Background: Mesh implantation is the standard approach in inguinal hernia repair. However, the use of penetrating sutures to secure the mesh slit in male patients may cause irritation to the tissues surrounding the spermatic cord. This pilot study evaluated the feasibility of a hybrid fixation technique utilizing a biodegradable, UV-curable adhesive biomaterial. Methods: Ten male patients aged 20-40 years with unilateral inguinal hernia underwent open repair and were assigned to two non-randomized groups (n = 5 each). Eligible patients were assigned alternately according to the order of enrollment. In the hybrid group, the mesh was secured partly conventionally, and the remaining portion was stabilized with the experimental UV-curable adhesive biomaterial. VAS, CCS, and EuraHS-QoL outcomes were assessed in both groups during the 24-month follow-up, whereas SF-36 data were available only for the hybrid group. Results: Adhesive-assisted partial mesh stabilization was associated with a shorter operative time than conventional fixation (52.0 ± 3.1 vs 60.2 ± 3.7 min). Mean VAS scores decreased from 2.6 and 2.8 on day 1 in the hybrid and conventional groups, respectively, to 0.8 in both groups on day 8 and 0 by week 6. Total CCS scores decreased from day 1 to 6 weeks in both groups (hybrid: 54.1% to 30.4%, conventional: 65.3% to 36.6%). No intraoperative complications or hernia recurrences were observed during the 24-month follow-up. The overall SF-36 scores increased from 77.8 preoperatively to 92.4 at 24 months. Conclusions: In this pilot cohort, hybrid fixation was feasible and was associated with shorter operative time. No intraoperative complications or hernia recurrences were observed during follow-up. These preliminary findings support further clinical investigation in larger patient populations to evaluate safety and comparative effectiveness.

Technical errors have an impact on the results of surgical lower limb revascularization. Use of ultrasound scanning or angiography on the operating table is inconvenient and, in case of angiography, carries a certain risk of radiation and contrast exposure. A simpler method of screening for errors is required. This study assessed the accuracy of a new simple hydrostatic bypass flow technique during surgical limb revascularization. In all, 885 patients were included in the retrospective study. All were treated for Chronic Limb-Threatening Ischemia (CLTI) with a femoropopliteal bypass. Preoperatively, the radiological Vascular Surgery/International Society of Cardiovascular Surgery (SVS/ISCVS) score was used to assess the complexity of the anatomical changes. The surgeon made a subjective runoff assessment for every surgery. In 267 cases, the hydrostatic bypass flow (HBF) technique was used, and, in 66 cases, a digital subtraction angiography (DSA) was used. In each case, a postoperative Doppler ultrasound (DUS) examination was performed following the HBF. Good early results were achieved in 89.46%, and 154 errors (17.4%) were detected (85 were detected on the operating table, including 57 technical errors). Independent efficacy in error detection was proven with a postoperative Doppler examination (Aera Under Curve (AUC) = 0.89; criterion mid-graft peak systolic velocity (PSV) <24 cm/s, p = 0.00001) and hydrostatic bypass flow (AUC = 0.71, criterion HBF < 53 mL/min, p = 0.00001) during surgery. The hydrostatic bypass flow technique is an effective intraoperative screening method in bypass surgery. Algorithmic use of HBF, DSA if needed, and DUS postoperatively improves the outcome. HBF sufficiently reduced the need for on-table angiography.

Endovascular aneurysm repair (EVAR) is a widely used minimally invasive treatment for abdominal aortic aneurysms. However, postoperative type II endoleak (T2EL) remains a relevant complication associated with a risk of aneurysm rupture and the need for repeated imaging follow-up, resulting in exposure to ionizing radiation. Identification of biological factors predisposing to T2EL may improve risk stratification. This pilot study aimed to investigate whether disturbances in hemostasis are associated with early T2EL development after EVAR. A total of 103 patients treated with EVAR for symptomatic or asymptomatic abdominal aortic aneurysms in a tertiary vascular center were prospectively enrolled. Blood samples were collected preoperatively and one month postoperatively to assess fibrinogen, prothrombin fragment F1+2 (F1+2), thrombin–antithrombin complex (TAT), tissue plasminogen activator antigen (tPA), plasminogen activator inhibitor-1 (PAI-1) activity, and platelet activity. Computed tomography angiography (CTA) during follow-up was used to detect endoleaks and calculate their volume. Patients with T2EL had significantly lower levels of prothrombin fragment F1+2 and higher PAI-1 activity compared with patients without endoleak. No significant association was observed between the analyzed biomarkers and endoleak volume. These findings suggest that reduced thrombin generation and impaired fibrinolysis may contribute to endoleak formation after EVAR and warrant further investigation in larger, confirmatory studies.