Promotional Information

Springer Book Archives

Table of Contents

1. General.- 1. Surgical Anatomy of the Anterolateral and Posterior Abdominal Walls and Points of Weakness.- I. The Anterolateral Abdominal Wall.- A. Cutaneous and Subcutaneous Layer.- B. Vascularization of the Cutaneous Layers of the Abdomen.- 1. Arterial Vascularization.- 2. Venous Drainage.- 3. Lymphatic Drainage.- C. Myofascial Layer.- 1. Rectus Abdominis.- Structure.- 2. Oblique and Transversus Muscles.- a) External Oblique.- b) Internal Oblique.- c) Transversus Abdominis Muscle.- (1) Transversalis Fascia.- (2) Fascia Propria.- 3. Rectus Sheath (Vagina Recti Abdominis).- a) Arcuate Line (Semicircular Line of Douglas).- b) Adhesion of the Rectus Abdominis to the Laminae of its Sheath.- 4. Linea Alba.- 5. Semilunar Line (Spigelius Line).- D. Vascularization of the Muscle Layers of the Anterolateral Abdominal Wall.- 1. Arterial Vascularization.- 2. Venous Drainage.- 3. Lymphatic Drainage.- E. Innervation of the Anterolateral Abdominal Wall.- 1. Superficial Layers.- 2. Deep Layers: Motor Innervation of the Parietal Muscles.- 3. Neural Anastomoses and Metamerization.- II. Weak Points of the Anterolateral Abdominal Wall.- A. Umbilicus.- 1. Outer Aspect.- 2. Structure.- a) Umbilical Ring.- b) Round Ligament of the Liver.- c) Umbilical Arteries.- d) Urachus.- e) Umbilical Fascia.- f) Umbilical Peritoneum.- 3. Vascularization and Innervation of the Umbilical Region.- a) Arteries.- b) Veins.- c) Lymph Vessels.- d) Nerves.- B. Inguinal Region.- 1. Outer Layer.- 2. Aponeurosis of the External Oblique Muscle of the Abdomen.- 3. Deep Myofascial Layer — The Myopectineal Orifice.- a) Components of the Fibromuscular Frame.- (1) Medial Margin.- (2) Superior Margin.- (3) Inferior Margin.- b) Umbilicoprevesical Fascia and Inguinal Peritoneum.- C. Other Weak Points of the Anterior Abdominal Wall.- 1. Linea Alba.- a) Radiological Study.- b) Functional Study.- 2. Semilunar Line.- III. The Posterior Abdominal Wall.- A. Deep Layer.- 1. Median Spinal Axis.- 2. Lateral Spinal Muscles.- a) Iliopsoas Muscles.- b) Quadratus Lumborum Muscle.- 3. Vascularization and Innervation of the Deep Muscle Layer of the Posterior Abdominal Wall.- a) Arterial Vascularization and Venous Drainage.- b) Lymphatic Network.- c) Innervation.- 4. Site of Emergence of the Terminal Branches of the Lumbar Plexus in Relation to the Iliopsoas Muscle.- 5. Action of the Deep Muscles of the Posterior Abdominal Wall.- B. Superficial Layer of the Posterior Abdominal Wall.- 2. Functional Anatomy of the Muscles of the Anterolateral Abdominal Wall: Electromyography and Histoenzymology — Relationship Between Abdominal Wall Activity and Intra-abdominal Pressure.- I. Detailed Study of Structure: Histochemical Analysis of the Fibers of the Abdominal Wall.- A. Material and Methods.- B. Results.- C. Functional Deductions.- II. Detailed Study of Function: Quantitative Kinesiological Electromyography of the Abdominal Wall Musculature.- A. Principles of the Method.- 1. Automatic Analysis of the Recordings.- 2. Selection of Muscle Activities Within Narrow Frequency Spectra.- B. Overall Results and Tentative Interpretation.- C. Results of the Method Applied to the Study of the Function of the Abdominal Wall Muscles.- 1. Technique.- 2. Comparative Performance of the Rectus and Flat Abdominal Muscles According to Study Subgroup.- a) Assessment of Performance.- b) Results According to Subject Category.- III. Study of Intra-abdominal Pressure in Operated Patients.- A. History.- B. Materials and Methods.- C. Results.- 1. Baseline Pressure.- a) First Postoperative Day.- b) Fourth Postoperative Day.- 2. Respiratory Modifications.- 3. Effort of Defecation with Blocking of Expiration.- 4. Modulation of Abdominal Pressure by Speech.- 5. Effects of Coughing on Abdominal Pressure.- D. Comments.- IV. Correlation of the Activity of the Diaphragm and Abdominal Wall Muscles with Intra-abdominal Pressure.- A. Material and Methods.- B. Results.- 1. With Normal Respiration.- 2. With Deep Inspiration.- 3. During Effort of Coughing.- 4. Infra-abdominal Pressure and Circulatory Physiology.- V. Conclusions and Surgical Applications.- 3. Procedures for Investigation of the Abdominal Wall.- I. Echography of the Abdominal Wall.- A. Technique of Echographic Investigation.- B. Echographic Anatomy of the Abdominal Wall.- 1. Epidermis and Dermis.- 2. Hypodermis.- 3. Muscles of the Abdominal Wall.- 4. Sheaths and Aponeuroses.- 5. Peritoneum.- C. Echography of the Pathological Abdominal Wall.- 1. Parietal Collection of Fluid.- 2. Hernia.- 3. Incisional Hernia.- 4. Tumor.- 5. Spontaneous Hematoma of the Rectus Sheath.- 6. Other Anomalies Seen on Echography.- 7. Postoperative Investigation.- 8. Doppler Studies.- D. Conclusion.- II. Computed Tomography of the Abdominal Wall.- A. Computed Tomography of the Normal Abdominal Wall.- B. Computed Tomography of the Pathological Abdominal Wall.- 1. Tumor Masses.- a) Benign Tumors.- b) Malignant Tumors.- 2. Inflammatory Lesions.- 3. Abdominal Wall Hernias.- C. Conclusion.- 2. Surgical Techniques.- 4. Surgical Approaches to the Abdomen.- I. Anterior Incisions.- A. Longitudinal.- 1. Supraumbilical Midline Laparotomy.- 2. Subumbilical Midline Laparotomy.- 3. Combined Supra- and Subumbilical Midline Laparotomy.- 4. Paramedian Laparotomy.- a) Transrectus Incision.- b) Lateral Pararectus Incision.- c) Medial Pararectus Incision.- B. Transverse.- 1. Right Transverse Subcostal.- 2. Left Transverse Subcostal.- 3. Bilateral Transverse Supraumbilical.- 4. Right Paraumbilical.- 5. Left Transverse Paraumbilical.- 6. Transverse Incision of Right Iliac Fossa.- 7. Pfannenstiel’s Transverse Suprapubic.- Variations on Pfannenstiel’s Incision.- C. Oblique.- 1. Subcostal.- 2. Bilateral Subcostal.- 3. McBurney’s.- 4. Inguinal.- II. Lateral and Posterior Incisions.- A. Lumbar Route.- B. Anterolateral Approaches.- 1. Oblique Anterolateral Incision.- 2. Other Horizontal Incisions.- 3. Iliac Incision.- III. Thoracoabdominal Incisions.- A. Midline Abdominal Incision with Sternotomy.- B. Midline Abdominal Incision with Extension to Thoracophrenolaparotomy.- C. Oblique Abdominal Incision with Extension to Thoracophrenolaparotomy.- IV. Selection of an Incision.- A. Operative Exposure.- B. Disadvantages of Laparotomy.- 1. Parietal Complications.- 2. Pulmonary Complications.- V. Procedures for Closure.- A. Layers to be Sutured.- 1. Peritoneal Layer.- 2. Fascial Layer.- a) Interrupted Versus Continuous Sutures.- b) Selection of Suture Material.- 3. Muscle Layer.- 4. Subcutaneous Layer.- 5. Cutaneous Layer.- B. Special Cases.- VI. Laparoscopic surgery.- A. The Pneumoperitoneum.- 1. Insufflation.- a) Uncomplicated Situations.- b) Suspension of the Abdominal Wall.- 2. The Trocars.- B. General Principles of the Laparoscopic Approach.- 1. Orientation.- 2. Disposition.- 3. Adaptation.- 4. Open Laparoscopy.- 5. “Laparo-assisted” Surgery.- 6. Advantages of Laparoscopy.- C. Complications of Laparoscopic Surgery.- 1. Complications of the Pneumoperitoneum.- 2. Complications Related to the Trocars.- 3. Postoperative Complications.- a) Early.- b) Secondary.- c) Late.- D. Conclusion.- 5. Pre- and Postoperative Care.- I. Preparation for Surgery of the Abdominal Wall.- A. General.- B. Skin.- C. Respiratory Apparatus.- II. Postoperative Care.- A. Drainage of the Abdominal Wall.- B. Transcutaneous Electrical Stimulation for Pain.- 6. Postoperative Complications.- I. Early Complications Involving the Abdominal Wall.- A. Hematoma.- B. Abscess.- C. Seroma.- 1. Preventive Treatment.- 2. Curative Treatment.- II. Residual Pain Subsequent to Laparotomy.- A. Pathophysioloy.- 1. Painful Stimuli.- 2. Subjective Pain.- 3. Muscular and Vegetative Reflex Response to Pain.- 4. Emotional Reaction.- 5. Behavioral Reaction.- B. Clinical Findings in Chronic Pain.- 1. Peripheral Nerve Lesion.- a) Pain of Neuroma.- b) Deafferentation Pain.- 2. Projected Pain.- a) Reported Pain Along an Intact Nerve.- b) Referred Pain at a Distance from the Lesion.- C. Proposed Treatment.- 1. Noninvasive Management.- 2. Invasive Methods.- a) Neuroma.- b) Deafferentation Pain.- c) Projected Pain.- D. Results of Treatment.- III. Tumors of the Scar Tissue.- A. Osteoma of the Abdominal Wall.- B. Endometriosis of Scar Tissue.- C. Inflammatory Granuloma.- D. Secondary Malignancy of Scar Tissue.- 7. Closed Trauma of the Abdominal Wall.- I. Hematoma.- II. Localized Rupture.- III. Extensive Subcutaneous Rupture of the Anterior Muscular Wall.- IV. Trauma of the Posterior Abdominal Wall.- V. Abdominointercostal Hernia.- VI. Trauma Caused by Seat Belts.- 8. Defects of the Abdominal Wall.- I. Pathological Defects.- A. Open Trauma.- 1. Burns.- 2. Shotgun Wounds.- 3. Major Dilaceration.- B. Tissue Destruction Due to Infection.- 1. Fournier’s Disease.- 2. Subcutaneous Streptococcal Cellulitis.- 3. Gangrene of the Abdominal Wall.- a) Etiology.- (1) Postoperative Gangrene.- (2) Trauma.- (3) Apparently Spontaneous Gangrene.- b) Pathological Findings.- c) Bacteriological Findings.- d) Clinical Features.- e) Prevention and Treatment.- (1) Medical Therapy.- (2) Surgical Treatment.- f) Sequelae.- II. latrogenic Defects.- A. Postoperative Burst Abdomen.- 1. Clinical Features.- a) Free.- b) Fixed.- c) Covered.- 2. Pathogenesis.- a) Emergency Surgery.- b) Site of Incision.- c) Technique of Closure.- d) Postoperative Course.- 3. Treatment.- a) Prevention.- (1) Preoperative.- (2) Peroperative.- (3) Postoperative.- b) Curative.- (1) Free Burst Abdomen.- (2) Delayed Burst Abdomen.- (3) Free Burst Abdomen and Fistula.- (4) Fixed Burst Abdomen and External Fistula.- c) Postoperative Care.- B. Major Incisional Hernia.- 1. Definition.- 2. Introduction.- 3. Natural History.- 4. Physiopathology.- a) Respiratory Disturbances.- (1) Disturbed Respiratory Function.- (2) Effects of Repair on Respiratory Function.- b) Visceral Disturbances.- c) Vascular Disturbances.- d) Muscular Disturbances.- e) Static Disturbances.- f) Surgical Lesions.- g) Medicolegal Considerations.- 5. Anatomicoclinical Subtypes.- a) Midline.- (1) Supraumbilical Incisional Hernia.- (2) Subumbilical Incisional Hernia.- (3) Massive Supra- and Subumbilical Midline Incisional Hernia.- b) Lateral.- (1) Subchondral Incisional Hernia.- (2) Inguinal Incisional Hernia.- (3) Incisional Hernia of the Flank.- 6. Complications.- a) Strangulation.- b) Trophic Ulceration.- c) Secondary Burst Abdomen.- d) Incisional Hernia with Colostomy.- e) Associated Forms.- 7. Principles of Surgical Management.- a) Chronic Incisional Hernia without Sepsis.- (1) Nonprosthetic Repair.- (2) Difficult Management.- b) Septic Incisional Hernia.- 8. Treatment.- a) Preparation.- (1) Role of the Anesthesiologist-Intensive Care Specialist.- (2) Role of the Nursing Staff.- (3) Role of the Surgeon.- b) Surgical Intervention.- (1) Anesthesia.- (2) Exposure and Exploration.- (3) Nonprosthetic Repair.- (4) Prosthetic Repair.- c) Postoperative Care.- d) Treatment of Complications.- 9. Results.- a) Using Prosthetic Material.- (1) Early Postoperative Course.- (2) Long-term Results.- b) Using Nonprosthetic Technique.- c) Emergency Operation.- 10. Comments.- a) Analysis of Results.- Prostheses.- b) Better Selection of Indications.- c) Technical Precautions.- 11. Conclusions.- III. Therapeutic Defects of the Abdominal Wall.- A. Tumors.- 1. Hydatid Cyst.- 2. Desmoid Tumors.- 3. The Dermatofibroma of Darier and Ferrand.- 4. Primary Malignancy.- 5. Secondary Malignancy.- B. Abdominal Wall Repair After Resection.- 1. Under Septic Conditions.- a) Simple Skin Closure.- b) External Cutaneous Reinforcement.- c) Internal Cutaneous Reinforcement with Polyglactine Mesh.- 2. Aseptic Defects.- a) Simple Suturing with Relaxing Incisions.- b) Turndown of Anterior Lamina of Rectus Sheath.- c) Prostheses or Autograft.- d) Myoplasty.- C. Therapeutic Evisceration (Laparostomy).- 1. History of Treatment of Burst Abdomen.- 2. Technique.- 9. Hernia of the Abdominal Wall.- I. Groin Hernias in the Adult.- A. Principles of Treatment.- 1. Some Aspects of Surgical Anatomy of the Inguinal Region.- 2. Hernial Lesions.- 3. Classification of Hernias.- 4. Mechanisms of Inguinal Hernias.- 5. Epidemiology.- 6. Length of Hospital Stay.- 7. Verification of Results and Quality.- 8. Informing the Patient.- B. General Principles of Herniorrhaphy.- 1. The Choice of Approach.- a) The Anterior Inguinal Approach.- b) The Transabdominal Approach.- c) The Preperitoneal Approach.- d) Advantages of the Laparoscopic Approaches.- (1) The Transabdominal Approach.- (2) The Totally Extraperitoneal Approach.- 2. Dissection of the Spermatic Cord.- 3. Management of the Hernial Sac.- 4. Reconstruction of the Inguinal Canal.- a) The “Tissue Repair Technique”.- b) “Mesh Repairs”.- 5. Anesthesia in Hernia Surgery.- a) Anesthesia and Laparoscopic Herniorrhaphies.- b) Local Anesthesia Performed by the Surgeon.- C. Classical Herniorrhaphy by the Inguinal Approach.- 1. The Marcy Operation (1871).- 2. The Bassini Operation (1887).- a) The Houdard Procedure.- b) The Chevrel Procedure.- 3. The Shouldice Operation.- a) Evolution of the Technique.- b) Weight Control.- c) Local Anesthesia.- d) Surgery.- (1) Dissection.- (2) Reconstruction.- e) Follow-up.- f) Complications.- (1) Infections.- (2) Hematomas.- (3) Hydroceles.- (4) Testicular Atrophy.- g) Activity.- h) Cost.- i) Conclusion.- 4. The McVay Operation.- 5. The Nyhus Operation.- 6. General Observations on Suture Repairs.- D. Tissue Transfers via the Inguinal Route.- 1. The Berger-Orr Procedure.- 2. The Hindmarsh Procedure.- 3. Transposition of the Spermatic Cord.- 4. Transfer of Fascia Lata or Skin.- 5. General Criticism of Tissue Transfer.- E. Techniques Involving the Use of Prosthetic Material.- 1. Prosthetic Repair by the Inguinal Route.- a) The Rives Operation.- (1) Preparation of the Prosthesis.- (2) Critical Comments.- b) The Lichtenstein Open Tension-free Hernioplasty.- (1) Techniques of Anesthesia.- (2) Technique of Operation.- (3) Outcome Measures.- (4) Prevention of Recurrences.- (5) Isolated Femoral Hernia and Recurrent Inguinal Hernia: Concept of the Plug Repair.- (6) Discussion.- c) The Gilbert Operation.- (1) Technique.- (2) Results.- (3) Complications.- (4) Conclusion.- d) The Plugs.- (1) A Short History of the Concept.- (2) Technique.- (3) Personal Experience.- (4) Discussion.- (5) Conclusion.- 2. Prosthetic Repair via the Open Abdomen.- a) The Rives Operation: Unilateral Prosthesis by the Preperitoneal Route.- b) The Stoppa Operation.- c) The Wantz operation.- 3. Prosthetic Repair via the Laparoscopic Route.- a) The Extraperitoneal Route (TEP).- (1) Technique.- (2) Variations.- (3) Complications.- (4) Indications.- b) The Trans-Abdominal Preperitoneal Route (TAPP).- (1) Technique.- (2) Special Cases.- (3) Advantages and Disadvantages.- (4) Results.- (5) Personal Series.- (6) Discussion.- (7) Conclusion.- F. Intraoperative Complications of the Classical Surgical Repairs.- 1. Hemorrhage.- 2. Spermatic Cord Lesions.- 3. Nerve Injury.- 4. Injury to the Vas Deferens.- 5. Bladder Injury.- 6. Injury to an Abdominal Organ.- G. The Postoperative Period.- 1. Postoperative Analgesia.- 2. Prevention of Thromboembolism.- 3. Antibiotics.- 4. Ambulation and Length of Hospital Stay.- 5. Resumption of Activities and Work.- 6. Early Postoperative Complications.- a) Hematomas.- b) Wound Infection.- c) Hydrocele.- d) Ischemic Orchitis.- e) Urinary Complications.- f) Thromboembolism.- g) Respiratory Complications.- h) Gastrointestinal Complications.- i) General Complications and Mortality.- H. Late complications.- 1. Sequelae.- a) Testicular Atrophy.- b) Chronic Postoperative Pain.- c) Painful Ejaculation.- d) Migration of the Prosthesis.- e) Late Infectious Complications (fistulae).- 2. Problems with Re-operation Following Retromuscular Prosthetic Repair.- a) Surgery for Benign Prostatic Hypertrophy.- b) Surgery for Prostatic or Vesical Malignancy.- c) Surgery of the External Iliac Vessels.- I. Special Problems.- 1. Irreducibility.- 2. Bruising around the Hernial Site.- 3. Problems with Trusses.- 4. Strangulation.- 5. Femoral Hernias.- a) An Umbrella for Femoral Hernias.- (1) The Source of the Problem.- (2) The Femoral Umbrella.- (3) Results.- (4) Discussion.- (5) Conclusion.- b) Strangulated Femoral Hernia.- 6. Richter’s Hernia.- 7. Bulky Hernias.- 8. Adherent Hernias. Sliding Hernias.- 9. Bilateral Hernias.- 10. Hernial Lipomas.- 11. Associated Lesions.- a) Patent Processus Vaginalis.- b) Hernias with Ectopic Testis.- c) Hernia and Hydrocele.- d) Hernia with Varicocele.- e) Hernias with Malformation of the Processus Vaginalis.- 12. Inguinal Hernias in Women.- 13. Hernias in the Elderly.- 14. “Incidental” Hernias.- 15. Recurrent Hernias.- a) Frequency.- b) Delay in Presentation.- c) Anatomical Types.- d) Mechanism.- e) Treatment.- f) Results of Repair of Recurrent Hernias.- II. Other Hernias.- A. Epigastric Hernias.- 1. Frequency.- 2. Pathological Anatomy.- 3. Clinical Picture.- 4. Treatment.- 5. Results.- B. Diastasis of the Rectus Muscles.- C. Spigelian Hernias.- 1. Frequency.- 2. Pathological Anatomy.- 3. Clinical Picture.- D. Lumbar Hernias.- 1. Pathological Anatomy.- 2. Clinical Picture.- 3. Treatment.- E. Pelvic Hernias.- 1. Obturator Hernias.- a) Frequency.- b) Clinical Picture.- c) Treatment.- (1) Route of Access.- (2) Results.- 2. Sciatic Hernias.- a) Frequency.- b) Pathological Anatomy.- c) Clinical Picture.- d) Treatment.- 3. Perineal Hernias.- a) Clinical Picture.- b) Treatment.- 10. Pathology of the Umbilicus.- I. Umbilical Hernia.- A. Pathological Anatomy.- B. Anatomicoclinical Forms.- 1. Small Hernia.- 2. Large Hernia.- 3. In Patients with Cirrhosis.- II. Tumors of the Umbilicus.- A. Primary Tumors.- B. Secondary Tumors.- C. False Tumors.- III. Fistula and Suppurative Lesions.- A. Fistula.- 1. Urinary Fistula.- 2. Fistula of the Urachus.- 3. Fistula of the Digestive Tract.- 4. Treatment.- B. Suppurative Lesions.- 1. Secondary Suppuration.- 2. Primary Suppuration.- IV. Conclusion.- 11. Abdominoplasty.- I. Consultation Prior to Abdominoplasty.- II. Therapy.- A. Low Transverse Incision.- B. Combined Low Transverse and Vertical Incision.- C. Indications, Resulting Scar, and Complications.- 1. Hematoma.- 2. Lymph Effusion.- 3. Cutaneous Necrosis.- 4. Thromboembolism.- D. Special Cases.- 1. Localized or Minor Cases.- 2. Major Cases or Those Accompanying Old Scars.- 3. Associated Lipolysis.- 4. Endoscopic Correction.- 5. Umbilicoplasty.- 12. The Abdominal Wall in Infants and Children.- I. Omphalocele, Cord Hernia, Laparoschisis.- A. Incidence and Etiological Factors.- B. Anatomicoclinical Aspects.- 1. Omphaloceles.- 2. Cord Hernias.- 3. Laparoschisis.- C. Embryological Facts.- D. Diagnosis.- E. Management at the Time of Birth.- F. Treatment.- 1. Primary Closure.- 2. Progressive Replacement.- 3. Deferred Reduction.- 4. Conservative Treatment.- 5. Special Problems Resulting from GI Tract Abnormalities.- 6. Postoperative Management.- G. Results.- II. Pathology of the Umbilicus Due to Defective Involution of the Omphalomesenteric Duct and Urachus.- A. Defective Involution of the Omphalomesenteric Duct.- 1. Total Persistence of the Omphalomesenteric Duct.- 2. Entero-umbilical Fistula.- 3. Umbilical Remnants.- B. Defective Involution of the Urachus.- 1. Urachal Fistula.- 2. Urachal Sinus.- 3. Urachal Cyst.- III. Groin Hernias in Children.- A. The Processus Vaginalis.- B. Incidence.- C. Diagnosis.- D. Treatment.- 1. Uncomplicated Hernias.- 2. Obstructed and Strangulated Hernia.- 3. Inguinal Hernia with Undescended Testis.- 4. Inguinal Hernia in Girls.- E. Particular Problems.- 1. Hernial Appendix.- 2. Meckel’s Diverticulum.- 3. Splenogonadal Fusion and Aberrant Splenic Nodules.- 4. Adrenal Nodules.- 5. Anomalies of Testicle and Vas Deferens.- 6. Mullerian Structures in Boys.- 7. Herniation of the Bladder.- 8. Cystic Hygroma.- 9. Hernias and General Congenital Abnormalities.- F. Direct Inguinal Hernias.- G. Recurrences.- H. Femoral Hernia.- IV. Umbilical Hernias in Children.- A. Incidence.- B. Diagnosis.- C. Treatment.- V. Epigastric Hernias in Children.- VI. Divarication of the Recti in Children.- VII. Spigelian Hernia in Children.