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[Aspects of peritoneal fascia closure after surgical laparoscopy].

Following laparoscopic surgery using trocar ports of 10 mm and more Richter's hernia and incarceration of bowel are reported. To prevent this wound closure of all layers is a must. Newly developed techniques are described. Fascia closure is accompanied by serious pain. Pain management is achieved by local anesthesia.

Anesthesia, Local↗

[Tragus perichondrium and cartilage, temporal fascia in tympanoplasty].

Plastic reconstruction of the tympanic membrane was performed with the use of tragus perichondrium and cartilage, temporal fascia in 245 and 141 patients, respectively, Tympanoplastic use of the tragus perichondrium and cartilage provides good morphological and functional results. Such surgery may be a method of choice in filling defects of the tympanic membrane.

Adolescent↗

Urethroplasty by superficial membranous fascia for long urethral strictures: a new approach.

36 patients has single-stage repair of severe bulbar urethral strictures using a superficial membranous fascia tubed flap. The length of follow-up varied from 9 months to 2 years (mean 15 months). Recurrence occurred in 1 case. Urodynamic studies in 35 cases before and after urethroplasty showed a marked improvement in urinary flow and voiding postoperatively. This procedure is safe, simple, economically preferable and has a no higher risk than other 1- and 2-stage procedures.

Adult↗

[Influence of the dentate fascia on the sensory responses of neurons in hippocampal field CA3].

In experiments with unanaesthetized rabbits the influences of electric stimulation of the dentate fascia (DF) on the extracellularly recorded spontaneous and evoked activity of the CA3 neurones were investigated. Stimulation of a fixed locus in the DF during recording in the CA3 by a microelectrode, shifted along the longitudinal axis of the hippocampus, supported the notion of the topical, "segmental" organization of connections between the DF and CA3. A relatively narrow "active zone" (approximately 700 nm) appeared in the CA3 during the threshold DF stimulation: it was bordered by zones with predominantly inhibitory responses to stimulation. The CA3 neurones in the "active zone" rapidly lost their reactivity to sensory stimuli. In the "inhibitory" and "zero" zones the normal level of reactivity to sensory stimuli was preserved.

Animals↗

The role of the fascia in muscle surgery.

Mishandling of the fascial tissues during surgery on the extraocular muscles accounts for unsatisfactory alignment of the eye in the primary position; restricted movement of the globe; scarred, injected, heaped conjunctiva; and changes in the normal eyelid level. These hardships may be impossible to overcome by performing secondary surgery. The most serious and frequently recurring abuse of the fascia during muscle surgery is the needless penetration of the Tenon's capsule beyond 10 mm. from the limbus, which results in prolapse of the fat cushion into the spaces that are normally between the movable fascial planes and sclera. The prolapsed fat infiltrates into the sclera and muscle capsules and undergoes fibrofatty proliferation; with time, cicatrization of these scarred tissues pulls the eye to a deviated position, restricting its normal movement. Also, the fat cushion migrates forward under the conjunctiva toward the limbus, causing the unsightly appearance of injected yellowish fleshy tissue near the limbus. A patient's ocular motility can be ruined for life and his appearance deformed because of a surgeon's disrespect for the important role Tenon's capsule plays in the motility of the globe.

Fasciotomy↗