What is a Pledgeted suture?
A pledgeted suture is one that is supported by a pledget, that is, a small flat non-absorbent pad normally composed of polytetrafluoroethylene, used as buttresses under sutures when there is a possibility of sutures tearing through tissue.
What is hiatal hernia?
Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen.
What is crural closure?
On the contrary, crural closure as a routine step of laparoscopic anti-reflux surgery is associated with lower postoperative rates of hiatal herniation and possibly better reflux control but may result in a higher incidence of dysphagia9.
What part of the body does a hiatal hernia affect?
A hiatal hernia occurs when the upper part of your stomach bulges through your diaphragm into your chest cavity. A hiatal hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm).
What are the classification of sutures?
Broadly, sutures can be classified into absorbable or non-absorbable materials. They can be further sub-classified into synthetic or natural sutures, and monofilament or multifilament sutures.
What are the 3 types of hiatal hernia?
Type 3 (mixed, sliding, and paraesophageal hiatal hernia) is the EGJ and stomach is located above the diaphragm and 2 cm or more of the fundus is located cephalad to the lower esophageal sphincter and esophagus.
What is the principle of Nissen Fundoplication Surgery?
The surgical principle is restoring an anti-reflux barrier by recreating a sufficient pressure gradient in the distal oesophagus, and by correcting the gastro-oesophageal Hiss. Nissen’ fundoplication is probably the most efficient anti-reflux procedure.
Which suture is preferred when performing a Nissen fundoplication?
A 3-0 silk suture is used to further secure the wrap and is most easily tied intracorporeally (Figure 9).
What are the principles of suturing?
Generally, the surgeon selects the smallest suture that adequately holds the healing wound edges. The tensile strength of the suture should never exceed the tensile strength of the tissue. As the wound heals, the relative loss of suture strength over time should be slower than the gain of tissue tensile strength.
What is PDS material?
Polydioxanone (PDS) or poly-p-dioxanone is a slowly absorbable monofilament suture composed of the polyester, poly (p-dioxanone). This is a monofilament with greater strength than monofilament nylon and polypropylene, and with less tissue drag than the multifilament materials.
What is the difference between a hiatus hernia and a hiatal hernia?
A hiatal hernia is when your stomach bulges up into your chest through an opening in your diaphragm, the muscle that separates the two areas. The opening is called the hiatus, so this condition is also called a hiatus hernia. There are two main types of hiatal hernias: sliding and paraesophageal.
What is the difference between a hiatal hernia and a hernia?
Unlike ventral hernias, which protrude through the abdominal wall, a hiatal hernia occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, the muscle that separates the abdomen from the chest.