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Dr., Iqbal Ahmed, Md Farouqe Hossain Dr., Md. Asaduzzaman Dr., and Riffat Chowdhury Dr. "Evaluation of Reducing the Excess Abdominal Skin, Subcutaneous Tissue and Anterior Abdominal Wall Laxity: A Prospective Observational Study at Dhaka Medical College Hospital." International Journal Of Medical Science And Clinical Research Studies 03, no. 04 (2023): 778–83. https://doi.org/10.5281/zenodo.7866792.
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<strong>Background:</strong> Lax abdominal muscles cause laxity or bulging. This is generally a consequence of age or post-pregnancy, causing the abdominal rectus muscles and fascia that overlies and divides them to weaken. Abdominoplasty, a popular cosmetic surgery, has improved in recent years. helped minimize abdominal fat and skin. Medical institutions are diagnosing and treating obesity at an increasing pace. <strong>Objective:</strong> The purpose of the study was reduce the excess abdominal skin,subcutaneous tissue and anterior abdominal wall laxity. <strong>Methods:</strong> The duration of this prospective observational research was from July 2014 to April 2015. The research population consisted of patients hospitalized to the Plastic Surgery Department of Dhaka Medical College Hospital and numerous private hospitals in Dhaka with extra abdominal skin and abdominal wall laxity owing to various causes, such as past pregnancy or severe weight loss. From the study population, 30 instances that satisfied the enrollment requirements were chosen. Results: The majority of patients (26, or 86.67 %) were female, and 76 % were married. At the time of surgery, the average age was 41.3 years. The total complication rate was 40%, with just four serious complications (13.33%) and the most being mild (9, 30 % ). Seroma (3, 10%), infection (2, 6.67%), hematoma (2, 6.67%), wound dehiscence (1, 3.33%), partial flap loss (2, 6.67%), umbilical stenosis (1, 3.33%), epidermolysis (1, 3.33%), DVT (1, 3.33%) were the most prevalent complications (1, 3.33 % ). Very excellent (19, 66.3%), good (9, 30%), and adequate were patients' ratings of satisfaction (2, 6 % ). No patient reported low or extremely bad satisfaction. <strong>Conclusion:</strong> Abdominoplasty may be done with little risk and provides excellent results. Patients reported relief from their symptoms and satisfaction with the result. However, there was a high rate of mild problems, most of which involved wound healing. At most cases, problems were mild and quickly treated in a doctor's office.
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Werner, Laura Anne, and Marcy Dayan. "Diastasis Recti Abdominis-diagnosis, Risk Factors, Effect on Musculoskeletal Function, Framework for Treatment and Implications for the Pelvic Floor." Current Women s Health Reviews 15, no. 2 (2019): 86–101. http://dx.doi.org/10.2174/1573404814666180222152952.
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Background:Diastasis Recti Abdominis (DRA) can occur during pregnancy and postpartum. It is defined as an increase of the inter-recti distance (IRD) beyond normal values. The diagnosis of DRA is inconsistent within the literature and varies depending on measurement instrument and activity during measurement (rest versus active curl-up). DRA is characterized by the stretching of linea alba (LA) and contributes to a protrusion of the anterior abdominal wall due to increased laxity in the myofascial system that supports abdominal viscera. DRA has been postulated to affect lumbopelvic support and function due to laxity of the LA and altered angle of muscle insertion, but recent studies have not confirmed this. Risk factors for the development of DRA have been investigated in pregnancy to 12-months postpartum.Objective:Rehabilitation for DRA has been traditionally focused on reducing the IRD, but recent research has proposed that a sole focus on closing the DRA is suboptimal.Results:It is important alongside the rehabilitation of the abdominal wall that there is the consideration of the pelvic floor (PF). In healthy individuals, with the activation of the transversus abdominis, there is a sub-maximal co-contraction of the PF muscles. This co-contraction can be lost or altered in women with urinary incontinence. An increase in intra-abdominal pressure without simultaneous co-contraction of the PF may cause caudal displacement of the PF.Conclusion:The aim of this review is to bring the reader up to date on the evidence on DRA and to propose a rehabilitation framework for the whole abdominal wall in DRA with consideration of the impact on the PF.
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Timerbulatov, M. V., A. S. Shornina, R. A. Lihter, and A. E. Kaipov. "Anterior abdominal wall reconstruction in patients with midline ventral hernia." Creative surgery and oncology 12, no. 4 (2023): 301–8. http://dx.doi.org/10.24060/2076-3093-2022-12-4-301-308.
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Introduction. Simultaneous hernio-abdominoplasty allows solving a complex of problems of the anterior abdominal wall in one surgical intervention. Th e relevance of this issue is determined by the lack of a unified algorithm for solving the combinations of anterior abdominal wall pathologies and by the presence of a number of complications, both in isolated and combined surgical techniques.Aim. The present paper analyzes the treatment results of patients undergoing simultaneous surgery for ventral hernia and deformations of the anterior abdominal wall.Materials and methods. Th e study enrolled 17 women (mean age 35.6 ± 7.0) undergoing inpatient and outpatient treatment in the Department of Plastic Surgery, Mother and Child Clinical Hospital, Ufa, in the period from 2019 to 2022. All patients had various aesthetic deformations of the anterior abdominal wall (laxity and excess skin, skin-fat apron, diastasis of the rectus abdominis muscles, excessive fat deposits) and midline ventral hernia of various sizes. 100 % patients had a history of pregnancy and childbirth; 64.7 % – grade 2 and 3 obesity.Results and discussion. Two cases (11.76 %) showed local complications as hematoma of the epigastric region and necrosis of the navel. In the first case, this can be explained by the fact that extensive liposuction of the anterior abdominal wall was performed, and in the second – by the presence of a multidefect ventral hernia of large size, in particular, an umbilical hernia with dimensions of 15x8 cm. Complications were mitigated on an outpatient basis within a period of 1.5 to 3 months by means of conservative therapy and physiotherapy.Conclusion. All patients were satisfied with the obtained aesthetic result
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Baccarani, Alessio, Marco Pappalardo, Pier Luca Ceccarelli, Marta Starnoni, and Giorgio De Santis. "Combined Double-breasted Full-thickness Abdominal Flap Plication and Acellular Dermal Matrix in Prune-belly Syndrome Reconstruction." Plastic and Reconstructive Surgery - Global Open 12, no. 4 (2024): e5744. http://dx.doi.org/10.1097/gox.0000000000005744.
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Background: Reconstruction of the abdominal wall in patients with prune-belly syndrome (PBS) following previous intra-abdominal procedures is a challenging problem with a high incidence of revision due to persistent bulging or herniation. The abdominal wall flaccidity not only produces a severe psychological and aesthetic discomfort for the patient but often determines functional disabilities, including inability to cough properly, impaired bowel and bladder function, and delay in posture and balance. Methods: The authors describe three cases of reconstruction of abdominal wall using a modified double-breasted abdominoplasty fascial plication with additional acellular dermal matrix interposition and review the literature for innovations in the use of abdominal repair for reconstruction of these difficult cases. Results: Three children with PBS at a mean age of 7.3 years achieved successful reconstruction of the abdominal wall, using the modified double-breasted abdominoplasty fascial plication with acellular dermal matrix interposition. Patients underwent previous procedures, including orchiopexy in two patients and bilateral nephrectomy in one patient. No postoperative complications have been found, apart from superficial skin dehiscence along the abdominal incision treated conservatively in one child. At mean follow-up of 42 months (range 28–56 months), no patient presented incisional hernia, persistent or recurrent fascial laxity with abdominal bulging. All patients achieved significant aesthetic and functional improvements, including children’s ability to cough, spontaneous gain of abdominal tonus, balance, and ambulation. Conclusion: Modification of the original vertical, two-layer plications of the deficient abdominal interposing biological mesh has the purpose of improving strength, aesthetics, and function of the abdominal wall in pediatric patients with PBS.
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Ibrahim, Ahmed Abdel Monem. "Simultaneous laparoscopic cholecystectomy with abdominoplasty." International Surgery Journal 4, no. 7 (2017): 2139. http://dx.doi.org/10.18203/2349-2902.isj20172761.
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Background: The use of laparoscope in surgical removal of gall bladder became one of the most popular surgical procedures and abdominoplasty which was used from long time even during 1900, mostly done as a separate surgical procedure in our research we combined both procedures in the patients subjected to the study.Methods: Thirty-two patients presented to our hospital with abdominal wall laxity and symptomatic cholelithiasis. All of them wanted to undergo a cosmetic procedure (abdominoplasty) to reduce the abdominal wall laxity. They were also diagnosed to have cholelithiasis and had intermittent episodes of pain in the right upper quadrant of the abdomen. The ports for laparoscopic cholecystectomy were made in such a way that all the ports sites were under the elevated skin flap that was excised during abdominoplasty, and there was no scar in the upper abdomen.Results: The procedure was completed without leaving any tell-tale signs of laparoscopic cholecystectomy, and this led to a better cosmetic result from the patients’ point of view.Conclusions:On conclusion, we recommend asking for abdominal ultrasound examination for all patients coming for abdominoplasty especially following weight loss after surgery for morbid obesity even if the patient is asymptomatic. We recommend the use of the technique which we used for port placement as it is convenient, easy, and has no side effects on patients in comparison with other techniques.
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Pillai, Ramya Thulaseedharan, Varghese Joseph, and Krishnakumar Marar. "Intra abdominal pressure changes in meshplasty and abdominal wall plication techniques in abdominoplasty: a comparative study." International Surgery Journal 8, no. 11 (2021): 3370. http://dx.doi.org/10.18203/2349-2902.isj20214373.
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Background: Measurement of intra abdominal pressures is used to identify patients at risk of intra-abdominal hypertension and abdominal compartment syndrome after abdominoplasty that may lead to tight closure of the abdomen. This comparative study was aimed at measuring the IAP of patients in groups of meshplasty and abdominal wall plication, intraoperatively and post operatively.Methods: A comparative study was conducted among 34 patients who underwent meshplasty and abdominal wall plication. Each group comprised of 17 patients. All preoperative blood investigations and pre anesthetic evaluations were done. The technique used is decided based on the soft tissue laxity, rectus diastasis and presence of ventral hernias. Intra operatively, IAP was measured soon after the placement of mesh or after Rectus plication and post operatively, IAP was measured within 24 hours. IAP was measured using the intra vesical technique using Foley’s Catheter.Results: Fifty percent of the total patients were in the age group 41-50yrs and 88.2% of the patients were females. No significant variations in IAP, either intraoperative (p=0.051) or post operative (p=0.202), was evidenced in both groups. Post operatively, patient developed minimal complications such as seroma collection, wound infection and respiratory complications, improving on symptomatic treatment and antibiotics.Conclusions: No significant intraoperative or postoperative IAP was found between the two study groups underwent meshplasty and abdominal wall placation techniques.
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Denney, Brad, and Jorge I. De Latorre. "Multipoint Suture Fixation Technique for Abdominal Wall Reconstruction with Component Separation and Onlay Biological Mesh Placement." American Surgeon 83, no. 5 (2017): 515–21. http://dx.doi.org/10.1177/000313481708300529.
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Component separation with mesh reinforcement has become the primary modality for complex abdominal wall reconstruction. However, many fundamental questions remain unanswered, such as whether underlay versus overlay mesh placement is superior, and what is the best means of suture fixation technique for mesh placement? This study presents the senior author's technique for onlay biologic mesh placement with multipoint suture fixation in combination with component separation and its subsequent low recurrence rates. This is a retrospective review of the senior author's cases of component separation with onlay biologic mesh placement during his tenure at the home institution of the University of Alabama at Birmingham. A total of 75 patients were included, all of whom underwent complex abdominal wall reconstruction from September 2002 to April 2012. Patients were excluded from the dataset if their surgery occurred less than two years before date of data collection to give a minimum 2-year follow-up. Patients were identified by Current Procedural Terminology codes for component separation and their charts reviewed by the home institution's electronic medical record. Data point entries included patient demographics and comorbidities, concomitant procedures such as bowel resection or panniculectomy, and characteristics of the reconstruction such as type of mesh used. Primary data endpoints were complications following surgery, particularly recurrence and laxity. A total of 75 patients were included in the study from September 2002 to April 2012 with a minimum 2-year follow-up period. The recurrence rate was 13 per cent and the rate of laxity 2.7 per cent. There was one death (1.35%). The most frequent complication was seromas at a rate of 17 per cent. Multipoint fixation suture technique for abdominal wall reconstruction with component separation and onlay biologic mesh is a reproducible technique with reliably low recurrence rates.
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Alsharif, Bayan, Hatan Mortada, Aeshah Mandili, and Fahad Aljindan. "Abdominoplasty: An Easy Approach to Giant Abdominal Lipomas." Case Reports in Surgery 2020 (February 11, 2020): 1–4. http://dx.doi.org/10.1155/2020/7875169.
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Introduction. Giant lipomas, which are greater than 10 cm, are rare, cosmetically unacceptable, and deteriorate the quality of daily living. Removal of giant abdominal lipomas either by liposuction, excision, or both, can lead to the formation of a loose, pendulous drooping abdomen, and abdominal wall laxity, which is aesthetically displeasing. The objective of this case report is to highlight an easy approach to treat giant abdominal lipoma through therapeutic abdominoplasty. Case History. In this case, a 29-year-old man with a known case of hypothyroidism and HCV was in remission but had a huge abdominal mass on his lower left side; it progressed for 7 years and increased in size and caused discomfort. His BMI was 29.53 and the mass measured about 15×13 cm. All other investigations were normal and showed no malignancies. He underwent excision of the giant abdominal lipoma using a standard abdominoplasty approach. Conclusion. In conclusion, in selected patients, giant abdominal lipomas can be successfully excised along with the redundant abdominal skin.
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Armstrong, Ruth, Alan Fryer, Sailaja Pisipati, and Edwin Jesudason. "Evaluating the association between congenital cystic adenomatoid malformation of the lung and abdominal wall laxity." Clinical Dysmorphology 16, no. 2 (2007): 77–80. http://dx.doi.org/10.1097/mcd.0b013e328014724e.
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Bond, Evalina S., Carol E. Soteropulos, Qiuyu Yang, and Samuel O. Poore. "The Impact of Prior Abdominal Surgery on Complications of Abdominally Based Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis." Journal of Reconstructive Microsurgery 37, no. 07 (2021): 566–79. http://dx.doi.org/10.1055/s-0041-1723816.
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Abstract Background Approximately half of all patients presenting for autologous breast reconstruction have abdominal scars from prior surgery, the presence of which is considered by some a relative contraindication for abdominally based reconstruction. This meta-analysis examines the impact of prior abdominal surgery on the complication profile of breast reconstruction with abdominally based free tissue transfer. Methods Literature search was conducted using PubMed, Scopus, and Web of Science. Included studies examined patients with a history of prior abdominal surgery who then underwent abdominally based free flap breast reconstruction. Prior liposuction patients and those with atypical flap designs were excluded. The Newcastle-Ottawa Scale was used to assess study quality. Flap complications included total and partial flap loss, fat necrosis, infection, and reoperation. Donor-site complications included delayed wound healing, infection, seroma, hematoma, and abdominal wall morbidity (hernia, bulge, laxity). Relative risk and 95% confidence intervals (CIs) between groups were calculated. Forest plots, I 2 statistic heterogeneity assessments, and publication bias funnel plots were produced. Publication bias was corrected with a trim-and-fill protocol. Overall effects were assessed by fixed-effects and random-effects models. Results After inclusion and exclusion criteria were applied, 16 articles were included for final review. These included 14 cohort and 2 case–control studies, with 1,656 (46.3%) patients and 2,236 (48.5%) flaps having undergone prior surgery. Meta-analysis showed patients with prior abdominal surgery were significantly more likely to experience donor-site delayed wound healing with a risk ratio of 1.27 (random 95% CI [1.00; 1.61]; I 2= 4) after adjustment for publication bias. No other complications were statistically different between groups. Conclusion In patients with a history of prior abdominal surgery, abdominally based free tissue transfer is a safe and reliable option. Abdominal scars may slightly increase the risk of delayed donor-site wound healing, which can aid the surgeon in preoperative counseling.
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Borille, Giuliano B., Gustavo A. Pereira Filho, Mariana Zancanaro, Vinicius W. Ribeiro, and Renato Giannini. "Surgical Correction of Abdomen Irregularities after Liposuction: Case Series." Plastic and Reconstructive Surgery - Global Open 12, no. 6 (2024): e5924. http://dx.doi.org/10.1097/gox.0000000000005924.
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Background: The occurrence of surface irregularities in the abdomen after liposuction is frequent and can be due to the fact that more liposuctions are being done nowadays, and perhaps, the fact that more noncore surgeons are doing it could be an important factor. These superficial changes compromise the aesthetic results of surgery, and their correction is a major technical challenge. Methods: The author presents a systematized approach for surgical treatment of fibrosis and post liposuction irregularities. Twenty-three patients underwent liposuction and abdominoplasty or mini abdominoplasty by a single surgeon (G.B.B.) over a period of 24 months to correct superficial abdominal wall irregularities after previous liposuction. All patients underwent evaluation through digital photography by two independent senior plastic surgeons according to an objective aesthetic outcome scale, 12 months after the operation. Results: All 23 patients showed an improvement in the appearance of the abdominal wall according to the aesthetic outcome scale used. Eighty-seven percent of the patients operated on in this series had previously undergone liposuction using technologies and 4.3% underwent liposuction alone. The overall minor complication rate was 26%. No major complications were noted. Conclusions: The combination of liposuction, direct fibrosis removal, and flap tensioning (abdominoplasty or mini abdominoplasty) could correct in this series the multiple factors (fibrosis, skin laxity, residual fat deposits post liposuction) related to abdominal wall surface irregularities in a safe, effective, and reproducible manner.
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Gonzalo, Oliván-Gonzalvo. "Pseudo prune belly syndrome: a female case report." Iberoamerican Journal of Medicine 3, no. 1 (2021): 98–99. https://doi.org/10.5281/zenodo.4411082.
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Kao, Cyrus, Robert D. Bunning, and John N. Aseff. "Poster 74 Abdominal Wall Laxity and Meralgia Paresthetica Following Rib and Pelvic Fractures: A Case Report." PM&R 6, no. 9 (2014): S208. http://dx.doi.org/10.1016/j.pmrj.2014.08.469.
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Dorafshar, Amir H., Cindy Wu, and Lawrence S. Zachary. "Abdominal Wall Imbrication Using Acellular Dermal Matrix: A Novel Technique for Correcting Laxity in Post–Bariatric Surgery Patients." Plastic and Reconstructive Surgery 124, no. 5 (2009): 270e—272e. http://dx.doi.org/10.1097/prs.0b013e3181b98ea5.
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Hsien, Chia-Fen, Chiu-Lin Wang, Cheng-Yu Long, et al. "Factors Associated with Types and Intensity of Postoperative Pain following Gynecological Laparoscopic Surgery: A Cross-Sectional Study." BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/2470397.
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Objective. To evaluate influences of various factors on the types and intensity of postoperative pain following gynecologic laparoscopic surgery. Study Design. Cross-sectional questionnaire and chart review. Results. A total of 84 questionnaires were distributed and returned. The types of postlaparoscopic pain are different in multiparous women and nulliparous ones (71.43% surgical wound pain versus 63.64% nonsurgical wound pain, p=0.0033) and those with striae gravidarum and without striae gravidarum (93.94% surgical wound pain versus 52.94% nonsurgical wound pain, p<0.0001). On postoperative day 1, the average VAS score is higher in nonsurgical wound pain than in surgical wound pain (5.62 ± 1.50 versus 3.51 ± 1.68, p<0.0001). The CO2 removal procedure has a significant negative correlation with the VAS of nonsurgical wound pain (coefficient: -0.4339, p=0.0187). Conclusion. Our study suggests that women with abdominal rigidity (nulliparous, no striae gravidarum) experience mainly nonsurgical wound pain, while women with abdominal wall laxity mostly experience surgical wound pain. The VAS score of nonsurgical wound pain is greater than surgical wound pain on postoperative day 1. The CO2 removal procedure has negative correlation to the VAS score of nonsurgical wound pain on postoperative day 1.
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Agrawal, Priti, Rishi Agrawal, and Jyotirmay Chandrakar. "Uterine torsion in a case of previous two caesarean section mimicking uterine rupture: a case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 3 (2021): 1169. http://dx.doi.org/10.18203/2320-1770.ijrcog20210754.
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Uterine torsion (UT) is defines as a rotation of the uterus of more than 45 degree on its long axis. The predisposing factors for UT can be uterine asymmetry due to fibroids or mullerian anomalies, foetal malpresentation, pelvic adhesions and abdominal or ligamentous laxity other possible causes include external cephalic version, maternal trauma and abdominal massage. The clinical presentation of UT is non-specific. We report a case of previous 2 CS where we suspected rupture uterus but intraoperatively it was UT with unruptured fibrosed scar of previous CS. A 31 years old, G3P2 presented in emergency department with history of amenorrhea 9 months and severe abdominal pain for 5-6 hours. She had previous 2 CS done for contracted pelvis. We immediately suspected rupture of previous CS scar. On laparotomy dense intra-abdominal adhesions were found. After adhesiolysis we could find any sign of previous scar on the visible uterine wall. Entire uterine wall seemed as if we were doing CS in a primiparous patient. This made us suspicious of UT. UT is considered rare and has been referred to as an ‘obstetrician’s once in a lifetime diagnosis’. Recently cases have been reported with no associated pelvic factors although a common feature in all these cases had been previous CS. UT is a potentially dangerous complication of pregnancy both to the mother and to the foetus. Maternal mortality in modern era highly unexpected event but maternal morbidity can occur because of complications like uterine rupture, uterine abruptio, sepsis, pulmonary embolism and iatrogenic complications like injury to blood vessels, urinary tract and rectum. During laparotomy where correction of UT is not possible, a deliberate posterior hysterotomy can be done for delivery of foetus. Bilateral plication of the round ligaments can be done to prevent immediate postpartum recurrence of UT. UT though rare should be kept in mind while performing CS in cases of previous CS, associated myomas, ovarian tumour, malpresentations of foetus. Clinical symptoms may be absent or nonspecific and the diagnosis may be intraoperative.
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Ahmed, Iqbal, M. Farouqe Hossain, and M. Asaduzzaman. "Early outcome of total abdominoplasty in thirty cases." International Surgery Journal 9, no. 9 (2022): 1528. http://dx.doi.org/10.18203/2349-2902.isj20222231.
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Background: Abdominoplasty, a popular cosmetic surgery, has improved in recent years. Kelly helped minimize abdominal fat and skin. Medical institutions are diagnosing and treating obesity at an increasing pace. The research aimed to examine early post-abdominoplasty outcomes.Methods: This prospective observational study was carried out from July 2014 to April 2015. Patients admitted at the plastic surgery department of Dhaka Medical College Hospital and different private hospitals in Dhaka with excess abdominal skin and abdominal wall laxity due to various reasons like previous pregnancy or massive weight reduction were the study population. A total of 30 cases that fulfilled the enrolment criteria were selected from the study population.Results: Most of the patients (26, 86.67%) were female, 76% of them were married. The mean age at the time of operation was 41.3 years. The overall complication rate was 40% with few major complication (4, 13.33%) and the maximum portion was minor (9, 30%). The most frequent was seroma (3, 10%), infection (2, 6.67%), hematoma (2, 6.67%), wound dehiscence (1, 3.33%), partial flap loss (2, 6.67%) and umbilical stenosis (1, 3.33%), epidermolysis (1, 3.33%), deep vein thrombosis (DVT) (1, 3.33%). Patients’ satisfaction was scored as very good (19, 66.3%), good (9, 30%), satisfactory (2, 6%). No patient scored his satisfaction as poor or very poor.Conclusions: Abdominoplasty is safe and comfortable. Patients were happy with the treatment and had improved symptoms with little health hazards. There were mild problems, especially with wound healing. Minor difficulties were simply treated in an office.
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Dumanian, G. A., and S. Moradian. "Mesh abdominoplasty for rectus diastasis in women and men." Hernia 25, no. 4 (2021): 863–70. http://dx.doi.org/10.1007/s10029-021-02461-1.
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Abstract Purpose Meshes clearly have improved outcomes for tissue approximation over suture repairs for incisional hernias. A knowledge gap exists as to the surgical complication rate and post-operative outcomes of a mesh rectus diastasis repair with a narrow well-fixed mesh that simultaneously narrows the rectus muscles and closes the widened linea alba. Methods Inclusion criteria for mesh abdominoplasty were patients who (1) underwent a retrorectus planar mesh for repair of rectus diastasis (2) did not have a concurrent incisional hernia and (3) underwent skin tailoring as part of a cosmetic aspect of their care. The primary endpoint was surgical site occurrence (SSO) at any time after surgery as determined with review of their office and hospital medical records. Secondary endpoints included the length and complexity of the return to the operating room for any reason, non-surgical complications, readmission, post-operative recovery, surgical site infection, recurrence/persistence of abdominal wall laxity, and soft tissue revision rates. Results SSO rate was 0% for the 56 patients who underwent this procedure. There were 40 women and 16 men. Superficial infections requiring oral antibiotics were required in three patients. One was a drain site erythema, one was for a superficial stitch abscess, and the third was for a mesh strip knot infection 6 months after the procedure. One patient underwent further tightening of the abdominal wall. Rates of soft tissue revision in the office for improved cosmesis were 23% in women and 6% in men. Conclusion Repair of rectus diastasis with a narrow well-fixed mesh and concurrent skin abdominoplasty is a well-tolerated and reliable procedure with low recurrence and low SSO in the manner described. It is a procedure that works for both female and male pattern rectus diastasis, and has become our procedure of choice for moderate and severe rectus diastasis.
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Galhego, Rodrigo Ferraz, Tulio Martins, Alvaro Cota Carvalho, Marco Faria-Correa, and Raquel Nogueira. "Mini Abdomen Experience: A Novel Approach for Mini-Abdominoplasty Minimally Invasive (MAMI) Abdominal Contouring." Surgical Techniques Development 14, no. 2 (2025): 16. https://doi.org/10.3390/std14020016.
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Purpose: Our aim is to offer an additional surgical option for patients with rectus diastasis, with or without associated abdominal wall hernias, through a minimally invasive approach with endoscopic surgical correction, presenting a new method for abdominal contouring via minimally invasive mini-abdominoplasty (MAMI). Ideas: According to the European Hernia Society (EHS) classification for RD, a widening greater than 2 cm of the linea alba is generally considered an indication for surgical correction. Recent approaches, such as MILA and SCOLA, are indicated for patients with a body mass index (BMI) of up to 28, based solely on height and weight. However, some authors consider this insufficient for determining the best surgical indication. Despite advances in skin retraction, there is still no evidence on how these devices affect postoperative outcomes when added to these techniques, as they depend on multiple factors such as age, skin firmness, number of passes, applied energy, etc. Consequently, even patients with a BMI of up to 28 may present significant flaccidity both above and below the umbilicus, as well as poor skin quality (thin, lax, with stretch marks), making SCOLA or MILA surgery alone unsuitable due to possible skin redundancy after surgery. Similarly, even patients with a high-positioned umbilicus, moderate flaccidity, and rectus diastasis, who in the past would have been strictly indicated for abdominoplasty, may benefit from mini-abdominoplasty with a minimally invasive approach (MAMI). Discussion: The main objective of this study is to provide another surgical option for patients who would otherwise be indicated for abdominoplasty and also for those undergoing MILA or SCOLA who still require minor skin removal to enhance the surgical result. Based on our experience, mini-abdominoplasty with a minimally invasive approach (MAMI) has the potential to serve a larger number of patients, since most present degrees of skin laxity that, even after using technologies, require skin excision. In addition to complementing the results, it reduces complications, results in smaller scars, allows a better correction and visualization of the diastasis, avoids periumbilical scars, and offers faster recovery compared to abdominoplasty. Conclusions: MAMI surgery has proven to be a safe and reproducible approach for selected women who wish to restore feminine body features after pregnancy and achieve a quick recovery. It yields satisfactory esthetic results due to the minimized scar, preservation of the natural umbilical scar, and improved surgical correction of rectus diastasis.
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Sadeghi, Payam, Daniela Duarte-Bateman, Wanyan Ma, et al. "Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring." Journal of Clinical Medicine 11, no. 15 (2022): 4315. http://dx.doi.org/10.3390/jcm11154315.
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Due to the increased prevalence of obesity in the last decades, bariatric surgery has been on the rise in recent years. Bariatric surgery is a compelling option for weight loss in obese patients with severe obesity-related comorbidities or for whom lifestyle modifications have proven ineffective. Redundant skin following significant weight loss is a common occurrence affecting up to 96% of patients who undergo bariatric surgery, negatively impacting physical and psychosocial health and detracting from activities of daily living. Statistics of the American Society of Plastic Surgeons show that 46,577 body contouring procedures were performed after massive weight loss in the USA in a 2020 report. Abdominoplasty, a well-established cosmetic surgery procedure for improving body contour, is performed by removing excess skin and fat from the abdominal wall and thereby restoring musculofascial integrity and skin elasticity, resulting in a more ideal body shape and increasing quality of life. Although abdominoplasty is a safe procedure, it has been associated with a higher complication rate compared with other body-contouring procedures. Technologic advances over the past decade have been developed as non-invasive alternatives or adjunctive tools to surgery to enhance cosmetic results and minimize complications. New energy-based technologies may supplant invasive surgery for mild to moderate skin laxity and/or diminish the extent of surgery and resulting scars. Plastic surgeons play a significant role in improving the quality of life of patients who suffer from obesity and underwent bariatric surgery. We are deeply convinced, however, that the advancement of knowledge and research in this field will determine the introduction of new technologies and custom-made techniques. This advancement will reduce the complication rate with a rapid reintegration of the patient into the world of work and resumption of daily activities.
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Ahmed, Dr Iqbal, Dr Md Farouqe Hossain, Dr Md Asaduzzaman, and Dr Riffat Chowdhury. "Evaluation of Reducing the Excess Abdominal Skin, Subcutaneous Tissue and Anterior Abdominal Wall Laxity: A Prospective Observational Study at Dhaka Medical College Hospital." International Journal Of Medical Science And Clinical Research Studies 03, no. 04 (2023). http://dx.doi.org/10.47191/ijmscrs/v3-i4-38.
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Background: Lax abdominal muscles cause laxity or bulging. This is generally a consequence of age or post-pregnancy, causing the abdominal rectus muscles and fascia that overlies and divides them to weaken. Abdominoplasty, a popular cosmetic surgery, has improved in recent years. helped minimize abdominal fat and skin. Medical institutions are diagnosing and treating obesity at an increasing pace. Objective: The purpose of the study was reduce the excess abdominal skin,subcutaneous tissue and anterior abdominal wall laxity. Methods: The duration of this prospective observational research was from July 2014 to April 2015. The research population consisted of patients hospitalized to the Plastic Surgery Department of Dhaka Medical College Hospital and numerous private hospitals in Dhaka with extra abdominal skin and abdominal wall laxity owing to various causes, such as past pregnancy or severe weight loss. From the study population, 30 instances that satisfied the enrollment requirements were chosen. Results: The majority of patients (26, or 86.67 %) were female, and 76 % were married. At the time of surgery, the average age was 41.3 years. The total complication rate was 40%, with just four serious complications (13.33%) and the most being mild (9, 30 % ). Seroma (3, 10%), infection (2, 6.67%), hematoma (2, 6.67%), wound dehiscence (1, 3.33%), partial flap loss (2, 6.67%), umbilical stenosis (1, 3.33%), epidermolysis (1, 3.33%), DVT (1, 3.33%) were the most prevalent complications (1, 3.33 % ). Very excellent (19, 66.3%), good (9, 30%), and adequate were patients' ratings of satisfaction (2, 6 % ). No patient reported low or extremely bad satisfaction. Conclusion: Abdominoplasty may be done with little risk and provides excellent results. Patients reported relief from their symptoms and satisfaction with the result. However, there was a high rate of mild problems, most of which involved wound healing. At most cases, problems were mild and quickly treated in a doctor's office.
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Negosanti, Luca. "Simultaneously Ventral Hernia Repair with Abdominoplasty: A Feasible Approach." SciBase Journal of Addiction & Recovery 1, no. 1 (2024). http://dx.doi.org/10.52768/addictrecovery/1002.
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Repair of ventral hernias still represents a challenge and, in some cases, patients present a concomitant abdominal wall laxity and an excess of skin and subcutaneous fat. The association of ventral hernia repair and abdominoplasty remains controversial.
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Halsey, Jordan N., Haripriya S. Ayyala, Sebastian R. Eid, and Frank S. Ciminello. "Laparoscopic-Assisted Relocation of the Umbilicus With Umbilicoplasty in Complex Abdominal Wall Reconstruction." American Surgeon, March 20, 2021, 000313482110030. http://dx.doi.org/10.1177/00031348211003068.
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Patients with complex abdominal wall pathology often present with significant distortion of their umbilicus. Ventral and umbilical hernias often create widening or protrusion of the umbilicus, while obesity and laxity of the skin and subcutaneous tissue of the abdominal wall further exacerbates the deformity. The primary goal of hernia repair is always reduction of the hernia with a tension-free repair; however, an important secondary goal is esthetic improvement of the abdominal wall. Often, in patients with complex hernia defects involving the umbilicus, there is discussion of not salvaging the umbilicus altogether. Although this certainly remains an option for many patients, we present a technique that would not only allow for hernia reduction under direct laparoscopic visualization but also an improved esthetic to the umbilicus.
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Whitehead-Clarke, Thomas, and Alastair Windsor. "The Use of Botulinum Toxin in Complex Hernia Surgery: Achieving a Sense of Closure." Frontiers in Surgery 8 (October 1, 2021). http://dx.doi.org/10.3389/fsurg.2021.753889.
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Abdominal wall surgeons have developed a host of tools to help facilitate fascial closure. Botulinum toxin A is one of the most recently identified treatments and has grown in popularity over recent years; showing great promise in a number of case series and cohort studies. The toxin paralyses lateral abdominal wall muscles in order to increase laxity of the tissues—facilitating medialisation of the rectus muscles. Several research groups around the world are developing expertise with its use-uncovering its potential. We present a review of the relevant literature over the last two decades, summarising the key evidence behind its indications, dosing and effects.
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Napier, Donna. "Sonographic anatomy of surgically acquired abdominal pseudohernia—A guide to the documentation of anterolateral integument denervation with ultrasound." Sonography, October 25, 2024. http://dx.doi.org/10.1002/sono.12479.
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AbstractIncisional hernia is a common clinical diagnosis when a patient presents with a post‐surgical abdominal wall bulge. Herniation is a complication that can result from a disruption to the anterior abdominal wall, however other differentials need to be considered to account for a localized prominence of the abdominal integument. One such differential is a pseudohernia; a bulging of an intact abdominal integument without protrusion of abdominal contents. This can occur as a direct consequence of operative trauma and subsequent denervation injury to abdominal wall musculature. Although surgical techniques have been refined to reduce the potential of segmental neuropathy, atrophy of the abdominal wall can be a long term sequalae that clinically mimics that of a hernia. Such an outcome can result from surgical approaches with a particular location and orientation leaving little option to avoid damage to nerves inherent to the area. Damage to these nerves can not only result in abdominal wall laxity but also to the development of further complications that can affect a patient's quality of life. The aim of this article is to increase sonographer awareness of postsurgical pseudohernia of the anterolateral abdominal wall as a differential to incisional hernia, and as such provide guidance on how to demonstrate this anomaly. Considering that pseudohernia and incisional hernia have differing management techniques, the sonographer can play a pivotal role in influencing patient management, negating the need for surgical hernia repair and advocate for a conservative management pathway.
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Hammond, Emily, Caitlin Jones-Sayyid, Jason Langer, Elizabeth Fox, and Andrew Lawson. "Posterior Rectus Sheath Hernia Causing Chronic Abdominal Pain." American Surgeon™, May 4, 2023, 000313482311739. http://dx.doi.org/10.1177/00031348231173989.
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Posterior rectus sheath hernias are rare hernias that can be difficult to diagnose due to unreliable physical exam characteristics and subtle radiological findings. We present an interesting case of an elderly female found to have a posterior rectus sheath hernia during a diagnostic laparoscopy for chronic abdominal pain. CT evaluation revealed possible appendicitis and laxity of the abdominal wall of the right lower quadrant. Intraoperatively, a 4 cm hernia defect in the right lateral abdominal wall was appreciated. Appendectomy and herniorrhaphy with mesh repair were performed. Postoperative review of CT imaging and intraoperative photographs determined that this hernia defect is a posterior rectus sheath hernia likely caused by trocar placement from previous laparoscopic surgery. This report contributes to the limited body of the literature for this rare type of hernia. Posterior rectus sheath hernias should be considered in differential diagnoses for patients presenting with chronic abdominal pain without clear etiology.
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Nazarpour, Mahmood, Mohammad Chavoshinejad, and Mina Alvandipour. "Spontaneous Rupture of Wandering Spleen: Case Report." Journal of Clinical and Medical Images, Case Reports 2, no. 3 (2022). http://dx.doi.org/10.55920/2771-019x/1182.
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A wandering spleen is a rare clinical occurrence with fewer than 500 cases reported and an incidence of less than 0.2% [1]. wandering spleen is caused by either extreme laxity or absence of the normal ligaments that anchor the spleen to the left upper quadrant. Gravity also plays a role by allowing the spleen to descend into the lower abdomen attached by its vascular pedicle [2]. Symptoms depend on the degree of torsion and range from chronic abdominal pain in mild torsion to acute pain in severe torsion and infarction. Accurate clinical diagnosis is difficult because of the rarity of the condition and non-specific symptoms. Radiological evaluation includes usage of ultrasound, Doppler, abdominal CT or MRI depending upon availability or preference [3]. A wandering spleen can be either congenital or acquired. In the congenital condition the ligaments fail to develop properly, whereas in the acquired form the hormonal effects of pregnancy and abdominal wall laxity are proposed as determining factors .However, the precise etiology of the wandering spleen is not known [1]. We present a spontaneous rupture of a wandering spleen with severe torsion and infarction and abdominal pain without any history of trauma.
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Villegas, Francisco. "TULUA Lipoabdominoplasty: No Supraumbilical Elevation Combined With Transverse Infraumbilical Plication, Video Description, and Experience With 164 Patients." Aesthetic Surgery Journal, June 29, 2020. http://dx.doi.org/10.1093/asj/sjaa183.
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Abstract Background TULUA (transverse plication, undermining halted at umbilicus, liposuction [without restrictions], umbilicoplasty with a skin graft, and abdominoplasty with low transverse scar localization) is a fundamentally different lipoabdominoplasty technique intended to reduce the risk of vascular compromise, correct wall laxity through a unique plication, allow freedom in choosing the umbilical position, reduce tension on closure, and keep the final scar low. Objectives The objectives of this article were to describe the TULUA technique and its variations, delineate the indications and contraindications, show the expected results, and determine its safety profile. Methods A series of 164 patients is presented. The technique’s basic tenets were (1) infraumbilical wide transverse plication; (2) no undermining above the umbilicus; (3) unrestricted liposuction, including the supraumbilical tissues; (4) umbilical amputation and neoumbilicoplasty in the ideal position with a skin graft; and (5) low transverse scar placement. Complications were recorded and tabulated. Results were evaluated utilizing Salles’ and the author’s graded scales. Results Scores averaged 9.4 out of 10 on the Salles’ scale and 5.6 out of 6 on the author’s scale, demonstrating adequate correction of the abdominal contour and the wall and skin laxity, with properly placed scars and umbilici, and without compensatory epigastric bulging. Overall, 20% of the patients experienced a complication: 9.7% experienced a delay in either the healing or graft take of the umbilicus, 0.6% developed skin necrosis, 0.6% experienced a wound dehiscence, 2.4% had an infection, and 4.9% developed a seroma. Conclusions The TULUA lipoabdominoplasty technique was found to improve abdominal wall laxity and aesthetics to a degree that is similar to traditional abdominoplasty, based on the evaluated parameters. The complications associated with the procedure are within the range of other abdominoplasty techniques, and the technique potentially has a reasonable safety profile with less risk of vascular compromise. Level of Evidence: 4
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-, Jaspreet Singh, Gurbinder Kaur -, and Deepmala Kumari -. "The Effectiveness of Physical Therapy Interventions in Management of Diastasis Recti in Postpartum Females: A Narrative Review." International Journal For Multidisciplinary Research 6, no. 4 (2024). http://dx.doi.org/10.36948/ijfmr.2024.v06i04.24421.
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Diastasis recti is a condition caused by increased intra-abdominal pressure which causes the linea alba to stretch resulting in a wider inter-rectus gap. It is most common after pregnancy but can also be caused by obesity or previous abdominal procedures. Research shows myofascial laxity affecting the entire front abdominal wall. Postpartum women have a doubling of the interrectus distance and pregnancy affects abdominal muscle strength with nulliparous women having a higher number of trunk flexors and rotators [1]. DRA is mostly treated conservatively. Patients referred to a physiotherapist receive training programmes that specifically target reducing IRD. Some studies recommend training with physiotherapist, while others let patients train on their own. Recommended frequency of training sessions varied from one to five sessions per week. The exercise interventions consist of the following: Core trainings, Breathing technique and Mindfulness teaching. This study aims to find out the effectiveness of different physical therapy interventions in the treatment of diastasis recti abdominis. The condition of diastasis recti abdominis has prevalence in postpartum females and it is important to address this for the welfare of women and required to explore the best physical therapy treatment available.
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Maaty, Sameh Abdallah, Fawzi Salah Fawzi, Bassem Helmy El-Shayeb, and Kirollos Adel Louiz Kamel. "A Comparative Study in Elective Repair of Large Incisional Hernias Using On-Lay Mesh vs. Sub-Lay Mesh – A Meta-Analysis." QJM: An International Journal of Medicine 117, Supplement_1 (2024). http://dx.doi.org/10.1093/qjmed/hcae070.235.
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Abstract Background Ventral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also increased incidence of obesity in females. Objective To assess incisional hernia repair using two different techniques: on-lay mesh and sub- lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma and flap necrosis. Patients and Methods The Pubmed, web of science and Scopus were searched on 15 March, 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, polypropylene. Results and Conclusion According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time consuming. Regarding post- operative complications there is no statistical difference in recurrence, seroma, hematoma, flap necrosis and infection but there is a statistical difference regarding in hospital stay as patients with sublay repair stays less than onlay.
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Hassan, Basma Hussein Abdelaziz, Kirollos Adel Louiz Kamel, Philobater Bahgat Adly Awad, et al. "A comparative study in elective repair of large incisional hernias using on-lay mesh vs. sub-lay mesh: a meta-analysis." Updates in Surgery, February 19, 2024. http://dx.doi.org/10.1007/s13304-024-01755-0.
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AbstractVentral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of the postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also an increased incidence of obesity in females. To assess incisional hernia repair using two different techniques: on-lay mesh and sub-lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma, and flap necrosis. Pubmed, Web of Science, and Scopus were searched on 15 March 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, and polypropylene. According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time-consuming. Regarding postoperative complications, there is no statistical difference in recurrence, seroma, hematoma, flap necrosis, and infection but there is a statistical difference regarding in hospital stay as patients with sub-lay repair stays less than only.
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Abdelhalim, Mostafa, Ahmed Zeina, Ahmed Omran, and Tarek Ahmed Zahra. "MANAGEMENT AND MAINTENANCE OF RESULTS IN CASES OF ANTERIOR ABDOMINAL WALL LAXITY DURING ABDOMINOPLASTY." Egyptian Journal of Plastic and Reconstructive Surgery, May 6, 2025, 0. https://doi.org/10.21608/ejprs.2025.376589.1421.
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Akila, Abdulaziz A., Salah Nasser M. Affifi, Adel Hussein Amr, and Sameh Adel Desawy Bakry. "Abdominoplasty Combined with the Anterior Component Separation Technique for Reconstruction of Midline Large Ventral Hernias: Functional and Aesthetic Outcome Clinical Study." QJM: An International Journal of Medicine 117, Supplement_1 (2024). http://dx.doi.org/10.1093/qjmed/hcae070.550.
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Abstract Background Large midline ventral hernias, diastasis of recti and the associated laxity and abdominal shape deformity, represent aesthetic and functional problems for the patients. So, the surgical treatment of both pathologies at the same time is highly recommended if the patient’s general condition permits. This can be achieved by a comprehensive technique incorporating abdominoplasty performed by a transverse lower abdominal incision into any of the hernia repair techniques. Objective The aim of this study is to evaluate the functional and aesthetic outcome of the combined abdominoplasty and anterior component separation technique in the management of midline ventral abdominal hernias. Patients and Methods This study is a prospective case control study that evaluates both functional and aesthetic outcome of performing abdominoplasty on patients with large midline ventral hernias. This study was conducted between December 2020 to March 2022 at the Plastic Surgery Department, Demerdash University Hospital, Cairo, Egypt. Study consisted of fifteen patients with different presentations of abdominal wall laxity and ventral hernias. Patients were evaluated regarding their age, BMI, degree of rectus diastasis, Pre-operative radiological findings, post Operative complication and hernia reoccurrence, patients’ satisfaction, and the pre-operative and post-operative umbilical measurements were compared. Results and Conclusion The current study showed that Abdomioplasty can be combined with complex hernia repair by anterior component separation technique within the same setting in high-risk patients safely with an excellent functional outcome and acceptable satisfactory aesthetic results. Although, this can be associated with an increased risk of postoperative surgical site complications such as; skin necrosis and wound infection. Patient characteristics associated with the development of complications following anterior component separation combined with abdominoplasty include obesity, previous abdominal procedures and previous pregnancies.
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Isaac, Therese Wagih Mickael, Emad EL Deen Farid, Hesham Mohammed Omran, and Ahmed Sobhi Hweidi. "Comparative study between using of quilting sutures vs. using of fibrin sealant in prevention of seroma after abdominoplasty." QJM: An International Journal of Medicine 114, Supplement_1 (2021). http://dx.doi.org/10.1093/qjmed/hcab097.058.
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Abstract Background Abdominoplasty is one of the most common body-contouring procedures. It is among the top five procedures in aesthetic surgery. The aim of abdominoplasty is to remove excess fat and skin and restore weakened muscles to create smoother firmer abdominal figure Aim of study The aim of the present study is to compare between the rate of seroma in patients undergone abdominoplasty using quilting sutures technique and patients undergone abdominoplasty using fibrin glue. Patients and Methods This study was conducted on 20 patients complaining of variable degrees of abdominal wall laxity seeking for surgical repair of abdominal wall, conducted from april 2019 till october 2019.on patients admitted at ain shams university hospitals and cairo university hospitals Results This study includes twenty patients with abdominal wall redundancy presented to Ain-Shams university hospital and kasr AL Ainy university hospital in the period (April 2019 - October 2019). The patients were divided into two groups: group A ten patients undergone abdominoplasty with quilting sutures technique, group B ten patients undergone abdominoplasty with fibrin glue. All 20 patients were females aging between 25 and 50 and with BMI between 25 and 30. Conclusion Within the limitations of our study we have concluded that this study adds to the mounting evidence that placement of quilting sutures or the application of fibrin glue is safe and effective and will contribute to a decrease in the seroma rate, the total amount of drain output, the time of drain removal and complications. It produces a safe and less eventful postoperative period.
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Khater, Nazih, Seth Swinney, Joseph Fitz-Gerald, et al. "Robotic Pediatric Urologic Surgery-Clinical Anesthetic Considerations: A Comprehensive Review." Anesthesiology and Pain Medicine 14, no. 3 (2024). http://dx.doi.org/10.5812/aapm-146438.
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: Minimally invasive robotic approaches have become standard in many institutions over the last decade for various pediatric urological procedures. The anesthetic considerations for common laparoscopic and robotic-assisted surgeries are similar since both require the insufflation of CO2 to adequately visualize the operative area. However, few studies exist regarding anesthesia for robotic procedures in children. We hypothesized that pediatric patients undergoing robotic urologic surgeries would require specific anesthetic strategies, especially given the inherently longer durations of these procedures. This study aimed to evaluate anesthetic considerations, current robotic procedures, optimal patient positioning, and port placement for robotic-assisted surgery in pediatric patients. A comprehensive literature review of all published manuscripts from PubMed, EMBASE database, and Google Scholar was performed, focusing on robotic procedures involving pediatric patients, anesthesia for pediatric urology patients, and related topics from 1996 to 2023. Forty published manuscripts were identified and reviewed in depth. In pediatric cases, insufflation pressures and volumes are lower due to the laxity of the abdominal wall. However, the increase in intra-abdominal pressure and absorption of CO2 may result in disproportionate changes in cardiopulmonary function. Specific patient positioning for robotic approaches may further compound these physiological changes. Correct patient positioning is essential to facilitate surgery optimally and safely. Understanding the physiological changes that can occur during a pediatric patient’s robotic urologic surgery allows for safer anesthesia management.
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Christopher, Shefali M., Alessandra N. Garcia, Suzanne J. Snodgrass, and Chad Cook. "Common musculoskeletal impairments in postpartum runners: an international Delphi study." Archives of Physiotherapy 10, no. 1 (2020). http://dx.doi.org/10.1186/s40945-020-00090-y.
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Abstract Background Postpartum runners report musculoskeletal pain with running. Because of inadequate research, little is known about the origin and pain-related classification. Through expert consensus, this study is the first attempt to understand the musculoskeletal impairments that these runners present with. The objective of this survey was to gather expert consensus on characteristics of reported impairments in postpartum runners that have musculoskeletal pain. Methods A web-based Delphi survey was conducted and was composed of five categories: strength, range of motion, alignment and flexibility impairments, as well as risk factors for pain in postpartum runners. Results A total of 117 experts were invited. Forty-five experts completed round I and forty-one completed rounds II and III. The strength impairments that reached consensus were abdominal, hip and pelvic floor muscle weakness. The range of motion impairments that reached consensus were hip extension restriction, anterior pelvic tilt and general hypermobility. The alignment impairments that reached consensus were a Trendelenburg sign, dynamic knee valgus, lumbar lordosis, over-pronation and thoracic kyphosis. The flexibility impairments that reached consensus were abdominal wall laxity, and tightness in hip flexors, lumbar extensors, iliotibial band and hamstrings. The risk factors for pain in postpartum runners were muscular imbalance, poor lumbopelvic control, too much too soon, life stressors, pain during pregnancy and pelvic floor trauma. Conclusion This study presents a framework for clinicians to understand pain in postpartum runners and that can be investigated in future cohort studies. Level of evidence 5
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Fahmy, Hany Fouad A., Hesham A. Helal, Salah Nasser M. Afifi, Khaled M. Elsherbeny, and Eman Nagy Mohamed. "Aesthetic and Functional Evaluation of Abdominal Contouring Using Lipo-Abdominoplasty versus Lipo-Abdominoplasty with TULUA Procedure: A Comparative Clinical Study." QJM: An International Journal of Medicine 117, Supplement_1 (2024). http://dx.doi.org/10.1093/qjmed/hcae070.547.
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Abstract Background Lipoabdominoplasty techniques may be followed by a wide range of complications as flap necrosis, wounddehiscence, surgical site infection, epigastric bulging, malpositioned umbilicus, high transverse scar and seroma formation. Villegas in 2014 introduced the TULUA abdominoplasty to improve the aesthetic outcome and to avoid the many associated complications mentioned. The objective of this study is to compare the aesthetic and functional outcomes between the traditional lipoabdominoplasty and TULUA abdominoplasty. Methods in this prospective comparative clinical study, sixty adult women with excess subcutaneous abdominal fat and skin laxity after repeated pregnancies with mild to moderate degree of diastasis of recti were included. The patients’ ages ranged between 28-55 years, their BMI scores were 25-35 kg/m2. Group A (30 patients) underwent lipoabdominoplasty while group B (30 patients) underwent TULUA abdominoplasty. The patients were followed up for a minimum of 6 months where the comparative study included aesthetic results as regards the abdominal contouring using clinical outcome scaling systemin addition to functional aspects assessing anatomical features, changes in anterior abdominal wall and finally the complication rate between both techniques. Results The average total liposuction aspirate volume of the abdomen was 2400 ml in group A, while in group B, the average volume was 3500 ml. The mean surface area of vertical plicature measured intraoperatively was 211.93 (±54.66) cm2 in group A, while in group (B) transverse plicature surface area was 369.47(±84.22) cm2. The increase in intra-abdominal pressure IAP after plication and skin closure in group A was 7.93±1.26 cmH2O; while for group B there was a highly significant increase by 9.87±1.01 cmH2O. Flap sloughing was seen in 4 cases(13.3%), wound dehiscence 2 cases (6.6%) seroma in 3 cases(10%) for group A,conversely no cases reported flap necrosis, wound dehiscence or seroma that need to be aspired in group B. The aesthetic outcomes were evaluated using a 5 points likert scale system through three indicators, f or group A,an overall result that was 4.50 ± 0.87, umbilical appearance 4.61±0.73, and scar quality 4.35 ± 0.82; On the other hand group B showed overall result 4.53 ± 0.71, umbilical appearance 4.52 ± 0.82, and scar quality 4.43 ± 0.87. Conclusions TULUA procedure is a safe, reproducible shift in abdominoplasty, with fewer complications to occur.
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Abdrabo, A. A., M. G. Elsayed, and A. M. A. Kabeel. "Comparison Between Abdominoplasty Assisted by Liposuction Utilizing Classical (U) Incision Versus (W) Incision: A Randomized Controlled Study." QJM: An International Journal of Medicine 113, Supplement_1 (2020). http://dx.doi.org/10.1093/qjmed/hcaa050.007.
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Abstract Background Traditional abdominoplasty techniques, which use primarily transverse incisions, seem to be most beneficial for those patients whose abdominal contour is relatively normal with only a minimal to moderate amount of flaccid skin. Objective The aim of the study was to compare between the results of two different incisions used in abdominoplasty with liposuction, and to detect the morbidities and complications which may occur after the surgical procedures such as Aesthetic complication which occured in the form of asymmetry, dog ears, residual deformity, unsatisfactory umbilicus and unsatisfactory scarring (widened, thickened, hypertrophic or keloid) and Non-aesthetic complications which occurred in the form of seroma, wound infection, partial skin necrosis, and wound dehiscence. In addition to comparing the aesthetic outcome and patient satisfaction. Patients and Methods The contour of the abdomen is the backbone of body contouring surgery. Patients usually seek abdominoplasty for abdominal wall laxity, excess skin, striae, or diastasis of the rectus muscles. The inevitable end scar must be invisible as possible, symmetrical, and located in regions covered with the minimal clothing. The study included 30 patients divided into 2 groups (A) & (B) each group consist of 15 patients. This study was a prospective comparative study between Classic (U) incision abdominoplasty and (W) incision abdominoplasty; Group (A) undergone Classic (U) incision abdominoplasty, and Group (B) undergone (W) incision abdominoplasty. Results: received from both groups were compared to each other and the collected results were evaluated, and subjected to statistical analysis . Patient satisfaction was assessed by direct patient questioning and included subjective and objective feedback on the overall satisfaction following abdominoplasty, areas of dissatisfaction and patients satisfaction post different types of abdominoplasty. Conclusion Abdominoplasty with Liposuction provide high levels of patient satisfaction. The combined procedure is similar in discomfort level to abdominoplasty alone and produces the highest level of patient satisfaction and the patient satisfaction represents a golden goal in the practical work.
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Sugiyama, Yoichi, Toshiaki Komo, Tatsuya Tazaki, Mohei Kohyama, Shinya Takahashi, and Masaru Sasaki. "Gastric volvulus associated with shrinkage of a gastrointestinal stromal tumor by neoadjuvant imatinib: a case report." Journal of Medical Case Reports 17, no. 1 (2023). http://dx.doi.org/10.1186/s13256-022-03735-7.
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Abstract Background During neoadjuvant chemotherapy for giant gastrointestinal stromal tumors, changes in gastrointestinal stromal tumor size are rarely associated with events such as perforation and bleeding that require emergency surgery. Moreover, it is very rare for gastrointestinal stromal tumors to shrink and become mobile, resulting in gastric volvulus. Herein, we report a case of gastrointestinal stromal tumor shrinkage during neoadjuvant imatinib treatment, resulting in gastric volvulus that required surgery. To the best of our knowledge, this is the first reported occurrence of gastric volvulus during neoadjuvant imatinib treatment for a giant gastrointestinal stromal tumor. Case presentation A 58-year-old Japanese woman who was diagnosed with a giant gastric gastrointestinal stromal tumor and administered neoadjuvant imatinib presented to our hospital with complaints of abdominal pain and retching. Enhanced computed tomography revealed that the gastrointestinal stromal tumor had shrunk and shifted in position, and the stomach had organoaxially twisted. Accordingly, the patient was diagnosed with gastric volvulus caused by a gastric gastrointestinal stromal tumor. Conservative treatment did not improve the volvulus; hence, laparotomy was performed. The tumor developed from the lesser curvature of the stomach and caused rotation of the gastric body. The local gastric wall was resected. Histopathological examination confirmed the diagnosis of gastrointestinal stromal tumor. The patient received adjuvant imatinib for 3 years and has been alive for 5 years without recurrence. Conclusions Gastric volvulus can be caused by the laxity of the ligaments that hold the stomach and gastric ptosis or esophageal hernia and diaphragmatic hernia; therefore, gastric gastrointestinal stromal tumors rarely cause gastric volvulus. However, a risk of torsion exists if the gastrointestinal stromal tumor develops extramural to lesser curvature and attains a certain size.