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Abdominal components separation

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https://www.readbyqxmd.com/read/28942568/endoscopic-anterior-component-separation-a-novel-technical-approach
#1
B Dauser, S Ghaffari, C Ng, T Schmid, G Köhler, F Herbst
PURPOSE: Open anterior release of the external oblique fascia to enable midline closure of large abdominal wall defects is associated with relevant morbidity due to extensive subcutaneous dissection. Using endoscopic techniques, wound complications can be minimized. However, identification of the correct entry point (e.g. for balloon trocar insertion) can be challenging especially in adipose patients. We therefore present a technical modification facilitating the entire procedure. METHODS: A novel technique for endoscopic anterior component separation using a trocar system allowing blunt and sharp dissection under direct vision is described...
September 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28923630/use-of-nonvascularized-abdominal-rectus-fascia-after-liver-small-bowel-and-multiorgan-transplantation-long-term-follow-up-of-a-single-center-series
#2
P A Farinelli, J S Rubio, J M Padín, C Rumbo, H Solar, D Ramisch, G E Gondolesi
BACKGROUND: The abdominal wall may be severely compromised in the vast majority of intestinal and multiorgan transplant candidates, and sometimes as a consequence of complex liver transplantation. Multiple options have been described to overcome this problem, varying from component separation to the extreme need of performing an abdominal wall transplantation. The aim of the present paper is to report the largest and longest-term results of patients that received an abdominal rectus fascia (ARF) after liver, intestinal, or multiorgan transplantation at a single transplant center...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28917217/post-operative-c-reactive-protein-profile-following-abdominal-wall-reconstruction-with-transversus-abdominis-posterior-components-separation
#3
A Pearce, L Thornton, P A Sutton, C J Walsh
INTRODUCTION: Abdominal wall reconstruction using posterior component separation with transversus abdominis release (AWTAR) produces a unique post-operative CRP profile, when compared to routine elective colorectal operations. Therefore, we aim to establish the normal post-operative C-reactive protein (poCRP) profile following AWRTAR and reduce the unnecessary invasive interventions in patients already at greater risk of septic complications. METHODS: A retrospective analysis of daily poCRP levels was performed both for patients who underwent uncomplicated AWRTAR (n=12), and a comparator group of uncomplicated open right hemicolectomies (RH) matched for age and sex (n=24)...
August 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28917019/the-trend-toward-minimally-invasive-complex-abdominal-wall-reconstruction-is-it-worth-it
#4
Igor Belyansky, Adam S Weltz, Udai S Sibia, Justin J Turcotte, Haley Taylor, H Reza Zahiri, T Robert Turner, Adrian Park
BACKGROUND: Open abdominal wall reconstruction (AWR) was previously one of the only methods available to treat complex ventral hernias. We set out to identify the impact of laparoscopy and robotics on our AWR program by performing an economic analysis before and after the institution of minimally invasive AWR. METHODS: We retrospectively reviewed inpatient hospital costs and economic factors for a consecutive series of 104 AWR cases that utilized separation of components technique (57 open, 38 laparoscopic, 9 robotic)...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28811004/component-separation-technique-for-giant-incisional-hernia-a-systematic-review
#5
REVIEW
Bram Cornette, Dirk De Bacquer, Frederik Berrevoet
The component separation technique (CST) has gained popularity among general surgeons in the management of giant abdominal hernia. A systematic review of the MedLine and EMBASE databases was performed. 36 observational cohort studies were included for data-analysis and divided in 4 main groups: Open Anterior Approach (OAA), Transversus Abdominis Release (TAR), Laparoscopic Anterior Approach (LAA) and Perforator Preserving Approach (PPA). Surgical Site Occurrences (SSO) occurred in 21.4%, 23.7%, 20.3% and 16...
August 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28792430/component-separation-technique-for-repair-of-massive-abdominal-wall-defects-at-a-pediatric-hospital
#6
James D Vargo, Michael T Larsen, Gregory D Pearson
BACKGROUND: Massive defects of the abdominal wall are commonly repaired with the component separation technique (CST) when insufficient tissue exists to close the defect primarily. Although the utility of CST has been documented in cases of large ventral hernias in adults, its application to congenital and acquired defects in pediatric patients has been largely unreported. This study is a retrospective case series discussing the success of CST at a large pediatric hospital. METHODS: Seven patients with massive abdominal wall defects, including ventral hernia and omphalocele, repaired with CST at a pediatric hospital were identified as candidates...
November 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28777155/a-splenic-igg4-sclerosing-angiomatoid-nodular-transformation-sant-treated-by-hemisplenectomy-a-radiologic-histochemical-and-immunohistochemical-study
#7
Raffaele Gaeta, Francescamaria Donati, Emanuele F Kauffmann, Daniela Campani
INTRODUCTION: Sclerosing angiomatoid nodular transformation (SANT) is a rare benign lesion of unknown origin for which total splenectomy is the standard treatment. CASE PRESENTATION: A 54-year-old man with a history of recurrent pancreatitis, bicuspid aortic valve, and aortic dissection underwent abdominal ultrasound, Computed tomography and magnetic resonance imaging, which revealed a 6-cm hypoechoic splenic mass diagnosed as cavernous hemangioma. Owing to his relevant past history, he was considered eligible for emisplenectomy and not for total excision, which is associated with long-term risks, especially infections...
August 2, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/28740773/botulinum-toxin-a-as-an-adjunct-to-abdominal-wall-reconstruction-for-incisional-hernia
#8
Sinor Soltanizadeh, Frederik Helgstrand, Lars N Jorgensen
BACKGROUND: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current literature on the administration of BTA as adjunct to surgical repair of abdominal incisional hernias was investigated. METHODS: The electronic databases PubMed and Embase were searched for eligible studies...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28738237/a-case-report-of-unexpected-pathology-within-an-incarcerated-ventral-hernia
#9
Erica D Kane, Katharine R Bittner, Michelle Bennett, John R Romanelli, Neal E Seymour, Jacqueline J Wu
INTRODUCTION: Incidence of hernial appendicitis is 0.008%, most frequently within inguinal and femoral hernias. Up to 2.5% of appendectomy patients are found to have Crohn's disease. Elucidating the etiology of inflammation is essential for directing management. PRESENTATION OF CASE: A 51-year-old female with achondroplastic dwarfism, multiple cesarean sections, and subsequent massive incisional hernia, presented with ruptured appendicitis within her incarcerated hernia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28705101/abdominal-wall-expanding-system-obviates-the-need-for-lateral-release-in-giant-incisional-hernia-and-laparostoma
#10
Dietmar Eucker, Andreas Zerz, Daniel C Steinemann
BACKGROUND: In large incisional hernias and after laparostoma midline closure may be impossible. A novel abdominal wall expander system (AWEX) is proposed and evaluated. METHODS: In patients with large incisional hernias and laparostoma where primary midline closure was impossible, AWEX was used. Patients undergoing abdominal wall reconstruction using AWEX between May 2012 and December 2015 were included. Intraoperative the abdominal wall was stretched by attaching the midline fascia borders to a retraction system under tension for 30 minutes...
October 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28689863/long-term-results-of-open-complex-abdominal-wall-hernia-repair-with-self-gripping-mesh-a-retrospective-cohort-study
#11
Leonard F Kroese, Lien H A van Eeghem, Joost Verhelst, Johannes Jeekel, Gert-Jan Kleinrensink, Johan F Lange
BACKGROUND: In case of complex ventral hernias, Rives-Stoppa and component separation technique are considered as favourable treatment techniques. However, mesh-related complications like recurrence, infection and chronic pain are still a common problem after mesh repair. Previous studies have reported promising results of the use of a self-gripping mesh (ProGrip™) in incisional hernia repair. This study aimed to evaluate the long term results of this mesh for complex ventral hernia treatment...
July 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28658342/robotic-transversus-abdominis-release-tar-is-it-possible-to-offer-minimally-invasive-surgery-for-abdominal-wall-complex-defects
#12
Maria Vitória França DO Amaral, José Ricardo Guimarães, Paula Volpe, Flávio Malcher Martins DE Oliveira, Carlos Eduardo Domene, Sérgio Roll, Leandro Totti Cavazzola
We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28647212/combined-primary-hepatic-neuroendocrine-carcinoma-and-hepatocellular-carcinoma-with-aggressive-biological-behavior-adverse-clinical-course-a-case-report
#13
Yukihiko Okumura, Kenichi Kohashi, Huanlin Wang, Masaki Kato, Yoshihiko Maehara, Yoshihiro Ogawa, Yoshinao Oda
Combined primary hepatic neuroendocrine carcinoma (PHNEC) and hepatocellular carcinoma (HCC) is a very rare malignant hepatic tumor. Its prognosis and histological features are uncertain. Here we report the case of such a tumor in a 70-year-old male Japanese patient with adverse prognosis. The patient underwent a right hepatic lobectomy for a tumor mass that measured 11×10cm in diameter located in the right lobe of the liver, treated with transcatheter arterial chemoembolization (TACE) and percutaneous transhepatic portal vein embolization (PTPE) therapy five weeks before the operation...
June 10, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28595856/component-separation-in-the-management-of-abdominal-wall-defect-after-laparostomy-clinical-and-anatomical-videos-with-video
#14
T Guilbaud, S Berdah, T Bege
No abstract text is available yet for this article.
June 5, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28541865/multipoint-suture-fixation-technique-for-abdominal-wall-reconstruction-with-component-separation-and-onlay-biological-mesh-placement
#15
Brad Denney, Jorge I de la Torre
Component separation with mesh reinforcement has become the primary modality for complex abdominal wall reconstruction. However, many fundamental questions remain unanswered, such as whether underlay versus overlay mesh placement is superior, and what is the best means of suture fixation technique for mesh placement? This study presents the senior author's technique for onlay biologic mesh placement with multipoint suture fixation in combination with component separation and its subsequent low recurrence rates...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28502552/bifurcated-bifurcated-aneurysm-repair-is-a-novel-technique-to-repair-infrarenal-aortic-aneurysms-in-the-setting-of-iliac-aneurysms
#16
Susanna Hewon Shin, Benjamin Ware Starnes
BACKGROUND: Up to 40% of abdominal aortic aneurysms (AAAs) have coexistent iliac artery aneurysms (IAAs). In the past, successful endovascular repair required internal iliac artery (IIA) embolization, which can lead to pelvic or buttock ischemia. This study describes a technique that uses a readily available solution with a minimally altered off-the-shelf bifurcated graft in the IAA to maintain IIA perfusion. METHODS: From August 2009 to May 2015, 14 patients with AAAs and coexisting IAAs underwent repair with a bifurcated-bifurcated approach...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501135/impact-of-hernia-volume-on-pulmonary-complications-following-complex-hernia-repair
#17
Elwin H H Mommers, Johannes A Wegdam, Sander van der Wolk, Simon W Nienhuijs, Tammo S de Vries Reilingh
BACKGROUND: Despite a multitude of evidence-based prediction models and risk factors for postoperative complications after ventral hernia repair, estimating a patient's risk of postoperative complications after ventral hernia repair remains challenging. In an attempt to improve the preoperative assessment of complex hernia patients, some studies have examined pulmonary changes after hernia repair hypothesizing that large hernias lead to pulmonary changes and increased pulmonary complication rates...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28489476/benefits-of-thoracic-epidural-analgesia-in-patients-undergoing-an-open-posterior-component-separation-for-abdominal-herniorrhaphy
#18
Daryl S Henshaw, Christopher J Edwards, Austin R Sellers, Gregory B Russell, Robert S Weller
An open posterior component separation (PCS) is a commonly utilized surgical approach for repair of complex abdominal wall defects and hernias. Although this approach may improve surgical outcomes, significant postoperative pain can be expected given the required laparotomy and extensive abdominal wall manipulation. Both systemic opioids and thoracic epidural analgesia (TEA) are viable postoperative analgesic options, and both are commonly utilized. Although the benefits of TEA have been investigated following a variety of surgeries, there is a paucity of literature related to its efficacy for this particular surgery...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28488072/modified-components-separation-technique-experience-treating-large-complex-ventral-hernias-at-a-university-hospital
#19
A Torregrosa-Gallud, J Sancho Muriel, J Bueno-Lledó, P García Pastor, J Iserte-Hernandez, S Bonafé-Diana, O Carreño-Sáenz, F Carbonell-Tatay
BACKGROUND: An increasing number of patients have large or complex abdominal wall defects. Component separation technique (CST) is a very effective method for reconstructing complex midline abdominal wall defects in a manner that restores innervated muscle function without excessive tension. Our goal is to show our results by a modified CST for treating large ventral hernias. MATERIALS AND METHODS: A total of 351 patients with complex ventral hernias have been treated over a 10-year period...
August 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28367363/a-functional-approach-to-the-body-condition-assessment-of-lactating-donkeys-as-a-tool-for-welfare-evaluation
#20
Emanuela Valle, Federica Raspa, Marzia Giribaldi, Raffaella Barbero, Stefania Bergagna, Sara Antoniazzi, Amy K Mc Lean, Michela Minero, Laura Cavallarin
BACKGROUND: The breeding of lactating donkeys is increasing in Western Europe; with it the evaluation of body condition is growing in importance since it is considered a key principle for their welfare. However, assessment of body condition is a complex task, since several factors are involved. The aim of the present study is to investigate which animal-based indicators are the most reliable to describe the body condition of lactating donkeys. For this purpose, new animal-based indicators, which are easy to measure in field conditions (including body measurements, fatty neck score (FNS), dental score), are recorded and their relationship with BCS (a proxy measure for overall adiposity) was assessed...
2017: PeerJ
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