V. V. Teplyy, B. G. Bezrodnyy Department of surgery №2, National O. O. Bogomolets Medical University, Kyiv, Ukraine icon

V. V. Teplyy, B. G. Bezrodnyy Department of surgery №2, National O. O. Bogomolets Medical University, Kyiv, Ukraine




НазваV. V. Teplyy, B. G. Bezrodnyy Department of surgery №2, National O. O. Bogomolets Medical University, Kyiv, Ukraine
Дата12.08.2012
Розмір5.27 Kb.
ТипДокументи

PREVENTION OF INTRAABDOMINAL HYPERTENSION AFTER ABDOMINOPLASTY

V.V. Teplyy, B.G. Bezrodnyy

Department of surgery №2, National O.O. Bogomolets Medical University,
Kyiv, Ukraine


Key words: abdominoplasty, intraabdominal hypertension, body contouring


Contact details: Valeriy Teplyy, associate professor, email: teplyy@ukr.net,

tel.: +38050 4457049


OBJECTIVE: To improve methods of prevention of intraabdominal hypertension following abdominoplasty (AP).

MATERIAL and METHOD: Forty one females who underwent AP with musculoaponeurotic system plication were enrolled prospectively. Simulation of myoaponeurotic repair was performed by external trunk compression with attempt to fit its “ideal” circumferences. Intraabdominal pressure (IAP) was estimated by measuring the urinary bladder pressure before and after this manoeuvre. Degree of laxity of musculoaponeurotic layer was estimated by the changes of the distances between fixed points after creation of a carboperitoneum during AP to the pressure equal to the preoperative standing IAP.

RESULTS: Preoperative simulation of musculoaponeurotic repair took 34.5±1.7 min. In 32 patients it confirmed the possibility to use the “ideal” anthropometric parameters as a guide and in 9 patients attempts to achieve the desired shape of the trunk caused a rise of IAP to 182.0±11.8 mm H2O. It was decided in 3 women to avoid repair of musculoaponeurotic layer and in other 6 – to make it less radical. Preoperative measurements correlated with IAP at the end of the operation (r=0.93; p<0.001). All manipulations connected with carboperitoneum took 15.3±4.9 min and didn’t cause any complication. Permanent monitoring of IAP during operation gave possibility to escape dramatic rise of IAP, simplified the choice of musculoaponeurotic repair method. In 11 patients some additional lax areas were found and strengthened after initial plication.

CONCLUSIONS: The proposed methods are easy, fast and precise; they improve the preoperative planning, intraoperative control over quality of musculoaponeurotic repair, make AP safer and the results more predictable.



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