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Intraabdominal pressure

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https://www.readbyqxmd.com/read/29030835/a-new-technique-for-tension-free-reconstruction-in-large-incisional-hernia
#1
Gabriele Munegato, Landino Fei, Michele Schiano di Visconte, Danilo Da Ros, Luana Moras, Gabriele Bellio
In the surgical management of large incisional hernias, the main target is the closure of the abdominal wall defect on the midline without a dangerous increase in the intraabdominal pressure. In this setting, new intraperitoneal prosthesis and components separation techniques were proposed to solve this problem. Both solutions present some critical issues. A new surgical approach with a free lateral double layer prosthesis totally in polypropylene both sides (FLaPp(®)) is proposed to overcome this problem...
October 13, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29018803/etiology-of-inguinal-hernias-a-comprehensive-review
#2
REVIEW
Stina Öberg, Kristoffer Andresen, Jacob Rosenberg
BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28960170/shunt-freedom-and-clinical-resolution-of-idiopathic-intracranial-hypertension-after-bariatric-surgery-in-the-pediatric-population-report-of-3-cases
#3
Kimberly B Hoang, Kristopher G Hooten, Carrie R Muh
Idiopathic intracranial hypertension (IIH), formerly known as pseudotumor cerebri, is a disease of elevated intracranial pressure that is thought to develop due to impaired CSF absorption related to elevated venous sinus pressure in the setting of increased intraabdominal and thoracic pressures. Symptoms can be disabling and, if left untreated, can lead to permanent visual loss. Previous treatments directed toward vision preservation include CSF diversion through shunting and optic nerve sheath fenestration...
September 29, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28905083/assessing-exercises-recommended-for-women-at-risk-of-pelvic-floor-disorders-using-multivariate-statistical-techniques
#4
Tania Tian, Stephanie Budgett, Jackie Smalldridge, Lynsey Hayward, James Stinear, Jennifer Kruger
INTRODUCTION AND HYPOTHESIS: There is a widely held, but untested, belief that certain exercises and activities generate intraabdominal pressure (IAP) that may compromise the function of the pelvic floor muscles. Women with, or at risk of, pelvic floor disorders are advised therefore to refrain from these exercises and activities in order to theoretically protect their pelvic floor. The aim of this study was to compare IAPs generated during exercises of different types that are recommended to women as pelvic floor "safe" with those generated during the corresponding conventional exercises that women are typically cautioned against...
September 13, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28799045/trauma-laparoscopy-when-to-start-and-when-to-convert
#5
Oleh Matsevych, Modise Koto, Moses Balabyeki, Colleen Aldous
BACKGROUND: The use of laparoscopy for stable patients with abdominal trauma is increasing and its accuracy is nearly 100%. However, indications for laparoscopy and for conversion differ among centers. The aim of this study was to investigate indications for trauma laparoscopy and for conversion to laparotomy. METHODS: All trauma patients managed with laparoscopy over a 4-year period were retrospectively analyzed. Indications for laparoscopy, morbidity, and reasons for conversion were investigated and predictors of morbidity and conversion were sought...
August 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28707173/intraoperative-ventilation-of-morbidly-obese-patients-guided-by-transpulmonary-pressure
#6
Lars Eichler, Katarzyna Truskowska, A Dupree, P Busch, Alwin E Goetz, Christian Zöllner
BACKGROUND: Bariatric surgery has proven a successful approach in the treatment of morbid obesity and its concomitant diseases such as diabetes mellitus and arterial hypertension. Aiming for optimal management of this challenging patient cohort, tailored concepts directly guided by individual patient physiology may outperform standardized care. Implying esophageal pressure measurement and electrical impedance tomography-increasingly applied monitoring approaches to individually adjust mechanical ventilation in challenging circumstances like acute respiratory distress syndrome (ARDS) and intraabdominal hypertension-we compared our institutions standard ventilator regimen with an individually adjusted positive end expiratory pressure (PEEP) level aiming for a positive transpulmonary pressure (P L) throughout the respiratory cycle...
July 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28661985/a-novel-approach-to-sealing-the-denuded-dermis-of-the-abdominal-wall-with-a-negative-pressure-wound-device-after-a-decompressive-laparotomy
#7
John Davis, Daniel M Caruso, Kevin N Foster, Marc R Matthews
The open abdomen is a well-known technique that is applied in a wide variety of clinical situations, including treatment of abdominal compartment syndrome, damage control laparotomy, and severe intraabdominal sepsis. Disease states such as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis or extensive deep partial and/or full-thickness torso burns involving the abdomen often result in a complete epidermal and partial dermal loss. When ABThera Open Abdomen Negative Pressure Wound Therapy is attempted in these patients, the exposed subcutaneous tissue rarely allows for an adequate seal between the adhesive barrier and the denuded skin...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28618765/the-influence-of-intraabdominal-pressure-on-the-mortality-rate-of-patients-with-acute-pancreatitis
#8
Petar Svorcan, Maja Stojanovic, Predrag Stevanovic, Aleksadar Karamarkovic, Radmilo Jankovic, Nebojsa Ladjevic
BACKGROUND/AIM: Intraabdominal hypertension (IAH) is a common clinical finding in patients with acute pancreatitis and is associated with poor prognosis. This study aimed to determine the impact of intraabdominal pressure (IAP) on the mortality rate in patients with acute pancreatitis in an intensive care unit. MATERIALS AND METHODS: A total of 50 patients with acute pancreatitis were included in this prospective cohort study. Based on the obtained values of IAP, the patients were divided into two groups: those with normal IAP (n = 14) and increased IAP (n = 36)...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28555442/-the-treatment-of-acute-secondary-peritonitis-a-retrospective-analysis-of-the-use-of-continuous-negative-pressure-therapy
#9
V Müller, G Koplin, J Pratschke, W Raue
BACKGROUND: Patients with acute secondary peritonitis often need relaparotomies and open abdominal lavages. Continuous negative pressure therapy seems to be beneficial. OBJECTIVES: Does the efficacy of the therapy depend on the continuous negative pressure system used? MATERIALS AND METHODS: A retrospective analysis was performed in the Chirurgische Klinik der Universitätsmedizin Berlin, Charité Campus Mitte, including all patients who underwent abdominal vacuum therapy between December 2013 and February 2015...
May 29, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28552090/deep-neuromuscular-blockade-and-low-insufflation-pressure-during-laparoscopic-hysterectomy
#10
Matias Vested Madsen, Olav Istre, Henrik Halvor Springborg, Anne Kathrine Staehr-Rye, Jacob Rosenberg, Jørgen Lund, Mona Ring Gätke
INTRODUCTION: Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. METHODS: This was a pre-planned secondary analysis of a randomized, controlled study...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28526462/-sudden-motor-and-sensorial-loss-due-to-retroperitoneal-hematoma-during-postoperative-periods-a-case-report
#11
Pelin Şen, Havva Gül Gültekin, İsmail Caymaz, Ömer Özel, Ayda Türköz
A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3-4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28501286/the-correlation-between-stabbing-related-upper-extremity-wounds-and-survival-of-stabbing-victims-with-abdominal-and-thoracic-injuries
#12
Michael Rozenfeld, Kobi Peleg, Adi Givon, Boris Kessel
BACKGROUND: When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing...
July 2017: Injury
https://www.readbyqxmd.com/read/28357467/-ulcers-in-obesity-associated-chronic-venous-insufficiency
#13
L Scholl, M Dörler, M Stücker
BACKGROUND: Chronic venous insufficiency is a frequently occurring disease consisting of a characteristic symptom complex and ulcerations. Normally, varicose veins with reflux or obstruction can be found. However, these symptoms have also been described in obese people and are considered functional chronic venous insufficiency. The aim of this work was to present patients with ulceration in obesity-associated chronic venous insufficiency and to describe typical features of ulceration in obese people...
July 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28330440/prevalence-and-predictors-of-intra-abdominal-hypertension-and-compartment-syndrome-in-surgical-patients-in-critical-care-units-at-kenyatta-national-hospital
#14
A Muturi, P Ndaguatha, Daniel Ojuka, A Kibet
BACKGROUND: Intra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatta National Hospital (KNH) critical care units is not known. The aim of this sudy was to determine the prevalence and factors associated with development of IAH/ACS among critically ill surgical patients. METHODS: This was a cross sectional descriptive study involving surgical patients in critical care units at KNH, carried out from March 2015 to October 2015...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28287013/a-different-technique-in-gasless-laparoendoscopic-single-site-hysterectomy
#15
Gökhan Demirayak
The aim of this study was to show a different technique for a gasless laparoendoscopic single-site (LESS) hysterectomy and to present advantages and limitations of this technique. Women undergoing gasless LESS hysterectomy with a different technique were evaluated. A total of 14 LESS hysterectomies were performed using this gasless technique and rigid laparoscopic instruments by one surgeon. The mean age of the patients was 48.6 (±4.6). The average blood loss was 80 ± 35 ml. The average time between an umbilical incision and starting hysterectomy was 5 (±2,1) min...
March 13, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28285427/association-between-intraabdominal-pressure-during-gynaecologic-laparoscopy-and-postoperative-pain
#16
RANDOMIZED CONTROLLED TRIAL
Sudip Kundu, Clara Weiss, Hermann Hertel, Peter Hillemanns, Rüdiger Klapdor, Philipp Soergel
PURPOSE: Laparoscopy is nowadays a well-established surgical method and plays a main role in an ever-increasing range of indications in gynaecology. High-quality studies of surgical techniques are necessary to improve the quality of patient care. The present study aims at evaluating postoperative pain after gynaecological laparoscopy depending on the intraoperative CO2 pressure. METHODS: In a prospective, monocentric, randomized single-blind study at the Department of Gynaecology and Obstetrics at the Hannover Medical School, we include patients scheduled for different laparoscopic procedures...
May 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28235528/effects-of-pneumoperitoneum-on-severe-hypernatremia-in-an-adult-patient-who-underwent-laparoscopic-surgery-of-hydatid-cysts
#17
Diego Anta, José M Beleña, Raquel Álvarez, Mónica Núñez
We describe the first case of severe hypernatremia associated to laparoscopic surgery for hydatid cyst in an adult patient after the use of hypertonic saline solution with complete resolution. Severe hypernatremia is an unusual fact at the immediate postoperative period but may have fatal consequences for the patient and need immediate action. The patient reached a serum sodium concentration of 179 mmol/L without adverse effects after 6 days of treatment. Laparoscopy could play a crucial role in Na(+) absorption due to high intraabdominal pressure caused by the pneumoperitoneum and its limitations to avoid peritoneal absorption of hypertonic saline solution...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#18
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28073188/effects-of-obesity-surgery-laparoscopic-sleeve-gastrectomy-technique-on-lower-urinary-tract-symptoms-depression-and-quality-of-life-of-males-prospective-study
#19
Fatih Uruç, Serkan Akan, Bekir Aras, Çaglar Yıldırım, Aytaç Sahin, Ozgur Haki Yuksel, Mehmet Timuçin Aydın, Ayhan Verit
PURPOSE: Technically, obesity weakens the pelvic base muscles by causing an increase in the intraabdominal pressure and intravesical pressure due to increasing fat and it triggers the occurrence of lower urinary tract symptoms. However it is believed that weight loss will cause recovery of these symptoms. Our purpose in this study is to research about the effects of the weight loss achieved by using especially the Laparoscopic Sleeve Gastrectomy (LSG) technique of bariatric surgery which is being more and more widely used today...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#20
Daxing Xie, Chaoran Yu, Chun Gao, Hasan Osaiweran, Junbo Hu, Jianping Gong
BACKGROUND: It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). (1-5) To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation...
May 2017: Annals of Surgical Oncology
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