AN ANTERIOR EXTRAPERITONEAL INCISION FOR DONOR NEPHRECTOMY THAT SPARES THE RECTUS ABDOMINIS MUSCLE AND ANTERIOR ABDOMINAL WALL NERVES

2000 ◽  
Vol 164 (6) ◽  
pp. 1898-1900 ◽  
Author(s):  
JOHN F. REDMAN
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Donor Nephrectomy ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle

scholarly journals Removing Rectus Abdominis Muscle Desmoid Tumour with Mesh Implant Reinforcement of Musculoaponeurotic Layer

2020 ◽  
Vol 9 (4) ◽  
pp. 305-310
Author(s):  
S. P. Muzhikov ◽  
M. Yu. Eremenko ◽  
Yu. S. Kuznetsov
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rectus Abdominis ◽  
Desmoid Tumour ◽  
Rectus Abdominis Muscle ◽  
Collagen Fibres ◽  
Mesenchymal Tumour ◽  
Cosmetic Effect ◽  
Surgery Department ◽  
Mesh Implant

Introduction. Desmoid fibroma is a rare mesenchymal tumour developing from differentiated fibroblasts and excessive amounts of collagen fibres. This paper presents a clinical case of removal of an anterior abdominal wall neoplasm — a rectus abdominis muscle desmoid tumour, with the following mesh implant reinforcement of the musculoaponeurotic layer.Materials and methods. A 35 year old female patient Ch. was referred to the surgery department of “V nadezhnykh rukakh” hospital in November 2019, with complaints of a neoplasm in the anterior abdominal wall that was causing pain when touched, and dysuria. The patient’s clinical diagnosis was recorded as a neoplasm of the anterior abdominal wall.Results and discussion. The patient underwent further examination and scheduled surgery. The neoplasm was removed completely leaving the surrounding healthy tissues, the anterior abdominal wall was reinforced with a mesh implant. The pathology results matched a rectus abdominis muscle desmoid tumour. Literature offers very little information on anterior abdominal wall neoplasms or procedures for their removal with simultaneous plastic mesh implantation. Cases such as this require further study.Conclusion. A desmoid tumour of the rectus abdominis muscle can be radically removed; the procedure can be combined with the anterior abdominal wall plastic surgery with a mesh implant, making it possible to achieve a pronounced cosmetic effect regardless of the extensive surgical injury.

scholarly journals A case report of aponeurotic origin of rectus abdominis

2014 ◽  
Vol 03 (02) ◽  
pp. 84-86
Author(s):  
Challa Ratna Prabha ◽  
Namburu Bhanu Sudha Parimala
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Andhra Pradesh ◽  
Anterior Abdominal Wall ◽  
Pubic Symphysis ◽  
Rectus Abdominis ◽  
General Surgeon ◽  
Pubic Tubercle ◽  
Middle Aged ◽  
Medical College

AbstractRectus abdominis is a long strap like muscle that extends along the entire length of anterior abdominal wall. Normally the rectus abdominis arises by two tendons. The larger lateral tendon attached to the crest of the pubis, pubic tubercle up to pectineal line. The medial tendon is attached to the pubic symphysis. The fleshy fibers of rectus abdominis replaced by aponeurosis below the umbilicus was found during the routine dissections of a middle aged female cadaver at Dr. Pinnamaneni Siddhartha Medical College, Chinnavutapalli, Andhra Pradesh, India. The knowledge of partial or complete absence of rectus abdominis and other anterior abdominal wall musculature is of immense importance for the General surgeon, Anatomist and the Gastroenterologist.

scholarly journals ANTERIOR ABDOMINAL WALL ENDOMETRIOMA: A DIAGNOSTIC CHALLENGE

2016 ◽  
Vol 3 (2) ◽  
pp. 44-46
Author(s):  
Salamat Khan ◽  
Krishna Bhasyal ◽  
Bhusan Raj Timilsina
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Lower Abdominal Pain ◽  
Radical Resection ◽  
Rectus Abdominis Muscle ◽  
Medical Sciences ◽  
Diagnostic Challenge ◽  
History Of

We are reporting a case of abdominal wall endometrioma (AWE) in a 32-year-old woman who had an 8 months history of lower abdominal pain and lump. The physical examination revealed an ill-defined mass without tenderness. Computed tomography (CT) showed an enhancing is odense mass at the level of umbilicus right to mid line in right rectus abdominis muscle. The patient was treated with a wide radical resection with a 1 cm margin. There was no postoperative complication. The histological examination confirmed endometriosis. The patient is now on regular follow-up and doing well without any recurrence, five months after her operation.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Page: 44-46 

scholarly journals Abdominal Wall Endoscopic Extraperitoneal Reconstruction Technique in Patients with Primary Midline Hernias and Diastasis of the Rectus Abdominis Muscles

2021 ◽  
Vol 14 (1) ◽  
pp. 19-24
Author(s):  
Vladislav Sergeevich Rakintsev ◽  
Anatolii Vladimirovich Yurasov
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rectus Abdominis ◽  
Reconstruction Technique ◽  
Type I ◽  
Anatomical Landmarks ◽  
Confined Space ◽  
Needle Holder ◽  
White Line ◽  
Surgical Department

Introduction. The paper focuses on technical features of endoscopic extraperitoneal reconstruction (EER) of the anterior abdominal wall in patients with primary median hernias combined with diastasis of the rectus abdominis muscles, the nuances of the operating room equipment and preparation of patients for intervention.The aim of the study was to analyze the stages and features of the technique for performing endoscopic extraperitoneal reconstruction of the anterior abdominal wall to ensure safe and qualified implementation of the operation in clinical practice.Materials and methods. This research was a prospective study including 45 clinical cases of patients with primary median hernias of the anterior abdominal wall combined with diastasis of the rectus abdominis muscles, who were exposed to endoscopic extraperitoneal reconstruction. The study was performed in the surgical department of the private healthcare facility "Central Clinical Hospital Russian Railways-Medicine" in 2019-2020. The median follow-up was 14 months (8 - 18 months), there were no complications estimated higher than type I according to the Clavien-Dindo classification and relapses.Results and discussion. Successful EER requires thorough preoperative preparation: to connect a second monitor; to distance anesthetic equipment; to ensure the patient is in an extension position in the lumbar segment of the spinal column; to identify principle anatomical landmarks under ultrasound control. The main two stages of EER - mobilization and reconstruction - are performed extraperitoneally in a confined space, and therefore the localization of the ports must be anatomically validated. The major point at the stage of mobilization is to maintain the integrity of the parietal peritoneum, this solves visualization problems and helps to work in the required layer of the anterior abdominal wall. Adherence to the principles of open surgery, namely, orientation of the needle holder at an angle close to 0 to the suture line (white line), and the needles at a right angle; maintaining working angles between the instruments 30-60, - allows effectively performing the reconstructive stage.Conclusion. Thus, a topographic-anatomically based approach to each stage of the operation and adherence to a set of features of the surgical technique allows safely and effectively applying EER for the treatment of patients with primary midline hernias and diastasis of the rectus abdominis muscles.

scholarly journals Optimization of the choice of laparoscopic and open alloplastic surgery of postoperative ventral hernias

2020 ◽  
pp. 289-291
Author(s):  
Ya.P. Feleshtynskyi
Keyword(s):  
Wound Infection ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rectus Abdominis ◽  
Postoperative Treatment ◽  
Abdominal Pressure ◽  
Electrolyte Balance ◽  
Preoperative Preparation ◽  
Diastasis Recti ◽  
Ventral Hernias

Background. Postoperative ventral hernias (PVH) account for 20.4-22 % of all abdominal hernias. The recurrence rate after alloplastic surgery of large and giant PVH is 10-25 %. Adequate selection of alloplastic surgery method in PVH may help to improve treatment outcomes and reduce the frequency of relapses. Objective. To describe the features of laparoscopic and open alloplastic surgery of PVH. Materials and methods. Analysis of literature sources on this topic. Results and discussion. According to the classification, PVH are divided into medial (subxiphoid, epigastric, umbilical, subumbilical, suprapubic) and lateral (subcostal, flank, iliac, lumbar). Autoplastic surgery (according to Sapezhko, Mayo) is used only for small-sized PVH in young and middle-aged people in the absence of diastasis recti and obesity (up to 3.5 %). In 96.5 % of cases alloplastic surgery is used (open – 81.1 %; laparoscopic – 15.4 %). There are about a dozen types of alloplastic interventions. When choosing the optimal intervention, it is necessary to take into account the width of the defect, the width of diastasis or contracture of the rectus abdominis muscles, the level of intra-abdominal pressure. When performing laparoscopic alloplastic intervention, prevention of trocar wound infection is performed using Dekasan solution (“Yuria-Pharm”) by rinsing before suturing. Alloplastic surgeries of giant PVH should be performed in combination with techniques for separating the anatomical components of the anterior abdominal wall and mandatory monitoring of intra-abdominal pressure, as intra-abdominal hypertension is a frequent complication of such procedures. Preoperative preparation and examination of patients before PVH surgery includes laboratory tests (general and biochemical blood tests, coagulation analysis), electro- and echocardiography, ultrasound or computed tomography of the required areas, spirography, consultations with related specialists, slag-free nutrition and 10-12 days of laxatives (in the outpatient settings), correction of comorbidities, maximum bowel cleansing before surgery, control of intra-abdominal pressure, prevention of infectious complications of the wound and prevention of thromboembolic complications. Contraindications to elective surgery include ineffective preoperative preparation, impaired cardiopulmonary activity, increased intra-abdominal pressure >12 mm H2O using bandage compression, reduction of breathing function <60 % of normal. To prevent postoperative wound infection during surgery at the stages of separation of the anatomical components of the anterior abdominal wall, fixation of the mesh and before drainage and suturing the wound, Decasan washing is used (400-800 ml depending on the wound surface area). Postoperative treatment includes analgesia (paracetamol – Infulgan, “Yuria-Pharm”), oxygen therapy, abdominal bandaging, monitoring of intra-abdominal pressure, stimulation of intestinal function (metoclopramide – Reosorbilact, “Yuria-Pharm”), antibacterial treatment, correction of electrolyte balance, nonsteroidal anti-inflammatory drugs. Removal of drainages from the mesh implant is performed in 3-4 days, from the subcutaneous wound – in 5-6 days. Conclusions. 1. The choice of PVH alloplastic surgery type should be made taking into account the size of the defects, the width of the diastasis recti and intra-abdominal pressure. 2. Optimization of the choice of treatment procedure for giant PVH can be achieved by determining the intra-abdominal pressure during surgery during contact of the rectus abdominis muscles. 3. Decasan lavage is used to prevent infection of trocar and surgical wounds.

scholarly journals Rectus Abdominis Muscle Malignant Fibrous Histiocytoma Causing a Large Abdominal Wall Defect: Reconstruction with Biological Mesh

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Evangelos Falidas ◽  
Stavros Gourgiotis ◽  
Christina Goudeli ◽  
Stavros Mathioulakis ◽  
Konstantinos Vlachos ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Malignant Fibrous Histiocytoma ◽  
Fibrous Histiocytoma ◽  
Abdominal Wall Defect ◽  
Biological Mesh ◽  
Rectus Abdominis ◽  
Abdominal Wall Defects ◽  
Rectus Abdominis Muscle ◽  
Wall Defect

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh.

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