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At least 811 records · Page 45Linked to original sources
PubMed1997

Modified Boerema technique for the closure of congenital abdominal wall defects to prevent incisional herniation and infection.

Tension and infection often cause wound dehiscence or incisional herniation after the fascial closure of congenital abdominal wall defects in neonates. To overcome these problems, a modification of the Boerema technique (a method for repairing large incisional hernia in adults) was applied to repair abdominal wall defects in 14 neonates. The efficacy of this technique is discussed in this report.

Abdominal Muscles↗
PubMed2006

Laparoscopic colorectal surgery using low-pressure pneumoperitoneum combined with abdominal wall lift by placement of anchoring sutures around the camera port.

BACKGROUND: This study aimed to evaluate the feasibility of low-pressure pneumoperitoneum in laparoscopic colorectal surgery. METHODS: The authors designed low-pressure (8 mmHg) laparoscopy combined with abdominal wall lift simply by placement of anchoring sutures around the camera port. RESULTS: The operative indications were 176 colon cancers, 297 rectal cancers, and 45 benign diseases. The average blood loss was 92 ml (range, 20-1200 ml), and the mean operating time was 204 min (range, 23-525 min). Conversion to an open procedure was required in eight cases (1.5%). Two patients experienced intraoperative complications. The mean number of removed lymph nodes was 28.9 in the colon cancer cases and 23.1 in the rectal cancer cases. The mean length of resected specimen was 27.3 cm (range, 8.5-136 cm). Postoperatively, cardiopulmonary complications developed in five patients (0.9%). CONCLUSIONS: Abdominal wall lifting by anchoring sutures around the camera port in addition to low-pressure pneumoperitoneum is a simple, safe, and effective method for laparoscopic colorectal procedure.

Abdominal Wall↗
PubMed2002

Traumatic hernia of the abdominal wall after pelvic and acetabular fracture: a case report.

Traumatic hernia of the abdominal wall is a rare and easily missed injury in the presence of major pelvic and abdominal lesions. We present a radiographically documented case of combined pelvic and acetabular fracture with a major contralateral traumatic hernia with avulsion of the internal oblique, the external oblique and the transverse abdominal muscles diagnosed four months after the initial trauma. To our knowledge no similar case has been described in the current literature.

Abdominal Wall↗
PubMed2001

Advancement flap umbilicoplasty after abdominal wall closure: postoperative results compared with normal umbilical anatomy.

BACKGROUND/PURPOSE: Umbilical reconstruction frequently is an adjunct used after repair of congenital abdominal wall defects. The authors describe a new technique of umbilicoplasty and compare their results with normal neonatal umbilical anatomy. METHODS: After fascial closure, 6 newborn infants with either gastroschisis (n = 3) or omphalocele (n = 3) underwent umbilicoplasty performed by advancing bilateral skin flaps including creation of an umbilical skin collar. The umbilical collar height, circumference, and distance from the xiphoid with respect to the pubis (ratio of xiphoid-umbilicus distance to xiphoid-pubis distance or XU:XP) were recorded and referenced to normal umbilical anatomy in additional 28 infants (24 to 40 weeks gestation [mean, 33.2 weeks] and age 2 to 131 days [mean, 26.5 days]). RESULTS: After umbilicoplasty, all infants had a near-normal-appearing umbilicus (collar height, 0.75 +/- 0.25 cm and circumference, 5.24 +/- 1.20 cm) compared with normal umbilical anatomy (collar height, 4.36 +/- 1.32 cm and circumference, 1.03 +/- 0.38 cm). However, after umbilicoplasty, the neoumbilicus was positioned more cephalad (XU:XP = 0.53 +/-.05) compared with normal (mean XU:XP, 0.67 +/- 0.07). The only complication encountered was a small dehiscence of the superior aspect of the abdominal wound. CONCLUSIONS: Closure of abdominal wall defects with simultaneous umbilicoplasty provides a cosmetically pleasing result. When performing umbilicoplasty, attempt should be made to position the neoumbilicus as inferior as possible, optimally at two thirds the distance from the xiphoid to the pubis.

Abdominal Muscles↗
PubMed2001

[Endometriosis of the abdominal wall: diagnosis and treatment techniques].

An analysis of abdominal wall endometrioma management was performed. History of cesarean section and/or uterine surgery and ultrasound are important in the diagnosis. Danazol test may confirm the diagnosis as well as reduce tumor size before operation. HF Electrosurgery, including spray coagulation technique are recommended in all cases. Hormonal therapy, including Danazol, Medroxyprogesterone or Lynestrenol gives poor effects in cases of endometrioma.

Abdominal Muscles↗
PubMedDate not supplied

Angiosarcoma of the abdominal wall after dermolipectomy in a morbidly obese man. A rare form of presentation of Stewart-Treves syndrome.

Angiosarcoma is a rare malignant tumor, with a predilection for skin in the head and neck region, although it has been described in many other locations. Its association with chronic lymphedema is well known, mainly in the setting of postmastectomy lymphedema of the arm in breast cancer patients (termed Stewart-Treves syndrome). However, angiosarcoma can appear in lower limbs with chronic lymphedema and rarely in other locations such as the abdominal wall. Herein, we present a unique case of angiosarcoma developing in the abdominal wall of a morbidly obese patient after extensive dermolipectomy.

Abdominal Wall↗
PubMed1989

Anterior abdominal wall defects.

A total of 48 infants with abdominal wall defects referred to the South West Regional Neonatal Surgical Centre over a period of six years were reviewed. There were 27 (56%) infants with gastroschisis and 21 (44%) infants with exomphalos. At the regional centre, four pregnancies with gastroschisis were terminated following a prenatal diagnosis, one child was stillborn, and one with exomphalos and trisomy 13 died soon after birth. Of the remaining 42 live births, the one year survival for babies born with a gastroschisis was 95% (21/22) and with an exomphalos was 81% (17/20). All deaths, except one, were due to factors other than the abdominal defect. The effect on outcome of prenatal diagnosis, parental counselling, in utero transfer, mode of delivery, and methods of surgical closure was reviewed.

Abdominal Muscles↗
PubMed1976

Closure of massive abdominal wall defects in adults.

Large full-thickness abdominal wall defects may be satisfactorily closed with the temporary use of prosthetic mesh. Within two weeks after placing silastic mesh directly over exposed bowel, a membrane forms below the mesh. When the membrane thickens, central eliptical portions of the mesh are progressively excised, diminishing the size of the defect. Eventually, the mesh may be removed and the defect closed primarily or repaired with permanent prosthetic mesh.

Abdominal Muscles↗
PubMed1991

Vocal cord dysfunction presenting as bronchial asthma: the association with abnormal thoraco-abdominal wall motion.

A 23 year old man with glottic dysfunction presented as recurrent bronchial asthma. His symptoms were aggravated by application of a noseclip and associated with asynchronous thoraco-abdominal wall motion. The glottic dysfunction was corrected by sedation but not continuous positive airway pressure. This is the first report of vocal cord dysfunction triggered by application of a noseclip and associated with asynchronous thoraco-abdominal wall motion.

Abdominal Muscles↗
PubMed1993

[Value of sonography in diagnosis of uncertain lesions of the abdominal wall and inguinal region].

In a prospective trial we investigated the value of ultrasound in 134 patients with clinical doubtful findings of the abdominal wall and inguinal region. Ultrasound diagnosis was made by predefined criteria. In 105 patients a definite diagnosis was made by means of operative findings, CT, NMR, or puncture. In 40 patients a hernia was found. The sensitivity of ultrasound was 85%, the specifity 93.8%, the positive predictive value as 89.5% and the negative predictive value was 91%. Separating the findings to localisation of the hernia results in highest sensitivity for epigastric hernia (100%) and lowest for crural hernia (72.7%). The specifity for all hernias was more than 96%. Liquid tumors (hematom, serom, abscess) could be differentiated from solid tumors (lymphom, metastatic nodule, lipom). The most frequent course of wrong diagnosis was mixing the different liquid or solid tumors among themselves because of similar sonomorphologic properties. The sensitivity for hematom, serom, abscess, lymphom and metastatic nodule was 87.5%, 100%, 66.6%, 77% and 85.7% respectively. The corresponding specifity was 97.8%, 97.8%, 100%, 96.7% and 98%. Ultrasound was found to be of value for the diagnosis of clinical indeterminal findings of the abdominal wall and inguinal region.

Abdominal Muscles↗
PubMed2005

Vacuum-assisted abdominal wall lift for minimal-access surgery: a porcine model study.

Carbon dioxide pneumoperitoneum, although used universally in laparoscopy, has several well-documented complications and disadvantages. The authors describe a simple method of creating vacuum between a rigid shell and the abdominal wall in a porcine model to create adequate operative space for minimal-access surgery, which does not requires carbon dioxide, does not raise intraabdominal pressure, and is safe, cost effective, and feasible. The proposed device and method could be useful wherever basic laparoscopic equipment and a vacuum pump are available, including many parts of the developing world. The study was carried out with three groups using individual porcine models for each study. Group 1 was studied for feasibility of abdominal wall lift, adequacy of intraabdominal space, optimal vacuum levels, and safety and efficacy of the procedure. Group 2 was subjected to laparoscopic cholecystectomy and salpingectomy. Group 3 was studied for 2 days and 8 days after the animals were subjected to prolonged, high-level vacuum and monitored every 24 h to establish long-term effects. In all three groups the safety and efficacy of the proposed method were established, as well as the absence of physiological or histological alterations.

Abdominal Wall↗
PubMed2006

Necrotizing fasciitis of the abdominal wall with lethal outcome: a case report.

Necrotizing fasciitis is an acute surgical condition that demands prompt and multi-faceted treatment. Early recognition, aggressive surgical debridement, and targeted antibiotic therapy significantly affect the overall course of treatment and survival. The author reports here the case of a woman with necrotizing fasciitis of the abdominal wall and the course and methods of treatment. Two comorbidity factors (extreme obesity, diabetes) and the late diagnosis of necrotizing fasciitis, the latter masked by celullitis and phlegmona of the abdominal wall, resulted in overdue adequate surgical treatment. The combination of these factors contributed to medical treatment failure and, consequently, a lethal outcome.

Abdominal Wall↗
PubMed2006

Traumatic abdominal wall hernia: epidemiology and clinical implications.

BACKGROUND: Traumatic abdominal wall hernias (TAWHs) are uncommon, and it remains controversial whether such patients require urgent laparotomy. As such, this study was undertaken to assess the clinical sequelae of operative versus nonoperative management of TAWH, and whether certain patient or injury characteristics are predictive of the need for early surgery. METHODS: Retrospective review of all patients presenting acutely with a TAWH at a Regional Trauma Center from January 2000 to December 2004. RESULTS: Thirty-four patients were identified (age 39 +/- 12 years; Injury Severity Score 31 +/- 13). The most frequent mechanism of injury was motor vehicle collision (MVC; 24 cases), followed by motorcycle collision (6) and falls (4). The diagnosis of a TAWH was made primarily by computed tomography scan. Overall, 19 patients underwent urgent laparotomy or laparoscopy (56%) and 15 patients required bowel resection (44%). TAWH secondary to a MVC more frequently required urgent laparotomy and bowel resection than other mechanisms (p < 0.05). All three patients with clinically apparent anterior TAWH had intra-abdominal injuries and required urgent laparotomy. Only eight patients (24%) had their TAWH repaired acutely. At follow-up, two patients managed nonoperatively had symptomatic hernias, and three patients that had had an early repair had developed recurrent hernias. CONCLUSIONS: First, the mechanism of injury should be considered when deciding if a patient with a TAWH needs an urgent laparotomy. Clinically apparent anterior TAWHs appear to have a high rate of associated injuries requiring urgent laparotomy. Finally, occult TAWHs diagnosed only by computed tomography may not require urgent laparotomy or hernia repair.

Abdominal Injuries↗
PubMed2000

[Combined plastic surgery of the abdominal wall in ventral hernia].

A combined mode of abdominal wall plasty in ventral middle-point hernia is presented. The principle of this method is to close the defect with hernial sac tunica, to dissect rectus sheath anterior layers and suture the medial margins of aponeurotic flaps. The defect formed between the lateral layers of aponeurosis are replaced either by an autodermal perforated flap treated by Yanov's procedure or by synthetic graft (polypropylene net). It is concluded that the combined mode of hernioplasty corresponds to the biomechanical conception of the pathogenesis of ventral hernia. This approach may expand indications for surgery in patients with serious concomitant diseases. The rate of early and late complications decreased.

Abdominal Muscles↗
PubMed1980

Repair of abdominal wall defects: Gore-Tex vs. Marlex graft.

The purpose of this study was to provide experimental evidence for the role of Gore-Tex polytetraflourethylene as an abdominal wall prosthesis. This was achieved by evaluating tissue reaction in animals to the plastic and comparing it to that of Marlex mesh. Ten Wistar rats received especially prepared Gore-Tex implants, and another ten received Marlex. The materials were inserted in a fashion that yielded results both intraperitoneally and extraperitoneally. Gross and microscopic data were recorded at the time of sacrifice, which ranged from two to ten weeks postoperatively. Grossly, both plastics were found to be similar in intraperitoneal tissue reaction. Microscopically, all of the Gore-Tex grafts retained their original shape and demonstrated focal adherence to the muscle. In contrast, strands of Marlex showed disorganization in the host in 90 per cent of the specimens and no focal adherence to muscle. Instead, it was seen walled off in fibrous tissues. It was concluded that specifically formulated Gore-Tex may provide the more suitable abdominal wall prosthesis and that further research is necessary.

Abdominal Muscles↗
PubMed1999

Neoperitoneal formation after implantation of various biomaterials for the repair of abdominal wall defects in rabbits.

OBJECTIVE: To study the interfaces between the visceral peritoneum and some of the biomaterials used to repair defects in the abdominal wall. DESIGN: Animal study. SETTING: School of medicine, Spain. MATERIAL: 48 New Zealand white rabbits divided into 4 groups of 12 each. INTERVENTIONS: Full thickness defects 50 x 70 mm were created in the abdominal wall and repaired with polytetrafluoroethylene (PTFE, Soft Tissue Patch), one of two polypropylene patches (Marlex and Prolene), or lyophylised dura mater (Lyo-Dura). 3 animals from each group were killed at 14, 30, 60 and 90 days and specimens examined by light microscopy, scanning electron microscopy, and immuno histochemistry by labelling of macrophages with RAM-11, a specific monoclonal antibody (MoAb). MAIN OUTCOME MEASURES: Infection, healing, development of adhesions, and histological appearance of the interface. RESULTS: Tissues responded similarly to materials of similar structures. Layered prostheses (PTFE and Lyo-Dura) caused formation of a well organised neoperitoneum with few adhesions to the abdominal viscera (loose adhesions in 2 animals in each group), whereas the mesh prostheses generated a disorganised neoperitoneum with many adhesions (Marlex loose adhesions 3, firm 8, and integrated 1; Prolene loose adhesions 2, firm 8, and integrated 2). Lyo-Dura was associated with the formation of areas of calcification. Labelling of macrophages with the MoAb showed that they were in direct contact with all materials studied. CONCLUSIONS: Layered biomaterials with little or no porosity (PTFE and Lyo-Dura) are the most suitable of the four for implantation in sites where the prosthesis is in contact with the visceral peritoneum, because they induce minimal adhesions.

Abdominal Muscles↗
PubMed1993

An association between fetal abdominal wall defects and elevated levels of human chorionic gonadotropin in mid-trimester.

We analysed maternal serum human chorionic gonadotropin (hCG) in 16 pregnancies with fetal abdominal wall defects previously identified prenatally by elevated maternal serum alpha-fetoprotein (AFP) or at birth. The AFP levels had a mean of 6.38 MOM (range 0.34-15.65), as expected with these defects. The hCG levels had a mean of 1.82 MOM (range 0.23-4.11). The hCG levels in five pregnancies (31.25 per cent) were above 2.30 MOM. Elevated levels of hCG may be associated with fetal abdominal wall defects.

Abdominal Muscles↗