Reconstruction of the tongue with reinnervated rectus abdominis musculoperitoneal flaps after hemiglossectomy

Reconstruction of the tongue after glossectomy is a primary objective in the process of improving the life quality of patients suffering from tongue cancer. We developed a new method of surgical reconstruction of the tongue after hemiglossectomy, with reinnervated rectus abdominis musculoperitoneal flaps. The rectus abdominis musculoperitoneal flap consisted of the rectus muscle, posterior rectus sheath, peritoneum, the 10th, 11th and 12th intercostal nerves, and the deep inferior epigastric artery and veins. Five patients underwent immediate reconstruction of the tongue with rectus abdominis musculoperitoneal flaps after hemiglossectomy. The intercostal nerves were anastomosed to the descending branch of the hypoglossal nerve. All transplanted flaps survived. The peritoneum was replaced by squamous epithelium eight weeks after surgery. During the follow-up period, the contour and function of the reconstructed tongues was satisfactory. Our experience indicates that reconstruction of the tongue with rectus abdominis musculoperitoneal flaps after hemiglossectomy is a suitable, cosmetically acceptable method.

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THE RECTUS ABDOMINIS MUSCULOPERITONEAL AND POSTERIOR RECTUS SHEATH PERITONEAL FLAPS

Plastic & Reconstructive Surgery ◽

10.1097/00006534-199809010-00065 ◽

1998 ◽

Vol 102 (3) ◽

pp. 923-924 ◽

Cited By ~ 3

Author(s):

Zahid B. M. Niazi ◽

Stanley J. Kogan ◽

Jane A. Petro ◽

Andrew C. Salzberg

Keyword(s):

Rectus Sheath ◽

Rectus Abdominis ◽

Posterior Rectus Sheath

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Experimental model to study correction of rectus diastasis by laparoscopy, in pigs

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502003001100011 ◽

2003 ◽

Vol 18 (spe) ◽

pp. 69-76 ◽

Cited By ~ 1

Author(s):

Fábio Xerfan Nahas ◽

Lydia Masako Ferreira

Keyword(s):

Experimental Model ◽

Rectus Sheath ◽

Rectus Muscle ◽

The Other ◽

Continuous Suture ◽

Anterior Rectus Sheath ◽

Rectus Diastasis ◽

Posterior Rectus Sheath ◽

The Right ◽

Inside Out

The use of swines as an experimental model to correct rectus diastasis by laparoscopy is described on this article. The correction of this deformity was achieved by the plication of the posterior rectus sheath with the insertion of two trocars on the inferior abdominal fold. One trocar was placed in the midline whereas the other was inserted laterally to the right rectus muscle. A continuous suture was made on the posterior rectus sheath with 0-Polipropilene. This suture was anchored at the anterior rectus sheath under direct vision. An incision of all layers was performed on the flank and the abdominal wall was turned inside out so that the area of plication could be assessed and evaluated. The experimental model described showed to be feasible to demonstrate the correction of rectus diastasis by laparoscopy.

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THE RECTUS ABDOMINIS MUSCULOPERITONEAL AND POSTERIOR RECTUS SHEATH PERITONEAL FLAPS

Plastic & Reconstructive Surgery ◽

10.1097/00006534-199809030-00065 ◽

1998 ◽

Vol 102 (3) ◽

pp. 923-924 ◽

Cited By ~ 1

Author(s):

Zahid B. M. Niazi ◽

Stanley J. Kogan ◽

Jane A. Petro ◽

C. Andrew Salzberg

Keyword(s):

Rectus Sheath ◽

Rectus Abdominis ◽

Posterior Rectus Sheath

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A new minimally invasive technique for the repair of diastasis recti: a pilot study

Surgical Endoscopy ◽

10.1007/s00464-021-08393-2 ◽

2021 ◽

Author(s):

Gabriele Manetti ◽

Maria Giulia Lolli ◽

Elena Belloni ◽

Giuseppe Nigri

Keyword(s):

Open Access ◽

Minimally Invasive ◽

Abdominal Wall Defect ◽

Rectus Sheath ◽

Rectus Muscle ◽

Laparoscopic Technique ◽

Invasive Technique ◽

Diastasis Recti ◽

Posterior Rectus Sheath

Abstract Background Diastasis recti is an abdominal wall defect that occurs frequently in women during pregnancy. Patients with diastasis can experience lower back pain, uro-gynecological symptoms, and discomfort at the level of the defect. Diastasis recti is diagnosed when the inter-rectus distance is > 2 cm. Several techniques, including both minimally invasive and open access surgical treatment, are available. Abdominoplasty with plication of the anterior rectus sheath is the most commonly used, with the major limitation of requiring a wide skin incision. The new technique we propose is a modification of Costa’s technique that combines Rives–Stoppa principles and minimally invasive access using a surgical stapler to plicate the posterior sheaths of the recti abdominis. Methods It is a fully laparoscopic technique. The pneumoperitoneum is induced from a sovrapubic trocar, placed using an open access technique. The posterior rectus sheath is dissected from the rectus muscle using a blunt dissector to create a virtual cavity. The posterior sheets of the recti muscles are plicated using an endo-stapler. A mesh is then placed in the retromuscular space on top of the posterior sheet without any fixation. Using a clinical questionnaire, we analyzed the outcomes in 74 patients who underwent minimally invasive repair for diastasis of the rectus abdominis sheath. Results Seventy-four patients (9 men and 65 women) were treated using this technique. Follow-up was started two months after surgery. All procedures were conducted successfully. There were no major complications or readmissions. No postoperative infections were reported. There were two recurrences after six months. There was a significant reduction in symptoms. Conclusions This new method is feasible and has achieved promising results, even though a longer follow-up is needed to objectively assess this technique.

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Use of human fetal liver cells for treatment of patients with lower limb peripheral artery disease

Cell and Organ Transplantology ◽

10.22494/cot.v2i1.39 ◽

2014 ◽

Vol 2 (1) ◽

pp. 10-13

Author(s):

R. Salyutin ◽

D. Dombrowski ◽

M. Komarov ◽

N. Sokolov ◽

S. Palyanitsya ◽

...

Keyword(s):

Progenitor Cells ◽

Lower Limb ◽

Fetal Liver ◽

Life Quality ◽

Liver Cells ◽

Surgical Reconstruction ◽

Clinical Effects ◽

Doppler Flowmetry ◽

Human Fetal Liver ◽

Fetal Liver Cells

In the group of patients (n = 21, mean age 54 ± 5.8 years) with chronic lower limb ischemia stage IIB who were non-liable for reconstructiverestoration surgery, we have established positive clinical effects of local transplantation of human fetal liver progenitor cells. Complex examination following 1, 3, 6 and 12 months after transplantation included duplex scanning of limb arteries, x-ray contrast arteriography and laser Doppler flowmetry as well as measuring pain-free walking and evaluating life quality based on individual questionnaire data.Owing to the transplant “Cryopreserved human fetal liver progenitor cells” the patients demonstrated stable increase of life quality index and pain-free walking as well as improvement of general health allowing assign them to the group of patients with lower ischemia stage, quicker social rehabilitation and lesser risk of disabling surgery (р < 0.05). Also, there were observations of improved microcirculation in the ischemic extremities owing to activation of endothelium-independent mechanisms of vasodilatation, reduced myotonus and neurotonus of the pre-capillaries and improved endothelium-dependent influence on the microhaemodynamic and, hence, an increased reserve capillary blood flow (p < 0.05).Analysis of the obtained results indicates prospects and effectiveness of using fetal liver cells transplantation in the patients who are not liable for surgical reconstruction of the vascular bed.

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Modified technique of extraperitoneal colostomy without incision of the posterior rectus sheath

Scientific Reports ◽

10.1038/s41598-021-82626-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tao Zhang ◽

Daye Yang ◽

Gongping Sun ◽

Dewei Zhang

Keyword(s):

Rectal Cancer ◽

Abdominoperineal Resection ◽

Parastomal Hernia ◽

Retrospective Studies ◽

Rectus Sheath ◽

Lower Rectal Cancer ◽

Modified Technique ◽

Posterior Rectus Sheath ◽

Rectal Sheath ◽

Extraperitoneal Colostomy

AbstractExtraperitoneal colostomy is a widely used technique during abdominoperineal resection (APR) operation for lower rectal cancer. This technique has been reported to be effective to prevent the postoperative parastomal hernia in some retrospective studies, however, there is still a certain incidence of parastomal hernia. A modification of the extraperitoneal colostomy technique is described in this paper that keeps posterior rectal sheath intact instead of having a conventional incision, to further reduce the risk of parastomal hernia. Until now, this modified technique has been performed in 15 patients, no occurrence of parastomal hernia was observed.

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P037 TOTALLY ENDOSCOPIC SUBLAY REPAIR FOR DIASTASIS RECTI AND CONCOMITANT MIDLINE HERNIA: FIRST CASE VIDEO-REPORT

British Journal of Surgery ◽

10.1093/bjs/znab395.035 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Camillo Leonardo Bertoglio ◽

Lorenzo Morini ◽

Simona Grimaldi ◽

Pietro Carnevali ◽

Giovanni Ferrari

Keyword(s):

Polyvinylidene Fluoride ◽

Rectus Sheath ◽

Barbed Suture ◽

Preperitoneal Space ◽

Anterior Rectus Sheath ◽

Linea Alba ◽

First Case ◽

Diastasis Recti ◽

Posterior Rectus Sheath ◽

Sublay Repair

Abstract Aim We describe in detail the step by step technique of the first case of TES repair at our institution. Methods We selected the case of a M2W3L3 hernia associated to xipho-umbilical diastasis recti in a young woman symptomatic for a progressively worsening back pain and local bulky sensation. Results The intervention is started directly with a suprapubic transverse incision of 2.5 cm and a circumferential, atraumatic retraction is inserted after a small incision of the anterior rectus sheath. Blunt dissection is further continued through this access by luxating the underlying rectus muscles to separate the preperitoneal space below the arcuate line. The pneumo-preperitoneum is then inducted through this port. Laparoscopic dissection allows for enlargement of the avascular space laterally and then two 5-mm trocars are placed on the bilateral aspects of rectus muscles. By means of a lap bipolar dissector the edge of posterior rectus sheath are incised from the arcuate line following the diastasis laterally up to the subxiphoid space. The Rives plane is recovered without opening of the linea alba. After reduction of the M2 hernia both the posterior sheath and the diastatic anterior fascia are sutured with a running long-resorbable 2/0 barbed suture. Polyvinylidene fluoride (PVDF) mesh fixed with the use of an hystoacrilic glue. Conclusion Minimally invasive extraperitoneal repair of small/medium hernia defects of the linea alba is gaining wide acceptance. Concomitant presence of rectum diastasis recti seems to be the ideal indication to approach the learning curve of such a technically demanding procedure

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Surgical placement of rectus sheath catheters in a cadaveric cystectomy model

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0169 ◽

2018 ◽

Vol 100 (2) ◽

pp. 120-124 ◽

Cited By ~ 2

Author(s):

ECP Chedgy ◽

G Lowe ◽

R Tang ◽

C Krebs ◽

A Sawka ◽

...

Keyword(s):

Abdominal Surgery ◽

Surface Area ◽

Nerve Root ◽

Rectus Sheath ◽

Rectus Muscle ◽

Midline Incision ◽

Nerve Roots ◽

The Mean ◽

Peritoneal Spread ◽

Nerve Root Involvement

Introduction Surgically inserted rectus sheath catheters (RSCs) are used increasingly for analgesia after cystectomy and other abdominal surgery. Currently, there is little information on the optimal positioning of RSCs to allow maximal spread of local anaesthetic. This study sought to assess the spread of dye injected via RSCs and to highlight the extent of its coverage in a fresh unembalmed cadaveric cystectomy model in order to confirm the nerve endings that are likely to be anaesthetised with RSCs. Methods Four cadavers underwent lower midline incision with limited bladder mobilisation. A RSC was inserted into the eight hemiabdomens. The RSCs were positioned either anterior (n=5) or posterior to the rectus muscle (n=3). Dye was injected down the RSCs to evaluate spread. The eight hemiabdomens were dissected anatomically to determine the surface area of dye spread and nerve root involvement. Results The mean surface area of dye spread with anteriorly placed RSCs was 30.6cm2 anterior and 25.9cm2 posterior to the rectus muscle. The mean surface area of dye spread with posteriorly placed RSCs was 11.3cm2 anterior and 37.3cm2 posterior to the rectus muscle. The mean number of nerve roots stained with anteriorly and posteriorly placed RSCs was 3.8 and 2.7 respectively. Subcutaneous spread of dye was seen with one anterior RSC insertion. Peritoneal spread was seen with one anteriorly positioned RSC. Conclusions This study has demonstrated efficient nerve root infiltration with anteriorly and posteriorly positioned RSCs. It appears that dye spreads between the fibres of the rectus muscle rather than out laterally to the nerve roots when spreading from its initial compartment.

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