Category Archives: Abdominal

Gastrointestinal Stromal Tumors of the Stomach: Is There Any Advantage of Robotic Resections?

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“Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive system. They account for less than 3% of all gastrointestinal malignancies, with an annual incidence rate estimated at 10–20 cases per million population in the United States. The most frequent anatomical location is the stomach (approximately 60% of cases). Although the introduction of tyrosine kinase inhibitors has changed the therapeutic algorithm of GISTs, surgical resection with negative margins remains the main treatment option for localized resectable tumors.”

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Laparoscopic entry techniques

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“Laparoscopy is a surgical procedure commonly used in gynaecology whereby a laparoscope is used to gain intra-abdominal access via less extensive incisions. Evidence suggests that laparoscopy provides significant benefits compared to laparotomy in terms of surgical outcomes for patients and costs for healthcare providers. Unlike in conventional open surgery, the surgeon is usually unable to visualise the initial entry into the peritoneal cavity. Most laparoscopic complications occur during the initial entry. These may happen
at several stages including Veress needle insertion, creation of a pneumoperitoneum, and primary trocar insertion. Opinion is divided as to the safest entry technique, and clinical practice is varied. Although gynaecologists commonly use a closed method of entry, other surgical specialties routinely use open methods of entry.”

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The Importance of Abdominal Wall Closure After DefinitiveSurgery for Enterocutaneous Fistula

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“In the case of enterocutaneous fistula (ECF) initial medical therapy aims to stabilize the patient, optimize the nutritional status and control of infections and fistula output. When surgery is required, extensive adhesiolysis, bowel resection and anastomosis along with abdominal wall reconstruction are necessary. The primary endpoint in patients undergoing surgical treatment with ECF as well as in the case of intestinal stomas, is to solve the intestinal defect, thus leaving in secondary terms other problems such as ventral hernias.
The simultaneous treatment of fistula/stoma closure with abdominal wall defect closure has been widely debated since some argue that the risk of complications such as anastomotic leakage is increased due to prolonged surgery and anesthetic time. However, various studies are reporting good results in patients undergoing simultaneous stoma with giant wall defect correction surgery, without increased risks and rates of complications.”

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Adult intussusception. Determining the appropriate surgical procedure.

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“Although surgery is the recommended treatment for adult intussusception, the optimal surgery remains controversial. Although abdominal computed tomography (CT) scan has
proven useful in diagnosing intussusception, it has limited value in discriminating whether a lead point is malignant, benign, or idiopathic. Reduction at surgery may avoid excessive bowel resection, although it can theoretically increase the risk of potential intraluminal seeding or venous tumor dissemination.
The aim of this study was to determine what the appropriate surgical procedure for adult intussusception is, depending on location of the intussusception or other specific situations.”

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Mesh Suture and Mesh Strips to Prevent Incisional Hernia Following Abdominal Wall Closure or Ventral Hernia Repair

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“Incisional hernias are an increasingly common complication encountered by surgeons and their patients, as survival rates from major abdominal surgery continue to improve. The
incidence of incisional hernia after midline laparotomy is estimated to be 9%–20% after 1 year, resulting in approximately 8000 UK repairs annually. While patient factors such as obesity, smoking and diabetes certainly contribute, excessive suture tension during the critical wound healing period causes local ischaemia at the suture-tissue interface and may initiate incisional hernia. Subsequent suture “cheese-wiring” through fascia creates small linear defects that enlarge over time with repeated abdominal wall straining. The clinical
and economic implications of incisional hernia have precipitated preventative research, including Jenkins rule, small-bite closure, and prophylactic mesh implantation which are
discussed in recent high-profile international guidelines. However, many surgeons continue to adopt suture closure over prophylactic planar mesh since this prolongs surgery and risks
infection in a contaminated field.”

Nip, Lawrence et al. “Mesh Suture and Mesh Strips to Prevent Incisional Hernia Following Abdominal Wall Closure or Ventral Hernia Repair: Systematic Review.” Journal of abdominal wall surgery : JAWS vol. 4 14573. 14 May. 2025 Free Full Text

Outcome of ligation of the inferior vena cava in the modern era

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“Injury to the inferior vena cava (IVC) is a relatively rare event occurring more commonly after penetrating trauma (.5%–5%) than after blunt trauma (.6%–1%). The incidence of IVC injuries, however, has been increasing in civilian trauma centers, with these injuries accounting for up to 40% of abdominal vascular injuries in recent series.
Because of the increasing frequency and persistently high mortality associated with these injuries, perioperative management of the IVC remains a focus of interest. Indeed, while ligation of the significantly injured IVC is an acceptable practice in the era of damage control surgery, little long-term follow-up data are available in survivors of this technique.”

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Management and Morbidity of Major Pelvic Hemorrhage in Complex Abdominopelvic Surgery

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“Complex abdominopelvic surgery (CAPS) includes a wide variety of difficulties related to primary disease and hostile intrapelvic environment. Any radical abdominopelvic operation which is not standardized is complex. Hence, radical oncologic operations for the primary advanced or recurrent carcinoma of pelvic organs, revisional operations for failed restorative operations for maintaining intestinal continuity are considered as CAPS.”

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