Simultaneous abdominoplasty and laparoscopic ventral hernia alloplasty in patients with obesity

2020 ◽  
Vol 26 (4) ◽  
pp. 45-49
Author(s):  
V.V. Boiko ◽  
◽  
K.Yu. Parkhomenko ◽  
◽  
◽  
...  
Keyword(s):  
Ventral Hernia ◽  
Postoperative Period ◽  
Average Length ◽  
Lower Lobe ◽  
Long Term Results ◽  
Hospital Treatment ◽  
Surgical Interventions ◽  
Cosmetic Results ◽  
Good Cosmetic ◽  
Ventral Hernias

Aim. To study the results of simultaneous abdominoplasty and laparoscopic ventral hernia alloplasty in patients with obesity. Material and Methods. Simultaneous adbominoplasty and laparoscopic hernioplasty for ventral hernias were performed in 31 patients. The mean age of the patients was 53.7±6.5 (95% CI 51.3; 56.0). All patients were diagnosed as obese (body mass index more than 30 kg/m2). Incisional hernia was the main indication for surgery in the majority of patients - 20 (64,5%); in 11 (35%) cases a primary hernia of median localization was detected. Immediate and long-term results of surgical interventions were studied. Results and Discussion. In the postoperative period after drainage removal accumulations of fluid (seromas) were revealed in 9 (29%) patients using ultrasound investigation; in 2 cases they were evacuated by puncture. In one case, a marginal necrosis of the skin around the formed umbilicus occurred (healing by secondary tension); in another, lower lobe pneumonia was diagnosed (eliminated by antibiotic therapy). The average length of hospital stay was 7.3±1.4 (95% CI 6.8; 7.9) days, 6-8 days in most cases. Only two patients were hospitalized for more than 8 days due to postoperative complications. No recurrences of hernias were registered at follow-up examination 1-3 years later; good cosmetic results were achieved. Conclusions. In patients with ventral hernias with obesity and fat apron it is advisable to perform simultaneous intervention - abdominoplasty and allogernioplasty. It is advisable to perform alloplasty of ventral hernias with simultaneous abdominoplasty via laparoscopic access according to IPOM technology with the use of mesh endoprosthesis with antiadhesive coating. Simultaneous abdominoplasty causes an increase in the frequency of seromas in the postoperative period, but it does not increase the duration of hospital treatment. Simultaneous surgeries allow achieving good cosmetic results and do not increase the incidence of hernia recurrence. Keywords: obesity, fat apron, ventral hernia, abdominoplasty, laparoscopic alogernioplasty, result

scholarly journals Features of laparoscopic hernioplasty of paracolostomy hernias in patients with combined abdominal pathology

2020 ◽  
Vol 24 (4) ◽  
pp. 600-603
Author(s):  
K. Yu. Parkhomenko
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Average Length ◽  
Abdominal Cavity ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Inguinal Hernias ◽  
Laparoscopic Hernioplasty ◽  
Commercial Enterprise ◽  
Laparoscopic Techniques ◽  
Ventral Hernias

Annotation. The aim of the study is to study the technological features and results of simultaneous laparoscopic hernioplasty of paracolostomy hernias in the presence of combined abdominal pathology. We analyzed the results of surgical treatment of 11 patients with paracolostomy hernias who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council “Regional Clinical Hospital” from 2016 to 2020, of whom – women – 4 (36%), men – 7 (64%), aged from 42 to 69 years old. Clinical, anamnestical and instrumental data for the prolongation of cancer were not identified in all patients. Out of 11 patients, in addition to paracolostomy hernia, 3 (27%) had inguinal hernias, 8 (73%) had postoperative ventral hernias. 3 (27%) patients with hernias also had cholecystolithiasis. All patients underwent laparoscopic hernioalloplasty of paracolostomy hernia. 3 patients underwent simultaneous TAPP for inguinal hernias, and 1 patient underwent laparoscopic cholecystectomy and TAPP. 6 patients with incisional ventral hernias underwent simultaneous IPOM according to the standard method, and 2 – according to the own method. Of the above, 2 patients suffering from cholecystolithiasis, in addition to hernioalloplasty, underwent laparoscopic cholecystectomy. In 4 (36%) patients, viscerolysis was additionally performed due to the presence of an adhesive process in the abdominal cavity. Simultaneous hernioalloplasty TAPP and IPOM, as well as laparoscopic cholecystectomy, had no significant effect on the development of complications and the duration of hospitalization. The average length of inpatient treatment was 9.2 bed-days. The study proves the expediency of widespread simultaneous surgical interventions for hernias of the anterior abdominal wall, as well as the preference for laparoscopic techniques.

scholarly journals PLASTICS OF THE ANTERIOR ABDOMINAL WALL IN POSTOPERATIVE VENTRAL HERNIA

2021 ◽  
pp. 91-97
Author(s):  
N. Sivets ◽  
◽  
D. Kluyko ◽  
A. Sivets ◽  
D. Holovach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Plastic Surgery ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Anterior Abdominal Wall ◽  
Treatment Efficiency ◽  
Ventral Hernias

Objective. Improving the postoperative ventral hernias surgical treatment efficiency. Authors of the article define the clinically developed method of plastic surgery of the anterior abdominal wall in postoperative ventral hernia. Operations with this technique were performed in 37 patients. The endoprosthesis used was a polypropylene net made by “Eticon”. In the postoperative period complications took place in 2 (5,4%) patients. Conclusion. The developed method of the anterior abdominal wall plastics effectiveness was established in the article.

Plasty of incisional ventral hernias using a mechanical suture

1982 ◽  
Vol 63 (3) ◽  
pp. 37-40
Author(s):  
B. L. Elyashevich ◽  
F. Sh. Sharafislamov ◽  
R. M. Ramazanov
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Anterior Abdominal Wall ◽  
Long Term Results ◽  
Mechanical Suture ◽  
And Function ◽  
Ventral Hernias

Developed and applied in patients with hernias of the anterior abdominal wall a method of plasty with own tissues using a mechanical suture. 109 patients with postoperative and recurrent ventral hernias were operated on. This method of ventral hernia repair allows to restore the anatomy and function of the abdominal wall, standardizes and simplifies the technique of the operation, reducing the time of its implementation, and gives 95.4% positive long-term results.

scholarly journals Outcome of Buck’s fascia repair with wingless glanuloplasty in distal penile hypospadias

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mir Fahiem-Ul-Hassan ◽  
Vinay Jadhav ◽  
Narendrababu Munianjanappa ◽  
Murali Saroja ◽  
Ramesh Santhanakrishnan
Keyword(s):  
Prospective Study ◽  
Postoperative Period ◽  
Simple Procedure ◽  
Exclusion Criteria ◽  
Testosterone Therapy ◽  
Cosmetic Results ◽  
Meatal Stenosis ◽  
Good Cosmetic ◽  
Hypospadias Surgery

Abstract Background Hypospadias surgery is technically demanding and is often encountered with complications like fistula and glanular dehiscence. To prevent these complications we have instituted Buck’s fascia repair (BFR) with wingless glanuloplasty (WLP) in the cases of distal penile hypospadias (DPH) deemed to be suitable for TIP repair. The aim of this prospective study was to assess the outcome of Buck’s fascia repair (BFR) with minimal wingless glanuloplasty (WGP). Methods This prospective study included 50 patients with coronal, subcoronal and midpenile hypospadias who received a tubularization of incised plate (TIP) repair. The exclusion criteria were glanular hypospadias, Thiersch Duplay repair, proximal penile hypospadias, previous penile surgeries, uncorrectable chordee, glans size < 14 mm, flat glanular groove and preoperative testosterone therapy. Results Over a period of 3 years, 50 patients with mean age of 3.5 ± 0.8 years were recruited for the study. Meatal position was coronal, subcoronal and midpenile in 6, 24 and 20 patients, respectively. Fistula occurred in one patient (2%) and meatal stenosis in one. Straining on micturition was noted in two patients that needed dilatation in postoperative period. None of the patients had glanular dehiscence. Surgeon acceptability of the procedure was good. Cosmetic results were also fair. Conclusion Buck’s fascia repair with Wingless glanuloplasty is a good repair for the distal penile hypospadias. It is effective and is associated with low fistula rates and glanular dehiscence. It is technically simple procedure involving minimal dissection. However, caution should be observed in midpenile hypospadias to avoid tight repair in subcoronal region.

scholarly journals RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 32-35
Author(s):  
A. V. Myzin ◽  
Vasily G. Kuleshov ◽  
A. E. Stepanov ◽  
N. V. Gerasimova ◽  
K. Yu. Ashmanov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Splenic Cysts ◽  
Good Cosmetic

Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.

scholarly journals ANALYSIS OF IMMEDIATE AND LONG-TERM RESULTS OF SUBLAY AND TAPP TECHNIQUES IN THE TREATMENT OF VENTRAL HERNIAS

2021 ◽  
pp. 42-46
Author(s):  
V. S. Dubchenko
Keyword(s):  
Ventral Hernia ◽  
State Institution ◽  
The State ◽  
Long Term Results ◽  
Ministry Of Health ◽  
Transabdominal Preperitoneal ◽  
Sublay Technique ◽  
Significant Difference ◽  
Ventral Hernias

The accumulated clinical experience has proven that the “sublay” technique allows to achieve greater functional activity of the anterior abdominal wall and is the method of choice in the treatment of ventral hernia. The use of self-adhesive nets during laparoscopic transabdominal preperitoneal plasty (TAPP- Transabdominal Preperitoneal Plastic) in the treatment of small and medium ventral hernia is safe and effective, with low values of postoperative pain syndrome and rapid functional recovery after surgery, without increasing the recurrence in the short term. The aim – was to analyze the immediate and long-term results of “sublay” and TAPP techniques in the treatment of ventral hernias of lower and median localization. The author noted that the search for technical methods aimed to reduce the intra-abdominal pressure in this hernioplasty technique was relevant and practically significant. Material and Methods. The work was performed on the basis of the surgical department of the State Institution “Specialized Multi-Purpose Hospital №1 of Ministry of Health of Ukraine”, Department of General Surgery of the State Institution “Dnipro State Medical University of Ministry of Health of Ukraine”. Results. Comparison of immediate and long-term results of peritoneal-prosthetic-aponeurosis thickness studies showed a statistically significant difference (p < 0.001) using different techniques. When analyzing the separated results, reliable differences (p <0.001) depending on the gender of patients were recorded. Thus, in males, when using the “sublay” technique the peritoneal-prosthetic-aponeurosis thickness was greater by 1.15 mm (by 42.43 %) in comparison with the Tapptechnique, and in females, by 1.16 mm (by 42.09 %), respectively. Conclusions. The analysis of the immediate and long-term results of the “sublay” and TAPP techniques in the treatment of ventral hernias of lower and median localization showed that the “sublay” technique was characterized by traumatic surgical intervention, shift of the prosthesis to one side, as a consequence of its deformation. When using this technique, peritoneum-prosthetic-aponeurosis thickness values were significantly higher  –  by 13.16 % and 42.40 % in the early and distant postoperative periods, respectively. Also, when using the Tapp technique in the distant period the thickness was significantly reduced (p <0,0001) by 49,47 % in comparison with the immediate results.

scholarly journals INCREASING SAFETY OF SURGICAL INTERVENTIONS IN PATIENTS WITH VENTRAL AND INCISIONAL HERNIA UNDER COMORBIDITY CONDITIONS WHEN PERFORMING DIFFERENT TYPES OF OPEN HERNIOPLASTY

2020 ◽  
pp. 135-139
Author(s):  
V. I. Piatnochka ◽  
I. Ya. Dziubanovskyi ◽  
A. M. Prodan
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Polypropylene Mesh ◽  
Immunosuppressive Agents ◽  
Technical Improvement ◽  
Surgical Interventions ◽  
Duration Of Surgery ◽  
Ventral Hernias

Abstract. In the period from 2001 to 2017, 1419 patients with ventral and postoperative ventral hernia were operated on. The unsatisfactory results of the surgical treatment of this pathology were due to a number of disadvantages: the choice of an inadequate method of hernioplasty in a specific clinical situation, an incomplete revision of the muscle-aponeurotic layer of the anterior abdominal wall, especially in patients with postoperative veterinary hernias, concomitant syndrome of undifferentiated connective tissue dysplasia and obesity, and weak points, the wrong choice of the type of mesh implant (“light” or “heavy” polypropylene mesh) and its size, the choice of an inappropriate type of suture material, as well as the high invasiveness of surgical intervention. Based on the given causes of complications in the operated patients with a high risk of their development, we have made a technical improvement of the existing methods of hernioplasty and development of new ones, which significantly reduced the number of postoperative complications and increased the safety of performing surgical interventions in patients with ventral and postoperative ventral hernia. Purpose. Based on the results of the analysis of surgical treatment of patients with comorbid conditions for primary and incisional ventral hernias to develop technical prerequisites for improving the safety of surgical interventions in this category of patients. Methods. Іn the period from 2001 to 2017, an in-depth comprehensive clinical-instrumental and laboratory examination of 1419 patients with primary ventral hernia (PVH) and postoperative ventral hernia (PVH) was conducted. The patients were divided into groups according to the periods of surgical treatment of patients. For this purpose, two periods were formed: from 2001 to 2009 and from 2010 to 2017. At the first period, 597 (42.07%) patients were examined and operated on. These patients formed a comparison group. The main group corresponding to patients who were treated in the period from 2010 to 2017 was 822 (57.93%) people. Results. Developed techniques for performing retromuscular allogernioplasty, which were based on controlled visualization of suturing when fixing polypropylene mesh to the posterior leaf of the vagina of the rectus muscle, allowed us to reliably and safely place and secure the implant in the retromuscular space, significantly reduce the trauma and duration of surgery. Kind of treatment using the mesh allograft with a liposomal complex with included antibacterial and immunosuppressive agents during the operation on the "onlay" method significantly reduced the number of local infectious complications. The location of the PRF membrane over the polypropylene mesh during retromuscular allogernioplasty improved neoangiogenesis at the mesh implantation site, increased fibroblast activity and the formation of collagen fibers around the mesh material, which provided maximum integration of the "light" abdominal wall with polypropylene tissue. Conclusion. These features of the dynamics of the used methods of surgical interventions and types of polypropylene nets with an individualized approach to each patient were reflected in a significant reduction in the number of both early local and general late postoperative complications, which improved the effectiveness of surgical treatment of patients with primary postoperative ventral hernias.

Vertebral hydatid disease

1976 ◽  
Vol 44 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Werner L. Apt ◽  
Juan L. Fierro ◽  
Ciro Calderón ◽  
Carlos Pérez ◽  
Patricio Mujica
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Postoperative Period ◽  
Long Term Results ◽  
Common Procedure ◽  
Laboratory Findings ◽  
Content Type ◽  
Surgical Interventions ◽  
Fine Print

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.

scholarly journals Method of prevention of postoperative gray allohernioplasty in laparoscopic ventral hernia

2018 ◽  
Vol 9 (1) ◽  
pp. 3-9
Author(s):  
Yu. V. Ivanov ◽  
D. N. Panchenkov ◽  
R. S. Chaikin ◽  
M. V. Zinovsky ◽  
A. S. Avdeev
Keyword(s):  
Intellectual Property ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Seroma Formation ◽  
Trans Position ◽  
Hernia Sac ◽  
Ventral Hernias ◽  
Hernial Orifice

The authors have developed a new method of seroma formation prevention after laparoscopic allohernioplasty in patients with postoperative ventral hernias. The results of the study showed that trans- position of hernia sac into the abdominal cavity and fixation to the unmodified abdominal wall around the perimeter of the hernial orifice can reliably eliminate Grajewo cavity and thereby to eliminate the possibility of seroma formation in the postoperative period. Federal service for intellectual property (Rospatent) decided to grant a patent for this method of seroma formation prevention at the surgery of postoperative ventral hernias as for the invention “Method of laparoscopic plasty of ventral hernias” (№2017120227/14(035085) from 17.01.2018).

scholarly journals Using the aponeurotic hypotensive suture in surgical treatment of patients with median postoperative ventral hernias

2016 ◽  
Vol 24 (4) ◽  
pp. 112-118
Author(s):  
P V Vnukov ◽  
Yu M Sheptunov
Keyword(s):  
Surgical Treatment ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Transverse Direction ◽  
Early Postoperative Period ◽  
Abdominal Pressure ◽  
Ventral Hernias

One of the operation about the median postoperative ventral hernia is retromuscular plastic Stoppa-Rives. For large defects closure rear sheets of the sheaths of direct muscles associated with the eruption of the seams. The authors propose a new hypotensive aponeurotic suture located opposite each other of the chains of stitches oriented in the transverse direction. This seam is used in 14 patients. All patients were able to take in rear sheets of the sheaths of direct muscles under the control of intra-abdominal pressure. During the early postoperative period without complications. Patients viewed through 6-20 months. Recurrence was not detected. It is concluded that the use of this seam is safe and effective closure of the fascia when alloplasty.

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