Comparative study of subcostal laparotomy complications using the small bites versus large bite technique

Ponce, I.; Pérez, Aintzane Lizarazu; Otaegui, Lander Gallego; Rodríguez, Laura Carballo; Capitán, Mikel Osorio; Iglesias, Ignacio M.a Goena; Galán, Carlos Placer

doi:10.20960/rhh.00434

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…Also, surgeons must take into consideration that using small bites outside the linea semilunaris may be difficult due to the lack of proper aponeurosis, since the 3 lateral muscles are covered by a weak fascia. A study that retrospectively compared conventional suture with small bites failed to demonstrate a statistically significant difference in the incisional hernia rate ( 34 ). Davey et al analyzed various studies addressing this topic, one of them being the INLINE meta-analysis, that suggests that a running suture with a slowly absorbable material has lower IH incidence in midline laparotomies.…”

Section: Closing the Incisionsmentioning

confidence: 99%

Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen

Pedrique¹,

Lersundi²,

Oliveros³

et al. 2023

J. Abdom. Wall Surg.

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Incisions performed for hepato-pancreatic-biliary (HPB) surgery are diverse, and can be a challenge both to perform correctly as well as to be properly closed. The anatomy of the region overlaps muscular layers and has a rich vascular and nervous supply. These structures are fundamental for the correct functionality of the abdominal wall. When performing certain types of incisions, damage to the muscular or neurovascular component of the abdominal wall, as well as an inadequate closure technique may influence in the development of long-term complications as incisional hernias (IH) or bulging. Considering that both may impair quality of life and that are complex to repair, prevention becomes essential during these procedures. With the currently available evidence, there is no clear recommendation on which is the better incision or what is the best method of closure. Despite the lack of sufficient data, the following review aims to correlate the anatomical knowledge learned from posterior component separation with the incisions performed in hepato-pancreatic-biliary (HPB) surgery and their consequences on incisional hernia formation. Overall, there is data that suggests some key points to perform these incisions: avoid vertical components and very lateral extensions, subcostal should be incised at least 2 cm from costal margin, multilayered suturing using small bites technique and consider the use of a prophylactic mesh in high-risk patients. Nevertheless, the lack of evidence prevents from the possibility of making any strong recommendations.

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Section: Closing the Incisionsmentioning

confidence: 99%

Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen

Pedrique¹,

Lersundi²,

Oliveros³

et al. 2023

J. Abdom. Wall Surg.

View full text Add to dashboard Cite

show abstract

Comparative study of subcostal laparotomy complications using the small bites versus large bite technique

Abstract: Estudio comparativo de las complicaciones de la laparotomía subcostal mediante la técnica small bites frente a la large bitesComparative study of subcostal laparotomy complications using the small bites versus large bite technique

Cited by 1 publication

References 23 publications

Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen

Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen

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