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Rhabdomyosarcoma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Gideon Sandler, Andrea Hayes-Jordan
Abdominal wall reconstruction is important in order to avoid an incisional hernia. Myofascial replacement can be achieved with mesh (biological or synthetic) and/or native tissue transfer by abdominal component separation, myocutaneous pedicled (e.g. anterolateral thigh flap based on the medial circumflex femoral artery) or free flaps. The spectrum of available meshes, component separation techniques, and various flaps is beyond the scope of this chapter and quality evidence supporting one over the other is scant. Growth in small children is less likely to be impacted by the type of abdominal reconstruction used. Preoperative consultation with a plastic and reconstructive surgeon is recommended.
Anatomy of the Anterior Abdominal Wall
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
The muscles of the abdominal wall are described in three anatomically distinct areas, two postero-lateral areas and a central strip running down the front of the abdominal wall. The postero-lateral areas contain three sheets of muscle: the external oblique, internal oblique and transversus abdominis. The central strip is formed by the rectus abdominis muscles contained within the rectus sheath (Figure 1.1). In addition the abdominal cavity is separated from the thorax by the diaphragm above and from the perineum by the levator ani below.
Abdomen
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The lateral side of the anterior abdominal wall has three main muscles, namely external oblique, internal oblique and transversus abdominis invested in fascial sheaths from superficial to deep. Beneath the muscles, the layers are the transversalis fascia, extraperitoneal fat and parietal peritoneum.
Robotic versus hybrid assisted ventral hernia repair: a prospective one-year comparative study of clinical outcomes
Published in Acta Chirurgica Belgica, 2023
Pirjo Käkelä, Kirsi Mustonen, Tuomo Rantanen, Hannu Paajanen
Repair of abdominal wall hernia is one of the most commonly performed surgical procedures [1]. Ventral hernias can be categorized as spontaneous such as epigastric, umbilical or Spigelian or acquired hernias [2]. About 5% of the general population is born with or develops a primary hernia [3]. Incisional or secondary hernias develop in up to 30% of patients undergoing abdominal operations [4]. Hernia types according to location are categorized using the European Hernia Society classification [5]. Operations of ventral hernia are associated with numerous complications including pain, seroma, infection, eventration, recurrence, poor cosmesis or poor function of the abdominal wall [6]. Laparoscopic ventral hernia repair (LVHR) usually implies intraperitoneal placement of a prosthetic mesh without closure of the fascial defect. It is often technically difficult to close the fascial defect, particularly for hernias wider than 10 cm [7,8]. In some cases, the mesh bulges through the defect and produces a sensation of hernia recurrence. Primary closure of the defect (hybrid) performed in a minimally invasive fashion is good for recreation of the abdominal wall, and to prevent recurrence or bulging [8].
Physiotherapeutic assessment and management of overactive bladder syndrome: a case report
Published in Physiotherapy Theory and Practice, 2023
Bartlomiej Burzynski, Tomasz Jurys, Karolina Kwiatkowska, Katarzyna Cempa, Andrzej Paradysz
Manual therapy of the lumbopelvic hip complex consisted of trigger point therapy, friction massage (i.e. stroking, rubbing, and kneading), and manual diaphragm release. These techniques were performed with the patient lying on her back with the upper limbs placed along the back and the lower limbs placed on a couch. The purpose was to relax the abdominal wall. Manual therapy per vaginum used trigger point therapy, friction massage (i.e. stroking, rubbing, and kneading), and post-isometric relaxation. This manual therapy was performed in the supine position with the patient’s lower limbs bent at the hip and knee joints with the feet placed flat on the couch. The purpose was to relax the pelvic floor muscles. Therapy of the superficial back line myofascial meridian and the lateral line myofascial meridian consisted of post-isometric relaxation and mobilization techniques. The techniques were performed in a supine position with the lower limb raised, bent at the hip joint, and straight at the knee joint. In order to stretch the posterior tape, a dorsiflexion of the foot was performed; in order to stretch the lateral line myofascial meridian, the patient’s lower limb was placed in adduction. Additionally, the range of flexion in the hip joint was increased. Also, transverse massage of the muscles of the lower extremities as well as post-isometric relaxation of the muscles of the lower extremities was used to increase the effectiveness of therapy. Musculus piriformis therapy was carried out using trigger point therapy and friction massage. The techniques were performed in the front lying position.
Rehabilitation of a patient with bilateral rectus abdominis full thickness tear sustained in recreational strength training: a case report
Published in Physiotherapy Theory and Practice, 2022
Omer B. Gozubuyuk, Ceylan Koksal, Esin N. Tasdemir
The rectus abdominis muscle’s primary function is flexing the spine in the sagittal plane and increasing abdominal-pelvic pressure (Maquirriain, Ghisi, and Kokalj, 2007). The origin and insertion of the muscle are the anterior midline of the ribcage and pelvis, respectively. Therefore, pain originated from the myofascial unit of rectus abdominis can refer to a wide area. Physiological, anatomical and biomechanical characteristics of the abdominal wall muscles enable the classification of these muscles as the stabilizers and the movers (Norris, 2001). The movers consist of RA and external oblique (EO), and the stabilizers consist of internal oblique (IO) and transversus abdominis (TA). The traditional ‘crunch’ movement involves a person lying supine initially and elevating their scapula and head from the floor. This moment is performed mainly by the prime-mover RA muscle, as shown by electromyography (EMG) studies (Nordin and Frankel, 2001). Trunk is flexed with a concentric action and returned back to initial position with an eccentric action of the RA (Maquirriain, Ghisi, and Kokalj, 2007). Alternatively, the movement can be performed using a crunch machine, in sitting position (Figure 1).