NEUMOPERITONEO PROGRESIVO PREOPERATORIO PARA REPARO DE HERNIA INCISIONAL CON PÉRDIDA DE DOMINIO: REPORTE DE UN CASO.

Incisional hernias with loss domain (HIPD), has a prevalence between 5 - 20%, due to its technical complexity are a challenge for abdominal wall surgeon, because decrease in abdominal compliance, for muscle atrophy and retraction, as well as complications associated with the procedure. We present the preoperative use of progressive pneumoperitoneum (NPP), as a technique for preparing the abdominal wall, by placing a multipurpose permanent catheter (pig tail type) guided by computed tomography, for a 69-year-old male patient, farmer, and colostomy carrier. by sigma volvulus, which presented abdominal sepsis secondary to anastomosis dehiscence, which led to a colostomy, and HIPD formation of 25 x 15 cm. The benefits of NPP are: it reduces the size of the second cavity formed, facilitates the placement of the mesh, reduces the tension in the closure of the abdominal wall and the development of intra-abdominal hypertension syndrome, therefore a lower probability of post-surgical recurrence. The repair technique used was release of the transverse muscle of the abdomen (TAR), which is indicated in HIPD. CONCLUSIONS. HIPD repair is technically difficult because compliance of the abdominal wall is affected, even more so in our case due to the presence of a colostomy. Optimization of the preoperative abdominal wall with the progressive pneumoperitoneum technique plus the TAR technique is one of the valid options available to achieve this goal.

The role of the submentalis muscle in the feeding biomechanics of the marine toad, Rhinella marina

It is well documented that coordination of feeding behavior in anuran amphibians requires precise coordination of the jaw levators and depressors with the timing of the protraction of the tongue. (for review, see Nishikawa, 2000). However, the neuronal mechanism initiating and synchronizing this coordination is not well understood. In addition to the intermandibularis muscle and tongue musculature in the lower jaw, there is a small, transverse muscle at the tip of the jaw, the m. submentalis. Previous anatomical work has demonstrated the presence of muscle spindles in the submentalis, leading to the hypothesis that the activation of this muscle may provide proprioceptive information to aid in coordinating the feeding biomechanics in Rhinella marina. Here, we demonstrate that the submentalis likely acts as a ‘trigger’ to initiate the hypoglossal nerve to activate the tongue, and without feedback information from the muscle spindles of the submentalis, tongue protraction is compromised.

The role of the submentalis muscle in the feeding biomechanics of the marine toad, Rhinella marina

It is well documented that coordination of feeding behavior in anuran amphibians requires precise coordination of the jaw levators and depressors with the timing of the protraction of the tongue. (for review, see Nishikawa, 2000). However, the neuronal mechanism initiating and synchronizing this coordination is not well understood. In addition to the intermandibularis muscle and tongue musculature in the lower jaw, there is a small, transverse muscle at the tip of the jaw, the m. submentalis. Previous anatomical work has demonstrated the presence of muscle spindles in the submentalis, leading to the hypothesis that the activation of this muscle may provide proprioceptive information to aid in coordinating the feeding biomechanics in Rhinella marina. Here, we demonstrate that the submentalis likely acts as a ‘trigger’ to initiate the hypoglossal nerve to activate the tongue, and without feedback information from the muscle spindles of the submentalis, tongue protraction is compromised.