-Background -Among meshes used in incisional hernias in open techniquerepair, 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.RESUMO -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 intraabdominais. 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 ...

LESS procedures are feasible and considered as further refinements in laparoscopic techniques. However, the peculiarities and difficulties inherent in these procedures require a specific training program combining theory and practice. The authors believe that this training is essential to achieve proficiency levels before the technique can be tried on human subjects.

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.

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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. Key words: X-Rays. Esophagus. Stomach. Duodenum. Rats. RESUMOObjetivo: 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 a...

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.

The combined use of polypropylene mesh and lactic acid bioprotector showed similar results in relation to intraperitoneal adhesion formation when compared to the sole use of the same mesh.

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.