Prospective cohort study on mesh shrinkage measured with MRI after robot-assisted minimal invasive retrorectus ventral hernia repair using an iron-oxide-loaded polyvinylidene fluoride mesh

Lateral single-dock robot-assisted retro-rectus ventral hernia repair (rTARUP/rTARM): observational study on long-term follow-up

Robot-assisted surgery for ventral hernias has gained popularity among surgeons in hospitals equipped with robotic platforms, despite the limited availability of high-level prospective data. Moreover, research on long-term outcomes of ventral hernia repair remains particularly challenging. This study aims to evaluate the long-term outcomes of patients operated for a ventral hernia with a robot-assisted repair using a self-fixating retro-rectus synthetic mesh with a lateral docking transabdominal approach (rTARUP/rTARM). The study is a mono-centric cohort study of a consecutive series of patients with a midline ventral hernia, including both primary and incisional hernias, treated with a robot-assisted lateral approach utilizing a self-fixating retro-rectus mesh. The patients were identified from a prospective online registry database and subsequently contacted for follow-up assessment. Among the 526 ventral hernia repairs registered between September 2016 and December 2019, 198 patients met the inclusion criteria for this study. Long-term follow-up with valid data on recurrence was achieved in 162 patients (82%). Valid data from the EuraHS Quality-of-Life (QoL) questionnaire were available for 111 patients (56%). The recurrence rate after rTARUP, with a median follow-up of 4.5 years, was 3.7% in 162 patients with valid recurrence data. The rTARUP procedure can be performed with a low complication rate of 6.1% and favorable long-term results on QoL. The robot-assisted transabdominal retromuscular approach is a safe and effective surgical technique with a low recurrence rate and favorable QoL scoring over time. It combines the favorable retro-rectus mesh position with minimal invasive surgery, however care should be taken on adopting the technique too early in the robot-training pathway since it does pose some anatomic challenges and requires advanced robotic skills.

Is there a link between Spigelian and inguinal hernias? A case series

INTRODUCTION

Spigelian hernias are among the rare primary ventral hernias. Diagnosis is often difficult, as many cases are asymptomatic. Spigelian and inguinal hernias are usually considered separately in current scientific literature. With this case series, we want to illustrate a possible relationship between the neighboring hernia types.

METHODS

In this article, we report on a case series of Spigelian hernias that were operated on in five hernia centers in the period from January 1st, 2021 to October 31st, 2023. We have summarized all patient characteristics with previous operations and the result of the secondary operation.

RESULTS

We report a case series with 24 Spigelian hernias, 15 of which have a connection to previous inguinal hernias. In these cases, however, it is not certain whether these are primarily overlooked or occult hernias or whether these Spigelian hernias have arisen secondarily, as a result of previous hernia surgery. With this case series, we would like to point out a possible connection between Spigelian hernia and inguinal hernia. Further studies are needed to shed more light on this entity and explain its genesis.

Potential of the Novel Slot Blot Method with a PVDF Membrane for Protein Identification and Quantification in Kampo Medicines

Kampo is a Japanese traditional medicine modified from traditional Chinese medicine. Kampo medicines contain various traditional crude drugs with unknown compositions due to the presence of low-molecular-weight compounds and proteins. However, the proteins are generally rare and extracted with high-polarity solvents such as water, making their identification and quantification difficult. To develop methods for identifying and quantifying the proteins in Kampo medicines, in the current study we employ previous technology (e.g., column chromatography, electrophoresis, and membrane chromatography), focusing on membrane chromatography with a polyvinylidene difluoride (PVDF) membrane. Moreover, we consider slot blot analysis based on the principle of membrane chromatography, which is beneficial for analyzing the proteins in Kampo medicines as the volume of the samples is not limited. In this article, we assess a novel slot blot method developed in 2017 and using a PVDF membrane and special lysis buffer to quantify advanced glycation end products-modified proteins against other slot blots. We consider our slot blot analysis superior for identifying and quantifying proteins in Kampo medicines compared with other methods as the data obtained with our novel slot blot can be shown with both error bars and the statistically significant difference, and our operation step is simpler than those of other methods.