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1.
J Laparoendosc Adv Surg Tech A ; 33(1): 15-20, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35731002

RESUMEN

Introduction: Staple line oversewing (SLO) is a prophylactic alternative due to its low cost and its effect of decreasing the incidence and severity of bleeding complications in sleeve gastrectomy (SG). However, this approach significantly increases the surgical time and may be associated with stenosis. The study aims to identify whether its usage was sufficient to optimize the surgical time in patients whose screening for the risk of occult bleeding was negative. Materials and Methods: The study enrolled 103 patients. Having the systolic blood pressure goal of 140 mmHg, the staple line is checked for bleeding points, counting as follows: >5 bleeding points proceed to SLO, <5 bleeding points are managed using clips, and if no bleeding points are found, the procedure can be completed. Results: The bleeding test was positive in 79.6% of the cases and oversewing was necessary for 44.7% of the total. The bleeding test result was significant for the increased surgical time. The mean surgical time in SLO was 16.4% higher than in clipping. There was a significant difference in surgical time between SLO and clipping; however, no significant difference was identified between clipping and continuing the procedure without further measures. No postoperative complication related to staple line bleeding was identified. Discussion: In a scenario with limitations for the use of high-cost homeostatic agents, the stratified protocol to prevent bleeding in SG stapling line was able to significantly reduce surgical time without significant added risks. Conclusion: A stratified protocol to prevent bleeding in SG stapling line was able to significantly reduce surgical time.


Asunto(s)
Laparoscopía , Obesidad Mórbida , Humanos , Tempo Operativo , Grapado Quirúrgico/métodos , Laparoscopía/métodos , Gastrectomía/efectos adversos , Gastrectomía/métodos , Hemorragia/cirugía , Obesidad Mórbida/cirugía
2.
J Robot Surg ; 15(6): 971-974, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33683532

RESUMEN

There is still a lot of debate about what is the best technique for ventral hernia (VH) repair surgery. Robotic-assisted procedures are an excellent alternative to overcome the technical difficulties of regular laparoscopic surgery. The onlay technique is one of the most performed surgeries worldwide in open ventral hernia surgery, and the anatomy is easily recognized by all surgeons. Introducing the robotic onlay approach, using robotic-assisted surgery to perform ventral hernia repair with a technique is usual for most surgeons. This "new" approach may change the initial concept that minimally invasive abdominal wall surgery requires specific and tedious training and can help standardize ventral hernia repair by robotic surgery and facilitate training, allowing more surgeons to perform minimally invasive abdominal wall surgery. Finally, clinical studies are needed to measure the impact of Robotot implementation in MIS ventral hernia repair and long-term results.


Asunto(s)
Hernia Ventral , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Hernia Ventral/cirugía , Herniorrafia , Humanos , Procedimientos Quirúrgicos Robotizados/métodos , Mallas Quirúrgicas
3.
Arq Bras Cir Dig ; 29Suppl 1(Suppl 1): 8-11, 2016.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-27683766

RESUMEN

Background: The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Methods: Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. Results: The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. Conclusion: The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group.


Racional: A avaliação do colágeno na parede abdominal é cada vez mais estudada, em virtude da relevância dele no processo cicatricial após laparotomia. Objetivo: Avaliar a quantidade de colágeno na linha alba de pacientes submetidos à cirurgia bariátrica e compará-la com a de cadáveres não-obesos. Métodos: Foram avaliados dois grupos com total de 88 amostras da aponeurose da linha alba abdominal, divididas em 44 de pacientes obesos (grupo obesidade) com indicação de cirurgia bariátrica e 44 de cadáveres não-obesos (grupo controle). As amostras foram retiradas da linha alba abdominal no período de 2013 a 2014 e inicialmente foram separadas conforme faixas etárias (18-30, 31-45 e 46-60), gênero, medidas de IMC, circunferência abdominal e cervical e espessura do subcutâneo do indivíduo. Foi coletado material para biópsia da linha alba supraumbilical para análise imunoistoquímica, diferenciando o colágeno tipo I e III e sua relação de tipo I/III. Utilizou-se o programa de contagem de pixels Image-Pro Plus(r), que mensurou a quantidade do colágeno. Resultados: O grupo obesidade teve idade 44,11±9,90 anos, Na faixa etária de 18-30 anos foram incluídos três (6,8%) obesos; na de 31-45 anos 22 (50%) e na de 46-60 anos 19 (43,1%). O gênero feminino apresentou predomínio, com 36 (81,8%) pacientes. O IMC (kg/m²) foi de 48,81±6,5; a circunferência abdominal (cm) foi de 136,761±13,55; a espessura do subcutâneo (cm) foi de 4,873±0,916. A quantidade de colágeno tipo I foi de 134.683,3±206.657,4; a de colágeno tipo III foi de 413.137,2±283.656,1; a razão do colágeno tipo I/III foi 0,419±0,636. Considerando-se faixas de idade, gênero e IMC, foram constatadas diferenças estatísticas em todas as análises quando comparadas com às dos cadáveres. Conclusão: Os obesos mórbidos apresentaram quantidade de colágeno na linha alba supraumbilical menor que a do grupo controle de cadáveres não-obesos na mesma faixa etária.

4.
ABCD (São Paulo, Impr.) ; 29(supl.1): 8-11, 2016. graf
Artículo en Inglés | LILACS-Express | LILACS | ID: lil-795054

RESUMEN

ABSTRACT Background: The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Methods: Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. Results: The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. Conclusion: The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group.


RESUMO Racional: A avaliação do colágeno na parede abdominal é cada vez mais estudada, em virtude da relevância dele no processo cicatricial após laparotomia. Objetivo: Avaliar a quantidade de colágeno na linha alba de pacientes submetidos à cirurgia bariátrica e compará-la com a de cadáveres não-obesos. Método: Foram avaliados dois grupos com total de 88 amostras da aponeurose da linha alba abdominal, divididas em 44 de pacientes obesos (grupo obesidade) com indicação de cirurgia bariátrica e 44 de cadáveres não-obesos (grupo controle). As amostras foram retiradas da linha alba abdominal no período de 2013 a 2014 e inicialmente foram separadas conforme faixas etárias (18-30, 31-45 e 46-60), gênero, medidas de IMC, circunferência abdominal e cervical e espessura do subcutâneo do indivíduo. Foi coletado material para biópsia da linha alba supraumbilical para análise imunoistoquímica, diferenciando o colágeno tipo I e III e sua relação de tipo I/III. Utilizou-se o programa de contagem de pixels Image-Pro Plus(r), que mensurou a quantidade do colágeno. Resultados: O grupo obesidade teve idade 44,11±9,90 anos, Na faixa etária de 18-30 anos foram incluídos três (6,8%) obesos; na de 31-45 anos 22 (50%) e na de 46-60 anos 19 (43,1%). O gênero feminino apresentou predomínio, com 36 (81,8%) pacientes. O IMC (kg/m²) foi de 48,81±6,5; a circunferência abdominal (cm) foi de 136,761±13,55; a espessura do subcutâneo (cm) foi de 4,873±0,916. A quantidade de colágeno tipo I foi de 134.683,3±206.657,4; a de colágeno tipo III foi de 413.137,2±283.656,1; a razão do colágeno tipo I/III foi 0,419±0,636. Considerando-se faixas de idade, gênero e IMC, foram constatadas diferenças estatísticas em todas as análises quando comparadas com às dos cadáveres. Conclusão: Os obesos mórbidos apresentaram quantidade de colágeno na linha alba supraumbilical menor que a do grupo controle de cadáveres não-obesos na mesma faixa etária.

5.
Rev Col Bras Cir ; 42(3): 149-53, 2015 Jun.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-26291254

RESUMEN

OBJECTIVE: To identify the nerves in the groin during inguinal hernia repair by inguinotomy. METHODS: We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh. RESULTS: The male patients were 36 (94.7%), with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%), smoking in 12 (31.5%) and obesity in two (5.2%). The hernia was located only on the right in 21 (55.2%) patients, only on the left in 11 (28.9%), and was bilateral in six (15.7%) patients. Prior hernia repair was present in seven (18.4%) patients. The identification of the three nerves during operation was made in 20 (52.6%) patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%), and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%). Resection of at least one of the nerves was performed in seven (18.4%) cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3%) returned to physical activity around the first postoperative visit, and 37 (97.3%) in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035). CONCLUSION: The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.


Asunto(s)
Ingle/inervación , Hernia Inguinal/cirugía , Herniorrafia , Adulto , Femenino , Herniorrafia/métodos , Humanos , Masculino , Ensayos Clínicos Controlados no Aleatorios como Asunto , Estudios Prospectivos
6.
Rev. Col. Bras. Cir ; 42(3): 149-153, May-June 2015. tab, ilus
Artículo en Inglés | LILACS | ID: lil-756003

RESUMEN

OBJECTIVE: To identify the nerves in the groin during inguinal hernia repair by inguinotomy. METHODS: We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh. RESULTS: The male patients were 36 (94.7%), with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%), smoking in 12 (31.5%) and obesity in two (5.2%). The hernia was located only on the right in 21 (55.2%) patients, only on the left in 11 (28.9%), and was bilateral in six (15.7%) patients. Prior hernia repair was present in seven (18.4%) patients. The identification of the three nerves during operation was made in 20 (52.6%) patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%), and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%). Resection of at least one of the nerves was performed in seven (18.4%) cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3%) returned to physical activity around the first postoperative visit, and 37 (97.3%) in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035). CONCLUSION: The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.


OBJETIVO: Identificar os nervos da região inguinal durante hernioplastia inguinal por inguinotomia. MÉTODOS: Estudo prospectivo, sequenciado, não randomizado, composto por 38 pacientes submetidos à herniorrafia inguinal com colocação de tela de polipropileno. RESULTADOS: Os pacientes masculinos eram 36 (94,7%), com média de idade e desvio-padrão de 43,1 ± 14,5, índice de massa corporal de 24,4 ± 2,8. As comorbidades eram HAS em dois (5,2%), tabagismo em 12 (31,5%) e obesidade em dois (5,2%). A hérnia localizava-se somente à direita em 21 (55,2%) pacientes, somente à esquerda em 11 (28,9%), e era bilateral em seis (15,7%) pacientes. O reparo prévio da hérnia foi feito em sete (18,4%) pacientes. A identificação dos três nervos durante a operação fez-se em 20 (52,6%) pacientes, o nervo ílio-inguinal e o nervo ílio-hipogástrico foram identificados em 33 (86,8%), e o ramo genital do nervo gênito-femoral em 20 (52,6%). A ressecção de ao menos um dos nervos foi realizada em sete (18,4%), sendo dois nervos ílio-hipogástricos e cinco nervos ílio-inguinais. O tempo médio de operação foi 70,8 ± 18,2 minutos. O tempo de internação hospitalar foi 1,42 ± 1,18 dias. Retornaram à atividade física no primeiro atendimento dez (26,3%) pacientes e, no último, 37 (97,3%). O tempo de acompanhamento foi 95,6 ± 23,5 dias. A impossibilidade de identificação do nervo ílio-inguinal associou-se ao reparo prévio (p=0,035). CONCLUSÃO: A identificação dos três nervos durante a hernioplastia inguinal foi descrito em mais da metade dos casos e o reparo prévio interferiu na identificação do nervo ílio inguinal.


Asunto(s)
Humanos , Dolor Crónico , Cirugía General , Hernia Inguinal , Herniorrafia , Neuralgia , Nervios Periféricos
7.
Arq Bras Cir Dig ; 26(1): 13-7, 2013.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-23702864

RESUMEN

BACKGROUND: Among meshes used in incisional hernias in open technique repair, the polypropylene is the most commonly used due to flexibility, cellular growth stimulation, satisfactory inflammatory response, easy manipulation and low price. However, it induces adhesions formation when in contact with the intra-abdominal contents. AIM: To evaluate the formation of adhesions after polypropylene and collagen coated polyester mesh with intraperitoneal placement. METHODS: Twenty six female Wistar rats were randomized in three groups. In the group 0 (sham) there was no prosthesis placement, in the polypropylene (group 1) the prosthesis was placed at the peritoneal surface and in the group 2, collagen coated polyester mesh was placed. The rats were killed on postoperative day 21 to evaluate adhesions regarding its degree, mesh percentage of involvement, bowel involvement and strength needed to cause rupture. RESULTS: There was no difference in weight between groups. The group 0 did not develop any adhesions. The groups 1 and 2 developed prosthetic mesh surface adhesions, mostly in the omentum. There was no difference in adhesion degree and percentage of surface involvement between groups. The collagen coated mesh did not develop adhesions. The adhesions occurred at the free edge of the mesh, in contact with the polyester. The Polypropylene group presented 80% of the surface involved with adhesions, while the collagen coated polyester group presented 10% (p<0,005). CONCLUSION: There was no difference between adhesion, degree of adhesion and strength needed to cause rupture. However, the polypropylene mesh presented significantly higher surface of adhesion when compared to the collagen coated polyester mesh.


Asunto(s)
Colágeno , Hernia Ventral/cirugía , Herniorrafia , Enfermedades Peritoneales/prevención & control , Poliésteres , Mallas Quirúrgicas , Animales , Diseño de Equipo , Femenino , Herniorrafia/efectos adversos , Enfermedades Peritoneales/etiología , Ratas , Ratas Wistar , Adherencias Tisulares/etiología , Adherencias Tisulares/prevención & control
8.
ABCD (São Paulo, Impr.) ; 26(1): 13-17, jan.-mar. 2013. ilus, tab
Artículo en Portugués | LILACS | ID: lil-674135

RESUMEN

RACIONAL: Entre as telas utilizadas na reparação de hérnias incisionais na técnica aberta, a de polipropileno é a mais utilizada devido à flexibilidade, estimulação do crescimento celular, resposta inflamatória satisfatória, fácil manipulação e baixo preço. No entanto, induz a formação de aderências, quando em contato com os conteúdos intra-abdominais. OBJETIVO: Avaliar as aderências formadas após a colocação intraperitoneal da tela de polipropileno e a tela de poliéster coberta com colágeno. MÉTODO: Foram utilizadas 26 ratas Wistar fêmeas, randomizadas em três grupos. No grupo 0 (sham) não houve colocação de prótese, apenas laparotomia; no grupo 1 foi implantada a prótese de polipropileno na superfície peritoneal; e no grupo 2, a prótese composta por poliéster coberta por colágeno. Todos os animais foram mortos 21 dias após o procedimento e avaliados quanto às vísceras envolvidas nas aderências, grau das aderências, percentual da tela acometimento por aderências e a força necessária para a sua ruptura. RESULTADOS: Não houve diferença de peso entre os grupos. O grupo 0 não apresentou aderência. Os grupos 1 e 2 apresentaram aderências na superfície da prótese, predominante no omento. O grau de aderências, superfície acometida não teve diferença representativa entre os grupos. A cobertura de colágeno não demonstrou aderências. As aderências ocorreram na borda livre da tela, em contato com a face de poliéster. Análise do tipo de superfície comprometida por aderências, o grupo polipropileno teve 80% e o grupo poliéster com colágeno apenas 10% (p<0,005). CONCLUSÃO: Para os parâmetros avaliados aderência, grau e força máxima de ruptura não houve diferença. No entanto, a tela de polipropileno teve superfície acometida pela aderência significativamente maior em relação à tela de poliéster protegida com colágeno.


BACKGROUND: Among meshes used in incisional hernias in open technique repair, the polypropylene is the most commonly used due to flexibility, cellular growth stimulation, satisfactory inflammatory response, easy manipulation and low price. However, it induces adhesions formation when in contact with the intra-abdominal contents. AIM: To evaluate the formation of adhesions after polypropylene and collagen coated polyester mesh with intraperitoneal placement. METHODS: Twenty six female Wistar rats were randomized in three groups. In the group 0 (sham) there was no prosthesis placement, in the polypropylene (group 1) the prosthesis was placed at the peritoneal surface and in the group 2, collagen coated polyester mesh was placed. The rats were killed on postoperative day 21 to evaluate adhesions regarding its degree, mesh percentage of involvement, bowel involvement and strength needed to cause rupture. RESULTS: There was no difference in weight between groups. The group 0 did not develop any adhesions. The groups 1 and 2 developed prosthetic mesh surface adhesions, mostly in the omentum. There was no difference in adhesion degree and percentage of surface involvement between groups. The collagen coated mesh did not develop adhesions. The adhesions occurred at the free edge of the mesh, in contact with the polyester. The Polypropylene group presented 80% of the surface involved with adhesions, while the collagen coated polyester group presented 10% (p<0,005). CONCLUSION: There was no difference between adhesion, degree of adhesion and strength needed to cause rupture. However, the polypropylene mesh presented significantly higher surface of adhesion when compared to the collagen coated polyester mesh.


Asunto(s)
Animales , Femenino , Ratas , Colágeno , Hernia Ventral/cirugía , Herniorrafia , Enfermedades Peritoneales/prevención & control , Poliésteres , Mallas Quirúrgicas , Diseño de Equipo , Herniorrafia/efectos adversos , Enfermedades Peritoneales/etiología , Ratas Wistar , Adherencias Tisulares/etiología , Adherencias Tisulares/prevención & control
9.
Rev. Col. Bras. Cir ; 39(6): 509-514, nov.-dez. 2012. ilus, tab
Artículo en Portugués | LILACS | ID: lil-662780

RESUMEN

OBJETIVO: Comparar fixação cirúrgica de telas de polipropileno (PP) e telas de polipropileno revestido (PCD), usando fio de sutura de polipropileno e cola biológica, quanto à formação de aderências intraperitoneais. MÉTODOS: Amostra de 46 ratas Wistar, randomizadas em seis grupos: dois grupos-controle, com cinco ratas cada, que foram submetidos um à incisão medial (IM) e o outro à uma incisão em forma de U (IU); nenhum desses grupos recebeu tela. Dois grupos com tela de PP, um com dez ratas, fixada com sutura (PPF), e o outro, com seis ratas, fixada com cola biológica (PPC). E Dois grupos com tela de PCD, no primeiro, com dez animais, a tela foi fixada com sutura (PCDF), e no segundo, com dez animais, com cola biológica (PCDC). RESULTADOS: Após o prazo de 21 dias, os grupos-controle não apresentaram aderências significantes. O grupo PPC apresentou menor grau de aderência do que o grupo PPF (p=0,01). Não houve diferença entre as fixações nos grupos com PCD. CONCLUSÃO: A comparação da fixação apresentou diferença estatística significativa apenas à tela de PP, com menor grau de aderência utilizando a cola. As aderências se localizaram predominantemente nas extremidades das telas estudadas.


OBJECTIVE: To compare surgical fixation of polypropylene mesh (PP) and coated polypropylene mesh (PCD) using polypropylene suture and fibrin glue, as for the formation of intraperitoneal adhesions. METHODS: A sample of 46 female Wistar rats were randomized into six groups: two control groups, with five rats each, were subjected to one medial incision (MI) and the other to a U-shaped incision (UI), none of these groups received the mesh. Two groups of PP mesh, with ten rats, fixed with suture (PPF), the other with six rats, fixed with biological glue (PPC). And two groups of PCD mesh, at first, with ten animals, the mesh was fixed with sutures (PCDFs) and the second with ten animals with biological glue (PCDC). RESULTS: After 21 days, the control groups showed no significant adhesions. The PPC group showed a lower degree of adhesion than the PPF group (p = 0.01). There was no difference between the groups with PCD. CONCLUSION: Comparison of fixation was statistically different only with PP mesh, with lesser degrees of adherence when using the glue. Adhesions were predominantly located at the extremities of the meshes studied.


Asunto(s)
Animales , Femenino , Ratas , Modelos Animales de Enfermedad , Adhesivo de Tejido de Fibrina/efectos adversos , Polipropilenos , Peritoneo/cirugía , Mallas Quirúrgicas/efectos adversos , Adherencias Tisulares/etiología , Adhesivos Tisulares/efectos adversos , Ratas Wistar
10.
Rev Col Bras Cir ; 39(3): 201-6, 2012.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-22836568

RESUMEN

OBJECTIVE: To compare intraperitoneal adhesion formation with placement of polypropylene mesh and use of lightweight polypropylene mesh coated with omega-3 fatty in rats. METHODS: Twenty-seven Wistar rats were randomized into three groups. In group 0 no mesh was placed; in group 1 we implanted a polypropylene mesh; and in group 2 there was implantation of a polypropylene mesh coated with omega-3 fatty acid. We evaluated adhesions presence and degree, breaking strength, percentage of area covered and retraction of the implanted meshes. RESULTS: Group 0 had no adhesion. Groups 1 and 2 showed adhesions on the surface of the mesh, omentum, liver and intestinal loops. There were grades 1 and 2 adhesions in 100% of the polypropylene coated group and in 60% of the polypropylene group. The remaining were grade 3 adhesions, and differed significantly between groups (p <0.001). The breaking strength of adhesions on the polypropylene coated group was significantly higher than with the polypropylene alone (p = 0.016). There was no difference in mesh retraction or area covered by the mesh. The analysis of the mesh coated with omega-3 fatty acid distribution showed adhesions preferentially located at the edges when compared to polypropylene, predominantly in the center. CONCLUSION: The type of adhesions, percentage of surface affected and retraction were not significantly different between meshes. The fatty acids coated mesh had a lower degree of adhesions and these required a greater force to rupture, possibly by their occurrence at the edges of the mesh.


Asunto(s)
Materiales Biocompatibles Revestidos , Ácidos Grasos Omega-3 , Enfermedades Peritoneales/etiología , Polipropilenos , Mallas Quirúrgicas/efectos adversos , Animales , Diseño de Equipo , Ratas , Ratas Wistar , Adherencias Tisulares/etiología
11.
Rev. Col. Bras. Cir ; 39(3): 201-206, maio-jun. 2012. ilus, tab
Artículo en Portugués | LILACS | ID: lil-643148

RESUMEN

OBJETIVO: Comparar as aderências entre dois grupos de ratas Wistar submetidas à colocação intraperitoneal da tela de polipropileno e malha leve de polipropileno revestida com ácido graxo ômega-3. MÉTODOS: Foram utilizadas 27 ratas Wistar randomizadas em três grupos. No grupo 0 não houve colocação de prótese, no grupo 1 houve implantação da prótese de polipropileno e no grupo 2, implantação de prótese de polipropileno revestida com ácido graxo ômega-3. Foi avaliadas a presença de aderências, grau, força de ruptura, percentual de área recoberta e retração das telas aferidas. RESULTADOS: O grupo 0 não apresentou aderência. Os grupos 1 e 2 apresentaram aderência na superfície da prótese, omento, fígado e alça intestinal. Foram encontradas aderências grau 1 e 2 em 100% do grupo polipropileno revestida com ácido graxo ômega-3 e em 60% do grupo polipropileno. As demais eram aderências grau 3, e diferiram significativamente entre os grupos (p< 0,001). A força de ruptura da aderência na tela polipropileno revestida com ácido graxo ômega-3 foi significativamente maior do que na tela de polipropileno (p= 0,016). Não houve diferença na retração das telas ou superfície acometida pelas telas. A análise da tela revestida com ácido graxo ômega-3 demonstrou distribuição preferencialmente nas bordas em relação ao polipropileno, com predomínio no centro. CONCLUSÃO: O tipo de aderência, percentual de superfície acometida e retração não foram significativamente diferentes entre as telas. A tela de baixo peso apresentou menor grau de aderências, e, estas, necessitaram força maior para ruptura, possivelmente pelo predomínio de sua ocorrência nas bordas da tela.


OBJECTIVE: To compare intraperitoneal adhesion formation with placement of polypropylene mesh and use of lightweight polypropylene mesh coated with omega-3 fatty in rats. METHODS: Twenty-seven Wistar rats were randomized into three groups. In group 0 no mesh was placed; in group 1 we implanted a polypropylene mesh; and in group 2 there was implantation of a polypropylene mesh coated with omega-3 fatty acid. We evaluated adhesions presence and degree, breaking strength, percentage of area covered and retraction of the implanted meshes. RESULTS: Group 0 had no adhesion. Groups 1 and 2 showed adhesions on the surface of the mesh, omentum, liver and intestinal loops. There were grades 1 and 2 adhesions in 100% of the polypropylene coated group and in 60% of the polypropylene group. The remaining were grade 3 adhesions, and differed significantly between groups (p <0.001). The breaking strength of adhesions on the polypropylene coated group was significantly higher than with the polypropylene alone (p = 0.016). There was no difference in mesh retraction or area covered by the mesh. The analysis of the mesh coated with omega-3 fatty acid distribution showed adhesions preferentially located at the edges when compared to polypropylene, predominantly in the center. CONCLUSION: The type of adhesions, percentage of surface affected and retraction were not significantly different between meshes. The fatty acids coated mesh had a lower degree of adhesions and these required a greater force to rupture, possibly by their occurrence at the edges of the mesh.


Asunto(s)
Animales , Ratas , Materiales Biocompatibles Revestidos , Polipropilenos , Enfermedades Peritoneales/etiología , Mallas Quirúrgicas/efectos adversos , Diseño de Equipo , Ratas Wistar , Adherencias Tisulares/etiología
12.
Rev Col Bras Cir ; 39(6): 509-14, 2012 Dec.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-23348648

RESUMEN

OBJECTIVE: To compare surgical fixation of polypropylene mesh (PP) and coated polypropylene mesh (PCD) using polypropylene suture and fibrin glue, as for the formation of intraperitoneal adhesions. METHODS: A sample of 46 female Wistar rats were randomized into six groups: two control groups, with five rats each, were subjected to one medial incision (MI) and the other to a U-shaped incision (UI), none of these groups received the mesh. Two groups of PP mesh, with ten rats, fixed with suture (PPF), the other with six rats, fixed with biological glue (PPC). And two groups of PCD mesh, at first, with ten animals, the mesh was fixed with sutures (PCDFs) and the second with ten animals with biological glue (PCDC). RESULTS: After 21 days, the control groups showed no significant adhesions. The PPC group showed a lower degree of adhesion than the PPF group (p = 0.01). There was no difference between the groups with PCD. CONCLUSION: Comparison of fixation was statistically different only with PP mesh, with lesser degrees of adherence when using the glue. Adhesions were predominantly located at the extremities of the meshes studied.


Asunto(s)
Modelos Animales de Enfermedad , Adhesivo de Tejido de Fibrina/efectos adversos , Peritoneo/cirugía , Polipropilenos , Mallas Quirúrgicas/efectos adversos , Adherencias Tisulares/etiología , Adhesivos Tisulares/efectos adversos , Animales , Femenino , Ratas , Ratas Wistar
13.
Acta Cir Bras ; 24(6): 490-5, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-20011836

RESUMEN

PURPOSE: To evaluate the anatomy of female Wistar rats and the workability of contrast radiography as a technique to investigate the gastrointestinal series. METHODS: Eight adult female Wistar rats were undergone to the contrast radiography as anteroposterior incidence and as posterior incidence in profile. The radiological examination was conducted at a 45 degrees angle to the radiological table. Film-focus distance (FFD) was 100 cm, film-object distance (FOD) was 0 cm, and object-focus distance (OFD) was 100 cm. An orogastric probe was used to inject barium contrast at 5-min intervals, for a total of four applications. After the radiological examination, animals were necropsy for confirmation of the radiological findings, and the radiographs were the absence of the normal anatomy variations inspected and described by an experienced radiologist. RESULTS: All the radiographs produced achieved satisfactory results in terms of position, exposure, location and quality. The upper esophageal sphincter (UES) was identified in the esophagus at the nerve C2, the lower esophageal sphincter (LES) was identified between spinal cord segments L1 and L2, the thoracic-abdominal junction was observed at T10, the esophageal-gastric junction (EGJ) at T13-L1, with the abdominal portion in the epigastric region. The stomach was observed mostly in the epigastric region, left hypochondrium, left and mesogastric flank. The duodenum findings presented higher variation, with most findings identified in the epigastric region, right hypochondrium, right flank and mesogastric ileal fossa at T13-L5. CONCLUSION: Contrast radiology is useful and may be employed to assess the anatomy of the animal being studied. The experimental model described afforded to fully identify all organs investigated, as well as other occasional relevant findings. No anatomical anomalies in the subsequent necropsy, confirming the radiographic findings.


Asunto(s)
Medios de Contraste , Intensificación de Imagen Radiográfica/métodos , Tracto Gastrointestinal Superior/diagnóstico por imagen , Animales , Sulfato de Bario , Duodeno/diagnóstico por imagen , Duodeno/patología , Esófago/diagnóstico por imagen , Esófago/patología , Femenino , Modelos Animales , Postura/fisiología , Intensificación de Imagen Radiográfica/normas , Distribución Aleatoria , Ratas , Ratas Wistar , Estudios Retrospectivos , Estómago/diagnóstico por imagen , Estómago/patología , Tracto Gastrointestinal Superior/patología
14.
Acta cir. bras ; Acta cir. bras;24(6): 490-495, Nov.-Dec. 2009. ilus
Artículo en Inglés | LILACS | ID: lil-533212

RESUMEN

PURPOSE: To evaluate the anatomy of female Wistar rats and the workability of contrast radiography as a technique to investigate the gastrointestinal series. METHODS: Eight adult female Wistar rats were undergone to the contrast radiography as anteroposterior incidence and as posterior incidence in profile. The radiological examination was conducted at a 45° angle to the radiological table. Film-focus distance (FFD) was 100 cm, film-object distance (FOD) was 0 cm, and object-focus distance (OFD) was 100 cm. An orogastric probe was used to inject barium contrast at 5-min intervals, for a total of four applications. After the radiological examination, animals were necropsy for confirmation of the radiological findings, and the radiographs were the absence of the normal anatomy variations inspected and described by an experienced radiologist. RESULTS: All the radiographs produced achieved satisfactory results in terms of position, exposure, location and quality. The upper esophageal sphincter (UES) was identified in the esophagus at the nerve C2, the lower esophageal sphincter (LES) was identified between spinal cord segments L1 and L2, the thoracic-abdominal junction was observed at T10, the esophageal-gastric junction (EGJ) at T13-L1, with the abdominal portion in the epigastric region. The stomach was observed mostly in the epigastric region, left hypochondrium, left and mesogastric flank. The duodenum findings presented higher variation, with most findings identified in the epigastric region, right hypochondrium, right flank and mesogastric ileal fossa at T13-L5. CONCLUSION: Contrast radiology is useful and may be employed to assess the anatomy of the animal being studied. The experimental model described afforded to fully identify all organs investigated, as well as other occasional relevant findings. No anatomical anomalies in the subsequent necropsy, confirming the radiographic findings.


OBJETIVO: Avaliar a anatomia normal de ratas Wistar e a viabilidade do exame contrastado nesta população. MÉTODOS: Foram submetidas ao exame oito ratas Wistar adultas, em incidência Ântero-Posterior e Perfil. A técnica consiste no posicionamento à 45º de inclinação em relação à mesa radiológica e colocado à Distância Foco Filme (DFF) de 100 cm, Distância Objeto Filme (DOF) de 0 cm, Distância Foco Objeto (DFO) de 100 cm. O contraste baritado foi injetado via sonda nasoesofágica, em intervalos de 5 minutos para cada fase, em um total de quatro fases. Após a realização do exame foi realizada necropsia dos animais para confirmação dos achados radiológicos e da ausência de variações da anatomia normal As radiografias foram analisadas e descritas por radiologista experiente no exame. RESULTADOS: Todos os exames foram satisfatórios no que se refere ao posicionamento, exposição, localização e qualidade do exame. Foi identificado o esôfago com o Esfíncter Esofágico Superior (EES) ao nível de segunda vértebra cervical (C2) e Esfíncter Esofágico Inferior (EEI) entre as vértebras lombares (L1-2), transição toracoabdominal na vértebra Torácica (T10), Junção Esôfago Gástrica em T13-L1, com a porção abdominal em região epigástrica. O estômago, predominantemente, localizou-se em região epigástrica, hipocôndrio esquerdo, flanco esquerdo e mesogástrico. O duodeno teve a maior variação, com predomínio dos achados na região epigástrica, hipocôndrio direito, flanco direito, fossa ilíaca direita e mesogástrica e ao nível de T13-L5. CONCLUSÃO: O exame contrastado pôde avaliar a anatomia normal do animal em estudo e foi identificada de forma integral em todos os órgãos avaliados com o método descrito, achados confirmados em todos os animais em necropsia subseqüente.


Asunto(s)
Animales , Femenino , Ratas , Medios de Contraste , Intensificación de Imagen Radiográfica/métodos , Tracto Gastrointestinal Superior , Sulfato de Bario , Duodeno/patología , Duodeno , Esófago/patología , Esófago , Modelos Animales , Postura/fisiología , Distribución Aleatoria , Ratas Wistar , Estudios Retrospectivos , Intensificación de Imagen Radiográfica/normas , Estómago/patología , Estómago , Tracto Gastrointestinal Superior/patología
15.
Acta cir. bras. ; 24(6): 490-495, Nov.-Dec. 2009. ilus
Artículo en Inglés | VETINDEX | ID: vti-5310

RESUMEN

PURPOSE: To evaluate the anatomy of female Wistar rats and the workability of contrast radiography as a technique to investigate the gastrointestinal series. METHODS: Eight adult female Wistar rats were undergone to the contrast radiography as anteroposterior incidence and as posterior incidence in profile. The radiological examination was conducted at a 45º angle to the radiological table. Film-focus distance (FFD) was 100 cm, film-object distance (FOD) was 0 cm, and object-focus distance (OFD) was 100 cm. An orogastric probe was used to inject barium contrast at 5-min intervals, for a total of four applications. After the radiological examination, animals were necropsy for confirmation of the radiological findings, and the radiographs were the absence of the normal anatomy variations inspected and described by an experienced radiologist. RESULTS: All the radiographs produced achieved satisfactory results in terms of position, exposure, location and quality. The upper esophageal sphincter (UES) was identified in the esophagus at the nerve C2, the lower esophageal sphincter (LES) was identified between spinal cord segments L1 and L2, the thoracic-abdominal junction was observed at T10, the esophageal-gastric junction (EGJ) at T13-L1, with the abdominal portion in the epigastric region. The stomach was observed mostly in the epigastric region, left hypochondrium, left and mesogastric flank. The duodenum findings presented higher variation, with most findings identified in the epigastric region, right hypochondrium, right flank and mesogastric ileal fossa at T13-L5. CONCLUSION: Contrast radiology is useful and may be employed to assess the anatomy of the animal being studied. The experimental model described afforded to fully identify all organs investigated, as well as other occasional relevant findings. No anatomical anomalies in the subsequent necropsy, confirming the radiographic findings.(AU)


OBJETIVO: Avaliar a anatomia normal de ratas Wistar e a viabilidade do exame contrastado nesta população. MÉTODOS: Foram submetidas ao exame oito ratas Wistar adultas, em incidência Ântero-Posterior e Perfil. A técnica consiste no posicionamento à 45º de inclinação em relação à mesa radiológica e colocado à Distância Foco Filme (DFF) de 100 cm, Distância Objeto Filme (DOF) de 0 cm, Distância Foco Objeto (DFO) de 100 cm. O contraste baritado foi injetado via sonda nasoesofágica, em intervalos de 5 minutos para cada fase, em um total de quatro fases. Após a realização do exame foi realizada necropsia dos animais para confirmação dos achados radiológicos e da ausência de variações da anatomia normal As radiografias foram analisadas e descritas por radiologista experiente no exame. RESULTADOS: Todos os exames foram satisfatórios no que se refere ao posicionamento, exposição, localização e qualidade do exame. Foi identificado o esôfago com o Esfíncter Esofágico Superior (EES) ao nível de segunda vértebra cervical (C2) e Esfíncter Esofágico Inferior (EEI) entre as vértebras lombares (L1-2), transição toracoabdominal na vértebra Torácica (T10), Junção Esôfago Gástrica em T13-L1, com a porção abdominal em região epigástrica. O estômago, predominantemente, localizou-se em região epigástrica, hipocôndrio esquerdo, flanco esquerdo e mesogástrico. O duodeno teve a maior variação, com predomínio dos achados na região epigástrica, hipocôndrio direito, flanco direito, fossa ilíaca direita e mesogástrica e ao nível de T13-L5. CONCLUSÃO: O exame contrastado pôde avaliar a anatomia normal do animal em estudo e foi identificada de forma integral em todos os órgãos avaliados com o método descrito, achados confirmados em todos os animais em necropsia subseqüente.(AU)


Asunto(s)
Animales , Femenino , Adulto , Ratas , Radiografía/métodos , Esófago , Estómago , Duodeno , Ratas Wistar
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