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Linea alba

Agata Michalska, Wojciech Rokita, Daniel Wolder, Justyna Pogorzelska, Krzysztof Kaczmarczyk
Diastasis recti abdominis is a condition in which both rectus abdominis muscles disintegrate to the sides, this being ac-companied by the extension of the linea alba tissue and bulging of the abdominal wall. DRA may result in the herniation of the abdominal viscera, but it is not a hernia per se. DRA is common in the female population during pregnancy and in the postpartum period. There is a scant knowledge on the prevalence, risk factors, prevention or management of the abovemen-tioned condition. The aim of this paper is to present the methods of DRA treatment based on the results of recent studies...
2018: Ginekologia Polska
Patrícia Mota, Augusto Gil Pascoal, Ana Isabel Carita, Kari Bø
STUDY DESIGN: Longitudinal descriptive exploratory study. OBJECTIVES: Evaluate the normal width of the linea alba in first-time pregnant women during pregnancy and postpartum. BACKGROUND: There are normative values on the width of the linea alba for nulliparous women, but limited knowledge about the normal width of the inter-rectus distance (IRD) in pregnant and postpartum women. METHODS: Ultrasound images were recorded in 84 primiparous women, at 3 locations on the linea alba (2 cm below the umbilicus, and 2 and 5 cm above the umbilicus) and at 4 time points (gestational weeks 35-41 and 6th to 8th, 12th to 14th, and 24th to 26th weeks postpartum)...
February 20, 2018: Musculoskeletal Science & Practice
G M Cooney, A Kiernan, D C Winter, C K Simms
BACKGROUND: Suturing techniques for midline abdominal wall incisions vary between surgeons. This study uses a biomechanical abdominal model to assess tissue stretch using different suturing techniques for midline laparotomy closure. METHODS: Deformation tests were performed on the linea alba of 48 porcine abdominal walls. Each pattern was tested three times at pressures ranging from 0 to 20 kPa using different continuous suturing techniques and a control. RESULTS: There was a sevenfold improvement when the best performing bite separation and bite width ([5, 16] mm) was compared with the most poorly performing combination ([15, 4] mm)...
March 2018: British Journal of Surgery
Zhang Jun, Jia Na, Chen Zhen, Yang Xuan, Wei Yan-Dong, Liu Shu-Li, Li Long
Objective: The aim of this study is to describe the technique and to evaluate the outcome of single-incision laparoscopic (SILC) approach for linea alba hernia in children. Materials and Methods: A 2 cm vertical umbilical incision was made and stretched horizontally. A 5-mm trocar was inserted through middle port for the telescope. Another extra-long 5-mm 30° trocar was inserted through the lateral port, 5 mm beside the middle port. The extraperitoneal fat was removed, and the defect of linea alba was repaired after hernial sac was excised...
February 27, 2018: Journal of Minimal Access Surgery
Nicole F Hills, Nadia Keshwani, Linda McLean
Purpose: An increased inter-rectus distance (IRD) can persist after a pregnancy and may be associated with lumbopelvic dysfunction. Ultrasound imaging (USI) is currently the gold standard for measuring IRD; however, no study has explored the need to standardize the transducer angle during these evaluations. The purpose of this study was to determine whether the angle of the ultrasound transducer relative to the underlying abdominal wall has an effect on measurements of IRD in parous women. Method: Ultrasound images of the linea alba (LA) were captured from 15 women, at rest and during a head lift, beginning with images acquired perpendicular to the LA at the midline, then tilted in 5° increments to 15° in both the cranial and the caudal directions...
2018: Physiotherapy Canada. Physiothérapie Canada
Kanoujia Sunil, Shiv Narain Kureel, Archika Gupta, Anand Pandey, Ashish Wakhlu, JileDar Rawat
Aim: The aim of this study is to report the technique and outcome of ischiopubic (IP) osteotomy for pelvic ring closure in classic exstrophy bladder. Methods: A total of 85 male classic exstrophies were selected based on trapezoid-shaped space between IP ramus on three-dimensional computed tomography pelvis. Using midline scroto-perineal approach, after bladder plate mobilization and radical corporal detachment; the pelvic surface of superior pubic ramus (SPR) was exposed...
January 2018: Journal of Indian Association of Pediatric Surgeons
Camila R S Souza, Kelly D Farnsworth, Claude A Ragle
The objective of this study was to assess and compare the bursting pressure and mode of failure of a 2-strand continuous crossing suture pattern and a simple continuous suture pattern for closure of the equine linea alba. No difference in bursting strength or mode of failure was found between the 2 suture patterns.
February 2018: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Edyta Bula, David A Upchurch, Yuheng Wang, Sheng Chen, Sara Roccabianca
OBJECTIVE To compare tensile strength and time to completion of body wall closure among 3 suture patterns. SAMPLE Eighteen 5 × 5-cm leather specimens and sixty-eight 5 × 5-cm full-thickness tissue specimens from the ventral portion of the abdominal body wall of 17 canine cadavers. PROCEDURES During experiment 1 of a 2-experiment study, each leather specimen was cut in half and sutured with a simple interrupted or simple continuous pattern or continuous pattern with intermittent Aberdeen knots (intermittent Aberdeen pattern)...
January 2018: American Journal of Veterinary Research
Rima A Safadi, Ashraf I Shaweesh, Abed AlHadi Hamasha, Reem Azzam, Melanie Alazzam, Darshan Devang Divakar
INTRODUCTION: To describe the relationship and impact of age group, gender and skin complexion on the prevalence and clinical distribution of oral mucosal alterations of developmental origin (OMA-DO) among school children aged 5-13. METHODS: A randomized representative national survey of Jordanian school children including all Country geographic areas was performed. Cut-off age that significantly correlated with presence and distribution of OMA-DO was identified (ROC curve)...
December 12, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
Michael J Pienta, Peng Zhang, Brian A Derstine, Binu Enchakalody, William B Weir, Tyler Grenda, Rebecca Goulson, Rishindra M Reddy, Andrew C Chang, Stewart C Wang, Jules Lin
BACKGROUND: The purpose of this study was to identify morphomic factors on standard, pretransplantation computed tomography (CT) scans associated with outcomes after lung transplantation. METHODS: A retrospective review of 200 patients undergoing lung transplantation at a single institution from 2003 to 2014 was performed. CT scans obtained within 1 year before transplantation underwent morphomic analysis. Morphomic characteristics included lung, dorsal muscle group, bone, and subcutaneous and visceral fat area and density...
February 2018: Annals of Thoracic Surgery
S Gillard, C G Ryan, M Stokes, M Warner, J Dixon
STUDY DESIGN: Cross-sectional repeated measures. OBJECTIVES: To quantify the effects of posture and measurement site on the inter-recti distance (IRD) and investigate the reliability of IRD measurement using ultrasound imaging in different postures. BACKGROUND: The linea alba connects the rectus abdominis muscles anteriorly and the width is known as the IRD. The IRD is usually measured in crook-lying and is the primary outcome measure to assess for a divarication of recti abdominis (DRA)...
November 22, 2017: Musculoskeletal Science & Practice
Reiko Wiessner, Thomas Vorwerk, Claudia Tolla-Jensen, Alexander Gehring
Despite extensive experience and significant reduction of complications in recent years, laparoscopic treatment of complex abdominal hernias is a challenge even for the experienced endoscopic surgeon. Patients with severe incisional hernias or symptomatic rectus diastasis benefit from the closure of the linea alba as a morphological and physiological reconstruction of the abdominal wall followed by mesh implantation. Occasionally, an additional component separation is necessary. In open surgery, this is associated with very large wound areas, postoperative seromas, poor wound healing and, in the worst case, mesh infections...
2017: Frontiers in Surgery
Fernando S Reina Rodriguez, Conor T Buckley, Joshua Milgram, Barbara M Kirby
OBJECTIVE: To compare biomechanical properties and mechanism of failure of 3 regions of ventral abdominal wall in cats by using 2 suture materials, 2 suture bite-to-stitch intervals (SBSI), and full-thickness versus fascia-only closure. STUDY DESIGN: Randomized, cadaveric, ex vivo mechanical testing. SAMPLE POPULATION: 16 adult cat cadavers, 3 samples per cat. METHODS: Three regions of ventral abdominal wall were mechanically tested (N = 48 samples)...
November 18, 2017: Veterinary Surgery: VS
Naoto Mizumura, Satoshi Okumura, Hiroshi Tsuchihashi, Masao Ogawa, Masayasu Kawasaki
A spontaneous external biliary fistula is most commonly a cholecystocutaneous fistula secondary to acute cholecystitis. A fistula arising from an intrahepatic duct is extremely rare. An 87-year-old man presented with swelling of the epigastric region and right upper quadrant abdomen. He had a history of cholecystectomy and endoscopic sphincterotomy. After antibiotic treatment and surgical opening of both lesions, abdominal computed tomography demonstrated a soft tissue mass cephalad to the umbilicus. We excised the mass, and found it to be associated with a fistula through the linea alba...
October 31, 2017: Clinical Journal of Gastroenterology
Chiara Petrosellini, Sala Abdalla, Tayo Oke
Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimic other conditions. Endometrial tissue in a surgical scar is uncommon and often misdiagnosed as a granuloma, abscess, or malignancy. Cyclical hemorrhagic ascites due to peritoneal endometriosis is exceptionally rare...
January 2018: International Journal of Fertility & Sterility
Ernest Schilders, Srino Bharam, Elan Golan, Alexandra Dimitrakopoulou, Adam Mitchell, Mattias Spaepen, Clive Beggs, Carlton Cooke, Per Holmich
PURPOSE: Adductor longus injuries are complex. The conflict between views in the recent literature and various nineteenth-century anatomy books regarding symphyseal and perisymphyseal anatomy can lead to difficulties in MRI interpretation and treatment decisions. The aim of the study is to systematically investigate the pyramidalis muscle and its anatomical connections with adductor longus and rectus abdominis, to elucidate injury patterns occurring with adductor avulsions. METHODS: A layered dissection of the soft tissues of the anterior symphyseal area was performed on seven fresh-frozen male cadavers...
December 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sante Capitano
BACKGROUND: In open surgery, extraperitoneal sublay mesh implantation is generally preferred to intraperitoneal placement, following the same principles as in "giant prosthetic reinforcement of the visceral sac" described for inguinal hernia repair [1, 2]. Miserez and Penninckx in 2002 described an endoscopic totally preperitoneal ventral hernia repair in a small cohort of 15 cases [3]. Unfortunately, this technique has not spread, probably because of the technical difficulties that require, but not for effectiveness...
March 2018: Surgical Endoscopy
Corey R Deeken, Spencer P Lake
Abdominal wall hernias are one of the most common and long-standing surgical applications for biomaterials engineering. Yet, despite over 50 years of standard use of hernia repair materials, revision surgery is still required in nearly one third of patients due to hernia recurrence. To date, hernia mesh designs have focused on maximizing tensile strength to prevent structural failure of the implant. However, most recurrences occur at the biomaterial-tissue interface. There is a fundamental gap in understanding the degree to which a mechanical mismatch between hernia repair materials and host tissue contributes to failure at this interface...
October 2017: Journal of the Mechanical Behavior of Biomedical Materials
Elwin H H Mommers, Jeroen E H Ponten, Aminah K Al Omar, Tammo S de Vries Reilingh, Nicole D Bouvy, Simon W Nienhuijs
BACKGROUND: Diastasis of the rectus abdominis muscles (DRAM) is characterised by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This causes the midline to "bulge" when intra-abdominal pressure is increased. Plastic surgery treatment for DRAM has been thoroughly evaluated, though general surgical treatments and the efficacy of physiotherapy remain elusive. The aim of this systematic literature review is to evaluate both general surgical and physiotherapeutic treatment options for restoring DRAM in terms of postoperative complications, patient satisfaction, and recurrence rates...
December 2017: Surgical Endoscopy
Ferdinand Köckerling, Marinos Damianos Botsinis, Christine Rohde, Wolfgang Reinpold, Christine Schug-Pass
BACKGROUND: Patients with symptomatic umbilical, trocar, and/or epigastric hernias and concomitant rectus abdominis diastasis represent a growing clinical problem. The optimal management of this complex hernia situation is the subject of debate in the literature. This paper reports the early results of an innovative surgical technique aimed at managing this hernia situation. METHODS: Endoscopic-assisted linea alba reconstruction (ELAR) with mesh augmentation is a surgical technique long known in the literature for its good outcome for incisional hernia repair (myofascial release, overlapping herniorrhaphy, Gibson's operation, shoelace repair, anterior rectus sheath repair, dynamic patch plasty) via a small access route...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
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