165 results on '"Hernia, Abdominal pathology"'
Search Results
52. [MORPHOMETRIC AND HISTOLOGICAL CHANGES OF TISSUES IN PATIENTS, WHO UNDERWENT OPERATIONS FOR POSTOPERATIVE ABDOMINAL HERNIAS].
- Author
-
Brek OO
- Subjects
- Abdominal Cavity surgery, Adult, Aged, Female, Hernia, Abdominal etiology, Hernia, Abdominal rehabilitation, Histocytochemistry, Humans, Male, Middle Aged, Treatment Outcome, Abdominal Cavity pathology, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Herniorrhaphy methods, Postoperative Complications, Surgical Flaps transplantation
- Abstract
The impact of hernioplasty on postoperative morphometric and histological changes in tissues of patients, suffering postoperative abdominal hernias (POAH), was studied. For POAH 135 patients were operated, in 85 of them (the main group)--combined methods of hernial gate plasty in accordance to procedures proposed, and in 50 (control group)--classical methods of hernial gate were applied. The most favorable course of the wound process of the inflammatory, changes reduction and stabilization of the tissues reaction on implant already on the 7th postoperative day was noted after application of a sub lay method in original modification.
- Published
- 2015
53. A spontaneous transomental hernia through the greater omentum.
- Author
-
Tidjane A, Tabeti B, Boudjenan Serradj N, Djellouli A, and Benmaarouf N
- Subjects
- Aged, Hernia, Abdominal diagnosis, Hernia, Abdominal surgery, Humans, Male, Hernia, Abdominal pathology, Herniorrhaphy methods, Omentum pathology
- Abstract
Transomental hernia is the rarest form of internal hernias. Clinical expression of this pathology is ambiguous and diagnosis is often made at complication phase, after irreversible strangulation of the herniated loop. Radiological diagnosis is still difficult and intraoperative exploration usually allows discovering this pathology when patient is operated for acute intestinal obstruction. Treatment is surgical and aims to treat intestinal obstruction and prevent recurrence. We describe the case of a 65 years old male operated for a preoperatively suspected internal hernia; surgical exploration found a transomental hernia trough the greater omentum.
- Published
- 2015
- Full Text
- View/download PDF
54. [A rare variant of enterocele entrapment in the abdominal cavity of a woman].
- Author
-
Vinnik YS, Prusov IA, Serova EV, Shirokobokov AO, Berdnikov SI, Struzik AS, and Loginovsky AS
- Subjects
- Abdominal Cavity surgery, Adult, Female, Hernia, Abdominal surgery, Humans, Intestine, Small surgery, Ovarian Cysts surgery, Abdominal Cavity pathology, Hernia, Abdominal pathology, Intestine, Small pathology, Ovarian Cysts pathology
- Abstract
Abdominal enterocele is a result of entering abdominal organs into peritoneal pockets and folds through the holes in mesenterium or into the adjoining cavities through defects in their walls. Enteroceles are localized at the sites where one segment of the gastrointestinal tract passes into another, in a pocket behind the cecum and sigmoid, between mesenteric layers of small intestine and colon, in the holes of mesenterium of vermiform appendage, gastrocolic and falciform ligaments, pockets and holes of broad ligament of the uterine, omental foramen, rectouterine excavation, and diaphragmal defects. We observed a 26 year old woman with enterocele entrapment in the abdominal cavity complicated by necrosis of part of the small intestine.
- Published
- 2015
55. Handlebar hernia: case report and literature review.
- Author
-
Angel Buitrago L and Lugo-Vicente H
- Subjects
- Abdominal Injuries diagnosis, Abdominal Injuries etiology, Abdominal Wall pathology, Adolescent, Hernia, Abdominal diagnosis, Hernia, Abdominal pathology, Humans, Male, Wounds, Nonpenetrating diagnosis, Wounds, Nonpenetrating etiology, Abdominal Injuries complications, Bicycling injuries, Hernia, Abdominal etiology, Wounds, Nonpenetrating pathology
- Abstract
Handlebar hernia is a rare traumatic abdominal wall hernia occurring after blunt trauma. We report a case of an adolescent patient with a traumatic rectus muscle abdominal wall hernia produced by injury with the bicycle handlebar. The skin abrasion caused by the trauma and a swelling reproduced after a Valsalva maneuver suggested the diagnosis. Traumatic wall hernias after blunt trauma should be repaired primarily to avoid complications.
- Published
- 2015
56. Left hepatic lobe herniation through an incisional anterior abdominal wall hernia.
- Author
-
Gayathri Devi HJ and Naik D
- Subjects
- Aged, Female, Hernia, Abdominal etiology, Humans, Incisional Hernia complications, Tomography, X-Ray Computed, Hernia, Abdominal pathology, Incisional Hernia pathology, Liver pathology
- Published
- 2015
- Full Text
- View/download PDF
57. [AN EXPERIMENTAL STUDY OF THE HISTOLOGICAL FIBRO GENESIS ABILITIES IN THE AREA OF IMPLANTATION OF ALOTRANSPLANTATES APPLYING INTRAABDOMINAL AND PREPERITONEAL PLASTIC SURGERY].
- Author
-
Ioffe Y, Shvets I, Tarasiuk T, Furmanov A, Stetsenko A, and Tsura Y
- Subjects
- Abdominal Cavity blood supply, Abdominal Cavity surgery, Abdominoplasty instrumentation, Animals, Disease Models, Animal, Female, Hernia, Abdominal pathology, Herniorrhaphy instrumentation, Humans, Inflammation pathology, Male, Neovascularization, Physiologic, Rabbits, Severity of Illness Index, Surgical Mesh, Vascularized Composite Allotransplantation instrumentation, Abdominoplasty methods, Hernia, Abdominal surgery, Herniorrhaphy methods, Postoperative Complications, Tissue Adhesions pathology, Vascularized Composite Allotransplantation methods
- Abstract
The histological fibro genesis abilities in the area of implantation of allotransplantates applying intraabdominal and preperitoneal plastic surgery were examined during experimental research. The experiment involved 12 Russian chinchilla rabbits. The animals were spitted into two groups: I group--operated using IPOM methodology (intraperitonealonlaymesh, n = 6) with the installation "Proceed" mesh made by "Ethicon", group II--modeling preperitoneal plastics with the installation of "Ethicon's Ultrapro" mesh (n = 6). After removing the animals from the experiment, the implants with adhering musculo-aponeurotic tissue layer were excised and sent for histological examination. At the same time the severity of the inflammatory process were rated, the composition of the inflammatory infiltrate, germination of the connective tissue through the pores of the prosthesis and neovascularization. Analyzing the research data of histological connective abilities complexes formed in the area of the allotransplants implantation using intra-abdominal and pre-peritoneal plastic during the experiment, we can conclude that intra-abdominal installation of mesh prostheses reduces the severity of inflammatory changes surrounding tissues and reduces the probability of seroma formation in comparison with the placement of the pre-peritoneal implant.
- Published
- 2014
58. Dermatan sulfate epimerase 1 deficient mice as a model for human abdominal wall defects.
- Author
-
Gustafsson R, Stachtea X, Maccarana M, Grottling E, Eklund E, Malmström A, and Oldberg A
- Subjects
- Animals, Carbohydrate Epimerases deficiency, Dermatan Sulfate metabolism, Dermis pathology, Disease Models, Animal, Embryo, Mammalian, Gene Expression, Hernia, Abdominal complications, Hernia, Abdominal pathology, Humans, Keratin-1 genetics, Keratin-1 metabolism, Keratin-15 genetics, Keratin-15 metabolism, Keratinocytes pathology, Mice, Mice, Knockout, Neural Tube Defects complications, Neural Tube Defects genetics, Neural Tube Defects pathology, Spinal Dysraphism complications, Spinal Dysraphism genetics, Spinal Dysraphism pathology, Abdominal Wall abnormalities, Carbohydrate Epimerases genetics, Dermis metabolism, Hernia, Abdominal genetics, Keratinocytes metabolism
- Abstract
Background: Dermatan sulfate (DS) is a highly sulfated polysaccharide with a variety of biological functions in extracellular matrix organization and processes such as tumorigenesis and wound healing. A distinct feature of DS is the presence of iduronic acid, produced by the two enzymes, DS-epimerase 1 and 2, which are encoded by Dse and Dsel, respectively., Methods: We have previously shown that Dse knockout (KO) mice in a mixed C57BL/6-129/SvJ background have an altered collagen matrix structure in skin. In the current work we studied Dse KO mice in a pure NFR genetic background., Results: Dse KO embryos and newborns had kinked tails and histological staining revealed significantly thicker epidermal layers in Dse KO mice when compared with heterozygote (Het) or wild-type (WT) littermates. Immunochemical analysis of the epidermal layers in newborn pups showed increased expression of keratin 5 in the basal layer and keratin 1 in the spinous layer. In addition, we observed an abdominal wall defect with herniated intestines in 16% of the Dse KO embryos. Other, less frequent, developmental defects were exencephaly and spina bifida., Conclusion: We conclude that the combination of defective collagen structure in the dermis and imbalanced keratinocyte maturation could be responsible for the observed developmental defects in Dse KO mice. In addition, we propose that Dse KO mice could be used as a model in pathogenetic studies of human fetal abdominal wall defects., (© 2014 Wiley Periodicals, Inc.)
- Published
- 2014
- Full Text
- View/download PDF
59. Surgery for incarcerated hernia: short-term outcome with or without mesh.
- Author
-
Venara A, Hubner M, Le Naoures P, Hamel JF, Hamy A, and Demartines N
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Emergencies, Female, Follow-Up Studies, Hernia, Abdominal mortality, Hernia, Femoral pathology, Hernia, Femoral surgery, Hernia, Inguinal pathology, Hernia, Inguinal surgery, Hernia, Umbilical pathology, Hernia, Umbilical surgery, Herniorrhaphy adverse effects, Hospital Mortality, Humans, Male, Middle Aged, Postoperative Complications surgery, Recurrence, Retrospective Studies, Risk Assessment, Severity of Illness Index, Surgical Wound Infection mortality, Surgical Wound Infection pathology, Survival Rate, Treatment Outcome, Young Adult, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Herniorrhaphy instrumentation, Herniorrhaphy methods, Surgical Mesh, Surgical Wound Infection surgery
- Abstract
Background: Incarcerated hernias represent about 5-15 % of all operated hernias. Tension-free mesh is the preferred technique for elective surgery due to low recurrence rates. There is however currently no consensus on the use of mesh for the treatment of incarcerated hernias, especially in case of bowel resection., Aim: The aims of this study were (i) to report our current practice for the treatment of incarcerated hernias, (ii) to identify risk factors for postoperative complications, and (iii) to assess the safety of mesh placement in potentially infected surgical fields., Methods: This retrospective study included 166 consecutive patients who underwent emergency surgery for incarcerated hernia between January 2007 and January 2012 in two university hospitals. Demographics, surgical details, and short-term outcome were collected. Univariate analysis was employed to identify risk factors for overall, infectious, and major complications., Results: Eighty-four patients (50.6 %) presented inguinal hernias, 43 femoral (25.9 %), 37 umbilical hernias (22.3 %), and 2 mixed hernias (1.2 %), respectively. Mesh was placed in 64 patients (38.5 %), including 5 patients with concomitant bowel resection. Overall morbidity occurred in 56 patients (32.7 %), and 8 patients (4.8 %) developed surgical site infections (SSI). Univariate risk factors for overall complications were ASA grade 3/4 (P = 0.03), diabetes (P = 0.05), cardiopathy (P = 0.001), aspirin use (P = 0.023), and bowel resection (P = 0.001) which was also the only identified risk factor for SSI (P = 0.03). In multivariate analysis, only bowel incarceration was associated with a higher rate of major morbidity (OR = 14.04; P = 0.01)., Conclusion: Morbidity after surgery for incarcerated hernia remains high and depends on comorbidities and surgical presentation. The use of mesh could become current practice even in case of bowel resection.
- Published
- 2014
- Full Text
- View/download PDF
60. [The operation of giant incisional hernia].
- Author
-
Eriksson A, Krag C, Jørgensen LN, and Rosenberg J
- Subjects
- Hernia, Abdominal pathology, Humans, Surgical Mesh, Hernia, Abdominal surgery, Surgical Procedures, Operative methods
- Abstract
Incisional hernia is a common complication to laparotomy impacting negatively on quality of life, risk of emergency surgery and cosmesis. The operation of giant incisional hernia (cross diameter of hernia defect > 20 cm) is a high risk procedure and the surgical techniques are not based on high level evidence. Mesh placement is possible onlay, inlay, sublay or intraperitoneal. These operations are most often performed as open procedures, or in combination with endoscopic techniques. These procedures should be centralized to few centers to improve quality and allow robust research.
- Published
- 2014
61. [The nature of postoperative complications in patients with peritonitis].
- Author
-
Churpiĭ IK
- Subjects
- Appendicitis mortality, Appendicitis pathology, Appendicitis surgery, Cholecystitis, Acute mortality, Cholecystitis, Acute pathology, Cholecystitis, Acute surgery, Female, Hernia, Abdominal mortality, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Male, Peritonitis mortality, Peritonitis pathology, Peritonitis surgery, Postoperative Care, Postoperative Period, Risk Factors, Salpingitis mortality, Salpingitis pathology, Salpingitis surgery, Stroke mortality, Stroke pathology, Stroke surgery, Survival Analysis, Appendicitis etiology, Cholecystitis, Acute etiology, Hernia, Abdominal etiology, Peritonitis complications, Postoperative Complications, Salpingitis etiology, Stroke etiology
- Abstract
We studied the postoperative period in patients with peritonitis. The structure of the most important factors that slow down the healing process and lead to mortality. Among the factors that affect the healing process is the most important character of fluid, and the prevalence of peritonitis (causative factor), which causes complications on the part of the internal organs and wounds.
- Published
- 2014
62. Criteria for definition of a complex abdominal wall hernia.
- Author
-
Slater NJ, Montgomery A, Berrevoet F, Carbonell AM, Chang A, Franklin M, Kercher KW, Lammers BJ, Parra-Davilla E, Roll S, Towfigh S, van Geffen E, Conze J, and van Goor H
- Subjects
- Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Patient Care Planning, Recurrence, Risk Factors, Severity of Illness Index, Surgical Mesh, Terminology as Topic, Hernia, Abdominal classification
- Abstract
Purpose: A clear definition of "complex (abdominal wall) hernia" is missing, though the term is often used. Practically all "complex hernia" literature is retrospective and lacks proper description of the population. There is need for clarification and classification to improve patient care and allow comparison of different surgical approaches. The aim of this study was to reach consensus on criteria used to define a patient with "complex" hernia., Methods: Three consensus meetings were convened by surgeons with expertise in complex abdominal wall hernias, aimed at laying down criteria that can be used to define "complex hernia" patients, and to divide patients in severity classes. To aid discussion, literature review was performed to identify hernia classification systems, and to find evidence for patient and hernia variables that influence treatment and/or prognosis., Results: Consensus was reached on 22 patient and hernia variables for "complex" hernia criteria inclusion which were grouped under four categories: "Size and location", "Contamination/soft tissue condition", "Patient history/risk factors", and "Clinical scenario". These variables were further divided in three patient severity classes ('Minor', 'Moderate', and 'Major') to provide guidance for peri-operative planning and measures, the risk of a complicated post-operative course, and the extent of financial costs associated with treatment of these hernia patients., Conclusion: Common criteria that can be used in defining and describing "complex" (abdominal wall) hernia patients have been identified and divided under four categories and three severity classes. Next step would be to create and validate treatment algorithms to guide the choice of surgical technique including mesh type for the various complex hernias.
- Published
- 2014
- Full Text
- View/download PDF
63. The combined application of human acellular dermal matrix and vacuum wound drainage on incarcerated abdominal wall hernias.
- Author
-
Han JG, Pang GY, Wang ZJ, Zhao Q, and Ma SZ
- Subjects
- Aged, Drainage adverse effects, Female, Hernia, Abdominal pathology, Humans, Male, Middle Aged, Postoperative Complications, Recurrence, Retrospective Studies, Skin Transplantation adverse effects, Suction adverse effects, Abdominal Wall surgery, Acellular Dermis, Drainage methods, Hernia, Abdominal surgery, Skin Transplantation methods, Suction methods
- Abstract
Purpose: Complex contaminated or infected abdominal wall defects present a particularly challenging problem to the surgeon. The aim of this study was to describe our experience with human acellular dermal matrix (ADM) in incarcerated abdominal wall herniorrhaphy., Methods: We retrospectively reviewed data from 63 patients (51 males and 12 females) who underwent emergency surgery for acute incarcerated abdominal wall hernias with ADM repair, between June 2008 and October 2011 at Beijing Chaoyang Hospital, Capital Medical University., Results: All hernias were repaired with an intraperitoneal underlay repair and received a high-vacuum wound drainage system after herniorrhaphy. 19 patients underwent reinforced repair with component separation. Over a median follow-up period of 32 (range 13-58) months, the recurrence rate was 4.8%. Two patients developed bulges, one developed a hematoma, one developed a seroma, and one had a superficial wound infection. No patients developed fistulae, intestinal obstruction, abdominal pain, or stiffness of the abdominal wall postoperatively., Conclusion: Our study suggests that the use of ADM as a biological mesh combined with high-vacuum wound drainage system in complex abdominal wall reconstruction is acceptable without major side effects., (Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
64. Hernia sacs: is histological examination necessary?
- Author
-
Wang T and Vajpeyi R
- Subjects
- Abdominal Neoplasms pathology, Aged, Aged, 80 and over, Appendicitis pathology, Endometriosis pathology, Female, Hernia, Abdominal complications, Hernia, Abdominal surgery, Hernia, Femoral complications, Hernia, Femoral pathology, Hernia, Femoral surgery, Hernia, Inguinal complications, Hernia, Inguinal pathology, Hernia, Inguinal surgery, Herniorrhaphy, Humans, Lipoma pathology, Male, Middle Aged, Omentum pathology, Perivascular Epithelioid Cell Neoplasms pathology, Pseudomyxoma Peritonei pathology, Retrospective Studies, Hernia, Abdominal pathology
- Abstract
The hernia sac is a common surgical pathology specimen which can occasionally yield unexpected diagnoses. The College of American Pathologists recommends microscopic examination of abdominal hernias, but leaves submission of inguinal hernias for histology to the discretion of the pathologist. To validate this approach at a tertiary care centre, we retrospectively reviewed 1426 hernia sacs derived from inguinal, femoral and abdominal wall hernias. The majority of pathologies noted were known to the clinician, including herniated bowel, lipomas and omentum. A malignancy was noted in three of 800 inguinal hernias and seven of 576 abdominal wall hernias; five of these lesions were not seen on gross examination. Other interesting findings in hernia sacs included appendices, endometriosis, a perivascular epithelioid cell tumour, and pseudomyxoma peritoneii. All hernia sacs should be examined grossly as most pathologies are grossly visible. The decision to submit inguinal hernias for histology may be left to the discretion of the pathologist, but abdominal and femoral hernias should be submitted for histology.
- Published
- 2013
- Full Text
- View/download PDF
65. Laparoscopic repair of internal hernia following laparoscopic anterior resection.
- Author
-
Ansari N, Keshava A, Rickard MJ, and Richardson GL
- Subjects
- Female, Hernia, Abdominal diagnostic imaging, Hernia, Abdominal pathology, Humans, Intestinal Obstruction etiology, Intestinal Obstruction surgery, Male, Middle Aged, Postoperative Complications etiology, Tomography, X-Ray Computed, Hernia, Abdominal etiology, Hernia, Abdominal surgery, Herniorrhaphy, Laparoscopy adverse effects
- Published
- 2013
- Full Text
- View/download PDF
66. [Reconstruction of complex abdominal wall defects using the component separation technique].
- Author
-
Kulhánek J and Mestak O
- Subjects
- Abdominal Wall pathology, Digestive System Surgical Procedures adverse effects, Hernia, Abdominal pathology, Humans, Plastic Surgery Procedures adverse effects, Treatment Outcome, Abdominal Wall surgery, Digestive System Surgical Procedures methods, Hernia, Abdominal surgery, Plastic Surgery Procedures methods
- Abstract
Introduction: Reconstruction of complex abdominal wall defects is among the most demanding procedures in reconstructive surgery. Introduction of the method of component separation represents the most significant advance in the care of these patients. We present our experience with the component separation technique on a series of 44 patients., Materials and Methods: We retrospectively reviewed patients operated on between 2009 and 2012. The inclusion criterion was the use of the component separation technique in the treatment of abdominal wall defect. The scoring criteria were recurrent hernia, wound hematoma, wound infection, skin necrosis and secondary healing., Results: We operated on 44 patients in the above period. The etiology of the defects was most frequently hernia in the scar after midline laparotomy (n = 29; 66%) and after incision across the epigastrium for total gastrectomy (n = 3; 7%). The other defects (n = 12; 27%) were caused by a wide diastasis of the abdominal rectus muscles (width 8-10 cm). The most common complication was a hematoma in the lateral part of the wound which occurred in 7 patients (16%). We did not detect any hernia recurrence in the original abdominal wall defects., Conclusion: The method of components separation allows us to stitch the edges of the full-thickness abdominal wall to each other, even in cases of large hernias. The introduction of this technique into practice has reduced the risk of recurrence of large hernias without a significant increase in postoperative complications.
- Published
- 2013
67. Herniation of duodenum into the right ventral hepatic peritoneal cavity with groove formation at the ventral hepatic surface in a 2-week-old chicken.
- Author
-
Haridy M, Sasaki J, and Goryo M
- Subjects
- Animals, Female, Hernia, Abdominal pathology, Histocytochemistry veterinary, Specific Pathogen-Free Organisms, Chickens, Duodenum pathology, Hernia, Abdominal veterinary, Peritoneal Cavity pathology
- Abstract
Internal hernia in avian species is very rare. A necropsy of a 2-week-old SPF White Leghorn chicken revealed that a loop of the duodenum and part of the pancreas (4 × 2 × 1 cm) was protruding through the abnormal foramen (2.5 cm in diameter) in the right posthepatic septum into the right ventral hepatic peritoneal cavity. The herniated loop was located underneath the ventral hepatic surface, leaving a groove on the right hepatic lobe (2 × 1.5 × 0.4 cm). The part of the pancreas involved in the hernia was grossly enlarged. Microscopically, a zone of pressure atrophy of hepatic tissue was characterized by crowdedness of hepatocytes with pyknotic nuclei and faint eosinophilic cytoplasm and indistinct narrow sinusoids. The pancreas revealed hypertrophy of the acinar cells with an increase in the secretory granules and basophilic cytoplasm. This is the first report of duodenum herniation into the right ventral hepatic peritoneal cavity resulting in groove formation on the ventral hepatic surface in a 2-week-old chicken.
- Published
- 2013
- Full Text
- View/download PDF
68. Single-port endo-laparoscopic surgery in combined abdominal procedures.
- Author
-
Kim G, Lomanto D, Lawenko MM, Lopez-Gutierrez J, Lee-Ong A, Iyer SG, Cheah WK, So JB, Tsang CB, and Fong YF
- Subjects
- Adrenal Gland Diseases complications, Adrenal Gland Diseases pathology, Adrenal Gland Diseases surgery, Aged, Feasibility Studies, Female, Gallbladder Diseases complications, Gallbladder Diseases pathology, Gallbladder Diseases surgery, Gastrointestinal Neoplasms complications, Gastrointestinal Neoplasms pathology, Hernia, Abdominal complications, Hernia, Abdominal pathology, Humans, Male, Middle Aged, Ovarian Cysts complications, Ovarian Cysts pathology, Ovarian Cysts surgery, Treatment Outcome, Adrenalectomy, Digestive System Surgical Procedures, Gastrointestinal Neoplasms surgery, Hernia, Abdominal surgery, Laparoscopy, Ovariectomy
- Abstract
Single-port endo-laparoscopic surgery has gained support in the surgical community because it is perceived to offer a better postoperative outcome as it requires only a single incision. We write this prospective observational study to ascertain the feasibility and safety of this technique in patients otherwise requiring two operations. Five patients who underwent double procedures with a single-port device were reviewed: Case 1, a transabdominal preperitoneal hernia repair and gastric wedge resection; Case 2, cholecystectomy and diaphragmatic hernia repair; Case 3, oophorectomy and incisional hernia repair; Case 4, anterior resection of the rectum and hepatic segmentectomy; and Case 5, left adrenalectomy and cholecystectomy. Patient demographics, type of port used, operative time, complications and incision length were collected. Mean operative time for the cases ranged from 100 to 315 min. Incision length for the single-port device was 2 cm. In Case 2, an additional 5-mm port was used and an intraoperative complication involving a laceration of the liver occurred during the suturing of the gallbladder fundus. An additional 8-cm lower abdominal incision (Pfannenstiel) was required in Case 4 to complete the colonic anastomosis and for specimen retrieval. Single-port endo-laparoscopic surgery is a feasible and safe technique for approaching double procedures. It drastically reduces the number of scars that a double procedure creates, and if difficulty arises, another port can always be added to ease the operation. It can also potentially reduce the number of admissions and anesthesia that a patient undergoes., (© 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.)
- Published
- 2013
- Full Text
- View/download PDF
69. Sonographic diagnosis of incarcerated Spigelian hernia during pregnancy.
- Author
-
Udare AS, Bhalekar PS, and Mondel PK
- Subjects
- Adult, Female, Hernia, Abdominal diagnostic imaging, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Intestine, Small pathology, Intestine, Small surgery, Laparotomy, Pregnancy, Ultrasonography, Doppler, Hernia, Abdominal diagnosis, Pregnancy Complications
- Published
- 2013
- Full Text
- View/download PDF
70. Use of vacuum-assisted closure in open incisional hernia repair: a novel approach to prevent seroma formation.
- Author
-
López-Cano M and Armengol-Carrasco M
- Subjects
- Aged, Female, Hernia, Abdominal pathology, Herniorrhaphy adverse effects, Humans, Male, Middle Aged, Seroma etiology, Abdominal Wound Closure Techniques, Hernia, Abdominal surgery, Negative-Pressure Wound Therapy, Seroma prevention & control
- Abstract
Introduction: Frequent complications in incisional hernia surgery are re-herniation, wound infection and seroma formation. The use of subatmospheric pressure dressings such as the vacuum-assisted closure (VAC) device has been shown to be an effective way to accelerate healing of various wounds. Here, we describe the application of the VAC device as a postoperative dressing to prevent seroma formation after open incisional hernia repair., Methods: Three consecutive patients (63, 65 and 60 years of age, respectively) underwent incisional hernia repair. Patient body mass index was 30.9, 26.6 and 29 kg/m(2), respectively. All hernias were complex with a defect size greater than 10 cm and were repaired using the onlay technique. After suture skin closure the incision was covered with a thin VAC sponge (KCI, San Antonio, TX) that was set at -125 mm Hg and left in place for 5 days before removal., Results: An abdominal CT scan performed before discharge from the hospital did not show seroma formation. Physical examination 3 months after surgery was normal with no evidence of seroma (abdominal bulge and/or fluid wave)., Conclusions: This successful preliminary experience in three patients encourages the use of the VAC system in incisional hernia repair, particularly in selected patients with risk factors for seroma formation (e.g., large defects, obesity, patient comorbidities, nutritional status, number of prior abdominal incisions, etc.). Therefore, prevention of seroma formation after incisional hernia repair may be added as a novel application of the VAC device.
- Published
- 2013
- Full Text
- View/download PDF
71. Mechanical response of animal abdominal walls in vitro: evaluation of the influence of a hernia defect and a repair with a mesh implanted intraperitoneally.
- Author
-
Podwojewski F, Otténio M, Beillas P, Guérin G, Turquier F, and Mitton D
- Subjects
- Animals, Swine, Abdominal Wall pathology, Abdominal Wall physiopathology, Abdominal Wall surgery, Hernia, Abdominal pathology, Hernia, Abdominal physiopathology, Hernia, Abdominal surgery, Herniorrhaphy, Models, Biological, Surgical Mesh
- Abstract
Better mechanical knowledge of the abdominal wall is requested to further develop and validate numerical models. The aim of this study was to characterize the passive behaviour of the abdominal wall under three configurations: intact, after creating a defect simulating an incisional hernia, and after a repair with a mesh implanted intraperitonally. For each configuration, controlled boundary conditions were applied (air pressure and then contact loading) to the abdominal wall. 3D local strain fields were determined by digital image correlation. Local strains measured on the internal and external surfaces of the intact abdominal wall showed different patterns. The air pressure and the force applied to the abdominal wall during contact loading were measured and used to determine stiffness. The presence of a defect resulted in a significant decrease of the global stiffness compared to the intact abdominal wall (about 25%). In addition, the presence of the mesh enabled to restore the stiffness to values that were not significantly different from those of the intact wall. These results suggest that intraperitoneal mesh seems to restore the global biomechanics of the abdomen., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
72. Components separation technique utilizing an intraperitoneal biologic and an onlay lightweight polypropylene mesh: "a sandwich technique".
- Author
-
Morris LM and LeBlanc KA
- Subjects
- Aged, Blood Loss, Surgical, Female, Hernia, Abdominal pathology, Humans, Male, Middle Aged, Operative Time, Recurrence, Bioprosthesis, Hernia, Abdominal surgery, Herniorrhaphy methods, Polypropylenes therapeutic use, Surgical Mesh
- Abstract
Purpose: Reconstruction of large, complex abdominal wall hernias is an ongoing challenge. Primary closure of such hernias is often not possible. The components separation technique (CST) is a practical option, however, recurrence rates remain unacceptably high. In an attempt to reduce recurrences, we added a biologic underlay mesh and a lightweight polypropylene onlay mesh to the traditional CST., Methods: Patients with a large hernia defect with or without multiple recurrences were selected to undergo a CST augmented with an acellular porcine dermal collagen mesh underlay. Following midline abdominal closure, a lightweight, large-pore polypropylene onlay mesh was fixed to the abdominal fascia. The skin and subcutaneous layers were closed over two sump drains and two closed suction drains., Results: Fifty-one patients underwent a mesh-reinforced CST from May 2006 to June 2010. The study population averaged 57.9 ± 1.5 years of age with 24 males and 27 females, BMI of 34.3 ± 0.9 kg/m(2), ASA score of 2.62 ± 0.08, 29 % were smokers, 29 % were diabetic, and 69 % had at least one previous abdominal wall hernia repair. Operative time averaged 196.5 ± 7.2 min with a blood loss of 318 ± 24 mL, and average hernia defect size of 301 ± 31 cm(2). Length of follow-up averaged 20.6 ± 2.1 months; surgical site occurrences were identified in 39 %, most commonly from skin necrosis. Hernia recurrence rate was 3.9 %., Conclusions: Repair of large, complex abdominal wall hernias by CST augmented with a biologic underlay mesh and a lightweight polypropylene onlay mesh results in lower recurrence rates compared to historical reports of CST alone.
- Published
- 2013
- Full Text
- View/download PDF
73. CT appearance of common cosmetic and reconstructive surgical procedures and their complications.
- Author
-
Frank SJ, Flusberg M, Friedman S, Swinburne N, Sternschein M, Wolf EL, and Stein MW
- Subjects
- Buttocks surgery, Fat Necrosis diagnostic imaging, Fat Necrosis etiology, Fat Necrosis pathology, Hernia, Abdominal diagnostic imaging, Hernia, Abdominal etiology, Hernia, Abdominal pathology, Humans, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Postoperative Complications pathology, Plastic Surgery Procedures adverse effects, Seroma diagnostic imaging, Seroma etiology, Seroma pathology, Transplant Donor Site pathology, Cosmetic Techniques adverse effects, Plastic Surgery Procedures methods, Surgical Flaps pathology, Tomography, X-Ray Computed, Transplant Donor Site diagnostic imaging
- Abstract
In this review, we illustrate the spectrum of imaging features after plastic surgical procedures including transverse rectus abdominis myocutaneous flap, deep inferior epigastric perforators flap, latissimus dorsi flap, liposuction, abdominoplasty, and buttocks augmentation. Examples of complications, including seromas, abscesses, fat necrosis, abdominal hernia, and flap necrosis, will also be discussed., (Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
74. [Surgical treatment of the defects of the lumbar-lateral region of the abdominal wall in elderly and senile patients].
- Author
-
Vorovs'kyĭ OO
- Subjects
- Abdominal Wall pathology, Aged, Cicatrix prevention & control, Female, Hernia, Abdominal etiology, Hernia, Abdominal pathology, Humans, Lumbosacral Region, Male, Middle Aged, Surgical Mesh, Treatment Outcome, Abdominal Wall surgery, Hernia, Abdominal surgery, Herniorrhaphy methods
- Abstract
The results of surgical treatment of 44 patients with defects in the lumbar-lateral abdomen. Age of patients ranged from 60 to 78 years. Causes defects in 32 (72.7%) patients were hernia after surgical interventions on the urinary system using lumbotomic accesses; in 4 (9.1%)--hernias, in 2 (4.5%)--eventration after applying troakar lateral openings during laparoscopic surgery; in 2 (4.5%)--hernias, in 2 (4.5%)--eventration, and in 2 (4.5%)--evisceration through aperture after removing drains for drainage of the abdominal cavity. To prevent the development of the proposed method of drainage of the abdominal cavity during laparoscopic operations (patent for useful model No 51170 from 12.07.10). Autotransplantation own tissues justified by the size of the defect W1. If there is a defect larger aloplastyc shown by the method of sub lay in the proposed original method.
- Published
- 2012
75. Pathogenesis of the epigastric hernia.
- Author
-
Ponten JE, Somers KY, and Nienhuijs SW
- Subjects
- Age Factors, Hernia, Abdominal pathology, Humans, Incidence, Prevalence, Sex Factors, Hernia, Abdominal epidemiology, Hernia, Abdominal etiology
- Abstract
Purpose: Epigastric herniation is a rather common condition with a reported prevalence up to 10 %. Only a minority is symptomatic, presumably the reason for the scarce literature on this subject. Epigastric hernias have specific characteristics for which several anatomical theories have been developed. Whether these descriptions of pathological mechanisms still hold with regard to the characteristics of epigastric hernia is the subject of this review., Methods: A multi-database research was performed to reveal relevant literature by free text word and subject headings 'epigastric hernia', 'linea alba', 'midline' and 'abdominal wall'. Reviewed were studies on anatomical theories describing the pathological mechanism of epigastric herniation, incidence, prevalence and female-to-male ratio and possible explanatory factors., Results: Three different theories have been described of which two have not been confirmed by other studies. The attachment of the diaphragm causing extra tension in the epigastric region is the one still standing. Around 1.6-3.6 % of all abdominal hernias and 0.5-5 % of all operated abdominal hernias is an epigastric hernia. Epigastric hernias are 2-3 times more common in men, with a higher incidence in patients from 20 to 50 years. Some cadaver studies show an epigastric hernia rate of 0.5-10 %. These specific features of the epigastric hernias (the large asymptomatic proportion, male predominance, only above umbilical level) are discussed with regard to the general theories., Conclusions: The epigastric hernia is a very common condition, mostly asymptomatic. Together with general factors for hernia formation, the theory of extra tension in the epigastric region by the diaphragm is the most likely theory of epigastric hernia formation.
- Published
- 2012
- Full Text
- View/download PDF
76. Factors affecting morbidity and mortality in patients who underwent emergency operation for incarcerated abdominal wall hernia.
- Author
-
Gul M, Aliosmanoglu I, Kapan M, Onder A, Taskesen F, Arikanoglu Z, and Tacyildiz I
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Emergencies, Female, Hernia, Abdominal mortality, Hernia, Abdominal pathology, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Treatment Outcome, Young Adult, Hernia, Abdominal surgery, Herniorrhaphy methods
- Abstract
Patients with incarcerated abdominal wall hernias (AWHs) are often encountered in emergency care units. Despite advances in anesthesia, antisepsis, antibiotic therapy, and fluid therapy, the morbidity and mortality rates for these patients remain high. Between 2006 and 2011, we retrospectively analyzed the cases of 131 patients who underwent emergency surgery for incarcerated abdominal wall hernias. Of these, there were 70 women (53.4%) and 61 men (46.6%) with an average age of 63.3 ± 17.4 years (range, 17-91 years). Morbidity was observed in 28 patients (21.4%), and the mortality rate was 2.3%. Intestinal resection, presence of concomitant disease, and general anesthesia were the independent variants that affected morbidity of patients with incarcerated abdominal wall hernias.
- Published
- 2012
- Full Text
- View/download PDF
77. [Rare internal hernia in the falciform ligament as a rare course of abdominal emergency and infrequent cause of ileus].
- Author
-
Cagaš J, Vlček P, and Jeřábek J
- Subjects
- Abdomen, Acute etiology, Emergencies, Female, Hernia, Abdominal complications, Hernia, Abdominal pathology, Humans, Middle Aged, Hernia, Abdominal surgery, Ileus etiology, Ligaments pathology
- Abstract
Intestinal obstruction caused by an internal hernia is considered to be a rare cause of ileus. The rarest of these is herniation through the falciform ligament. In our article we present the case of a 45-year old female patient operated on for small bowel herniation through a defect in the falciform ligament. The loops were laparoscopically repositioned into the free abdominal cavity and the defect was removed by electrocautery. After the operation the patient was stabilised and discharged into outpatient care. Our article also analyses relevant literature and the diagnostic methods because the abovementioned diagnosis is rare and often established as late as postoperatively. Key words: internal hernia - the falciform ligament - iatrogenous defect in the falciform ligament.
- Published
- 2012
78. A mesenteric hernia complicated with a triple necrotic volvulus.
- Author
-
Tassinari D, Santoro S, Bernardi F, and Lima M
- Subjects
- Abdominal Pain pathology, Abdominal Pain surgery, Child, Female, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Intestinal Obstruction pathology, Intestinal Obstruction surgery, Intestinal Volvulus surgery, Intestine, Small surgery, Mesentery surgery, Necrosis, Shock, Abdominal Pain etiology, Hernia, Abdominal complications, Intestinal Obstruction etiology, Intestinal Volvulus complications, Intestine, Small pathology, Mesentery pathology
- Abstract
A 6-year-old girl was admitted to the paediatric emergency department with colicky abdominal pain. She had a significant medical history, with four previous admissions due to recurrent abdominal pain in the past year. On examination the abdomen was soft, there was no rebound tenderness and Rovsing's sign was negative. Her blood tests revealed a raised white cells count, although her C reactive protein was within the normal range. Abdominal x-ray revealed small bowel obstruction. During her assessment the patient rapidly deteriorated and seemed to go into shock. Her clinical state in addition to the radiological findings meant that she was taken to theatre for surgical exploration. This showed a triple volvulus with necrotic bowel loops that had herniated through a mesenteric defect. The necrotic bowel was subsequently resected.
- Published
- 2012
- Full Text
- View/download PDF
79. Intestinal occlusion through extrinsec stenosis of transverse colon associated with internal right mesocolic hernia.
- Author
-
Balanescu R, Topor L, Tala S, Ulici A, and Frumuseanu B
- Subjects
- Barium Sulfate, Child, Constriction, Pathologic, Enema, Female, Hernia, Abdominal pathology, Humans, Intestinal Obstruction pathology, Colon, Transverse pathology, Hernia, Abdominal complications, Intestinal Obstruction complications, Mesocolon pathology
- Abstract
Rationale: The incidence of malrotation has been estimated at 1 in 600 live births. An increased incidence of 0,2% has been found in barium swallow studies, whereas autopsy studies estimate that the true incidence may be high as 1% of the total population. The clinical manifestations are elusive; therefore, the diagnosis must be based on the presence or absence of the acute obstruction. Radiologic investigations, especially those using contrast substances, are the ones used most often in the diagnosis of malrotation. Laparoscopy may give the clinician a valuable tool that will help him diagnose the rotational anomalies and correct the potentially obstructing lesions with minimal surgical trauma to the patient. The role of the surgical treatment is to prevent volvulus and to treat any kind of obstruction. Ladd's procedure provides all the elements for reaching this goal., Objective: The following report describes a particular case of one female patient, 8 years old, admitted in our clinic with signs of intestinal obstruction. She had similar episodes in the last three months, but the symptoms had resolved spontaneously., Methods and Results: Upper gastrointestinal series showed an anomaly of rotation and barium enema discovered a tight stenosis on the transverse colon. Emergency surgery using laparotomy enabled diagnosis. Intraoperatively, a right mesocolic hernia and a transverse colon extrinsic stenosis due to abnormal peritoneal attachments were noted., Discussion: Colon obstruction due to peritoneal bands is extremely rare. The clinical manifestations are not specific and we need radiologic procedures to help diagnose the disease. The cause of the obstruction is not always evident despite the availability of modern imaging techniques. Since preoperative diagnosis is difficult, morbidity and mortality can be decreased by an early surgical intervention.
- Published
- 2012
80. Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience).
- Author
-
Ozkan E, Yıldız MK, Cakır T, Dulundu E, Eriş C, Fersahoğlu MM, and Topaloğlu U
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Anesthesia, General adverse effects, Anesthesia, General statistics & numerical data, Emergencies, Emergency Medical Services, Emergency Service, Hospital, Female, Hernia, Abdominal mortality, Hernia, Abdominal pathology, Humans, Length of Stay, Male, Middle Aged, Morbidity, Necrosis, Risk Factors, Sex Factors, Time Factors, Hernia, Abdominal epidemiology, Hernia, Abdominal surgery
- Abstract
Background: The aim of the present study was to investigate morbidity and mortality-related risk factors in patients undergoing surgery due to incarcerated abdominal wall hernia., Methods: The patients were grouped according to the type of hernia (inguinal, umbilical, incisional, femoral), and these groups were evaluated in terms of risk factors affecting morbidity and mortality such as age, gender, American Society of Anesthesiologists (ASA) score, type of anesthesia, concomitant diseases, and the presence of intestinal strangulation and necrosis., Results: Inguinal hernia was frequent in males, whereas femoral hernia was frequent in females (p<0.001). The rate of intestinal resection due to strangulation and necrosis was found significantly higher among femoral hernias as compared to the other types of hernia (p<0.005 and p<0.001, respectively). Advanced age (≥ 65 years), concomitant disease, strangulation, necrosis, high ASA score (III-IV), time from the onset of symptoms, and time to hospital admission were found to have significant influences on morbidity and mortality. General anesthesia was found to be a risk factor for morbidity as well (p<0.05)., Conclusion: Incarcerated abdominal wall hernias are surgical problems with high morbidity and mortality rates. Therefore, surgery should be planned under elective conditions when hernia is detected.
- Published
- 2012
- Full Text
- View/download PDF
81. Retromuscular preperitoneal repair of flank hernias.
- Author
-
Phillips MS, Krpata DM, Blatnik JA, and Rosen MJ
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Hernia, Abdominal etiology, Hernia, Abdominal pathology, Herniorrhaphy instrumentation, Humans, Male, Middle Aged, Postoperative Complications epidemiology, Retrospective Studies, Surgical Mesh, Treatment Outcome, Hernia, Abdominal surgery, Herniorrhaphy methods, Peritoneum surgery
- Abstract
Introduction: Flank hernias represent a challenging problem to reconstructive surgeons. Their anatomic proximity to the bony prominence and major neurovascular structures limits fixation options and restricts mesh overlap. We present our technique and outcomes of a preperitoneal repair with wide mesh overlap., Methods: This study is a retrospective analysis of patients undergoing open flank hernia repair with a retromuscular preperitoneal approach., Results: Between September 2007 and April 2011, 16 patients, mean age 55 years (range 34-80) and BMI 33 kg/m² (range 26-46), underwent open flank hernia repair. Eight were recurrent hernias; six previously had mesh placed; nine were incarcerated. Mean hernia defect size was 232 cm² (range 25-800). Mean operative time was 178 min (range 105-245). One intraoperative complication, ureteral injury in a transplant recipient, occurred and was primarily repaired without sequela. Two patients developed wound complications, one requiring superficial debridement and another requiring partial excision (<5 %) of the mesh with secondary healing. With a mean follow-up of 16.8 months (range 2-49), no recurrent hernias were noted., Conclusion: Open retromuscular preperitoneal repair of flank hernias with iliac bone fixation is technically feasible, allowing wide mesh overlap for a durable repair. This approach may offer advantages of treating abdominal wall laxity and repair of larger defects when compared to laparoscopic approaches.
- Published
- 2012
- Full Text
- View/download PDF
82. Strangulated lesser sac hernia.
- Author
-
Guinier D and Tissot O
- Subjects
- Hernia, Abdominal complications, Hernia, Abdominal pathology, Humans, Intestinal Obstruction diagnostic imaging, Jejunal Diseases diagnostic imaging, Hernia, Abdominal diagnostic imaging, Intestinal Obstruction etiology, Jejunal Diseases etiology, Peritoneal Cavity diagnostic imaging, Peritoneal Cavity pathology, Tomography, X-Ray Computed
- Abstract
Internal hernias account for less than 1% of acute mechanical bowel obstruction. Because of their rarety, they are often not considered in the clinical or radiologic diagnosis of bowel obstruction; diagnosis is often delayed, and is most often made at the time of surgery. We present images obtained during the management of a strangulated transomental internal hernia; computerized tomography permitted timely preoperative diagnosis and specifically adapted surgical therapy., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
83. [Internal herniation during pregnancy following gastric bypass surgery].
- Author
-
Hjørnet Kamper C, Kruse CE, and Ovesen PG
- Subjects
- Abdominal Pain diagnosis, Adult, Female, Hernia, Abdominal complications, Hernia, Abdominal diagnosis, Hernia, Abdominal pathology, Humans, Jejunum pathology, Jejunum surgery, Laparoscopy, Pregnancy, Pregnancy Complications surgery, Abdominal Pain etiology, Gastric Bypass adverse effects, Hernia, Abdominal etiology, Pregnancy Complications etiology
- Abstract
In Denmark, the number of bariatric operations, including gastric bypass surgery, has increased dramatically in recent years. Internal herniation as a possible cause of acute abdominal pain, is a well-known complication after gastric bypass operation. We report two cases of internal herniation during pregnancy following gastric bypass operation. The diagnosis of internal herniation can be difficult as radiologic investigations may be inconclusive. Clinical suspicion alone should lead to surgical exploration due to the risks of morbidity and mortality if patients are not diagnosed properly.
- Published
- 2012
84. Extrahepatic, nonneoplastic, fat-containing lesions of the abdominopelvic cavity: spectrum of lesions, significance, and typical appearance on multidetector computed tomography.
- Author
-
Kani KK, Moshiri M, Bhargava P, and Kolokythas O
- Subjects
- Female, Hernia, Abdominal diagnostic imaging, Hernia, Abdominal pathology, Humans, Lipomatosis etiology, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Male, Panniculitis, Peritoneal diagnostic imaging, Panniculitis, Peritoneal pathology, Urinary Bladder Diseases etiology, Lipomatosis diagnostic imaging, Lipomatosis pathology, Tomography, X-Ray Computed, Urinary Bladder Diseases diagnostic imaging, Urinary Bladder Diseases pathology
- Abstract
Fat may be noted in a diffuse or focal manner in a variety of nonneoplastic abdominopelvic conditions. The specific signature of macroscopic fat on computed tomography along with the usually characteristic findings of these entities makes the diagnosis of most of these conditions relatively straightforward. In the intestinal tract, the "fat halo sign" usually arises in the context of subacute to chronic bowel wall inflammation. Excess fat in the renal sinus may occur with renal sinus lipomatosis or "replacement lipomatosis of the kidney." Some cases of "pancreatic lipomatosis" may culminate in steatopancreatitis and ultimately neoplastic transformations. "Fibrofatty mesenteric proliferation" is a characteristic feature of Crohn disease. In the setting of the acute abdomen, accurate diagnosis of fat-containing lesions (epiploic appendagitis or omental infarction) from other causes of the acute abdomen is critical. Mesenteric panniculitis is 1 of the causes of the "misty mesentery." Juxtacaval fat deposition is a benign process that has the potential to be confused with more serious conditions. More diffuse fat deposition (abdominal or pelvic lipomatosis) has the potential to become symptomatic by causing mass effect upon the adjacent structures. Fat can also be seen in a variety of postoperative/iatrogenic conditions or abdominal wall/diaphragmatic hernias., (Copyright © 2012 Mosby, Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
85. Abdominal hernia repair with a decellularized dermal scaffold seeded with autologous bone marrow-derived mesenchymal stem cells.
- Author
-
Zhao Y, Zhang Z, Wang J, Yin P, Zhou J, Zhen M, Cui W, Xu G, Yang D, and Liu Z
- Subjects
- Animals, Cell Differentiation, Cell Proliferation, Cells, Cultured, Hernia, Abdominal pathology, Peritoneum cytology, Peritoneum pathology, Rabbits, Bone Marrow Cells cytology, Dermis cytology, Hernia, Abdominal surgery, Mesenchymal Stem Cell Transplantation, Mesenchymal Stem Cells cytology, Tissue Engineering methods
- Abstract
Surgeons usually use synthetic polymer meshes for abdominal wall hernia repair. However, synthetic polymer meshes exhibit a lack of growth and related complications. In this study, we produced a tissue-engineered patch for abdominal hernia repair. Autologous bone-marrow-derived mesenchymal stem cells (BMSCs) were isolated and proliferated in vitro; decellularized dermal scaffolds (DSs) were prepared using enzymatic process; and then BMSCs were seeded onto the DSs for the construction of tissue-engineered patches. Under general anesthesia, rabbits underwent creation of abdominal wall defects and which were repaired with BMSC-seeded DSs, acellular DSs, and skin sutures only, respectively. Animals were sacrificed after 2 months for assessing the histological and gross examination. Abdominal hernias were absent in animals repaired with cell-seeded group, and abdominal hernias or bulges appeared in all animals repaired with acellular group. All the animals that were not repaired died within 10 days. The cell-seeded implants were thicker and indicated good angiogenesis compared with that of the acellular implants, both in histological and gross examination. The tissue-engineered patches prepared with BMSCs seeding on DSs can be used for abdominal wall hernia repair., (© 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)
- Published
- 2012
- Full Text
- View/download PDF
86. Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study.
- Author
-
Sabbagh C, Dumont F, Fuks D, Yzet T, Verhaeghe P, and Regimbeau JM
- Subjects
- Abdominal Cavity diagnostic imaging, Adult, Aged, Aged, 80 and over, Female, Forced Expiratory Flow Rates, Forced Expiratory Volume, Hernia, Abdominal diagnostic imaging, Hernia, Abdominal surgery, Humans, Male, Middle Aged, Organ Size, Prospective Studies, Residual Volume, Spirometry, Tomography, X-Ray Computed, Viscera diagnostic imaging, Vital Capacity, Abdominal Cavity pathology, Hernia, Abdominal pathology, Herniorrhaphy methods, Pneumoperitoneum, Artificial methods, Viscera pathology
- Abstract
Introduction: Progressive preoperative pneumoperitoneum (PPP) is used to prepare incisional hernias with loss of domain (IHLD) operations. The aim of the present study was to analyze the effect of PPP on peritoneal volume [measured using a new computed tomography (CT)-based method] and respiratory function., Methods: From July 2004 to July 2008, 19 patients were included in a prospective, observational study. The volumes of the incisional hernia (VIH), the abdominal cavity (VAC), the total peritoneal content (VP) and the VIH/VP ratio were measured before and after PPP using abdominal CT scan data. Spirometric parameters were measured before and after PPP, and postoperative clinical data were evaluated., Results: Before and after PPP, the mean VIH was 1,420 cc and 2,110 cc (P < 0.01), and the mean VAC was 9,083 cc and 11,104 cc (P < 0.01). The VAC increased by 2,021 cc (P < 0.01) and was greater than the mean VIH before PPP. After PPP, the spirometric measurements revealed a restrictive syndrome. The overall postoperative morbidity rate was 37%., Conclusions: PPP increased the hernia and abdominal volumes. PPP induced a progressive, restrictive syndrome.
- Published
- 2012
- Full Text
- View/download PDF
87. [Correction of a connective tissue dysplasia in the treatment of postoperative abdominal hernias].
- Author
-
Chetverikov SH, Vododiuk VIu, Ier'omin IuV, and Osadchyĭ DM
- Subjects
- Abdominal Wall pathology, Abdominal Wall surgery, Collagen agonists, Collagen biosynthesis, Connective Tissue drug effects, Follow-Up Studies, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Immunohistochemistry, Orotic Acid administration & dosage, Orotic Acid analogs & derivatives, Orotic Acid therapeutic use, Postoperative Complications surgery, Postoperative Period, Surgical Mesh, Transplantation, Homologous, Connective Tissue transplantation, Hernia, Abdominal drug therapy, Postoperative Complications drug therapy
- Abstract
There were analyzed the results of treatment of 112 patients, suffering postoperative abdominal hernia, in whom the anterior abdominal wall alloplasty was performed as well as postoperative pathogenetically substantiated complex therapy, taking into account the presence of a connective tissue dysplasia syndrome (CTDS) and the early and late postoperative complications prophylaxis. The peculiarities of postoperative period course and late follow-up results were studied up. Phenotypic features of CTDS were revealed in 53 (47.3%) patients, immunohistochemical features of a connective tissue dysplasia (a failed collagen type I and III ratio, manifested by increase of a collagen type III fibers quantity in 3 or more times) were revealed in 78 (69.6%) patients, in whom the processes of a collagen and its supermolecular formations synthesis were stimulated, using a magnesium orotate (Magnerot), which was prescribed in 1 g dose twice a day during 4 - 6 weeks. Application of composite nets, owing big pores, in a complex with a postoperative pathogenetically substantiated therapy conduction have positively influenced the disease course and the late follow-up results achieved.
- Published
- 2012
88. Internal supravesical hernia - a rare cause of intestinal obstruction: report of two cases.
- Author
-
Bouassida M, Sassi S, Touinsi H, Kallel H, Mighri MM, Chebbi F, Ali MB, Bouzeidi K, and Sassi S
- Subjects
- Adult, Female, Hernia, Abdominal diagnosis, Hernia, Abdominal pathology, Humans, Intestinal Obstruction diagnosis, Intestine, Small, Male, Middle Aged, Umbilical Arteries, Urinary Bladder pathology, Hernia, Abdominal complications, Intestinal Obstruction etiology, Tomography, X-Ray Computed methods
- Abstract
Supravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They are exceptional and are often the cause of intestinal obstruction. We report two cases of surgically proven internal supravesical hernias presenting with small bowel obstruction. Abdominal computed tomography showed, for our first case, the relation of the incarcerated intestine anterior to and compressing the urinary bladder. We believe that the preoperative diagnosis of supravesical hernia by abdominal computed tomography is possible, as shown in our first case.
- Published
- 2012
89. A preclinical evaluation of alternative synthetic biomaterials for fascial defect repair using a rat abdominal hernia model.
- Author
-
Ulrich D, Edwards SL, White JF, Supit T, Ramshaw JA, Lo C, Rosamilia A, Werkmeister JA, and Gargett CE
- Subjects
- Actins metabolism, Animals, Antigens, CD metabolism, Benzophenones, Biocompatible Materials chemical synthesis, Biomarkers metabolism, Body Weight drug effects, Collagen metabolism, Disease Models, Animal, Drug Evaluation, Preclinical, Fascia metabolism, Fascia pathology, Fasciotomy, Female, Gelatin chemistry, Hernia, Abdominal metabolism, Hernia, Abdominal pathology, Immunohistochemistry, Ketones chemistry, Macrophages drug effects, Nylons chemistry, Polyethylene Glycols chemistry, Polymers, Rats, Rats, Sprague-Dawley, Tensile Strength, Biocompatible Materials pharmacology, Fascia drug effects, Gelatin pharmacology, Hernia, Abdominal surgery, Ketones pharmacology, Nylons pharmacology, Polyethylene Glycols pharmacology, Surgical Mesh
- Abstract
Introduction: Fascial defects are a common problem in the abdominal wall and in the vagina leading to hernia or pelvic organ prolapse that requires mesh enhancement to reduce operation failure. However, the long-term outcome of synthetic mesh surgery may be unsatisfactory due to post-surgical complications. We hypothesized that mesh fabricated from alternative synthetic polymers may evoke a different tissue response, and provide more appropriate mechanical properties for hernia repair. Our aim was to compare the in vivo biocompatibility of new synthetic meshes with a commercial mesh., Methods: We have fabricated 3 new warp-knitted synthetic meshes from different polymers with different tensile properties polyetheretherketone (PEEK), polyamide (PA) and a composite, gelatin coated PA (PA+G). The rat abdominal hernia model was used to implant the meshes (25 × 35 mm, n = 24/ group). After 7, 30, 60, 90 days tissues were explanted for immunohistochemical assessment of foreign body reaction and tissue integration, using CD31, CD45, CD68, alpha-SMA antibodies. The images were analysed using an image analysis software program. Biomechanical properties were uniaxially evaluated using an Instron Tensile® Tester., Results: This study showed that the new meshes induced complex differences in the type of foreign body reaction over the time course of implantation. The PA, and particularly the composite PA+G meshes, evoked a milder early inflammatory response, and macrophages were apparent throughout the time course. Our meshes led to better tissue integration and new collagen deposition, particularly with the PA+G meshes, as well as greater and sustained neovascularisation compared with the PP meshes., Conclusion: PA, PA+G and PEEK appear to be well tolerated and are biocompatible, evoking an overlapping and different host tissue response with time that might convey mechanical variations in the healing tissue. These new meshes comprising different polymers may provide an alternative option for future treatment of fascial defects.
- Published
- 2012
- Full Text
- View/download PDF
90. Long-term anisotropic mechanical response of surgical meshes used to repair abdominal wall defects.
- Author
-
Hernández-Gascón B, Peña E, Pascual G, Rodríguez M, Bellón JM, and Calvo B
- Subjects
- Animals, Anisotropy, Collagen metabolism, Hernia, Abdominal metabolism, Hernia, Abdominal pathology, Hernia, Abdominal physiopathology, Materials Testing, Porosity, Rabbits, Time Factors, Hernia, Abdominal surgery, Mechanical Phenomena, Surgical Mesh
- Abstract
Routine hernia repair surgery involves the implant of synthetic mesh. However, this type of procedure may give rise to pain and bowel incarceration and strangulation, causing considerable patient disability. The purpose of this study was to compare the long-term behaviour of three commercial meshes used to repair the partially herniated abdomen in New Zealand White rabbits: the heavyweight (HW) mesh, Surgipro(®) and lightweight (LW) mesh, Optilene(®), both made of polypropylene (PP), and a mediumweight (MW) mesh, Infinit(®), made of polytetrafluoroethylene (PTFE). The implanted meshes were mechanical and histological assessed at 14, 90 and 180 days post-implant. This behaviour was compared to the anisotropic mechanical behaviour of the unrepaired abdominal wall in control non-operated rabbits. Both uniaxial mechanical tests conducted in craneo-caudal and perpendicular directions and histological findings revealed substantial collagen growth over the repaired hernial defects causing stiffness in the repair zone, and thus a change in the original properties of the meshes. The mechanical behaviour of the healthy tissue in the craneo-caudal direction was not reproduced by any of the implanted meshes after 14 days or 90 days of implant, whereas in the perpendicular direction, SUR and OPT achieved similar behaviour. From a mechanical standpoint, the anisotropic PP-lightweight meshes may be considered a good choice in the long run, which correlates with the structure of the regenerated tissue., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
91. Peritoneal volume is predictive of tension-free fascia closure of large incisional hernias with loss of domain: a prospective study.
- Author
-
Sabbagh C, Dumont F, Robert B, Badaoui R, Verhaeghe P, and Regimbeau JM
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Herniorrhaphy, Humans, Male, Middle Aged, Multivariate Analysis, Organ Size, Pneumoperitoneum, Artificial, Predictive Value of Tests, Prospective Studies, Wound Closure Techniques, Fasciotomy, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Peritoneal Cavity anatomy & histology
- Abstract
Introduction: The surgical treatment of large incisional hernias with loss of domain (LIHLD) carries the risk of fascia closure under tension and, thus, abdominal compartment syndrome. We investigated volume measurements as a predictive factor for tension-free fascia closure., Patients and Methods: From September 2004 to July 2008, we prospectively included 17 patients with LIHLD. The operation was prepared by a progressive preoperative pneumoperitoneum (PPP) technique known as the Goni Moreno procedure. The patient's age and body mass index (BMI), the incisional hernia's width, length and surface area, and the incisional hernia volume (IHV)/peritoneal volume (PV) ratio <20% were evaluated as predictive factors for tension-free fascia closure. A tension-free closure was defined as a closure in which the use of a surgical device for avoiding postoperative compartment syndrome was not required., Results: The mean PPP volume introduced was 12.7 ± 4.4 l (range 4.5-19.2) over a period of 11 ± 6 days (range 4-24). The mean width, height and surface area of the incisional hernia after PPP were 11.3 ± 4.7 cm (range 4.5-19), 13.4 ± 7.8 cm (range 4.4-30) and 165 ± 101 cm(2) (range 19-304), respectively. The mean IHV after PPP was 2,374 ± 1,356 cc (range 517-4,802) and the mean abdominal cavity volume was 9,558 ± 4,106 cc (range 4,785-21,782). The mean IHV/PV ratio was 16.3 ± 10.4% (range 4.4-34). In a univariate analysis, the BMI and the IHV/PV ratio were predictive of tension-free fascia closure. In a multivariate analysis, only an IHV/PV ratio <20% was a significant predictive factor., Conclusions: The IHV/PV ratio is predictive of tension-free fascia closure for hernias or incisional hernias with loss of domain. Simplification of the volumetry method is necessary.
- Published
- 2011
- Full Text
- View/download PDF
92. [Factors affecting morbidity in urgent repair of abdominal wall hernia with intestinal incarceration in adults].
- Author
-
Ezer A, Calışkan K, Colakoğlu T, Parlakgümüş A, Belli S, and Tarım A
- Subjects
- Adult, Female, Hernia, Abdominal etiology, Hernia, Abdominal pathology, Humans, Injury Severity Score, Male, Middle Aged, Mortality, Postoperative Complications, Turkey epidemiology, Emergency Treatment statistics & numerical data, Hernia, Abdominal epidemiology, Hernia, Abdominal therapy, Intestines surgery
- Abstract
Background: The aim of this study was to investigate factors that affect morbidity in adults with incarcerated intestinal hernia of the abdominal wall., Methods: 124 patients with a mean age of 61 ± 13.87 years (73 males) underwent emergency surgery for incarcerated intestinal hernia between March 1999 and March 2008. The median duration of the hernia was 5 years (0.1-30). Type and duration of hernia, accompanying diseases, surgical procedure, and operation-related complications were retrospectively evaluated., Results: Twenty-five patients (20%) had complications. Twelve patients (10%) had surgical site infection and 10 patients (8%) had septic complications. Four patients (3%) died in the postoperative period. Out of 40 patients developing strangulation, 18 underwent bowel resection. The only independent variable concerning bowel resection other than inguinal hernia was found to be ventral hernia (p=0.039). There was no statistical significance between duration of hernia and incarceration and complications. The rate of complications was significantly high in the patients with accompanying diseases (p<0.001). The relation between age and complications was also significant (p=0.034). Multivariate analyses showed high ASA scores as the only independent variable for development of complications (p<0.001)., Conclusion: Patients with comorbid diseases and high ASA scores should be informed about the elevated risk of complications, and scheduled surgery before the development of incarceration should be recommended.
- Published
- 2011
- Full Text
- View/download PDF
93. Maximum forces acting on the abdominal wall: experimental validation of a theoretical modeling in a human cadaver study.
- Author
-
Konerding MA, Bohn M, Wolloscheck T, Batke B, Holste JL, Wohlert S, Trzewik J, Förstemann T, and Hartung C
- Subjects
- Abdominal Wall surgery, Biomechanical Phenomena, Cadaver, Fascia physiology, Fasciotomy, Hernia, Abdominal complications, Hernia, Abdominal surgery, Humans, Laparotomy methods, Postoperative Complications, Pressure, Tensile Strength, Validation Studies as Topic, Abdominal Wall pathology, Hernia, Abdominal pathology, Models, Biological
- Abstract
Incisional hernias following median laparotomy have a high incidence and recurrence rate after repair, so that a better understanding of the linea alba biomechanics is desirable. The mechanical stress exerted on the linea alba in living humans is primarily generated by the musculature. In this human cadaver study, intraabdominal pressure was simulated by insertion of a balloon that was increasingly filled to maximal pressures of 200 mbar. The related forces acting transversely on the linea alba at maximum pressure were found to be between 41.6 and 52.2N/cm (mean=45.9N/cm), which is in agreement with a recent modeling of the related forces., (Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
94. Ultrasonographic findings in patients with peristomal bulging.
- Author
-
Sjödahl RI, Thorelius L, and Hallböök OJ
- Subjects
- Abdominal Muscles diagnostic imaging, Abdominal Muscles pathology, Abdominal Wall pathology, Adult, Aged, Aged, 80 and over, Female, Hernia, Abdominal pathology, Humans, Male, Middle Aged, Pelvic Organ Prolapse diagnostic imaging, Pelvic Organ Prolapse pathology, Ultrasonography, Abdominal Wall diagnostic imaging, Colostomy adverse effects, Hernia, Abdominal diagnostic imaging, Surgical Stomas
- Abstract
Aim: The aim of this study was to obtain a classification of peristomal bulging based on findings at ultrasonography in patients with a sigmoid colostomy., Methods: The patient material comprised 30 men and 33 women. The median age was 69 years (28-90) and the median time between stoma creation and investigation was 68 months (3-426). Any bulging was measured, and the abdominal opening for the stoma bowel was evaluated at the clinical examination. At the ultrasonographic investigation, the patients were first investigated in the supine position to measure the transverse and vertical diameter of the abdominal opening and the thickness of the abdominal muscles., Results: Three types of ultrasonographic findings were identified. In ultra-I, the stoma bowel was completely fixed or showed telescoping-like movement through the abdominal opening. In ultra-II, fatty tissue was prolapsed together with the stoma bowel forming a bend in the subcutaneous tissue. In ultra-III, another bowel segment or fatty tissue passed beside the stoma bowel through the abdominal opening into the abdominal wall. A normal finding without any bulging at the clinical examination was associated with a smaller area and a smaller diameter of the abdominal opening than the area and diameter in patients with a visible peristomal bulging. There was no difference in the thickness of the muscle layer of the abdominal wall between patients with and without bulging., Conclusions: Ultrasonography can make a dynamic diagnosis of parastomal hernia. In patients with visible peristomal bulging, the area of the abdominal opening is increased but there is no decrease in the thickness of the muscles of the abdominal wall.
- Published
- 2011
- Full Text
- View/download PDF
95. Evaluation of human acellular dermis versus porcine acellular dermis in an in vivo model for incisional hernia repair.
- Author
-
Ngo MD, Aberman HM, Hawes ML, Choi B, and Gertzman AA
- Subjects
- Abdominal Wall pathology, Animals, Dermis pathology, Hernia, Abdominal pathology, Humans, Rabbits, Swine, Tensile Strength, Transplantation, Heterologous, Transplantation, Homologous, Abdominal Wall surgery, Dermis transplantation, Hernia, Abdominal surgery
- Abstract
Incisional hernias commonly occur following abdominal wall surgery. Human acellular dermal matrices (HADM) are widely used in abdominal wall defect repair. Xenograft acellular dermal matrices, particularly those made from porcine tissues (PADM), have recently experienced increased usage. The purpose of this study was to compare the effectiveness of HADM and PADM in the repair of incisional abdominal wall hernias in a rabbit model. A review from earlier work of differences between human allograft acellular dermal matrices (HADM) and porcine xenograft acellular dermal matrices (PADM) demonstrated significant differences (P < 0.05) in mechanical properties: Tensile strength 15.7 MPa vs. 7.7 MPa for HADM and PADM, respectively. Cellular (fibroblast) infiltration was significantly greater for HADM vs. PADM (Armour). The HADM exhibited a more natural, less degraded collagen by electrophoresis as compared to PADM. The rabbit model surgically established an incisional hernia, which was repaired with one of the two acellular dermal matrices 3 weeks after the creation of the abdominal hernia. The animals were euthanized at 4 and 20 weeks and the wounds evaluated. Tissue ingrowth into the implant was significantly faster for the HADM as compared to PADM, 54 vs. 16% at 4 weeks, and 58 vs. 20% for HADM and PADM, respectively at 20 weeks. The original, induced hernia defect (6 cm(2)) was healed to a greater extent for HADM vs. PADM: 2.7 cm(2) unremodeled area for PADM vs. 1.0 cm² for HADM at 20 weeks. The inherent uniformity of tissue ingrowth and remodeling over time was very different for the HADM relative to the PADM. No differences were observed at the 4-week end point. However, the 20-week data exhibited a statistically different level of variability in the remodeling rate with the mean standard deviation of 0.96 for HADM as contrasted to a mean standard deviation of 2.69 for PADM. This was significant with P < 0.05 using a one tail F test for the inherent variability of the standard deviation. No significant differences between the PADM and HADM for adhesion, inflammation, fibrous tissue or neovascularization were noted.
- Published
- 2011
- Full Text
- View/download PDF
96. [The role of connective tissue nonspecific dysplasia in postoperative and recurrent abdominal hernias formation].
- Author
-
Akhmedov NI
- Subjects
- Adult, Aged, Connective Tissue surgery, Connective Tissue Diseases pathology, Connective Tissue Diseases surgery, Female, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Male, Middle Aged, Postoperative Complications pathology, Recurrence, Severity of Illness Index, Young Adult, Connective Tissue pathology, Connective Tissue Diseases complications, Hernia, Abdominal etiology, Postoperative Complications etiology
- Abstract
There were studied the rate of clinical indices diagnosis concerning nondifferentiated form of connective tissue dysplasia (NFCTD) as well as their significance in postoperative and recurrent abdominal hernias formation in 61 patients, ageing 20 - 78 years. It was established, that in 77% of patients the hernia have had formated on a NFCTD background, including in 16.4%--with a mild degree, in 27.8%--moderate degree and in 32.8%--a severe one. The authors recommend while abdominal hernia is present to study a characteristic phenotypical signs of a connective tissue dysplasia and, if more than 4 signs are diagnosed, to prefer the application of alloplastic methods.
- Published
- 2011
97. Comparison of three separate antiadhesive barriers for intraperitoneal onlay mesh hernia repair in an experimental model.
- Author
-
Gruber-Blum S, Petter-Puchner AH, Brand J, Fortelny RH, Walder N, Oehlinger W, Koenig F, and Redl H
- Subjects
- Animals, Fibrin Tissue Adhesive therapeutic use, Hernia, Abdominal pathology, Random Allocation, Rats, Rats, Wistar, Tissue Adhesives therapeutic use, Hernia, Abdominal surgery, Surgical Mesh, Tissue Adhesions prevention & control
- Abstract
Background: Adhesion formation is a common adverse effect in intraperitoneal onlay mesh (IPOM) surgery. Different methods of adhesion prevention have been developed, including coated meshes and separate antiadhesive barriers (SABs). In this study one type of mesh was tested with different SABs, which were fixed to the sutured mesh using fibrin sealant. The primary aim was to compare adhesion prevention between different SABs. Secondary aims were the assessment of tissue integration and evaluation of SAB fixation with fibrin sealant., Methods: Thirty-two rats were randomized to one of three treatment groups (SurgiWrap, Prevadh and Seprafilm) or a control group (no SAB). Animals were operated on with an open IPOM technique (8 per group). One macroporous polypropylene mesh per animal (2 × 2 cm) was fixed with four non-absorbable sutures. An antiadhesive barrier of 2·5 × 2·5 cm was fixed with fibrin sealant. After 30 days, adhesion formation, tissue integration, seroma formation, inflammation and vascularization were evaluated macroscopically and by histology., Results: Prevadh and Seprafilm groups showed a significant reduction in adhesion formation compared with the control group. Tissue integration of the mesh was reduced in these groups. Fibrin sealant fixed the SAB to the mesh securely in all groups., Conclusion: Prevadh and Seprafilm are potent materials for the reduction of adhesion formation. A potential relationship between effective adhesion prevention and impaired tissue integration of the implant was observed. Fibrin sealant proved an excellent agent for SAB fixation., (Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.)
- Published
- 2011
- Full Text
- View/download PDF
98. [Comparative assessment of national and foreign endoprostheses for hernioplasty].
- Author
-
Zhukovskiĭ VA
- Subjects
- Abdominal Wall pathology, Abdominal Wall physiopathology, Cicatrix etiology, Equipment Failure Analysis, Foreign-Body Reaction etiology, Hernia, Abdominal pathology, Hernia, Abdominal physiopathology, Humans, Materials Testing, Outcome Assessment, Health Care, Patient Satisfaction, Polypropylenes, Porosity, Prosthesis Design, Prosthesis Implantation adverse effects, Surgical Mesh classification, Surgical Mesh standards, Abdominal Wall surgery, Hernia, Abdominal surgery, Prostheses and Implants classification, Prostheses and Implants standards, Prosthesis Implantation instrumentation
- Abstract
The used foreign endoprostheses have redundant strength, and great number and stiffness of implanted material might be a cause of complications and result in patients' discomfort associated with decreased mobility of the anterior abdominal wall. Less material consumption of endoprostheses results in increased porosity and less thickness facilitating rapid integration of the grid into the elastic and strong connective tissue scar. Company "Lintex" has developed and produced endoprostheses from polypropylene and polyvinylenfluoride monothreads in heavy, standard and light version, which allows their choice with a glance to the particular surgical situation.
- Published
- 2011
99. Case report of a traumatic abdominal wall hernia resulting from falling onto a flat surface.
- Author
-
Yücel N, Uğraş MY, Işık B, and Turtay G
- Subjects
- Acetabulum diagnostic imaging, Adult, Fractures, Bone diagnostic imaging, Hernia, Abdominal pathology, Humans, Ileostomy, Male, Resuscitation, Tomography, X-Ray Computed, Treatment Outcome, Abdominal Wall pathology, Accidental Falls, Fractures, Bone etiology, Hernia, Abdominal etiology
- Abstract
This article reports a case of high-energy type traumatic abdominal wall hernia (TAWH) associated with multiple organ injuries including pelvic fractures, liver laceration and ascending colon perforation. The cause of the trauma was falling to the ground from a height of approximately 8 meters. Since the forces affecting the abdomen are unique when falling on a flat surface, the mechanism of defect may be different between a low-energy type handlebar hernia and high-energy type TAWH. Only a few cases of high-energy type TAWH exist in the literature, all reporting falling on or hitting an angled or curved material. To our knowledge, this is the only report of TAWH resulting from falling onto a flat surface. The diagnosis and management are summarized, the literature data are reviewed, and the mechanism of action is discussed.
- Published
- 2010
100. Appendiceal mucinous adenocarcinoma presenting as an enterocutaneous fistula in an incisional hernia.
- Author
-
Sayles M, Courtney E, Younis F, O'Donovan M, Ibrahim A, and Fearnhead NS
- Subjects
- Abdominal Abscess diagnosis, Adenocarcinoma, Mucinous pathology, Adenocarcinoma, Mucinous surgery, Aged, Appendectomy, Appendiceal Neoplasms pathology, Appendiceal Neoplasms surgery, Colectomy, Female, Hernia, Abdominal pathology, Hernia, Abdominal surgery, Humans, Intestinal Fistula pathology, Intestinal Fistula surgery, Laparoscopy, Lymph Node Excision, Neoplasm Staging, Postoperative Complications pathology, Postoperative Complications surgery, Reoperation, Adenocarcinoma, Mucinous diagnosis, Appendiceal Neoplasms diagnosis, Bone Transplantation, Hernia, Abdominal diagnosis, Ilium surgery, Intestinal Fistula diagnosis, Postoperative Complications diagnosis, Tissue and Organ Harvesting
- Abstract
A 68-year-old woman with a history of bone-graft harvesting from the right iliac crest presented with an incisional hernia and abscess at the graft donor site. Following incision and drainage of the abscess, CT demonstrated an enterocutaneous fistula between the appendix and bone-graft incision with appendicitis assumed to be the original cause of the abscess. At laparoscopy, the appendix was adherent to the hernia sac with mucinous material at the superficial orifice of the fistula site but not in the peritoneal cavity. Laparoscopic appendicectomy with fistula track excision was performed. Histological evaluation confirmed a well-to-moderately differentiated mucinous adenocarcinoma arising on a background of dysplastic villous adenoma. Tumour extended along the fistula track to involve the surface skin. A laparoscopic right hemicolectomy, lymph node dissection and wide local excision of the fistula track were carried out at a second procedure. Final histology confirmed pT4N1 tumour with clear resection margins.
- Published
- 2010
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.