A Randomized Controlled Trial for Abdominal Binder Use after Laparoendoscopic Single-Site Surgery

Kliethermes, C.J.; Blaźek, K; Ali, Kausar; Nijjar, J.B.; Kliethermes, Stephanie; Guan, Xiaoming

doi:10.1016/j.jmig.2017.12.021

Cited by 11 publications

(12 citation statements)

References 4 publications

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“…There might be a beneficial effect in reducing pain and facilitating mobilization after open abdominal or hernia surgery ( 35 – 37 ). For laparoscopic procedures, the data shows conflicting results ( 38 , 39 ).…”

Section: Discussionmentioning

confidence: 99%

“…There might be a beneficial effect in reducing pain and facilitating mobilization after open abdominal or hernia surgery (35)(36)(37). For laparoscopic procedures, the data shows conflicting results (38,39). Dietz et al (40) recommended a review on incisional hernia techniques postoperative reduced activity or weight-lifting restrictions for 3-6 weeks, though they also stated there is not enough evidence to substantiate any binding recommendation.…”

Section: Implications For the Clinical Routinementioning

confidence: 99%

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Recommendations on Postoperative Activities After Abdominal Operations and Incisional Hernia Repair—A National and International Survey

et al. 2021

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Background: There is no conclusive data on postoperative recommendations after abdominal and hernia surgery, and there is significant variation in the literature on that question. Thus, this study evaluates the status quo of recommendations of postoperative activity restriction after abdominal surgery.Materials and Methods: A national (German) and international survey of general surgeons on postoperative recommendations after abdominal and hernia surgery was pooled and analyzed.Results: A total of 74.6% recommended postoperative reduced activity for 2 weeks or less after laparoscopy. For midline laparotomy, 48.8% considered a reduced activity of 4 weeks or less to be sufficient. A majority from the national survey recommended more than 4 weeks instead (60.2%), whereas only 31.5% from the international survey did so (p = 0.000). In the pooled analysis, 258 of 450 (57.3%) rated 4 weeks or less suitable. However, the recommendations differed significantly between the surveys (4 weeks or less: a national survey, 47.1% vs. international survey, 64.6%; p = 0.000).Conclusion: There was substantial variation in the given recommendations. However, we found no evidence against immediate mobilization, reduced physical activity, and lifting for up to 2 weeks after laparoscopic surgery and for up to 4 weeks after open abdominal surgery and open incisional/ventral hernia repair in uncomplicated and standard cases. There might be individual and socioeconomic benefits to allow patients to return to their whole personal level of activity and work without putting them at risk of complications. Due to lack of evidence, both retrospective and prospective, controlled studies are in need to develop reliable recommendations.

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Section: Discussionmentioning

confidence: 99%

Section: Implications For the Clinical Routinementioning

confidence: 99%

Recommendations on Postoperative Activities After Abdominal Operations and Incisional Hernia Repair—A National and International Survey

et al. 2021

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“…Postoperative phase Postoperative garment use, to increase ambulation and decrease narcotic requirements. 115-117 Early and frequent ambulation—all patients are ambulating within 20 minutes of entrance to PACU, and every 2 hours thereafter with assistance. 118-120 Modified Aldrete Score, modified PADS, fast track discharge criteria 121-123 Increased inspired oxygen in PACU 124 Generous PO fluids—patient must “replace” typical IV fluids.…”

Section: Eras Bl Protocolmentioning

confidence: 99%

An Enhanced Recovery After Surgery (ERAS) Protocol for Outpatient BodyLift Surgery

Nuveen

Matthesen²,

Cox

et al. 2020

Am J Cosmet Surg

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The concept of enhanced recovery after surgery (ERAS) was developed in 2001 in order to create a multimodal, scientifically based approach to the development and audit of protocols for improving outcomes after surgical procedures. These protocols undergo constant evolution and evaluation toward the goal of quality of recovery. The BodyLift (BL) is the procedure that most comprehensively addresses the cosmetic needs of patients after massive weight loss (MWL). In the course of performing 136 consecutive outpatient BL surgeries over 7 years, we have developed a management protocol that has provided consistently high patient satisfaction, minimized frequent complications, and has documented 100% safety in all cases performed without deep vein thrombosis (DVT), transfusion and with 1 postoperative hospital admission. Each evidence-based component in the protocol was instituted to reduce risk of complications known to be most commonly associated with circumferential body contouring surgery. ERAS protocols are now widely used in many other surgical subspecialties. These protocols have the common goal of returning the patient to normal function as expeditiously as possible and are associated with decreased complications as well as shorter length-of-stay (LOS) and reduced costs. We have enumerated the many components of our protocol and aligned each with elements of an ERAS paradigm. In our retrospective review of 7 years of BL surgery (n = 136), this protocol has reduced both major and minor complications to previously unpublished levels. Our independently formulated ERAS protocol for outpatient BL surgery aligns closely with the ERAS concept, limiting surgical stress, thus reducing complications and affording a smooth and predictable perioperative experience. This is of importance for elective cosmetic surgery patients, who often have high expectations for an uneventful recovery and are unaccepting of potentially out-of-pocket costs associated with complications.

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“…Prophylactic intravenous cefazolin 1–2 g (Ancef, SmithKline Beecham, London, United Kingdom) was given before the start of surgery. Patients were discharged from the hospital with pain medication (600–800 mg; ibuprofen; Tylenol with codeine #3 or Motrin; Johnson & Johnson, New Brunswick, New Jersey, USA) and an abdominal binding was placed for reducing postoperative pain, 15 when they tolerated an oral diet, were ambulatory with well-controlled pain, and resumed normal urinary function. For 6 weeks after surgery, the patients were counseled to avoid vaginal intercourse and not to lift anything heavier than 10 pounds.…”

Section: Case Seriesmentioning

confidence: 99%

Robotic Single-Site Sacrocolpopexy with Retroperitoneal Tunneling

Liu

Bardawil

Zurawin

et al. 2018

JSLS

Self Cite

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Introduction:This series of cases was an investigation of the safety and feasibility of robotic laparoendoscopic single-site surgery (R-LESS) as a method of performing sacrocolpopexy.Case Presentation:This is a retrospective series of 15 cases of R-LESS sacrocolpopexy with the V-Loc (Medtronic, Minneapolis, Minnesota, USA) suture and a retroperitoneal tunneling technique performed by a single surgeon, combined with a literature review. Patient demographic information and perioperative data were analyzed. The standard robotic sacrocolpopexy steps were followed, but the surgeon used a combined technique of V-Loc suture and retroperitoneal tunneling to simplify the procedure. No additional ports were necessary in any of the patients.Management and Outcome:Using the pelvic organ prolapse quantification (POP–Q) scoring method, the mean preoperative C-point of the 15 patients was +1.16 compared to the mean immediate postoperative C-point, which was −5.5. The mean total sacrocolpopexy time was 74.7 (range, 50–99) minutes and mean mesh anchoring time was 22.60 ± 3.85 minutes. The mean sacral promontory fixation and tunneling and mesh position times were 11.87 ± 3.02 and 5.80 ± 2.14 minutes, respectively. All 15 cases were performed without perioperative or long-term complications.Discussion:R-LESS in combination with the V-Loc suture and the retroperitoneal tunneling technique can be safely and feasibly performed, especially in sacrocolpopexy and, potentially, in other POP surgeries. With adequate and systematic training, surgeons can acquire the necessary skills to perform this complex surgical procedure.

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A Randomized Controlled Trial for Abdominal Binder Use after Laparoendoscopic Single-Site Surgery

Cited by 11 publications

References 4 publications

Recommendations on Postoperative Activities After Abdominal Operations and Incisional Hernia Repair—A National and International Survey

Recommendations on Postoperative Activities After Abdominal Operations and Incisional Hernia Repair—A National and International Survey

An Enhanced Recovery After Surgery (ERAS) Protocol for Outpatient BodyLift Surgery

Robotic Single-Site Sacrocolpopexy with Retroperitoneal Tunneling

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