Implantation of biologic mesh in ventral hernia repair—does it make sense?

International audienc

Rosetta Lander Batteries Experience During All Operation Phases

Rosetta is an ambitious ESA mission, launched in March 2004 from Kourou and which performed a rendezvous with comet 67/P Churyumov-Gerasimenko. Its lander, Philae, achieved landing on comet soil on the 12th November 2014 and performed 64 hours of science activities on its batteries before going into hibernation due to lack of solar energy. Philae is operated by the Lander Control Centre (LCC) at DLR Cologne Germany and the Science Operations and Navigation Centre (SONC) at CNES Toulouse France. The Lander system was provided by a European consortium (Germany, France, Italy, Hungary, Finland, UK, Ireland, Switzerland and Austria) and supports a scientific payload of 10 instruments. The Philae battery system was provided by CNES, it is composed of a Saft primary battery (1518Wh) and an ABSL secondary battery (151Wh). The primary is made of non-rechargeable LSH20 (LiSOCl2) Saft cells and the secondary of rechargeable ABSL Li-ion 18650HC. For the Philae mission, the energetic constraint was very important. Indeed, before launch, the operations had to be planned considering variability of several parameters (descent duration, communication slots, comet temperature, solar power availability, etc.). Since Rosetta launch, cells and batteries have been stored and specific ground test plans have been identified in order to follow the battery ageing and to validate the final Philae operation schedule. From ground test results, an electrical model of the batteries was developed to help the operations scheduling. During cruise, the operations consisted of secondary batteries monitoring and tests and primary battery conditioning. During separation and on-comet operations, the behaviour of the batteries system was checked and electric simulations helped with activities scheduling. Firstly, this paper will describe the Philae mission. In a second part, the batteries system will be presented. The ground strategy will be detailed. Finally, the operations of Philae batteries system will be described

Rosetta Lander Batteries Experience During All Operation Phases

Rosetta is an ambitious ESA mission, launched in March 2004 from Kourou and which performed a rendezvous with comet 67/P Churyumov-Gerasimenko. Its lander, Philae, achieved landing on comet soil on the 12th November 2014 and performed 64 hours of science activities on its batteries before going into hibernation due to lack of solar energy. Philae is operated by the Lander Control Centre (LCC) at DLR Cologne Germany and the Science Operations and Navigation Centre (SONC) at CNES Toulouse France. The Lander system was provided by a European consortium (Germany, France, Italy, Hungary, Finland, UK, Ireland, Switzerland and Austria) and supports a scientific payload of 10 instruments. The Philae battery system was provided by CNES, it is composed of a Saft primary battery (1518Wh) and an ABSL secondary battery (151Wh). The primary is made of non-rechargeable LSH20 (LiSOCl2) Saft cells and the secondary of rechargeable ABSL Li-ion 18650HC. For the Philae mission, the energetic constraint was very important. Indeed, before launch, the operations had to be planned considering variability of several parameters (descent duration, communication slots, comet temperature, solar power availability, etc.). Since Rosetta launch, cells and batteries have been stored and specific ground test plans have been identified in order to follow the battery ageing and to validate the final Philae operation schedule. From ground test results, an electrical model of the batteries was developed to help the operations scheduling. During cruise, the operations consisted of secondary batteries monitoring and tests and primary battery conditioning. During separation and on-comet operations, the behaviour of the batteries system was checked and electric simulations helped with activities scheduling. Firstly, this paper will describe the Philae mission. In a second part, the batteries system will be presented. The ground strategy will be detailed. Finally, the operations of Philae batteries system will be described

C-reactive protein is a predictive factor for complications after incisional hernia repair using a biological mesh

International audienceAbstract The introduction of biological or absorbable synthetic meshes has provided an alternative to conventional repair for incisional hernia. The ability to predict the development of complications after hernia surgery is important, as it guides surgical planning and patient management. This retrospective study assessed whether the postoperative C-reactive protein (CRP) level can predict complications after incisional hernia repair using biological mesh reinforcement. Patients who underwent incisional hernia repair surgery using biological meshes between February 2009 and February 2015 were screened for study inclusion. Patients included in the study were divided into two groups: those with and without postoperative complications. The two groups were analysed based on sex, surgical operation, length of intensive care unit stay (ICU), complications and mortality. Laboratory values, including white blood cell (WBC) count and CRP levels, were determined preoperatively and up to postoperative day (POD) 10. Postoperative complications requiring further management occurred in 32 of the 60 patients (53.3%). Among 47 patients, the mean CRP and WBC levels were 6.6 mg/L and 9.073 G/L in the group without complications vs. 141.0 mg/L, 16.704 G/L in the group with complications (p  100 mg/L vs. 46% in the group with CRP  100 mg/L) up to POD10 may serve as a predictor of postoperative complications in patients undergoing incisional hernia using biological meshes

Bile Duct Injury During Cholecystectomy: Necessity to Learn How to Do and Interpret Intraoperative Cholangiography.

Biliary duct injury (BDI) is a serious complication during cholecystectomy. Perioperative cholangiography (POC) has recently been generating interest in order to prevent BDI. However, the current literature (including randomized controlled trials) cannot conclude whether POC is protective or not against the risk of BDI. The aim of our study was to investigate whether POC could demonstrate earlier BDI and which criteria are required to make that diagnosis. We performed a retrospective study between 2005 and 2018 in our French tertiary referral center, which included all patients who had presented following BDI during cholecystectomy. Twenty-two patients were included. Nine patients had POC, whereas 13 did not. When executed, POC was interpreted as normal for three patients and abnormal for six. In this latter group, only two cases had a BDI diagnosed intraoperatively. In other cases, the interpretation was not adequate. BDIs are rare but may reduce patients' quality of life. Our study highlights the surgeon's responsibility to learn how to perform and interpret POC in order to diagnose and manage BDIs and potentially avoid catastrophic consequences

Identification of risk factors for morbidity and mortality after Hartmann’s reversal surgery – a retrospective study from two French centers

International audienceAbstract Hartmann’s reversal procedures are often fraught with complications or failure to recover. This being a fact, it is often difficult to select patients with the optimal indications for a reversal. The post-recovery morbidity and mortality rates in the literature are heterogeneous between 0.8 and 44%. The identification of predictive risk factors of failure of such interventions would therefore be very useful to help the practitioner in his approach. Given these elements, it was important to us to analyze the practice of two French university hospitals in order to highlight such risk factors and to allow surgeons to select the best therapeutic strategy. We performed a bicentric observational retrospective study between 2010 and 2015 that studied the characteristics of patients who had undergone Hartmann surgery and were subsequently reestablished. The aim of the study was to identify factors influencing morbidity and postoperative mortality of Hartmann’s reversal. Primary outcome was complications within the first 90 postoperative days. 240 patients were studied of which 60.4% were men. The mean age was 69.48 years. The median time to reversal was 8 months. 79.17% of patients were operated as emergency cases where the indication was a diverticular complication (39.17%). Seventy patients (29.2%) underwent a reversal and approximately 43% of these had complications within the first 90 postoperative days. The mean age of these seventy patients was 61.3 years old and 65.7% were males. None of them benefited from a reversal in the first three months. We identified some risk factors for morbidity such as pre-operative low albuminemia (p = 0.005) and moderate renal impairment (p = 0.019). However, chronic corticosteroid use (p = 0.004), moderate renal insufficiency (p = 0.014) and coronary artery disease (p = 0.014) seem to favour the development of anastomotic fistula, which is itself, a risk factor for mortality (p = 0.007). Our study highlights an important rate of complications including significant anastomotic fistula after Hartmann’s reversal. Precarious nutritional status and cardiovascular comorbidities should clearly lead us to reconsider the surgical indication for continuity restoration

MASCOT—The Mobile Asteroid Surface Scout Onboard the Hayabusa2 Mission

International audienceOn December 3rd, 2014, the Japanese Space Agency (JAXA) launched successfully the Hayabusa2 (HY2) spacecraft to its journey to Near Earth asteroid (162173) Ryugu. Aboard this spacecraft is a compact landing package, MASCOT (Mobile Asteroid surface SCOuT), which was developed by the German Aerospace Centre (DLR) in collaboration with the Centre National d'Etudes Spatiales (CNES). Similar to the famous predecessor mission Hayabusa, Hayabusa2, will also study an asteroid and return samples to Earth. This time, however, the target is a C-type asteroid which is considered to be more primitive than (25143) Itokawa and provide insight into an even earlier stage of our Solar System