Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in a cadaveric model of bovine fetus

Carla Rozilene Guimarães Silva; Thiago da Silva Cardoso; Késia Bandeira da Silva; Heytor Jales Gurgel; João Pedro Monteiro Barroso; Luiz Henrique Vilela Araújo; Luis Enrique Soza Altamirano; Loise Araújo de Sousa; Luiza Paula Araújo Alcântara; Marcos Emanoel Martins Ferreira; Lucas Santos Carvalho; José Leandro da Silva Gonçalves; Jhoisse Hamar Guimarães Rodrigues; Francisco Décio de Oliveira Monteiro; Rinaldo Batista Viana; Pedro Paulo Maia Teixeira

doi:10.1371/journal.pone.0285988

Peer Review History

Original SubmissionAugust 23, 2022
21 Nov 2022 Decision Letter - Adolfo Maria Tambella, Editor PONE-D-22-23559Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in an animal modelPLOS ONE Dear Dr. Silva, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== Reviewers raised minor concerns about the manuscript. It is recommended that the authors follow the suggestions of the reviewers and then modify the manuscript accordingly. In addition, the following aspects need to be clarified or changed. English-language proofreading of the entire text of the manuscript is required (please have the correct form of writing by a native English speaker or use an English writing service); More specifics about the method used are required, especially in the VG group, so that the reader will potentially be able to reproduce it, in particular: -precisely describe the positioning of the trocars and ports (it is not enough to write "through the right flank"); -methods of entry of the CO2 into the abdominal cavity in the induction phase of the pneumoperitoneum (for example use of the Verres needle or direct introduction of the trocar through a parietal incision?); -please specify the length of the catheter used. In Statistical analysis, what’s the meaning of “with the post test”? Perhaps do authors mean a post-hoc test? But if so, it seems inappropriate given that, being a comparison between two groups, a t-test was rightly done, and not an ANOVA. Furthermore, it is not necessary to specify "Wilcoxon" in parentheses, “Mann-Whitney test” is sufficient. In abstract and method section the authors define the surgical steps with S1 and S2, then in results (Table 1) with E1 and E2: please homogenize by using the same acronyms in the whole manuscript (the same for GV and VG, as suggested by the reviewer). Authors should please indicate major limitations of the study. ============================== Please submit your revised manuscript by Jan 05 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The study was done to develop a study model for laparoscopic surgical correction of umbilical defects in calves. The manuscript is well presented and can be accepted with minor corrections mentioned below. Title: The title should include "study model" as no live animal was involved in the surgical correction to observe the prognosis. Abstract: The video-surgical group (line 33) was termed VG but in Materials and methods it was denoted GV (lines 87, 89, 141). Please correct this. Line 109: the meaning of Cd is should be caudal. In fig 4, please mention the labeling of I-IV. Statistical analysis: p < 0.05 should be considered significant. Reviewer #2: It is interesting work with great finding. However, I have some comments that should be addressed to increase clarity Abstract: Add a good background and conclusive statement for the abstract Introduction: Better to indicate the differential dx for hernia in general and umbilical hernia in specific such as hematoma, tumor.... Material and methods: Better to say Study animals/ experimental animals What breed of cattle were used? Regarding your criteria for inclusion, why do you like to use pregnant animals as your experimental animal? Do you think the case more frequent on pregnant animals if so please indicate this on the introduction section. Please indicate limitation of you study. Discussion Please try to also provide an update on what new technique can be adopted from this experimental study as compared to already existing techniques? This will increase visibility of your research. Conclusion It should be related with your main findings of the experiment. Reviewer #3: Accepted without any comments, In fact, this study contains a scientific addition and a new and modern method in laparoscopy without problems or complications, and the care after the operation is simple and uncomplicated. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Moinul Hasan Reviewer #2: Yes: Haben Fesseha Reviewer #3: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0285988.r001
Revision 1
27 Feb 2023 Author Response Academic Editor English-language proofreading of the entire text of the manuscript is required (please have the correct form of writing by a native English speaker or use an English writing service. Response: More specifics about the method used are required, especially in the VG group, so that the reader will potentially be able to reproduce it, in particular: -precisely describe the positioning of the trocars and ports (it is not enough to write "through the right flank"); Response: Suggestion inserted in the manuscript (113-117) -methods of entry of the CO2 into the abdominal cavity in the induction phase of the pneumoperitoneum (for example use of the Verres needle or direct introduction of the trocar through a parietal incision?); Response: Suggestion inserted in the manuscript (127) -please specify the length of the catheter used. Response: Suggestion inserted in the manuscript (124) In Statistical analysis, what’s the meaning of “with the post test”? Perhaps do authors mean a post-hoc test? But if so, it seems inappropriate given that, being a comparison between two groups, a t-test was rightly done, and not an ANOVA. Furthermore, it is not necessary to specify "Wilcoxon" in parentheses, “Mann-Whitney test” is sufficient. Response: Corrected in manuscript (186) In abstract and method section the authors define the surgical steps with S1 and S2, then in results (Table 1) with E1 and E2: please homogenize by using the same acronyms in the whole manuscript (the same for GV and VG, as suggested by the reviewer). Response: Corrected in manuscript Authors should please indicate major limitations of the study As limitations of this study, the laparoscopic techniques are influenced by the surgeon's experience, in cases of very large hernias they can be difficult, not using meshes in these procedures and obtaining bovine fetuses to perform the techniques. Reviewer Comments: 5. Review Comments to the Author Reviewer 1: The study was done to develop a study model for laparoscopic surgical correction of umbilical defects in calves. The manuscript is well presented and can be accepted with minor corrections mentioned below. Title: The title should include "study model" as no live animal was involved in the surgical correction to observe the prognosis. Response: Suggestion included in the manuscript (2) Abstract: The video-surgical group (line 33) was termed VG but in Materials and methods it was denoted GV (lines 87, 89, 141). Please correct this. Response: Corrected in manuscript Line 109: the meaning of Cd is should be caudal. Response: Corrected in manuscript In fig 4, please mention the labeling of I-IV. Response: Corrected in manuscript (163) Statistical analysis: p < 0.05 should be considered significant. Response: Corrected in manuscript (187-188) Reviewer 2: It is interesting work with great finding. However, I have some comments that should be addressed to increase clarity Abstract: Add a good background and conclusive statement for the abstract Response: Suggestion included in the manuscript Introduction: Better to indicate the differential dx for hernia in general and umbilical hernia in specific such as hematoma, tumor.... Response: Suggestion included in the manuscript Material and methods: Better to say Study animals/ experimental animals What breed of cattle were used? Response: Mixed breed animals. Regarding your criteria for inclusion, why do you like to use pregnant animals as your experimental animal? Do you think the case more frequent on pregnant animals if so please indicate this on the introduction section. Response: We did not use pregnant animals in the study, we used fetuses obtained from pregnant animals that were slaughtered for consumption. We use dead fetuses as these are newly developed techniques and surgeons need to gain necessary skills in cadavers without causing pain or suffering to live animals. Please indicate limitation of you study. The limitations of this study were during the collection and conservation of bovine fetuses. Most of the cows that were destined for slaughter were not pregnant and the slaughterhouse was far from the place where this experiment was carried out. To get the total number of bovine fetuses planned, several displacements were necessary. After obtaining the fetuses, they were kept under refrigeration for conservation until the period of the experiment. In the first moment, days before the practices, there was a power outage, the refrigerated chamber stopped working and all the animals were not suitable for use, they were lost. In the second moment after obtaining more animals, the experiment was carried out. Discussion Please try to also provide an update on what new technique can be adopted from this experimental study as compared to already existing techniques? This will increase visibility of your research. Conclusion It should be related with your main findings of the experiment. https://doi.org/10.1371/journal.pone.0285988.r002
27 Mar 2023 Decision Letter - Adolfo Maria Tambella, Editor PONE-D-22-23559R1Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in an animal model (study model)PLOS ONE Dear Dr. Silva, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The quality of the manuscript has improved since the first revision, however there are still minor revisions to be made. English-language proofreading of the new version of the whole text is still suggested to increase the clarity of the manuscript. The following specific aspects need to be clarified or changed. -Keywords: please replace “invasive minimally technique” with “minimally invasive technique”. -Title: please avoid redundancy in the title; First suggested option for title: “Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in an animal model”. Second suggested option for title: “Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in a cadaveric model of bovine fetus”. -lines 37-42: please rephrase to facilitate the reader's understanding. -line 89: please replace “All these pregnant cows” with “All the pregnant cows”. -line 91: delete “without causing pain or suffering to the animals.” To avoid redundancy as cadavers are used. -line 126: please replace "lighting" with "lighting cable". -lines 164-169 (capture of figure 4): please replace “nylon” with “nylon thread”, as in caption of figure 5. -line 187: please replace “, surgical techniques:” with “;” -lines 202-203: please rephrase to facilitate the reader's understanding. -line 212: Since in the table is reported the p-values, it is suggested to delete “p≤0.05” from the caption. -line 222: It is not clear what these values “(08/01–12.5%)” indicates. Maybe you mean “(1 case out of 8, 12.5%)”? Please clarify or delete. -lines 224-225: please rephrase to facilitate the reader's understanding. -line 236: please delete “and other methods”. -lines 271-273: please rephrase to facilitate the reader's understanding. Please submit your revised manuscript by May 11 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Adolfo Maria Tambella, DVM, MSc Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Moinul Hasan ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0285988.r003
Revision 2
29 Apr 2023 Author Response Ref: PONE-D-22-23559R1 Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in an animal model (study model) Answers to the reviewers Academic Editor English-language proofreading of the new version. Response: Yes (Enclosed English proofreading certificate). - Keywords: please replace “invasive minimally technique” with “minimally invasive technique” Response: Suggestion inserted in the manuscript. -Title: please avoid redundancy in the title; First suggested option for title: “Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in an animal model”. Second suggested option for title: “Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in a cadaveric model of bovine fetus”. Response: Second suggestion inserted in the manuscript. -lines 37-42: please rephrase to facilitate the reader's understanding. Response: Suggestion inserted in the manuscript. “The procedures were performed in two steps. The first step consisted of creating an abdominal wall defect in the umbilical region by laparoscopic approach in an iatrogenic manner (Step 1: E1). The second stage consisted of conventional abdominorrhaphy of the umbilical region wall defect in the CG group and video-assisted percutaneous suturing of the edges of the iatrogenic abdominal wall defect in the VG group, until reversal of the laparoscopic accesses (Step 2: E2).” -line 89: please replace “All these pregnant cows” with “All the pregnant cows”. Response: Suggestion in manuscript. -line 91: delete “without causing pain or suffering to the animals.” To avoid redundancy as cadavers are used. Response: Suggestion inserted in manuscript. -line 126: please replace "lighting" with "lighting cable". Response: Correction inserted in manuscript. -lines 164-169 (capture of figure 4): please replace “nylon” with “nylon thread”, as in caption of figure 5. Response: Suggestion inserted in manuscript. -line 187: please replace “, surgical techniques:” with “;” Response: Substitution realized in manuscript. -lines 202-203: please rephrase to facilitate the reader's understanding. Response: Correction inserted in manuscript. “The right lateral approach, with the establishment of laparoscopic accesses, allowed the execution of the procedures properly, as it guaranteed access to the abdominal wall defect with a wide field of view, contributing to the feasibility of the technique.” -line 212: Since in the table is reported the p-values, it is suggested to delete “p≤0.05” from the caption. Response: Suggestion inserted in manuscript. -line 222: It is not clear what these values “(08/01–12.5%)” indicates. Maybe you mean “(1 case out of 8, 12.5%)”? Please clarify or delete. Response: Values excluded in the manuscript. -lines 224-225: please rephrase to facilitate the reader's understanding. Response: Correction inserted in manuscript. “Dieresis of the musculature and peritoneum was performed to correct the iatrogenic defect of the abdominal wall with subsequent dermarrhaphy by separate simple suture in the CG group.” -line 236: please delete “and other methods”. Response: Suggestion inserted in manuscript. -lines 271-273: please rephrase to facilitate the reader's understanding. Response: Correction inserted in manuscript. “The time for correction of the abdominal wall defect in the umbilical region was shorter with the aid of laparoscopy”. Attachments Attachment Submitted filename: Response to reviewers R2.docx https://doi.org/10.1371/journal.pone.0285988.r004
7 May 2023 Decision Letter - Adolfo Maria Tambella, Editor Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in an animal model (study model) PONE-D-22-23559R2 Dear Dr. Silva, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Adolfo Maria Tambella, DVM, MSc Academic Editor PLOS ONE Additional Editor Comments (optional): After carefully considering the old and new versions of the manuscript, the scientific quality has grown and now it can be considered suitable for publication. Congratulations to the authors. Reviewers' comments: https://doi.org/10.1371/journal.pone.0285988.r005
Formally Accepted
22 May 2023 Acceptance Letter - Adolfo Maria Tambella, Editor PONE-D-22-23559R2 Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in a cadaveric model of bovine fetus Dear Dr. Silva: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Adolfo Maria Tambella Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0285988.r006

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