Surgery of Complex Abdominal Wall Defects

 

Description:

As with the first edition, the second edition of this book covers the surgical anatomy of the abdominal wall, pathology of abdominal wall defects, such as hernias, enterocutaneous or entero-atmospheric fistulae, and indications for and surgical techniques used to reconstruct the abdominal wall from the practical stand point. In addition, through a number of illustrations, the placement of mesh in the abdominal wall reconstruction as well as manipulations of patient’s tissue including lateral compartment release techniques and other tissue transfer techniques are described in detail. The text also covers reconstruction of complex contaminated abdominal wall defects in patients with complex enteric fistulae, stomas, defects created after the excision of previously placed infected prosthetic mesh, and defects associated with acute tissue loss after severe trauma or necrosis of abdominal wall such as necrotizing soft tissue infections. Complex abdominal wall defects in the pediatric population and long-term outcomes and durability of these repairs are also addressed. The second edition of Surgery of Complex Abdominal Wall Defects is written by experts in their respective areas from around the world and has been updated thoroughly. As with the first edition, it will continue to serve as a guide for current practice for surgeons, including general, trauma, acute care, plastic and reconstructive surgeons.

 

Table of Contents:

 

Reason 1: Surgeons’ Need

Reason 2: Patients’ Need

Reason 3: Need to Share Knowledge and the Existing Expertise

Reason 4: Increased Frequency of Abdominal Wall Defects

Reason 5: Increased Complexity of Most Abdominal Wall Defects

Reason 6: Three Principles of Surgical Care

Reason 7: New Technologies

Reason 8: Need for a Multidisciplinary Approach

Reason 9: Continuous Changes and Need for Progress in Complex Surgery Education

Contents

Contributors

Part I: Preoperative Considerations

1: Intraoperative Decision-Making Process in Complex Surgery

Introduction

The Anatomy of Surgeons’ Intraoperative Decisions

Patient’s Physiology as Factor of Intraoperative Decisions

Summary

References

2: History of Abdominal Wall Repair: In Search of New Techniques and Materials

Introduction

Early Reports in the Annals of Surgery

Prosthetic Materials

Finding the Perfect Mesh

Nonabsorbable Mesh

Absorbable Mesh

Laparoscopic Repair

Conclusion

References

3: Anatomy and Physiology of the Abdominal Wall: Surgical Implications

Introduction

Anatomical Boundaries

Abdominal Wall Distensibility

Surgical Implications

Conclusion

References

4: Nutritional Consideration of Patients with Open Abdomens and Fistulas

Introduction

The Open Abdomen

Physiology of the Open Abdomen

Nutritional Considerations for the Open Abdomen

Summary of Nutritional Considerations for the Open Abdomen

Enterocutaneous Fistulas

Classification and Physiology of Enterocutaneous Fistulas

Nutritional Considerations for Fistulas

Total Parenteral Versus Enteral Nutrition for Enterocutaneous Fistulas

Minimizing Enterocutaneous Fistula Output

Summary of Nutritional Considerations for Fistula Patient

Conclusion

References

5: The Biology of Complex Abdominal Wall Defects: Definitions and Causes

Definition of Complex Abdominal Wall Defects

Causes of Complex Abdominal Wall Defects

Abdominal Wall Infections and Recurrent Incisional Hernias

Damage Control and the Open Abdomen Approach

Resection of Abdominal Wall Tumors

Complex Recurrent Incisional Hernias and the Pathophysiology of Wound Healing of the Abdominal

Biological and Mechanical Factors Involved

Local and General Factors Affecting Wound Healing

Local Factors

Closure Under Tension and Blood Supply

Hematoma

Infection

Irradiation

Mechanical Stress

Surgical Technique

Tissue Type

General Factors

Age

Anemia

Diabetes

Nutrition

Steroids

Jaundice

Malignant Disease

Obesity

Temperature

Trauma, Hypovolemia, and Hypoxia

Uremia

Complex Abdominal Wound Defects from Damage Control Surgery and the Open Abdomen

Summary

References

6: Perioperative Radiologic Evaluation of Patients with Difficult Abdominal Wall Defects

Introduction

Diagnosis

Ultrasonography

Computerized Scan

Barium Studies with Small-Bowel Follow-Through

Magnetic Resonance Imaging

Operative Planning Guided by Imaging Techniques

Intraoperative Guidance

Postoperative Radiologic Assessment

Recurrence

References

Part II: Surgical Consideration: Techniques and Outcome

7: Abdominal Wall Reconstruction in Patients with Complex Defects: A Nine-Step Treatment Strategy

Introduction

A Nine-Step Management Strategy

Step 1: I = Identification of Postoperative Fistulas

Step 2: S = Sepsis Control and Eradication

Step 3: O = Optimization of Nutrition

Step 4: W = Wound Care

STEP 5: A = Redefining the Anatomy

Step 6: T = Timing of Operation or Takedown of ECF

Step 7: S = Surgical Approach

Step 7.1: Getting in the Abdomen

Step 7.2: Adhesiolysis

Step 7.3: Fistula Resection

Step 7.4: Intestinal Anastomosis

Step 7.5: Definitive Abdominal Wall Reconstruction

Step 7.6: Lateral Component Separation

Step 7.7: Surgical Technique of Open Component Separation

Step 7.8: Posterior Component Separation with Transversus Abdominus Release

Step 7.9: Laparoscopic Component Separation

Step 7.10: Mesh Graft Selection

Step 7.11: Mesh Placement

Step 8: P = Postoperative Care

Step 8.1: Dealing with Complications of Biologic Grafts

Step 9: L = Long-Term Follow-Up

Summary

References

8: A Difficult Abdomen: Temporary Closure and Management of the Consequences

Introduction

Leaving the Abdomen Open

Temporarily “Closing” the Abdomen

Towel Clip Closure

Temporary Skin Only Suture Closure

Retention Sutures

Temporary Silos

Vacuum-Assisted Wound Closure

Use of Skin Graft in Open Abdomen Management

Sequential Closure of Abdominal Wall Following DCS

Managing the Consequences of Temporary Closure

Choosing Materials for Repair

Synthetic Mesh

Biologic Mesh

Use of Hernia Grading System as a Guide to Repair

Principles of Repair

Summary

References

9: Timing of Definitive Reconstructive Surgery of Abdominal Wall Defects in Patients with Entero

Introduction

Etiology of Enterocutaneous Fistula

When Should We Operate?

Factors Affecting Timing for Surgical Intervention

Evidence for Enterocutaneous Fistula Repair Timing

Abdominal Wall Defect Repair Timing

Summary

References

10: Practical Approach to Patient with a Hostile Abdomen: Clinical Scenarios

Introduction

Key Questions

Preoperative Conditions

Scenario 1

Scenario 2

Scenario 3

Creating a Surgical Plan

Providing Patient-Centered Care: Involving the Patient

Timing of the Operation

Preparing for the Operation

Entering the “Frozen Lake”

Mobilizing the Entire GI Tract

How Much of the Intestines to Resect and How to Create the Anastomoses

Definitive Reconstruction of Temporary Closure of the Abdomen

Summary

References

11: Staged Reconstructions of Abdominal Wall Defects

Introduction

Three Stages of Reconstruction

Stage 1: Temporary Abdominal Closure

Stage 2: The Maturation Period

Stage 3: Definitive Abdominal Wall Reconstruction

Tensor Fascia Latae Flap for Abdominal Wall Reconstruction

Selection of the Appropriate Reconstruction Method

Summary

References

12: Complex Abdominal Wall Reconstruction-Plastic Surgeon’s Perspective

Introduction

Current Indications for Utilization of Bioprosthetic Mesh

Patient Selection

Abdominal Wall Reconstruction Principles

Component Separation Technique

Management of the Skin: Deficiency and Redundancy

Staged Abdominal Wall Reconstruction

Postoperative Care

Conclusions

References

13: Complex Tissue Transfer in the Management of Abdominal Wall Defects

Introduction

Temporary Abdominal Wall Closure for Acute Abdominal Wall Defect and During Open Abdomen Manageme

Abdominal Wall Reconstruction Following Temporary Closure in the Management of Abdominal Wall D

Complex Tissue Transfer in the Management of Abdominal Wall Defects

Basic Musculoskeletal and Neurovascular Anatomy of Anterior Abdominal Wall

Component Separation Method

Modifications of Component Separation Method

The Anterior Rectus Abdominis Sheath Turnover Flap Method

Surgical Procedures

Blood Supply to the Anterior Rectus Turnover Flap

Conclusion

References

14: Minimally Invasive Component Separation for the Repair of Large Abdominal Wall Defects

Introduction

Definition of Large Abdominal Defects

Surgical Options in Complex Abdominal Hernias

Anterior Component Separarion Technique

Minimally Invasive Anterior Component Separation Technique

Introduction

Minimally Invasive Component Separation Technique Without the Use of Video-Assisted Equipment

Video-Assisted Anterior Component Separation Technique

Comparing Results from Different Anterior Component Separation Techniques

Pre-operative Care

Surgical Technique

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Post-operative Care

Special Cases

The Open Abdomen

The Use of Chemical Component Sepration and Tissue Expanders

Stomas

Previous Anterior Component Separation

Summary

References

15: Abdominal Wall Reconstruction in the Pediatric Population

Introduction

History

Gastroschisis

Epidemiology

Surgical Management

Primary Closure

Staged Reduction and Closure

Sutureless Closure

Ward Reduction Versus General Anesthesia

Management of Intestinal Atresia

Omphalocele

Epidemiology

Surgical Management

Primary Closure

Giant Omphalocele

Staged Closure

Delayed Closure

Definitive Surgical Management

Cosmetic Outcomes

Summary

References

16: Surgical Approach to Abdominal Wall Defects and Hernias in Patients with End Stage Organ Dis

Introduction

Hernia Classification and Grading

Grading

Classification

End Stage Organ Disease

Liver

Compensated Chronic Liver Disease

Risk Stratification

Kidney

Post Transplant Hernia Repair

Liver

Minimally Invasive and Open Surgery

Primary and Staged Closures

Primary Repair VS Mesh Repair

Kidney

Hernias in Pediatric Recipients

Urgent Vs. Elective

Live Donors

References

17: Management of Flank Complex Hernia

Introduction

Classification

Topographic Anatomy

Clinical and Diagnosis

Surgical Treatment

General Considerations

Open Technique

Suprafascial Mesh

Intramuscular Mesh

Preperitoneal Mesh

Intraperitoneal Mesh

Double Mesh

Tight Double-Mesh Technique

Medial Approach

Laparoscopic Technique

Laparoscopic Technique in Hernia Repair Has Become Common

References

18: Laparoscopic Access to the Difficult Abdomen in Patients with Large Abdominal Wall Defects

Introduction

General Features

Patient Selection

Surgical Technique

Potential Advantages

Conclusion

References

19: Laparoscopic Techniques in the Repair of Large Abdominal Wall Defects

Introduction

Patient Preparation, Equipment, and Positioning

Surgical Technique

Postoperative Care

Complications and Outcome

References

20: Selection of Prosthetic Materials in the Repair of Complex Abdominal Wall Defects

Introduction

Considerations when Selecting Prosthetic Materials for the Management of CAWD

Prosthetic Mesh

Synthetic Non-absorbable Polymers

Polypropylene

Polyester

Expanded Polytetrafluoroethylene (ePTFE)

Absorbable Synthetic Polymers

Composites

Biologic Prosthetics (Grafts)

Fibrin Sealant in Hernia Repairs

Complications

Conclusion

References

21: Mesh Placement in Complex Abdominal Wall Defects: Techniques and Outcomes

The Role of Mesh

Choice of Mesh

Mesh Placement Technique

Onlay Mesh Placement

Underlay Mesh Placement

Rives–Stoppa Mesh Placement Technique

Interposition or Bridge Mesh Placement

References

Part III: Post-operative Complications and Reoperative Surgery

22: Abdominal Compartment Syndrome and Hypertension in Patients Undergoing Abdominal Wall Reconstr

Introduction

Pre-operative Considerations for Prevention of IAH/ACS

Patient Selection

Size of Hernia: “Loss of Domain”

Size of Defect

Intra-operative Considerations

Post-operative Considerations

Post-operative Care/Monitoring

Therapy for Post-operative IAH/ACS

Medical/Minimally Invasive Therapy

Surgical Decompression

Conclusions

References

23: The Surgical Nightmare: Dealing with Infected Mesh

Introduction

Risk Factors and Pathogenesis of Mesh Infection

Diagnosis of Mesh Infection

Management of Mesh Infection

Conclusions and Recommendation

References

24: Abdominal Plastic Surgery and Adjunctive Procedures

Introduction

Liposuction

Abdominoplasty Techniques

Long Term Post-operative Outcome Results

Plastic Surgical Management Following Massive Weight Loss Patient

Pre-massive Weight Loss Panniculectomy

Post-massive Weight Loss Abdominoplasty

Post-massive Weight Loss Circumferential Lower Truncal Contouring

Complications in Abdominal Plastic Surgery

Seroma

Dehiscence

Infection

Hematoma

Ischemic Complications

Deep Venous Thrombosis

Pulmonary Embolism

Nerve Problems

Abdominal Compartment Syndrome

Scar Deformity

Conclusion

References

25: Short Bowel Syndrome: A Clinical Update

Introduction

Pathophysiology of Short Bowel Syndrome

Nutritional and Metabolic Management of Short Bowel Syndrome

Immediate Postoperative Period

Bowel Adaptation Period

Long-Term Management Period

Experience with the Growth Hormone, Glutamine, and Modified Diet Regimen

Growth Factors and Intestinal Adaptation in Short Bowel Syndrome

Other Factors Affecting Intestinal Adaptation and Outcomes in SBS

Management of Liver Disease in SBS/IF Patients Dependent on Parenteral Nutrition

Surgical Considerations

Intestinal Transplantation in Short Bowel Syndrome Patients

The Future of Management of Short Bowel Syndrome

Summary and Conclusions

References

26: Minimizing Postoperative Complications by Preoperative Optimization

Introduction

Preoperative Evaluation

Assessing the Perioperative Risk

Neurological System Evaluation

Cardiovascular System Evaluation

Summary of the 2014 ACC/AHA Guidelines

Renal System Evaluation

Gastrointestinal System Evaluation

Endocrine System Evaluation

Hematologic and Coagulation Evaluation

Infections

Nutritional Evaluation and Optimization

Control of Premorbid Conditions

Social and Addiction Issues

Prevention Strategies

Summary

Suggested Readings

27: The Final Word on a Complex Problem

Looking into the Future: Will Tissue Engineering Be the Next Answer?

References

Index

 

An aparitie	2018
Autor	Rifat Latifi
Dimensiuni	21.01 x 1.6 x 27.89 cm
Editura	Springer
Format	Paperback
ISBN	9783319857671
Limba	Engleza
Nr pag	275