scholarly journals ABDOMINOPLASTY IN THE SURGICAL TREATMENT OF PATIENTS WITH COMPLEX ABDOMINAL WALL DEFECTS

2019 ◽  
Vol 19 (2) ◽  
pp. 63-67
Author(s):  
G. R. Salimov ◽  
R.B. Lysenko
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Subcutaneous Fat ◽  
Abdominal Wall Defects ◽  
Municipal Hospital ◽  
Surgical Department ◽  
Excess Skin ◽  
Simultaneous Operations ◽  
Type Size ◽  
Surgical Tactics

Patients with complex abdominal wall defects usually have deformations of the abdomen, which may remain after the operation, and require the solution of a whole ramge of problems. Quite often, abdominal wall defects are combined with a variety of aesthetic deformities that are associated with abnormal postoperative scars, trophic ulcers, and fistulas. Though the restoration or improvement of abdominal wall functionality is the main goal of alloplasty for complex abdominal wall defects, the cosmetic aspects of the operation, sometimes far more important for patients, deserve special attention. The choice of optimal operative access largely depends on lateral surgery, but most surgeons do not pay special attention to it and mainly use framing incisions above the defect or protrusion. By this time, such values ​​as the type, size of the incision, depth, and borders of flaps flaking are reported empirically and often lead to additional deformation of the operative area and the development of complications. Abdominoplasty is one of the most controversial operations in aesthetic and plastic surgery, where complications reach 27.5-30.8%. The concept of "abdominoplasty" provides techniques for the operational correction of abdominal wall deformities presented by excess skin and subcutaneous fat, pathological postoperative scars, as well as defects of the muscular aponeurotic layer in abdominal area. There are several abdominoplasty techniques. The purpose of this work is to determine the efficacy of the modified abdominoplasty in the surgical treatment of complex abdominal wall defects. Materials and methods. The study involved 360 patients with complex abdominal wall defects operated on at the surgical department of the Poltava Municipal Hospital №1 in for the last 10 years. Various deformities of the abdominal wall were detected in 289 patients (80,3%). Localization of the defects can be described as following: M – 306 (85%), L – 31 (8,6%), ML – 23 (6,4%). The size of the defects: W1 – 103 (28,6%), W2 – 188 (52,2%), W3 – 69 (19,2%). Additional diastase rectus muscles were detected in 179 patients (49,7%). The combined surgical diseases were found in 332 patients (92,2%); 18,1% of them were diagnosed to have intra-abdominal pathology. Results and discussion. The following types of dermatolipectomy were used: longitudinal - 77 cases (28,1%), by Babcock - 114 cases (41,6%), by Kelly - 6 cases (2,2%), by Fernandes - 63 cases (22,9%), modified Fernandez - 7 cases (2,5%), by Berson - 3 cases (1,1%), by Torek - 2 cases (0,8%), by Hrazer – 2 cases (0,8%). Simultaneous operations were performed on in 65 patients (18,1%). Types of alloplasty used: «onlay» - 3 cases (0,8%), «sublay» - 289 cases (80,3%), «sublay-inlay» - 38 cases (10,6%), «inlay» - 3 cases (0,8%), Ramirez – 4 cases (1,1%), intra-abdominal - 2 cases (0,6%), combine – 21 (5,8%). Conclusions. The term abdominoplasty has a broader definition than it was considered previously. Differentiated surgical tactics for patients with complex abdominal wall defects improves the abdominoplasty outcomes.

scholarly journals RESULTS OF SURGICAL TREATMENT OF NEWBORNS WITH ANTERIOR ABDOMINAL WALL MALFORMATIONS

2020 ◽  
Vol 24 (1) ◽  
pp. 5-10
Author(s):  
A. A. Shchukina ◽  
O. G. Mokrushina ◽  
A. S. Gurskaya ◽  
E. Yu. Dyakonova ◽  
O. N. Nakovkin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Functional Results ◽  
Abdominal Wall Defects ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Satisfactory Condition ◽  
National Medical ◽  
Increased Risk

Introduction. Malformations of the anterior abdominal wall in newborns is one of the actual problems in neonatal surgery. Antenatal diagnostics of such defects as omphalocele and gastroschisis allows to diagnose and perform necessary surgical interventions in time. Often, outcomes of treatment of newborns with embryonic hernia depend not only on the form of the defect, but also on the accompanying abnomalies. Purpose. To present outcomes of surgical treatment of newborns with anterior abdominal wall malformations. Material and methods. From December 2017 till May 2019, 34 pregnant women with fetal anterior abdominal wall malformations were consulted; 17 out of them with omphalocele and gastroschisis were treated. Results. In December 2017, the surgical department for newborns and infants at the National Medical Research Center for Children’s Health successfully helped children with malformations of the anterior abdominal wall. 16 children were discharged home in a satisfactory condition; there was one unsatisfactory outcome. 11 patients were treated for gastroschisis; 6 patients were treated for omphalocele. 3 patients had repeated surgeries for concomitant pathologies. There were no any adhesive processes and commissural intestinal obstruction. Conclusions. In Russia, there are two groups of newborns with anterior abdominal wall defects: children with isolated defects and children with concomitant pathologies who have an increased risk of unsatisfactory outcomes. The technique developed by us for treating newborns with anterior abdominal wall malformations and concomitant pathologies has very good cosmetic and functional results and reduces the number of postoperative complications and unsatisfactory outcomes.

scholarly journals A new surgical treatment for abdominal wall defects

Medicine ◽  
2018 ◽  
Vol 97 (9) ◽  
pp. e9993 ◽  
Author(s):  
Qiang Chen ◽  
Qi Liu ◽  
Yan Suo ◽  
Qingping Xie
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defects

Processed Bovine Tunica Vaginalis as a Biomaterial for the Repair of Large Abdominal Wall Defects in Surgical Treatment

2001 ◽  
Vol 2 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Wong Siew Tung ◽  
Jamaludin Zainol . ◽  
A. G. Pillay . ◽  
Norimah Yusof . ◽  
Loqman Mohamad Yusof .
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defects ◽  
Tunica Vaginalis

scholarly journals Polypropylene endoprostheses in the surgical treatment of strangulated postoperative ventral hernias

2012 ◽  
Vol 93 (3) ◽  
pp. 541-544
Author(s):  
I M Fatkhutdinov
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Subcutaneous Tissue ◽  
Abdominal Cavity ◽  
Subcutaneous Fat ◽  
Postoperative Mortality ◽  
Early Postoperative Period ◽  
Mesh Endoprostheses ◽  
Ventral Hernias

Aim. To determine and implement the best ways to position mesh endoprostheses in the anterior abdominal wall during strangulated postoperative ventral hernias; to introduce methods of non-stretch hernioplasty into emergency surgery of giant hernias. Methods. 115 patients (27 males and 88 females) with strangulated postoperative ventral hernias aged 30-73 years were under observation. Depending on the size of the hernia and on the intraoperative findings different methods of implantation of the mesh endoprostheses were used, which prevented the mesh contact with subcutaneous fat and abdominal organs. For small and medium-sized hernias the mesh was placed under or over the abdominal membrane, it was fixed to the abdominal wall, the aponeurosis was sewn together in an «edge to edge» fashion. In cases with giant hernias non-stretch hernioplasty was performed. During the operation of non-stretch hernioplasty, dissection and excision of the hernial sac was performed in such a way that made it possible to use it to cover the abdominal wall defect. Results. In the early postoperative period in 17 (14.8%) patients seromas had formed in the wound, which were treated by needle puncture under ultrasound guidance. Postoperative mortality was 5.2% (6 people). In 5 cases the deaths were due to myocardial infarction and pulmonary embolism. One patient developed peritonitis due to suture insufficiency of the enteric anastomosis. Of all patients with lethal outcomes five patients were admitted after more than 6 hours from the start of the strangulation, one patient was admitted after 3 hours. Conclusion. The usage of techniques that delimit the mesh prosthesis from the abdominal cavity and subcutaneous tissue, and the introduction of non-stretch methods for giant hernias in the surgical treatment of strangulated postoperative ventral hernia contribute to improved outcomes of treatment in this group of patients.

A New Technique for Surgical Treatment of Large Abdominal Wall Defects: An Experimental Study

1997 ◽  
pp. 80-85
Author(s):  
A. Iuppa ◽  
M. Migliore ◽  
D. Santagati ◽  
G. Petralia ◽  
C. Sapienza ◽  
...  
Keyword(s):  
Experimental Study ◽  
Surgical Treatment ◽  
Abdominal Wall ◽  
New Technique ◽  
Abdominal Wall Defects ◽  
A New Technique

scholarly journals Laparoscopic alloplasty of troacary hernia paraumbilically area

2019 ◽  
Vol 2 (8) ◽  
pp. 47-52
Author(s):  
Ia.P. Feleshtynsky ◽  
V. А. Dadayan
Keyword(s):  
Surgical Treatment ◽  
Length Of Stay ◽  
Early Postoperative Period ◽  
Surgical Department ◽  
Abdominal Hernias ◽  
Scientific Justification ◽  
Group 5 ◽  
Group 2 ◽  
Surgical Tactics ◽  
Number Of Faces

Currently, researchers continue to debate about the choice of surgical treatment for such hernias, which is more appropriate to use: classic laparoscopic alogioplasty or a modified laparoscopic alloplasty technique. Objective. The scientific justification for the choice of surgical tactics and improve the results of surgical treatment of trocar hernias of the paraumbilical site and prove the effectiveness of the proposed method. Materials and methods. The article presents the results of the analysis of surgical treatment of trocar abdominal hernias in 64 patients aged 30 to 75 years. During the analysis, we divided the patients into two groups equal in number of faces, the inclusion factor in the first group was classical laparoscopic alogioplasty (32 patients), and the second group included patients who underwent our modified surgery - laparoscopic alloplasty of postoperative trocar hernias paraumbilical plot. Research results and discussion. When conducting a comparative analysis of the course of the early postoperative period in patients of the first group, we found that seroma was observed in 12.5% (4) patients, the second group – in 6.3% (2) patients. Postoperative wound infection was observed in only one (3.1%) patient of the first group. The length of stay of patients in the clinic, in the inpatient department, ranged from 7 to 2 days. Patients of the first group - 5 ± 2.12 (p <0.05) days, and patients of the second group - 2 ± 1.31 (p <0.05) days, respectively. Findings. Therefore, we found that laparoscopic alloplasty of trocar hernias of the abdomen has significant advantages over open by reducing the frequency of postoperative complications by more than two times from the side of the wound. In addition, the length of stay of such patients in the surgical department is reduced by 2.5 times, which, in turn, significantly reduces costs. During the prospective observation of patients  who underwent laparoscopic allogernioplasty of trocar abdominal hernias (within three years after the intervention), we can state that the elimination of the defect by the proposed method is not accompanied by relapse.  

scholarly journals Combination of autoplasty with autodermoplasty in the treatment of lateral abdominal hernias

2012 ◽  
Vol 93 (2) ◽  
pp. 250-255
Author(s):  
A A Botezatu ◽  
I N Nurmeev
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
State Institution ◽  
Case Histories ◽  
Treatment Results ◽  
Surgical Department ◽  
Lateral Abdominal Wall ◽  
New Methods ◽  
Abdominal Hernias

Aim. To improve the outcomes of treatment in patients with lateral abdominal hernias by combining autoplastic methods with autodermoplasty. Methods. 42 case histories of patients with lateral abdominal wall hernias, operated in the first surgical department of the State Institution «Republican Clinical Hospital», Tiraspol city, from 2001 to 2011 were subjected to retrospective analysis. In all of the cases surgical treatment was performed. Combined methods of hernioplasty, which combine autoplasty with autodermoplasty, were applied. The authors’ personal patented method of hernioplasty was also used among others. Results. According to the classification of Chevrel-Rath (2000) 23 (54.7%) of the patients had inferolateral hernias, 5 (11.9%) patients - supra-lateral hernias, 8 (19%) patients - lumbar hernias, there were also 2 (4.8%) patients each with transrectal, pararectal and paracolostomy hernias. Despite their small number in the total amount of postoperative hernias (17.5%), 26 (65%) patients had large and giant lateral hernias, while recurrences were present in 7 (16.7%) cases. Treatment results were satisfactory. Complications and recurrence occurred in 1 (2.9%) patient each. Conclusion. The combination of autoplasty with autodermoplasty is an effective method of treatment for inferolateral, supra-lateral, pararectal, transrectal, paracolostomy and lateral hernias; during lumbar hernias autodermoplasty even with two autodermal grafts was not as effective, and therefore justified is the search for new methods of hernioplasty.

Surgical Treatment of Large Contaminated Abdominal Wall Defects

2005 ◽  
Vol 201 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Hendrikus J.A.A. van Geffen ◽  
Roger K.J. Simmermacher ◽  
Theo J.M.V. van Vroonhoven ◽  
Christiaan van der Werken
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defects
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