Myth-Busting the DIEP Flap and an Introduction to the Abdominal Perforator Exchange (APEX) Breast Reconstruction Technique: A Single-Surgeon Retrospective Review

Conclusions: This study revealed no added risk when using pedicle disassembly to spare muscle/nerve structure during abdominal perforator flap harvest. Abdominal bulge/hernia was nearly completely eliminated. Fat necrosis rates were extremely low, suggesting benefit to pedicle disassembly and vascular routing exchange when required. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Breast: Original Articles Source Type: research

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ConclusionsAbsent patency of the abdominal wall vasculature is a novel risk factor for incisional hernia development in the setting of aortic disease. Preoperative assessment of perfusion may convey the risk of hernia development and may be a tool to guide measures such as prophylactic mesh placement to reduce the future risk of incisional hernia.
Source: Hernia - Category: Sports Medicine Source Type: research
CONCLUSION: The affection of testicular vascularity postoperatively is transient and returns to be near to the preoperative values in the late postoperative period (six months postoperatively). Additionally, no significant change in testicular volume postoperatively. PMID: 31091967 [PubMed - as supplied by publisher]
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research
Conclusion: Intraoperative ICG fluorescence angiography provides an objective method of judging bowel perfusion and therefore represents a useful tool for assessing intestinal perfusion in patients with incarcerated hernia. PMID: 30154915 [PubMed]
Source: Patient Safety in Surgery - Category: Surgery Authors: Tags: Patient Saf Surg Source Type: research
AbstractBackgroundMyocardial perfusion imaging (MPI) often employs attenuation-correction computed tomography (CTAC) to reduce attenuation artifacts and improve specificity. While there is no specific guideline on how they should be reported, incidental noncardiac findings identified on these scans may be clinically significant. The prevalence of these findings in veterans is not currently known. In addition, variability in reporting these findings may depend on the interpreting physician ’s specialty.MethodsTo guide future decision-making, CTACs in veterans referred for MPI were prospectively evaluated in a quality-...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
ConclusionsOur data suggest that bilateral endoscopic TEP hernia repair with polypropylene mesh does not impair fertility, as no differences in testicular blood flow, testicular volume, or semen quality were observed. Postoperative levels of LH and inhibin B differed significantly from preoperative measurements, yet no clinical relevance could be ascribed to these findings.
Source: Hernia - Category: Sports Medicine Source Type: research
This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy.Recent FindingsSBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn ’s disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and secondarily from intraluminal fluid accumulation. Dilatation increases mural tension, decreases mucosal perfusion, causes bacterial proliferation, and decreases mural tensile strength that increases bowel perforation risks. Classical clinical tetrad i...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
CONCLUSIONS: These findings indicate that non-uniform lung hypoplasia caused by DH alters the distribution of ventilation away from hypoplastic and into normally grown lung regions. During transition, the increase in PBF and pulmonary venous return, which is vital for maintaining cardiac output, is not affected by lung hypoplasia.Pediatric Research accepted article preview online, 11 April 2017. doi:10.1038/pr.2017.91. PMID: 28399114 [PubMed - as supplied by publisher]
Source: Pediatric Research - Category: Pediatrics Authors: Tags: Pediatr Res Source Type: research
Dharmraj Meena, Richa Jhuria, Sangeeta Saxena, Umesh SainiIndian Journal of Radiology and Imaging 2017 27(1):78-81An inguinal hernia occurs when an intestinal loop or part of the omentum or genital organs passes into the scrotal cavity or labia through an incompletely obliterated processus vaginalis. Inguinal hernias are most common in preterm neonates, especially at 32-weeks gestation. Content of hernia is mostly bowel and ovary/testicles. Presence of uterus in herniated sac is rare, and only few cases are reported in literature. Hernia is more frequently located on the right side because the right processus vaginalis clo...
Source: Indian Journal of Radiology and Imaging - Category: Radiology Authors: Source Type: research
Recent advances in laparoscopy and accumulated experience in laparascopic techniques have expanded the use of laparoscopic herniorrhaphy (LH) to treat pediatric inguinal hernias. To achieve a better cosmetic appearance and avoid the technical difficulties associated with suturing and knotting within the abdominal cavity, the single-port laparoscopic percutaneous extraperitoneal closure (LPEC) was introduced in 2009. However, no studies have evaluated the effect of LH or single-port LPEC on the orientation of the vas deferens in children.
Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
Background: Repair of hernias with loss of domain can lead to elevated intraabdominal pressure. The authors aimed to characterize the effects of elective hernia repair on intraabdominal pressure, as well as its predictors and association with negative outcomes. Methods: Patients undergoing elective hernia repair requiring myofascial release had intraabdominal and pulmonary plateau pressures measured preoperatively, postoperatively, and on the morning of the first postoperative day. Loss of domain was measured by preoperative computed tomography. Outcome measures included predictors of an increase in plateau pressure, respi...
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Reconstructive: Trunk: Original Article Source Type: research
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