Grooved Director Aids Fascial Enlargement and Closure

نویسندگان

  • Magdy Makar
  • C. Dale Mercer
چکیده

Gallbladder retrieval following laparoscopic cholecystectomy through the umbilical or epigastric port site is at times tedious, may result in gallbladder perforation from excessive tearing forces applied to the gallbladder or from instrumental perforation while attempting to enlarge the fascia and is very "low tech" compared to the laparoscopic procedure. Port-site herniae develop when the fascia at either site is not closed adequately with sutures because of inadequate vision through the small incision and the concern for inadvertent injury to the tissues underlying the fascia. This study reports the use of a simple instrument, a spoon-shaped grooved director, to aid both the fascial enlargement and the fascial closure. The instrument has been used in more than 30 laparoscopic cholecystectomies and has been found to be simple, safe and effective for fascial enlargement and closure. This reusable instrument should be used routinely for laparoscopic cholecystectomy but offers significant advantages in the obese individual.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Laparoscopic Cholecystectomy; closure versus non-closure of the fascial sheath opening of the sub-umbilical port site “10 mm”.

Background: Laparoscopic Surgery (LS) may be associated with many port site complications such as hernia, bleeding, infection, subcutaneous emphysema and ugly scars. Some of these complications are serious such as obstructed port site hernia . Rate of these complications is low depending  on size and site of the port incision, type of the trocar that it is used, the condition of  the patient a...

متن کامل

Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included "open abdomen," "abdominal compartment syndrome," "laparostomy," "celiotomy," ...

متن کامل

Vacuum with mesh is a feasible temporary closure device after fascial dehiscence.

INTRODUCTION The open abdomen is a challenging condition and a temporary abdominal closure device is required in order to protect the intra-abdominal viscera. We aimed to evaluate the feasibility of a recent device: vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) after fascial dehiscence focusing on fascial closure rate, mortality and procedure-related complications. ...

متن کامل

Closing the open abdomen: improved success with Wittmann Patch staged abdominal closure.

BACKGROUND Although the "open abdomen" has likely contributed to improved outcomes in trauma patients, the challenge of subsequent fascial closure has emerged. Since mid 2004, we have incorporated Wittmann Patch staged abdominal closure into our management of the open abdomen. The purpose of this study was to evaluate the impact of this device on our incidence of fascial closure versus planned ...

متن کامل

Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assist...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 3  شماره 

صفحات  -

تاریخ انتشار 1999