Combined surgical approach for large sacral chordoma resection with pelvic floor reconstruction – a video vignette

2020 ◽  
Author(s):  
Sergey Efetov ◽  
Victor S. Kochetkov ◽  
Kirill B. Puzakov ◽  
Inna A. Tulina ◽  
Polina S. Kozlova ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Surgical Approach ◽  
Pelvic Floor Reconstruction ◽  
Sacral Chordoma ◽  
Video Vignette

Pelvic floor reconstruction with bilateral gracilis flaps following extralevator abdominoperineal excision - a video vignette

2017 ◽  
Vol 19 (12) ◽  
pp. 1120-1121 ◽  
Author(s):  
C. S. Jones ◽  
J. Nowers ◽  
N. J. Smart ◽  
J. Coelho ◽  
A. Watts ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Abdominoperineal Excision ◽  
Pelvic Floor Reconstruction ◽  
Video Vignette

Combined surgical approach for retrorectal tumours with intra‐operative CT guidance: sacral chordoma—a video vignette

2020 ◽  
Author(s):  
Sotirios Georgios Popeskou ◽  
Alessandra Cristaudi ◽  
Fabio Garofalo ◽  
Diana Celio ◽  
Francesco Mongeli ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Ct Guidance ◽  
Sacral Chordoma ◽  
Video Vignette

Modified rectus abdominis myoperitoneal flap for pelvic floor reconstruction

2019 ◽  
Vol 153 (2) ◽  
pp. 463-464 ◽  
Author(s):  
D. Cibula ◽  
J. Slama ◽  
R. Kocian ◽  
O. Nanka
Keyword(s):  
Pelvic Floor ◽  
Rectus Abdominis ◽  
Pelvic Floor Reconstruction

Transient ureteric obstruction following pelvic floor reconstruction

2021 ◽  
Vol 14 (5) ◽  
pp. e238669
Author(s):  
Liam Joseph Beamer ◽  
Sarah Neary ◽  
Thomas McCormack ◽  
David Ankers
Keyword(s):  
Pelvic Floor ◽  
Kidney Injury ◽  
Solitary Kidney ◽  
Percutaneous Nephrostomy ◽  
Pelvic Organ ◽  
Ureteric Obstruction ◽  
Pelvic Floor Reconstruction ◽  
Transient Nature ◽  
Recurrent Pelvic Organ Prolapse ◽  
History Of

We describe the first reported case of transient distal ureteric obstruction attributed to post-surgical oedema in a patient with a solitary kidney. This occurred following combined pelvic floor repair and sacrospinous fixation for recurrent pelvic organ prolapse and manifested clinically as anuria, radiological hydroureter and acute kidney injury in the postoperative period. The transient nature of this obstruction, which was managed by a temporary percutaneous nephrostomy, indicates that it was caused by ureteric compression secondary to soft tissue oedema following surgery. We highlight the importance of this potential complication in females with a history of nephrectomy, unilateral renal tract anomalies or severely diminished renal reserve.

scholarly journals The results of use of myoplasty for closure of the pelvic floor defect after extralevator abdominoperineal excision of the rectum

2019 ◽  
Vol 17 (6) ◽  
pp. 35-40
Author(s):  
N. A. Domansky ◽  
V. V. Semiglazov ◽  
A. M. Karachun ◽  
K. K. Lebedev ◽  
D. V. Samsonov ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Early Postoperative Period ◽  
Wound Complications ◽  
Pelvic Floor Reconstruction ◽  
Group Iii ◽  
Group I ◽  
Perineal Wound Complications ◽  
Group Ii

Background. Extralevator abdominoperineal excision is associated with a high incidence of perineal wound complications. There is no uniform standard for choosing the method for pelvic floor reconstruction after extralevator abdominoperineal excision.The purpose of the study was to compare the results of extralevator abdominoperineal excisions of the rectum using various methods of perineal wound closure.Materials and Methods. Between 2014 and 2018, 120 patients underwent extralevator abdominoperineal excisions of the rectum using various options for closure of the pelvic floor. The patients were divided into 3 groups. Group I patients (n=64) underwent simple plasty of the peritoneal wound. Group II patients (n=43) underwent myoplasty using the gluteus maximus muscle. Group III patients (n=13) underwent myoplasty using the rectus abdominis muscle. The incidence of perineal wound complications in the early postoperative period was assessed.Results. The total number of perineal wound complications in Group I, II and III was 33 (51.5 %), 13 (30.2 %), and 6 (46.1 %), respectively. Grade IIIA-IIIB complications according to the Clavien-Dindo classification were observed in 25 % of Group I patients, in 18.6 % of Group II patients and in 7.7 % of Group II patients. Postoperative perineal wound complications occurred more often in Group I patients after simple plasty than in Group II and III patients after myoplasty (51.5 % versus 30.2 %). However, perineal wound complications were observed more often in Group III than in Group II (46.1 % versus 30.2 %, respectively). No significant differences in the frequency of complications between 3 groups were found.Conclusion. Using various options for closure of the pelvic floor after extralevator abdominoperineal excisions of the rectum, there was a tendency to reduction in the incidence of grade IIIA-IIIB perineal wound complications.

scholarly journals BLADDER RECONSTRUCTION DURING SEPARATION OF A CONJOINT TWIN ISCHIOPAGUS TRIPUS

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Fajar Effendi ◽  
Safendra Siregar ◽  
Jupiter Sibarani
Keyword(s):  
Urinary Tract ◽  
Pelvic Floor ◽  
Conjoined Twins ◽  
Team Work ◽  
Lower Limbs ◽  
Pelvic Floor Reconstruction ◽  
Unique Challenge ◽  
Left Ureter ◽  
Ischiopagus Tripus ◽  
The Right

Objective: Conjoined twins represent one of the rarest congenital anomalies occurring with a varying incidence of about approximately 1 : 50.000 - 1 : 200.000 births. Ischiopagus conjoined  twinning (Fuse at the hip region) is even rare representing only 6% of all conjoined  twins. Here we report our experience in lower urinary tract reconstruction during separation of a conjoined twin ischiopagus tripus in Hasan Sadikin Hospital, Bandung. Case(s) Presentation: Two years old female conjoined twins, weighing in total of 8 kilograms, were brought to our hospital. The twins were fused  at  the lower  halves of  their bodies with two separate lower limbs at the right side and a fused left lower limb. External genitalia were absent. From CT Angiography we found four kidneys, two in each child with two separate bladders, with right ureter of baby A and left ureter of  baby B enter the  right bladder, while left ureter of  baby A and  right ureter of  baby B enter the left bladder. There was one cloaca that drains urine and feces. During the separation surgery, we performed ureteroneocystostomy and temporary ureteral stenting, followed by cystostomy. The pediatric surgeon performed bowel separation by stapling technique, pelvic wall separation, ileostomy, and pelvic floor reconstruction. The orthopedic surgeon performed femur separation, pelvic floor reconstruction, reconstruction of the pelvic ring, and femur reconstruction. The patients underwent defect closure, which performed by plastic surgeon. The operation was successful, without any complication to the kidney and the urinary tract of both babies. Discussion: Ischiopagus conjoined twins are the most complex conjoined twins and occur in only 6% of all conjoined twin cases. Ischiopagus is usually located along the axis with the head located on the opposite side. This case usually has one umbilicus and the two bodies are fused below this level, the union occurs in the lower abdomen and the pelvis. The internal organs that usually coalesce in cases of ischiopagus conjoined twins are liver, lower gastrointestinal, and genitourinary. The fused gastrointestinal part is the ileo-colic part of terminal ileum (Meckel's diverticulum). Conclusion: The separation of conjoined twin is a unique challenge due to its complex anatomy and physiology. Although advancement in imaging and monitoring has improved the survival rate separation can be successfully achieved only with meticulous planning and team work.

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