation of the wound edges is impractical or when reexploration is planned. Methods The behavior of a Composite Prosthesis (PL-PU99) designed by our group was evaluated as a method of temporary abdominal closure in white New Zealand rabbits. After a 7 cm long midline laparotomy, a spindle-shaped 4 cm (maximum width) by 7 cm (length) fragment of PL-PU99 was sutured to the edges of the peritoneal, muscular, and fascial abdominal tissues, so that the biomaterial remained in contact with the exterior. The PL-PU99 Composite is composed of a polypropylene mesh adhered to a sheet of polyurethane with an acrylic cement. At 7 and 14 days after implant, animals were sacrificed and specimens taken for morphological, ultrastructural, morphometry of the neoperitoneum, and immunohistochemical (macrophage reaction, RAM-11) analysis. Results No death or signs of infection or rejection of the prostheses were recorded. No adhesions could be macroscopically observed between the Composite and the intestinal loops. The biomaterial achieved a good seal, no leakage of fluids being detected. Fourteen days after implant, the neoperitoneum formed on the Prosthesis was of an even structure and was made up of organized, vascularized connective tissue covered by an uninterrupted mesothelium. Conclusions The PL-PU99 Prosthesis shows optimal behavior at the Prosthesis/visceral peritoneum interface, making it ideal for its use in the temporary closure of the abdomen. The implanted Composite may also prove useful for the permanent repair of the abdominal wall.
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Evaluation of a new Composite Prosthesis (PL-PU99) for the repair of abdominal wall defects in terms of behavior at the peritoneal interface
World Journal of Surgery, 2002Co-Authors: Juan M. Bellón, Natalio García-honduvilla, Alberto García-carranza, Francisca Jurado, Antonio Carrera-san Martín, Julia BujánAbstract:Le but de cette étude a été d’évaluer le comportement biologique d’une nouvelle prothèse Composite (PL-PU99) placée directement en contact avec les viscères lors de la réparation pariétale. Sous anesthésie, on a créé des pertes de substance complètes de la paroi abdominale (7×5 cm) chez 36 lapins blancs New Zealand. Les defects ont été réparés avec soit du polypropylène (PL) ( n =18), soit la prothèse PL-PU99 (composée de PL et une feuille de polyuréthane collée sur la feuille de PL par une adhesive acrylique) ( n =18). Les animaux ont été sacrifiés 14, 30 et 90 jours après l’insertion de la prothèse et des prélèvements tissulaires comprenant la prothèse et les tissus environnants ont été examinés en microscopie classique et électronique; le néopéritoine a été analysé morphométriquement. L’analyse immunohistochimique a été réalisée par des anticorps monoclonaux spécifiques du lapin RAM-11. La solidité bio-mécanique des implants a été évaluée. De fortes adhérences ont été détectées en ce qui concerne les plaques PL, alors qu’il n’y en avait pratiquement pas en cas de prothèses PL-PU99. La surface couverte par des adhérences était plus grande ( p
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Evaluation of a new Composite Prosthesis (PL-PU99) for the repair of abdominal wall defects in terms of behavior at the peritoneal interface.
World journal of surgery, 2002Co-Authors: Juan M. Bellón, Natalio García-honduvilla, Alberto García-carranza, Francisca Jurado, Antonio Carrera-san Martín, Julia BujánAbstract:This study was designed to evaluate the behavior of a new Composite polypropylene-polyurethane (PL-PU99) when placed in direct contact with the visceral peritoneum during the repair of an abdominal wall defect. Full-thickness abdominal wall defects (7×5 cm) were created in 36 anaesthetized white New Zealand rabbits. The defects were repaired with polypropylene prostheses or PL-PU99 prostheses (comprised of PL and a polyurethane sheet glued to the PL with acrylic adhesive) to establish two study groups (n=18 each). Animals were sacrified 14, 30, or 90 days after implantation and Prosthesis/surrounding tissue specimens were subjected to light and electron microscopy and morphometric analysis of the newly formed peritoneum. Immunohistochemical analysis was performed using the rabbit specific monoclonal antibody RAM-11. The biomechanical strength of the implants was also assessed. Firm adhesions were detected in the PL implants, whereas adhesions were practically non-existent in the PL-PU99 implants. The surface area covered by adhesions was greater (p
S. Olmi - One of the best experts on this subject based on the ideXlab platform.
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Use of fibrin glue (Tissucol^®) in laparoscopic repair of abdominal wall defects: preliminary experience
Surgical Endoscopy, 2007Co-Authors: S. Olmi, A. Scaini, L. Erba, E. CroceAbstract:Introduction The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol^®) for the nontraumatic fixation of a Composite Prosthesis (Parietex^®) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall. Materials and methods From October 2003 to October 2005, 40 patients underwent laparoscopic repair at the hands of one surgeon with expertise in laparoscopic surgery; all meshes were implanted in an intraperitoneal position. Follow-up visits were scheduled for 7 days and 1, 6, and 12 months. These included assessments for pain and postoperative complications. Results Forty patients (24 females, 16 males) with a mean age of 50 years (range, 26–65 years) and a mean Body Mass Index (BMI) of 27 (range 25 to 30) were included in the study. Sixteen patients had incisional hernias, and 24 had primary defects. The size of the defects varied from 2 to 7 cm. Adhesiolysis was necessary in 92.5% of cases (25/40). There were no intraoperative complications or conversions. After a mean follow-up of 16 months (range, 3–24 months), no postoperative complications were observed. The mean surgical intervention time was 36 min (range, 12–40 min), with an average hospitalization time of 1 day. Conclusions The use of fibrin glue in the present study provided stable and uniform fixation of the Prosthesis and minimized intraoperative and postoperative complications. Consequently, laparoscopic treatment of small to medium-sized abdominal defects using this approach is our therapeutic option of choice.
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Use of fibrin glue (Tissucol) in laparoscopic repair of abdominal wall defects: preliminary experience.
Surgical endoscopy, 2006Co-Authors: S. Olmi, A. Scaini, L. Erba, E. CroceAbstract:Introduction The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol®) for the nontraumatic fixation of a Composite Prosthesis (Parietex®) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall.
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Prospective clinical study of laparoscopic treatment of incisional and ventral hernia using a Composite mesh: indications, complications and results
Hernia, 2006Co-Authors: S. Olmi, L. Erba, S. Magnone, A. Bertolini, E. CroceAbstract:The aim of this study is to establish the indications, safety, efficacy, feasibility and reproducibility of the laparoscopic technique in treating defects in the abdominal wall, including those of large dimensions, to standardise the surgical technique and to confirm the performance of the Composite Prosthesis used (Parietex, Sofradim). The study encompassed the period from January 2001 to December 2004 and included 178 nonselected patients (108 women and 70 men), with an average age of 56 years (range: 26–77 years) and an average body mass index (BMI) of 30 (range: 26–40). These patients were treated for either abdominal hernia (156 patients; 89.7%) or a primary defect (22 patients; 10.3%). The dimensions of the abdominal hernias treated varied from 4 to 26 cm (average: 12.1 cm). All patients were treated using the laparoscopic technique, and all meshes were placed in the intraperitoneal position. Eleven (7%) postoperative complications arose after an average follow-up period of 29 months (range: 1–48 months): seven seromas (4.4%) lasting for 4 weeks, with one becoming infected after being punctured repeatedly; we removed the infected Prosthesis by laparoscopy; three (1.9%) patients with persistent neuralgia, which were resolved after 2 months with a prescription for FANS; one patient with a haematoma at the trocar site. There were also four recurrences (2.5%), all of which occurred between 1 and 3 months postsurgery: one in the 'small' group of abdominal hernias (less than 9 cm) and three in the 'large' group of abdominal hernias. With the exclusion of any primary defects, an adhesiolysis was carried out in 99.3% of the patients. In seven cases (4.4%) we carried out a raphe for speritonealisations of loops in the small intestine; in four patients (2.5%), following tenacious adhesion (one patient) and loops fixed to the previous scar by stitches (three patients), we carried out an intestinal perforation (ileus) which was sutured by laparoscopy. The average operating time was 65.6 min (range: 28–130 min), with an average postoperative period in the hospital of 2.1 days (range: 1–5 days). No conversion was observed, and mortality was zero. The results obtained during the clinical trial demonstrate the safety and efficacy of the laparoscopic technique and of the mesh used as well as the reproducibility of the technique in the intraperitoneal treatment of congenital and postincision defects in the abdominal wall, including those of large dimensions.