Classification of primary and incisional abdominal wall hernias

A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable.Comparative StudyConsensus Development ConferenceJournal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

The preperitoneal memory-ring patch for inguinal hernia : a prospective multicentric feasibility study

To evaluate the feasibility, the reproducibility, the safety and the efficacy of a recently introduced preperitoneal memory-ring patch (Polysoft(A (R)), Davol Inc., C.R. Bard Inc., Crawley, UK) by a prospective multicentric observational study. We performed 235 unilateral groin hernia repairs in 200 consecutive patients during a 12-month period. Patients were operated by three different surgeons in two different centres. Pre- and intraoperative data, as well as postoperative complications, were prospectively recorded. Two hundred patients, with a mean age of 55.4 years, were operated for primary or recurrent unilateral groin hernias. The mean operation time for unilateral hernia repair was 22 min (range 14-37 min). Seventy-one patients (35.5%) were operated in an ambulatory setting. Considering pain scores, we observed a preoperative visual analogue scale (VAS) score of 1.4 (range 0-3.7). After 24 h, 3 weeks and 6 months, VAS was 4.2 (0.5-6.9), 1.7 (0-2.0) and 0.1 (0-1.5), respectively. The follow-up was more than 18 months in all patients (range 19-31 months). In total, three patients were diagnosed with a recurrence and were reoperated by an anterior Lichtenstein repair with large-pore mesh. This transinguinal minimally invasive preperitoneal mesh repair is reproducible, easy to perform and safe with acceptable mid-term results. These elements, together with a minimal superficial dissection in the inguinal canal, preperitoneal mesh placement and the absence of fixation, are possible elements to reduce acute and chronic postoperative pain compared to other open and also laparoscopic techniques that have to be proven in larger (randomised) trials

Imaging Features of Hypertrophic Olivary Degeneration

Hypertrophic olivary degeneration (HOD) is a unique form of transneuronal degeneration caused by a disruption of the dentato-rubro-olivary pathway, also known as the triangle of Guillain-Mollaret. The triangle of Guillain-Mollaret is involved in fine voluntary motor control and consists of both the inferior olivary nucleus and the red nucleus on one side and the contralateral dentate nucleus. Clinically, patients classically present with symptomatic palatal myoclonus. Typical magnetic resonance imaging findings include T2-hyperintensity and enlargement of the inferior olivary nucleus evolving over time to atrophy with residual T2-hyperintensity. In this article, we provide a case-based illustration of the anatomy of the Guillain-Mollaret-triangle and the typical imaging findings of hypertrophic olivary degeneration

Free Bipedicled Radial Forearm and Posterior Interosseous Artery Perforator Flap Phalloplasty

Introduction: The free radial forearm (FRFA) flap is universally still considered as the gold standard technique in penile reconstruction. Typically, a considerably large flap is required, often involving almost the entire circumference of the forearm. Partial necrosis may occur at the distal-most (dorsoradial) part of the flap as a result of insufficient perfusion. Aim: To describe a new technique using the posterior interosseous artery (PIOA) to supercharge FRFA phalloplasty. Methods: In a 12-month period, all patients having FRFA flap phalloplasty were enrolled. Perioperative, after complete flap dissection, an indocyanine green perfusion scan was performed. In case of insufficient perfusion at the distalmost part of the flap, a supramicrosurgical anastomosis was performed between the FRFA pedicle and the PIOA (artery only). Main Outcome Measures: Studied outcomes included the rate of marginal necrosis, surgical time, postoperative posterior interosseous nerve damage and urethral complications (fistula, stenosis or necrosis). Results: A total of 27 FRFA flap phalloplasties was performed. Anastomosis of the PIOA was needed in 15 cases. No marginal necrosis was observed in these cases. There were no cases of postoperative posterior interosseous nerve damage. There were no significant differences in urethral complications (fistula, stenosis or necrosis) between the 2 groups. Clinical Implications: In selected cases where insufficient perfusion of the dorsoradial part of the flap is present, patients may benefit from arterial supercharging to prevent postoperative marginal necrosis. Strength & Limitations: Strengths include a single surgeon, thus lending continuity of skill and technique, a consecutive series, and 100% short-term follow-up. Limitations include single institution series and a limited number of patients. Conclusion: Arterial supercharging is effective in improving perfusion of large FRFA flaps used in phalloplasty when dorsoradial hypoperfusion is detected on an indocyanine green perfusion scan. It is a technically challenging addition to the standard technique because of the small size of the vessels, the close relationship between the PIOA and the posterior interosseous nerve, and the vulnerability of the newly constructed intra-flap anastomosis. De Wolf E, Claes K, Sommeling CE, et al. Free Bipedicled Radial Forearm and Posterior Interosseous Artery Perforator Flap Phalloplasty. J Sex Med 2019;16:1111–1117

FP7-CHEETAH Project Knowledge Exchange Portal: an Advanced Tool to Efficiently Bring Information to the European Photovoltaic RTD Community

FP7-CHEETAH is a combined collaborative project (CP) and coordination and support action (CSA) funded under the European Commission’s 7th Framework program and coordinated by ECN, NL with the aims to solve specific R&D issues and to overcome fragmentation of European PV R&D by intensifying the collaboration between R&D providers and industry to accelerate the industrialization of innovations. The project is also tightly linked to the EERA-PV Joint Program. The CHEETAH Knowledge Exchange Area Portal (KEAP), in parallel to the project web site and other dissemination activities (newsletter, communication, etc), constitutes the pillar of the project to distribute information in a uniform and simple way. It is based on several very efficient ICT procedures by operating from the collection to management of information by dynamic data base matrix: any uploaded information is linked to all others. All interested browsers/readers can have efficient access to any stored data thanks to the utilization of a search engine/query keywords and user friendly graphic interfaces. Based on the implementation of SOPHi@webinar platform, the portal also offers its own e-learning platform. CHEETAH KEAP represents for its peculiarities a major breakthrough in the field with highly innovative contents and a substantial improvement in comparison with the state of the art of knowledge exchange on PV RTD