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Dive into the research topics where A. Agrusa is active.

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Featured researches published by A. Agrusa.


Hernia | 2011

Nerve degeneration in inguinal hernia specimens

Giuseppe Amato; E. Ober; Giorgio Romano; Giuseppe Salamone; A. Agrusa; Gaspare Gulotta; Rossana Bussani

BackgroundThe histological study of the herniated inguinal area is rare in the literature. This report is focused on the detection of structural changes of the nerves within tissues bordering the inguinal hernia of cadavers. Their physiopathological consequences are hypothesized.Materials and methodsPrimary inguinal hernia was diagnosed in 30 fresh cadavers. Tissue specimens from the inguinal region close to and around the hernia opening were excised for histological examination. A control of the data was achieved through tissue samples excised from equivalent sites of the inguinal region in 15 cadavers without hernia.ResultsThe detected nerves in the inguinal area demonstrated pathological changes such as fibrotic degeneration, atrophy, and fatty dystrophy of the axons. The thickening of the perineural sheath was constantly seen. These findings were consistently present, independent of the hernia type.ConclusionsThe detected nerve alterations lead us to imagine a worsening, or even the cessation, of the nervous impulse to the muscles, leading to atrophy and weakening of the abdominal wall. This could represent one of the multifactorial causes of hernia genesis.


Hernia | 2012

Muscle degeneration in inguinal hernia specimens

Giuseppe Amato; A. Agrusa; Giorgio Romano; Giuseppe Salamone; Gaspare Gulotta; Furio Silvestri; Rossana Bussani

BackgroundThere are few articles in the literature reporting the histological changes of groin structures affected by inguinal hernia. A deeper knowledge of this matter could represent an important step forward in the identification of the causes of hernia protrusion. This study aimed to recognise the pathological modifications of muscular structures in autopsy specimens excised from tissues surrounding the hernia orifice.MethodsInguinal hernia was identified in 30 autopsied cadavers, which presented different varieties of hernia, including indirect, direct and mixed. Tissue specimens were resected for histological study from structures of the inguinal area surrounding the hernia opening, following a standardised procedure. The histological examination was focussed on the detection of structural changes in the muscle tissues. The results were compared with biopsy specimens resected from corresponding sites of the inguinal region in a control group of 15 fresh cadavers without hernia.ResultsSignificant modification of the muscular arrangement of the inguinal area was recognized. Pathological alterations such as atrophy, hyaline and fibrotic degeneration, as well as fatty dystrophy of the myocytes were detected. These findings were observed consistently in the context of multistructural damage also involving vessels and nerves. In cadavers with hernia these alterations were always present independent of hernia type. No comparable damage was found in control cadavers without hernia.ConclusionsThe high degree of degenerative changes in the muscle fibres in the inguinal area involved in hernia protrusion described in this report seems to be consistent with chronic compressive damage. These alterations could embody one important factor among the multifactorial sources of hernia genesis. Conjectures concerning its impact on the physiology and biodynamics of the inguinal region are made. The relationship between the depicted degenerative injuries and the genesis of inguinal hernia is also a focus of discussion in this article.


Hernia | 2011

New mesh shape and improved implantation procedure to simplify and standardize open ventral hernia repair: a preliminary report

Giuseppe Amato; Giorgio Romano; Thorsten Goetze; Giuseppe Salamone; A. Agrusa; Gaspare Gulotta; V. Paolucci

IntroductionIssues in ventral hernia repair are represented by the need for mesh fixation and how to assure a sufficient mesh overlap of the defect. Aiming to resolve these problems, this study describes a modified technique for ventral and incisional hernia repair based upon a newly developed mesh with a special design. This new type of implant allows broader coverage of the abdominal wall and results in tension- and fixation-free repair.Materials and methodsA unique geometrically shaped mesh consisting of a large central body and radiating arms was used to repair ventral or incisional hernia. The mesh was intended not to be point-fixated. The friction of the straps passing through the tissues was hypothesized to be adequate to maintain the mesh firmly fastened in the abdominal wall, ensuring a wide coverage far from the hernia border. The newly designed mesh was placed in the preperitoneal sublay in 22 patients with ventral or incisional hernia. All straps were passed laterally through the transverse and oblique muscles. In all patients, a defect overlap of at least 8–12xa0cm was achieved.ResultsIn a midterm follow-up of 18–24xa0(mean 22)xa0months, three seromas and one infection occurred, which were successfully managed without mesh removal. No hematoma, chronic pain, or recurrence has been reported to date.ConclusionsThe described arm system of the implant allowed for a much smaller incision and eliminated the complicated maneuvers associated with suturing the mesh. The fixation arms seemed to have ensured the mesh stayed orientated in all patients. A very wide lateral mesh placement was accomplished, assuring sufficient defect overlap when shrinkage occurs.


Hernia | 2010

Prosthetic strap system for simplified ventral hernia repair: results of a porcine experimental model

Giuseppe Amato; Giorgio Romano; A. Agrusa; G. Cassata; Giuseppe Salamone; Gaspare Gulotta

IntroductionAiming to achieve a simplified ventral hernia repair, a proprietary oval-shaped mesh was experimentally tested in a porcine model. The mesh is structured with a large central body and radiating straps. The friction of the straps passing through the tissues are hypothesized to be adequate to maintain the position of the mesh during tissue ingrowth, avoiding classic point fixation while ensuring a wide coverage of the abdomen.MethodsThe mesh, having six radial straps, was placed using a sublay preperitoneal technique in four pigs. All straps were passed laterally through the abdominal wall and exteriorized from the skin. The straps were trimmed at the level of the skin, allowing the stumps to recoil into the subcutaneous space. The animals were euthanized at 1 and 4xa0months to determine the integration of the straps.ResultsMacroscopically, all 24 straps were firmly incorporated within the abdominal wall. The tension-free placement of the mesh by using the straps was effective. The friction of the straps passing through the tissues was adequate to keep the mesh well orientated. No dislocation of the implants was observed. The strap system also allowed a broader coverage of the abdominal wall, far beyond the wound opening.ConclusionsThe described arm system of the aforementioned implant seems to be effective in eliminating point fixation of the mesh. The fixation arms seemed to have ensured that the mesh stayed orientated in all of the animals. A very wide lateral mesh placement was accomplished, assuring sufficient defect overlap when shrinkage occurs.


Hernia | 2015

Topic: Inguinal Hernia — Joined guidelines

G. Amato; Giorgio Romano; A. Agrusa; G. Di Buono; Gianfranco Cocorullo; Gaspare Gulotta

Introduction: Combined hernia represents an almost frequent type of inguinal hernia protrusion. It is characterized by the merging of a direct and indirect hernia that develops through the inguinal floor. Nevertheless, regarding its classification there is a certain degree of confusion. Further uncertainty exists in determining how the protrusions confluence and progress. This investigation aims to clarify these matters thus enabling a better understanding of its development. The results of the research could result helpful in finalizing updated surgical techniques for a suitable management of this intricate anatomical condition.


Il Giornale di chirurgia | 2012

Laparoscopic approach in abdominal emergencies: a 5-year experience at a single center.

A. Agrusa; Giorgio Romano; G. Di Buono; A. Dafnomili; Gaspare Gulotta


Hernia | 2010

Dynamic autostatic implant for inguinal hernia repair. Early results in an explorative cohort of patients

G. Amato; Giuseppe Salamone; A. Agrusa; Giorgio Romano; Vita Anna Saladino; G. Morfino; Gaspare Gulotta


Il Giornale di chirurgia | 2009

Primary malignant fibrous histiocytoma of the mesocolon transversum

G. Cocchiara; Marco Romano; Giuseppe Buscemi; Attilio Ignazio Lo Monte; Ada Maria Florena; Tommaso Vincenzo Bartolotta; Adele Taibbi; Antonino Di Bernardo; P. Di Paola; Emilia Marrazzo; A. Agrusa; Giorgio Romano


Hernia | 2012

Fixation free incisional hernia repair with a newly designed mesh with integrated bands

G. Amato; Gaspare Gulotta; A. Agrusa; Giorgio Romano; Giuseppe Salamone; G. Di Buono; I. Goetze; V. Paolucci


Journal De Chirurgie | 2010

La ligature terminale des branches de l’artère thyroïdienne inférieure diminue la morbidité parathyroïdienne après thyroïdectomie totale pour goitre

G. Cocchiara; Massimo Cajozzo; Giuseppe Amato; Antonino Mularo; A. Agrusa; Giovanni Paolo Romano

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G. Amato

University of Cagliari

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