Inferior Pedicled De-epithelialized Dermal Flap for Abdominal Wall Support in Recurrent Abdominal Hernias

Relevance. Improving the electrical function of abdominal muscles in patients with extensive median hernias of the anterior abdominal wall can be facilitated by optimizing the choice of methods for combined hernioplasty, taking into account the clinical severity of connective tissue dysplasia among the hernia carriers. Objective. Study the electrical function of abdominal muscles after the methods of combined hernioplasty of extensive median hernias, taking into account the severity of connective tissue dysplasia among the hernia carriers. Results. The average numbers of electromyogram frequencies of the abdominal muscles of patients with extensive median hernias from the group without clinical signs of connective tissue dysplasia were almost the same after all the applied methods of combined hernioplasty. The predominance of the rectus muscles electric function over the lateral abdominal muscles among the patients of this group was 33,5 %. Electrofunctional rehabilitation of the abdominal muscles of patients in the second group of examinations depended on the method of combined hernioplasty and changed in the event of an increase or decrease in the severity of connective tissue dysplasia. The recovery of electroactivity of abdominal muscles in the postoperative period in patients from the second group was more significant with an increase in the number of abdominal muscles applied to aponeuroses and vagina of relaxing sections, which contributed to an increase in mobility and contractility of the musculoaponeurotic layers of the anterior abdominal wall. Conclusions. Thus, with an increase in the severity of connective tissue dysplasia in patients with extensive median abdominal hernias, the method of combined hernioplasty with the most pronounced relaxing effect in relation to the anterior abdominal wall promoted optimal rehabilitation of abdominal muscles.

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Lumps and Bumps of the Abdominal Wall and Lumbar Region—Part 1: Hernias, What the Radiologist Should Know

Journal of Gastrointestinal and Abdominal Radiology ◽

10.1055/s-0038-1676156 ◽

2018 ◽

Vol 01 (01) ◽

pp. 012-018

Author(s):

Sangoh Lee ◽

Sarah R. Hudson ◽

Catalin V. Ivan ◽

Tahir Hussain ◽

Ratan Verma ◽

...

Keyword(s):

Abdominal Wall ◽

Abdominal Cavity ◽

Abdominal Wall Hernia ◽

Clinical Suspicion ◽

Lumbar Region ◽

Abdominal Hernias ◽

Pictorial Review

AbstractAbdominal hernias represent common conditions and occur when a structure of the abdominal cavity protrudes through a defect in the abdominal wall. Recently, there has been an increase in demand from the clinical teams to confirm the clinical suspicion of an abdominal wall hernia, and to assess preoperatively large or complex hernias through imaging. This pictorial review aims to present the different appearances of abdominal wall and lumbar region hernias on imaging.

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Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

International Surgery ◽

10.9738/intsurg-d-16-00242.1 ◽

2018 ◽

Vol 103 (7-8) ◽

pp. 355-365

Author(s):

Aseel Sleiwah ◽

Sandra McAllister

Keyword(s):

Abdominal Wall ◽

Primary Repair ◽

Abdominal Wall Reconstruction ◽

Hernia Recurrence ◽

Transversus Abdominis ◽

Wound Complications ◽

Cochrane Central Register ◽

Components Separation ◽

Abdominal Hernias ◽

Wall Components

The aim of this study is to assess the clinical effectiveness of posterior abdominal wall components separation with transversus abdominis muscle release (PCS-TAR) in the management of ventral abdominal hernias. Ventral abdominal hernias complicate up to 11% of laparotomy wounds. Surgical management includes primary repair, hernioplasty, flaps, and components separation. A technique has been described to close large abdominal defects by releasing bilateral myofascial flaps of rectus abdominis from external oblique and advancing these flaps to the midline. Minimally invasive and endoscopic techniques were subsequently developed to reduce complications. A recently described method is PCS-TAR. The hypothesis is that PCS-TAR for abdominal wall reconstruction is associated with lower rates of wound complications and hernia recurrence than other components separation techniques. A comprehensive search of databases including Medline, Embase, Cochrane Central Register of Controlled Trials, and Scopus was conducted in accordance with PRISMA guidelines, looking for the primary outcomes of hernia recurrence and wound complications following different techniques of components separation. Inclusion and exclusion criteria were defined. The quality of studies was examined independently by 2 assessors. A total of 363 studies were identified. Three retrospective comparative studies met the inclusion criteria. No randomized control trial comparing different techniques of abdominal wall components separation was identified. No technique could be identified as superior to others, due to a paucity of the literature. However, based on a few retrospective cohort studies, PCS-TAR emerges as a well-tolerated new technique, with a low incidence of wound complications and hernia recurrence.

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Incisional abdominal hernias, some consideration about it.

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v8i10.02 ◽

2021 ◽

Vol 8 (10) ◽

pp. 5683-5686

Author(s):

Dritan Çobani ◽

Agron Dogjani ◽

Arben Gjata ◽

Kastriot Haxhirexha ◽

Etmont Çeliku ◽

...

Keyword(s):

Risk Factors ◽

Abdominal Surgery ◽

Abdominal Wall ◽

Abdominal Wall Hernia ◽

Suture Technique ◽

University Hospital ◽

Abdominal Wall Defects ◽

Abdominal Incision ◽

Abdominal Hernias ◽

Number Of Patients

Background: Abdominal incision hernia is a common complication of abdominal surgery. Despite significant improvements in medical technology and healthcare, an increasing number of patients are also benefiting from complex surgical procedures. The objective of this study was to analyze the risk factors for incisional abdominal hernias and to identify measures that could reduce the incidence of this complication. Material and methods: All patients included in the study are from the University Hospital of Trauma for a period of 3 years, from January 1, 2015, to December 31, 2017. Eighty-seven adult patients who underwent surgical repair of incisional abdominal wall hernia were enrolled. Variables that are compared in this study include the type of suture material, type of suture technique and concomitant diseases .etc. Results: According to our study the risk factors for incisional hernia are related to patients and the abdominal surgery used, the size of the abdominal wall defects. Conclusions: Risk factors such as the size of the defect, wound infection, obesity, use of steroids and chronic constipation have great importance and have to be strictly evaluated as they have more chances to lead to a possible recurrence…

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Physiology in Medicine: physiological basis of diaphragmatic dysfunction with abdominal hernias–implications for therapy

Journal of Applied Physiology ◽

10.1152/japplphysiol.00276.2014 ◽

2015 ◽

Vol 118 (2) ◽

pp. 142-147 ◽

Cited By ~ 6

Author(s):

Patrick Koo ◽

Eric J. Gartman ◽

Jigme M. Sethi ◽

F. Dennis McCool

Keyword(s):

Abdominal Surgery ◽

Incisional Hernia ◽

Abdominal Wall ◽

Common Complication ◽

Diaphragmatic Dysfunction ◽

Physiological Basis ◽

Diaphragm Dysfunction ◽

Incisional Hernias ◽

Abdominal Hernias ◽

Diaphragm Function

An incisional hernia is a common complication after abdominal surgery. Complaints of dyspnea in this population may be attributed to cardiopulmonary dysfunction or deconditioning. Large abdominal incisional hernias, however, may cause diaphragm dysfunction and result in dyspnea, which is more pronounced when standing (platypnea). The use of an abdominal binder may alleviate platypnea in this population. We discuss the link between diaphragm dysfunction and the lack of abdominal wall integrity and how abdominal wall support partially restores diaphragm function.

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Bowel Obstruction and Peritoneal Dialysis: A Case Report of a Patient with Complications from a Broad Ligament Hernia

Clinical Medicine Insights Case Reports ◽

10.4137/ccrep.s40059 ◽

2016 ◽

Vol 9 ◽

pp. CCRep.S40059 ◽

Cited By ~ 5

Author(s):

Naoko Otani-Takei ◽

Tetsu Akimoto ◽

Ai Sadatomo ◽

Osamu Saito ◽

Shigeaki Muto ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Abdominal Wall ◽

Bowel Obstruction ◽

Correct Diagnosis ◽

Broad Ligament ◽

Exploratory Laparotomy ◽

Peritoneal Dialysis Patient ◽

Internal Hernias ◽

Abdominal Hernias ◽

Initial Work

Abdominal hernias are a common cause of bowel obstruction. The major types of abdominal hernias are external or abdominal wall hernias, which occur at areas of congenital or acquired weakness in the abdominal wall. An alternative entity is internal hernias, which are characterized by a protrusion of viscera through the peritoneum or mesentery. We herein present the case of a female peritoneal dialysis patient with bowel obstruction due to an internal hernia. Although an initial work-up did not lead to a correct diagnosis, an exploratory laparotomy revealed that she had intestinal herniation due to a defect in the broad ligament of the uterus, which was promptly corrected by surgery. The concerns about the perioperative dialytic management as well as the diagnostic problems regarding the disease that arose in our experience with the present patient are also discussed.

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Hernia sacs: is histological examination necessary?

Journal of Clinical Pathology ◽

10.1136/jclinpath-2013-201734 ◽

2013 ◽

Vol 66 (12) ◽

pp. 1084-1086 ◽

Cited By ~ 23

Author(s):

Tao Wang ◽

Rajkumar Vajpeyi

Keyword(s):

Abdominal Wall ◽

Tertiary Care ◽

Epithelioid Cell ◽

Tertiary Care Centre ◽

Hernia Sac ◽

Perivascular Epithelioid Cell ◽

Abdominal Hernias ◽

Inguinal Hernias ◽

Pathology Specimen ◽

Gross Examination

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.

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