Linea alba

The most common surgical repair of abdominal wall hernia consists in implanting a mesh to reinforce hernia defects during the healing phase. Ultrasound shearwave elastography (SWE) is a promising non-invasive method to estimate soft tissue mechanical properties at bedside through shear wave speed (SWS) measurement. Combined with conventional ultrasonography, it could help the clinician plan surgery. In this work, a novel protocol is proposed to reliably assess the stiffness of the linea alba, and to evaluate the effect of breathing and of inflating the abdomen on SWS...

Diastasis recti abdominis (DRA) affects a significant number of postpartum women, while its treatments are still under debate. This study aimed to systematically evaluate the effectiveness of rehabilitation training programs for postpartum DRA treatment. Four databases were systematically searched to identify eligible studies published up to February 1, 2023. We followed the PRISMA for scoping reviews guideline in this study. The characteristics and the main findings of the included studies were extracted. Sixteen studies enrolling 1129 women during the ante- and/or postnatal period were included...

OBJECTIVE: To investigate the effect of acute contraction of the pelvic floor muscles (PFM) and abdominal exercises on the inter-rectus distance (IRD) compared to resting values, and differences between gestation weeks 27 and 37, in pregnant women with diastasis recti abdominis (DRA). DESIGN: Experimental longitudinal design. SETTING: Physiotherapy clinic, primary health care. PARTICIPANTS: Thirty-eight pregnant women with DRA ≥ 2...

Background: The pyramidalis muscle is a tiny triangular-shaped muscle that is located in the anterior abdominal wall, which originates from the body of the pubis and pubic symphysis and is inserted into linea alba. This study aimed to measure the different parameters of the pyramidalis muscle in adult cadavers. Methods: This study was carried out on 31 adults (26 males and five females) 10% formalin embalmed cadavers of both sexes from the Department of Anatomy at Kasturba Medical College, Manipal. Results: The mean length of the right pyramidalis muscle was 64...

OBJECTIVE: Diastasis of the rectus abdominis muscle (DRAM) is a widening of linea alba, it also could be accompanied by abdominal bulging. DRAM is often a cause of quality-of-life impairment, especially when it is of large dimensions. Repair with direct rectus plication is the most common treatment for Diastasis Recti Abdominis (DRA), but it can result in high recurrence rates. The authors aimed to show their results in applying the component separation technique in wide DRA cases. PATIENTS AND METHODS: From January 2015 to July 2018, 43 patients with DRA ≥ 10 cm at 3 cm over the umbilicus have been treated with component separation technique associated to panniculectomy...

BACKGROUND: With the increased interest in inter-recti distance measurement using ultrasound imaging in physiotherapy, there is a question of measurement reliability, and the importance of the examiner's experience. PURPOSE: The study aimed to investigate the reliability of inter-recti distance measurement in a DICOM viewer software by an experienced radiologist. For the measurement, the radiologist used linea alba images captured by two physiotherapists who were novice examiners...

OBJECTIVE: To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba. STUDY DESIGN: Laboratory study. ANIMAL OR SAMPLE POPULATION: Adult light horse cadavers (n = 24). METHODS: A 25 cm incision was made through the linea alba, and a 200 L polyurethane bladder was positioned within the abdomen. The linea alba was closed either using USP2/EP5 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture in a simple continuous pattern...

BACKGROUND: Currently, there are not enough studies comparing the width of the linea alba in women with and without stress urinary incontinence in postpartum women. The primary aim of the study was to compare the width (IRD) in postpartum women with and without symptoms of stress urinary incontinence (SUI). The secondary aim of the study was to compare pelvic floor muscle morphometry in postpartum women with and without SUI symptoms. METHODS: IRD distance was measured with a linear probe via 2D US...

BACKGROUND: Tension-free abdominal closure is a primary tenet of laparotomy. But this concept neglects the baseline tension of the abdominal wall. Ideally, abdominal closure should be tailored to restore native physiologic tension. We sought to quantify the tension needed to re-establish the linea alba in patients undergoing exploratory laparotomy. METHODS: Patients without ventral hernias undergoing laparotomy at a single institution were enrolled from December 2021 to September 2022...

BACKGROUND: After completion of training, practicing surgeons rely on hands-on courses to expand their procedure armamentarium and improve their surgical technique. However, such courses vary in standardized teaching methods. SAGES developed the Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program as a method of longitudinal instruction utilizing standardized teaching techniques, mentorship, and webinars to cover additional techniques. This study examines the adoption of learned techniques and participant confidence before and after an ADOPT course focused on extended-view totally extraperitoneal (eTEP) hernia repair...

video width="640" height="480" controls controlsList="nodownload" poster="https://www.revistachirurgia.ro/pdfs/video/Diana_Teodora_Cucu-Abdominal_Wall_Reconstruction.jpg" style="margin-top: -20px;" source src="https://www.revistachirurgia.ro/pdfs/video/Diana_Teodora_Cucu-Abdominal_Wall_Reconstruction.mp4" type="video/mp4" Your browser does not support the video tag. /video Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity...

The aims of this study were to perform an exploratory analysis of probable awake (AB) and sleep bruxism (SB) prevalence using of different diagnosis criteria based on the International Consensus; evaluate the associations between self-report and clinical signs/symptoms in adolescents. Participated in this cross-sectional study 403 adolescents aged 12- to 19-years-old enrolled in public and private schools from Belo Horizonte, Brazil. Parents/caregivers answered a questionnaire about sociodemographic status and adolescents' health status...

BACKGROUND: Surgery is still the most important treatment method for thyroid cancer. The classic linea alba cervicalis approach caused obvious neck scarring. This study explored an alternative open operative approach with concealed incision for hemithyroidectomy, and demonstrated whether it was non-inferior to traditional approach in postoperative complications and operation efficiency. METHODS: Patients ( n =220) from November 2019 to November 2020 willing to undergo hemithyroidectomy because of differentiated thyroid cancer were randomly divided into the sternocleidomastoid intermuscular approach (SMIA) group ( n =110), and the linea alba cervicalis approach (LACA) group ( n =110)...

BACKGROUND: Examination for the presence of diastasis of the rectus abdominis muscle and examination of the entire posture is very important in postpartum women. Currently, examination by 2D ultrasound, caliper and palpation is used. It is examined at rest and during stress tests. METHODS: Case study of a patient with diastasis of the direct abdominal muscle after a first spontaneous uncomplicated delivery at the age of 32 years. Examination to confirm diastasis of the rectus abdominis muscle - the width of linea alba was measured with a 2D linear probe by ultrasound 4...

BACKGROUND: Linea alba hernias are relatively rare types of hernias. They manifest as small protrusions situated in the linea alba between the umbilicus and xiphoid cartilage. Usually, hernia contents comprise the pre-peritoneal fat, omentum, and gastrointestinal tract. However, very few cases of linea alba hernias involving the hepatic round ligament have been reported, to date. CASE PRESENTATION: An 80-year-old woman presented with upper abdominal pain and a 1-week history of a mass in the upper midline...

The manuscript describes the transoral endoscopic thyroidectomy vestibular approach (TOETVA) for thyroid lobectomy. The patient is placed in the supine position with extension and fixation of the neck. One 20 mm transverse incision and two 5 mm incisions are made through the mucosa of the oral vestibule for camera and instrument placement after disinfection of the skin and oral cavity. The workspace is established and maintained by the skin suspension device, which is made of unabsorbable string (3-0) and rubber bands, and the CO2 insufflation pressure...

The vast majority of pelvic and intra-abdominal surgery is undertaken through at least one incision, through either the linea alba or the rectus sheath. These connective tissue layers are formed from the aponeuroses of the rectus muscles (anterior and posterior rectus sheath) and are vital for the structural integrity of the abdominal wall. Poor healing of these connective tissues after surgery can lead to significant morbidity for patients, who can develop unsightly and painful incisional hernias. Fibroblasts within the rectus sheath are responsible for laying down and remodeling collagen during the healing process after surgery...

Diastasis recti is a frequent problem that women, particularly, experience after pregnancy. It is an abdominal wall defect in which there is more than 2 cm separation between the abdominal rectus muscles. Aside from being repaired most commonly with a full abdominoplasty, in some cases, diastasis might present with minimal excessive adipocutaneous tissue, thus requiring a mini-abdominoplasty. Because umbilical transposition is not needed in that latter scenario, diastasis repair is only possible by ligating and cutting the existing umbilical stalk to be able to have a direct clear access to the supraumbilical linea alba...

BACKGROUND: Inter-recti distance (IRD) measurement using musculoskeletal USI has been used in physiotherapy research, in particular, to investigate pregnancy-related diastasis recti abdominis (DRA) and to seek its effective treatment methods. Severe and untreated diastasis may result in the formation of umbilical or epigastric hernias. OBJECTIVE: This study aimed to systematically map physiotherapy-related research articles that included descriptions of IRD measurement procedures using USI to present their similarities and differences, and formulate recommendations on the procedure...

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