The Biologics Explosion Era
Product Source Cross-linked Sterilization method Alloderm (Lifecell, Branchburg, NJ) Human dermis No Ionic Allomax (Davol, Warwick, RI) Human dermis No E beam Flex HD (Ethicon, Sommerville, NJ) Human dermis No…
Considerations in Abdominal Wall Reconstruction
Type Porous structure Examples Type I Macroporous (> 75 µ) Marlexa, Proleneb Trelexc Type II Microporous (< 10 µ in at least one direction) ePTFE, Dual-Meshd Type III Macro and microporous PTFEd, Mersileneb Surgiproe…
Damage Control
Fig. 2.1 Damage control for intra-abdominal sepsis from acute bowel ischemia Fig. 2.2 a Abdomen left open secondary to significant bowel edema. b , c Necrotizing soft tissue infection of…
Abdominal Compartment Syndrome
Definition 1 IAP is the steady-state pressure concealed within the abdominal cavity Definition 2 APP = MAP − IAP Definition 3 FG = GFP − PTP = MAP − 2 * IAP Definition 4 IAP should be expressed in mm Hg and measured at end-expiration…
Complications
Fig. 8.1 Enteroatmospheric fistula treated with tube cannulation in a patient with an open abdomen Deep exposed fistulae evolve into a complex pathology that lead to tremendous metabolic drain from…
Historical Perspective
Fig. 1.1 Artist rendition of towel-clip, skin-only closure. (Used with permission K. Dangleben) Esmarch Closure Originally described by Cohn et al. in 1995 [7] , an Esmarch bandage (latex or latex…
Laparoscopic Sleeve Gastrectomy: Management of Complications
Early complications • Gastric leak • Gastric fistula • Bleeding • Obstruction/stricture Late complications • GERD • Nutrient deficiencies Gastric Leak (GL) Leaks are the most concerning and potentially life-threatening…
Operating Room Positioning, Equipment, and Instrumentation for Laparoscopic Bariatric Surgery
Fig. 1. Use of lateral transfer device to move patient on and off operating table. During surgery, we use a supine position with legs together and arms abducted. The patient…
Essential Bariatric Equipment: Making Your Facility More Accommodating to Bariatric Surgical Patients
Essential equipment recommendations •Inpatient units (floor, ICU, PACU) •Wide beds Standard to 440 lb Automated/adjustable to full sitting position Built-in scale Low air loss mattress Lifting/transferring equipment Wide commodes Wide…
Laparoscopic Malabsorptive Procedures: Technique of Duodenal Switch
Fig. 1. Sleeve gastrectomy and beginning of duodenal switch: patient and team’s positioning. Trocars’ Positioning The following six abdominal trocars are placed: a 10 mm trocar (T1) 20 cm distal…
