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The encircling mesh in abdominal wall surgery: rationale and technical details of a dorso-ventral physiological restoration  B Palmieri, S Grappolini,

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Presentation on theme: "The encircling mesh in abdominal wall surgery: rationale and technical details of a dorso-ventral physiological restoration  B Palmieri, S Grappolini,"— Presentation transcript:

1 The encircling mesh in abdominal wall surgery: rationale and technical details of a dorso-ventral physiological restoration  B Palmieri, S Grappolini, G Benuzzi  British Journal of Plastic Surgery  Volume 57, Issue 3, Pages (April 2004) DOI: /j.bjps

2 Graphic 1 Case selection for ‘round mesh’ procedure: (A) Laparocoele; (B) Wide umbilical hernia and abdominal muscle weakening with previous unsuccessful classic abdominoplasty; (C) Abdominal and synchronous inguinal hernia in patients performing heavy works; (D) Abdominal wall metastatic tumor; (E) Recti muscles diastasis and ventral hypotonia in pluriparous, overweight women; (F) Severe weight loss and muscle relaxation after open or laparoscopic bariatric surgery; (G) Aesthetic abdominoplasty in pluriparous (one or more caesarean sections) non-obese women. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

3 Graphic 2 Main symptoms enclosed for ‘round mesh’ eligibility: (A) Lumbar pain on prolonged standing; (B) Impairment of squatting-uplifting movements; (C) Bilateral and (D) unilateral lombosciatalgia; (E) Pain due to trunk bending and rotating; (F) Pain due to arm lifting and tiptoeing walking. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

4 Figure 1 Intraoperative steps: (A) drawing of the round mesh; (B) disposable introducer with removable tip: the mesh is plicated and introduced into the lumen, to be passed across the spine; (C) lateral view of the access for the mesh introduction; (D) introducer output into the operative field, contralaterally to the flank access; (E) criss-crossed expansion of the mesh above the ventral fascia; (F) periosteal unabsorbable stitches to fix anteriorly the ‘round mesh’. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

5 Figure 2 Pre (A and B) and post (C and D) frontal and lateral view of operated patients. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

6 Figure 3 Pre (A and B) and post (C and D) frontal and lateral view of operated patients. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

7 Graphic 3 Overlapping agreement between doctors and patients as to functional and cosmetic outcome of the ‘round mesh’. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

8 Graphic 4 Overlapping agreement between doctors and patients as to functional and cosmetic outcome of the ‘round mesh’. British Journal of Plastic Surgery  , DOI: ( /j.bjps )

9 Figure 4 Sample of pre (blue) and postoperative (red) change of the ‘Centre of Pressure’ (CoP) measured by optoelectronic system: the gravity centre of the body is shifted forward. British Journal of Plastic Surgery  , DOI: ( /j.bjps )


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