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Abdominal wall closure

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https://www.readbyqxmd.com/read/29324653/surgical-dynamometer-to-simultaneously-measure-the-tension-forces-and-the-distance-between-wound-edges-during-the-closure-of-a-laparotomy
#1
Joan Roca, Miquel Nogués, Rafael Villalobos, María Carmen Mías, Martí Comellas, Cristina Gas, Jorge Juan Olsina
The closure of the abdominal wall after making a laparotomy is a major challenge for surgeons, since a significant percentage of closures fail and incisional hernias rise. The suture has to withstand the forces required to close the incision, while not hindering the adequate wound healing progression. Currently, there is no surgical measuring device that could be used to determine the required closing forces, which can be very different depending on the patient. This paper presents a dynamometer to measure the tension forces to be applied while closing a surgical incision, and it simultaneously measures the distance between wound edges...
January 11, 2018: Sensors
https://www.readbyqxmd.com/read/29309326/components-separation-for-abdominal-wall-reconstruction-in-the-recalcitrant-high-comorbidity-patient-a-review-of-311-single-surgeon-cases
#2
Sanjay Naran, Sameer Shakir, Kenneth C Shestak, James M Russavage, Vu T Nguyen
PURPOSE: Components separation of the abdominal musculature remains a mainstay for closure of complicated midline and paramedian abdominal wall defects. The authors critically analyzed their experience with this technique to identify prognosticators affecting long-term clinical outcomes. METHODS: A retrospective review was performed of patients undergoing components separation by a single senior surgeon (J.M.R.) between 2000 and 2010. Numerous perioperative patient characteristics were collected and analyzed to determine their effects on long-term clinical outcomes...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29287163/comparison-of-tensile-strength-and-time-to-closure-between-an-intermittent-aberdeen-suture-pattern-and-conventional-methods-of-closure-for-the-body-wall-of-dogs
#3
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
https://www.readbyqxmd.com/read/29259055/hughes-abdominal-repair-trial-hart-abdominal-wall-closure-techniques-to-reduce-the-incidence-of-incisional-hernias-feasibility-trial-for-a-multicentre-pragmatic-randomised-controlled-trial
#4
Rhiannon L Harries, Julie Cornish, David Bosanquet, Buddug Rees, James Horwood, Saiful Islam, Nadim Bashir, Alan Watkins, Ian T Russell, Jared Torkington
OBJECTIVES: Incisional hernias are common complications of midline abdominal closure. The 'Hughes Repair' combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. There is evidence to suggest this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared Hughes repair with standard mass closure for the prevention of incisional hernia formation. This paper aims to test the feasibility of running a randomised controlled trial of a comparison of abdominal wall closure methods following midline incisional surgery for colorectal cancer, in preparation to a definitive randomised controlled trial...
December 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/29229138/abdominal-wall-reconstruction-after-cytoreduction-surgery-hyperthermic-intraperitoneal-chemotherapy
#5
Anthony J Scholer, Joseph B Oliver, Jesus Rosado, Jimmy S Patel, Lindsay J Lynch, Kevin M Spiegler, Karen Houck, Ravi J Chokshi
BACKGROUND: Cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) improve survival and decrease recurrence of peritoneal metastasis in a select population of patients. Abdominal wall resection is often needed to achieve complete CRS and the extent of abdominal wall resection may necessitate abdominal wall reconstruction (AWR). We sought to investigate if postoperative morbidity and mortality was increased in patients who underwent AWR with CRS-HIPEC (AWR group) compared to CRS-HIPEC without AWR (non-AWR group) and to identify if patient, tumor, and operative risk factors were associated with poor outcomes following AWR...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29223010/pelvic-abscess-complicating-sigmoid-colon-perforation-by-migrating-intrauterine-device-a-case-report-and-review-of-the-literature
#6
Omar Toumi, Houssem Ammar, Abdessalem Ghdira, Amine Chhaidar, Wided Trimech, Rahul Gupta, Randa Salem, Jamel Saad, Ibtissem Korbi, Mohamed Nasr, Faouzi Noomen, Mondher Golli, Khadija Zouari
INTRODUCTION: Intrauterine devices (IUDs) are commonly used as a contraceptive method. However, they may cause rare but potentially serious complications such as migration through the uterine wall and gastrointestinal perforation. PRESENTATION OF CASE: We report a case of a 26-year woman, carrying an IUD for 2 years, who presented to the emergency with pelvic pain with breakthrough bleeding. Abdominal imaging revealed the presence of two devices the first of which was located in the uterine cavity and the other in the wall of the sigmoid colon associated with a 5-centimeter pelvic collection...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29219861/sacrocolpopexy-with-concomitant-total-vs-supracervical-hysterectomy-functional-support-comparisons-in-cadavers
#7
Pedro Antonio Maldonado, Kyle P Norris, Maria E Florian-Rodriguez, Nemi M Shah, Clifford Y Wai
OBJECTIVE: This study aimed to compare the ability of abdominal sacrocolpopexy (ASC) with concomitant total vs supracervical hysterectomy to resist downward traction as a measure of functional anatomic support in human cadavers. METHODS: Supracervical hysterectomy was performed on unembalmed cadaver specimens, followed by ASC attaching polypropylene mesh to the posterior cervix/vagina only and then the anterior and posterior cervix/vagina. Using a metal bolt placed through the cervix tied to a filament passing through a fixed pulley system, successive weights of 0...
December 7, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29216840/over-the-scope-clip-pre-mounted-onto-a-double-balloon-enteroscope-for-fast-and-successful-closure-of-post-emr-jejunal-perforation-case-report
#8
Flaminia Purchiaroni, Takeshi Nakajima, Taku Sakamoto, Seiichiro Abe, Yutaka Saito
BACKGROUND: Familial adenomatous polyposis (FAP) is a rare, autosomal dominant disease clinically characterized by the early onset of many adenomatous polyps throughout the colon, which turn into colon cancer, if left untreated. In FAP patients, polyps can also occur in the upper gastrointestinal (GI) tract, especially in the duodenum. Adenomas beyond duodenum are rare and mostly located in the proximal jejunum and distal ileum. The management of such polyps can be either surgical or endoscopic, depending on the features of the polyp, Spigelman stage and patient's clinical conditions...
December 8, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29214557/laparoscopic-intraperitoneal-onlay-mesh-for-pediatric-incisional-hernia-a-case-report
#9
Maho Inoue, Shigeyoshi Aoi, Akihiro Taniguchi, Kohei Sakai, Mayumi Higashi, Shigehisa Fumino, Taizo Furukawa, Tatsuro Tajiri
BACKGROUND: The incidence of incisional hernia in pediatric patients is low in comparison with that reported in adults. In the pediatric population, primary closure has generally been favored. However, synthetic or biomedical mesh offers advantages in the repair of larger defects when primary closure is difficult. The use of laparoscopic intraperitoneal onlay mesh (IPOM) in the adult population has been well documented. In the pediatric population, a few laparoscopic approaches with direct suturing have been proposed; however, there are no reports of laparoscopic repair with the use of IPOM...
December 7, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29203735/histomorphologic-changes-of-esophageal-mucosa-in-experimental-third-degree-stricture
#10
Volodymyr O Shaprynskyi, Yevgeniy V Shaprinskiy, Yaroslav V Karyi, Serhii A Lysenko
INTRODUCTION: Nowadays the level of early and late complications after the operations for esophageal corrosive strictures such as esophago-organ anastomotic leak, development of infections, pneumonia, pleural empyema, mediastinitis, peritonitis, postoperative corrosive stricture development etc. remains rather high. Besides, postoperative mortality rate is high as well - 3.5-30 %. For that reason, an experimental model of esophageal stricture was suggested and ultrastructural mucosal changes in the stricture itself were studied to elaborate the unified pathogenic approach in treatment of esophageal stricture and improvement of its results...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29195831/bladder-exstrophy-closure-in-the-newborn-period-with-external-pelvic-fixation-performed-without-osteotomy-a-preliminary-report
#11
A Alam, R Blachman-Braun, J C Delto, P R M Moscardi, M Castellan, M A Tidwell, A Labbie, R Gosalbez
BACKGROUND: Successful primary bladder closure is the most crucial element for urinary continence in patients with classic bladder exstrophy (CBE). In the newborn period, bladder closure can be performed in the first 48 h without pelvic osteotomy or external fixation, but requires postoperative lower extremity immobilization (i.e., spica cast, Bryant's or Buck's traction). OBJECTIVE: To present a novel surgical approach for primary bladder closure for CBE using two-pin external fixation without pelvic osteotomy, and without postoperative lower extremity immobilization...
November 21, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29191669/incidence-and-factors-associated-with-development-of-heterotopic-ossification-after-damage-control-laparotomy
#12
Yifan Wang, Agatha Stanek, Jeremy Grushka, Paola Fata, Andrew Beckett, Kosar Khwaja, Tarek Razek, Dan L Deckelbaum
INTRODUCTION: The incidence of heterotopic ossification (HO) following damage control laparotomy (DCL) is unknown. Abdominal wall reconstruction may prove more challenging in patients with HO. This study examines the incidence and factors associated with HO in patients with an open abdomen following DCL. METHODS: A retrospective review of all patients with an open abdomen after DCL at a level 1 trauma centre from 2009 to 2015 was conducted. Demographics and peri-operative outcomes of patients with and without HO were compared...
November 26, 2017: Injury
https://www.readbyqxmd.com/read/29164131/continuous-laparoscopic-closure-of-the-linea-alba-with-barbed-sutures-combined-with-laparoscopic-mesh-implantation-ipom-plus-repair-as-a-new-technique-for-treatment-of-abdominal-hernias
#13
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
https://www.readbyqxmd.com/read/29160639/predictors-of-mortality-in-neonates-with-giant-omphaloceles
#14
Amulya K Saxena, Maja Raicevic
INTRODUCTION: This analysis was performed a review of giant-omphaloceles to determine the predictors of mortality. EVIDENCE ACQUISITION: Pubmed® and KoBson databases were searched for terms "giant" "omphalocele" and "mortality". Primary end points included mortality correlation with gestational age (GA), birth weight (BW), eviscerated organs, associated anomalies and management. To calculate mean and median values IBM SPSS version 23.0 was used. EVIDENCE SYNTHESIS: After de-duplication and review search revealed 42 articles of which 23 met our inclusion criteria with 396 giant-omphaloceles for this analysis...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29159603/prophylactic-intraperitoneal-onlay-mesh-reinforcement-reduces-the-risk-of-incisional-hernia-two-year-results-of-a-randomized-clinical-trial
#15
Philippe Brosi, Philippe M Glauser, Benjamin Speich, Samuel A Käser, Christoph A Maurer
BACKGROUND: Incisional hernias still are a major concern after laparotomy and are causing substantial morbidity. This study examines the feasibility, safety and incisional hernia rate of the use of a prophylactic intraperitoneal onlay mesh stripe (IPOM) to prevent incisional hernia following midline laparotomy. METHODS: This prospective, randomized controlled trial randomly allocated patients undergoing median laparotomy either to mass closure of the abdominal wall with a PDS-loop running suture reinforced by an intraperitoneal composite mesh stripe (Group A) or to the same procedure without the additional mesh stripe (Group B)...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29150964/de-novo-donor-specific-hla-antibodies-after-combined-intestinal-and-vascularised-composite-allotransplantation
#16
Annemarie Weissenbacher, Georgios Vrakas, Mian Chen, Srikanth Reddy, Philip Allan, Henk Giele, Martin Cnm Barnardo, Anil Vaidya, Peter J Friend, Susan V Fuggle
Combining vascularised composite allotransplantation (VCA) with intestinal transplantation to achieve primary abdominal closure has become a feasible procedure. Besides facilitating closure, the abdominal wall can be used to monitor intestinal rejection. As the inclusion of a VCA raises the possibility of an enhanced alloimmune response, we investigated the incidence and clinical effect of de novo donor specific HLA antibodies (dnDSA) in a cohort of patients receiving an intestinal transplant with or without a VCA...
November 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29150929/biomechanical-properties-of-feline-ventral-abdominal-wall-and-celiotomy-closure-techniques
#17
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
https://www.readbyqxmd.com/read/29140545/neobladder-vaginal-fistula-the-university-of-southern-california-experience
#18
Shilo Rosenberg, Gus Miranda, David A Ginsberg
AIMS: The use of orthotropic neobladder (ONB) construction in women has increased in popularity. With increasing numbers so have complications distinct to this procedure. Neobladder vaginal fistula (NVF) is a rare but challenging complication. We present our experience correcting this problem. METHODS: An IRB approved database of female patients with an ONB was retrospectively reviewed. Patients with a history of NVF were identified and charts reviewed. Our standard technique of radical cystectomy and orthotopic diversion in female patients includes interposition of omentum between the neobladder and anterior vaginal wall and sacrocolpopexy...
November 15, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29103165/the-urethral-closure-mechanism-is-deteriorated-after-anterior-colporrhaphy
#19
Yasmine Khayyami, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Urethral pressure reflectometry (UPR) has proven highly reproducible in women with pelvic organ prolapse. We hypothesized that urethral parameters would decrease after anterior colporrhaphy. METHODS: A prospective, observational study where women with anterior vaginal wall prolapse ≥stage II were assessed before and after anterior colporrhaphy. Assessments consisted of prolapse staging according to the Pelvic Organ Prolapse Quantification system, UPR measurements at rest, during squeezing and straining (at a standardized abdominal pressure of 50 cmH2O, PO-Abd 50), standardized stress tests with 300 ml saline, and answering the International Consultation on Incontinence - Urinary incontinence short form...
November 4, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/29094323/enormous-postoperative-perforation-after-endoscopic-submucosal-dissection-for-duodenal-cancer-successfully-treated-with-filling-and-shielding-by-polyglycolic-acid-sheets-with-fibrin-glue-and-computed-tomography-guided-abscess-puncture
#20
Yoshiko Ohara, Kengo Takimoto, Takashi Toyonaga, Tomohiro Yamaguchi, Hiroya Sakaguchi, Fumiaki Kawara, Shinwa Tanaka, Tsukasa Ishida, Yoshinori Morita, Eiji Umegaki
A female in her 70s underwent esophagogastroduodenoscopy (EGD) for screening, and a 0-IIa lesion measuring approximately 15 mm was detected in the descending portion of the duodenum. Due to the malignant potency of the lesion, endoscopic submucosal dissection (ESD) was performed. Microperforation occurred during ESD. The lesion was removed en bloc and the post-ESD ulcer bed was closed with clips. The next day, the patient had abdominal pain and computed tomography (CT) revealed a small amount of free air in the retroperitoneal space...
November 1, 2017: Clinical Journal of Gastroenterology
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