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There is not enough evidence to say whether particular techniques for closing the abdominal wall during caesarean section are better than others.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 18, 2004

A defect in the abdominal wall through which organs can protrude is called hernia. Hernias may occur spontaneously (primary hernia) or at the site of a previous surgical incision (incisional hernia). A hernia is usually recognized as a bulge or tear under the abdominal skin. Occasionally it causes no discomfort for the patient but it can hurt while lifting heavy objects, coughing, or having bowel movements. Also after prolonged standing or sitting it can cause heavy discomfort.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 16, 2011

Key‐hole removal of the gallbladder (laparoscopic cholecystectomy) is currently the preferred treatment for people with symptoms related to gallstones in the gallbladder. This is generally performed by distending the tummy (abdomen) using carbon dioxide gas (pneumoperitoneum) so that there is adequate space for instruments and to visualise the structures within the abdomen. This enables the surgeons to identify and divide the appropriate structures. However, distending the abdominal wall can result in various physiological changes that affect the functioning of the heart or lungs. These changes are more pronounced at higher pressures of the gas used to distend the abdomen. They are generally tolerated well in people with a low risk of anaesthetic problems. However, those with pre‐existing illnesses may not tolerate this distension of the abdomen well. So, an alternate method of enabling the surgeons to visualise the structures in the abdomen and to use instruments by lifting up the abdominal wall using special devices (abdominal wall lift) has been suggested for people undergoing laparoscopic cholecystectomy. We reviewed all the relevant information from randomised trials (a type of study which provides the best information on whether one treatment is better than the other, if conducted properly) in the literature to find out if abdominal wall lift is better than distending the abdomen using carbon dioxide gas. We adopted methods to identify all the possible studies and used methods that decrease the errors in data collection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: August 31, 2013

During operations surgeons make a cut (incision) in the skin to gain access to the surgical site. Incisions are closed with sutures (stitches), staples, tissue adhesives or tapes. Sutures can be continuous or interrupted. Continuous sutures are usually inserted underneath the skin surface using absorbable or non‐absorbable suture material. Interrupted sutures involve the full thickness of the skin and are usually non‐absorbable (but not always).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 14, 2014

An incisional hernia is a bulge of tissue or an organ through an operation scar in the abdominal wall. Incisional hernias occur in 10 to 23 percent after abdominal operations.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 16, 2008

Poorly controlled pain after abdominal surgery is associated with a variety of unwanted post‐operative consequences, including patient suffering, distress, confusion, chest and heart problems, and prolonged hospital stays. Traditionally, pain relief is provided by: medications injected in to a vein using a 'drip' such as morphine or paracetamol; administering local anaesthetic into the skin around the surgical wound; or by providing epidural pain relief where local anaesthetic and other pain relieving medications are injected through a fine plastic tube into the epidural space of the lower back ‐ numbing the nerves that supply the abdomen. Following surgery, Transversus Abdominis Plane (TAP) block is a relatively new way of anaesthetising nerves which numb the abdomen after surgery in order to help improve patient comfort after their surgery. In the past few years, there has been increasing research and interest describing how TAP blocks are being used for pain relief in both adults and children having abdominal surgical procedures. However, there have not been any systematic reviews evaluating the effectiveness of the TAP block in reducing pain after surgery. We have searched for research investigating the effectiveness of rectus sheath (a similar block to TAP) and TAP blocks in providing pain relief after abdominal surgery. We have included eight studies, with a total of 358 participants in this review, that show some limited evidence that TAP blocks improve pain relief after abdominal surgery. More research is indicated, comparing TAP blocks with other standard methods of pain relief such as, morphine medication, epidural analgesia and local anaesthetic injection into and around the surgical wound. There are many studies currently underway or awaiting publication which assess the effectiveness of the TAP block and compare it with other techniques. We intend to include these studies in an updated version of this review in the near future.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 8, 2010

Large abdominal aortic aneurysms may rupture (break open) unexpectedly. Surgery can prevent that from happening, but carries risks of its own. So it’s important to carefully consider the pros and cons of surgery before making a decision. The larger an aneurysm is, the greater the chances are that it will rupture. It is estimated that an abdominal aortic aneurysm that is over 5.5 cm in diameter will rupture within one year in about 3 to 6 out of 100 men. That's why surgery is often recommended. But there may also be good reasons to not have surgery.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 14, 2017

In a caesarean section operation, there are various types of incisions in the abdominal wall that can be used. These include vertical and transverse incisions, and there are variations in the specific ways the incisions can be undertaken. The review of studies identified four trials involving 666 women. The Joel‐Cohen incision showed better outcomes than the Pfannenstiel incision in terms of less fever for women, less postoperative pain, less blood loss, shorter duration of surgery and shorter hospital stay. However, the trials did not assess possible long‐term problems associated with different surgical techniques.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 31, 2013

Medication to treat fibroid symptoms usually only works while you are taking it. Many women who have severe pain and heavy menstrual bleeding end up considering surgery as an option. There are a number of different types of surgical treatments, each with its own pros and cons. Surgery is done in the hope that it can permanently stop the symptoms of uterine fibroids. Some women do, in fact, experience long-term relief. But surgery always carries risks too. Whether or not surgery is an option – and, if so, what kind of surgery – will depend on how the woman feels about the different advantages and disadvantages. The size, number and location of the fibroids will also influence the choice of treatment. Not all types of surgery are suitable for women who still want to have children. Your doctor may recommend taking hormones such as GnRH analogues several weeks before having surgery. These kinds of artificial hormones are used to shrink the fibroids. Doctors can then make smaller cuts during surgery, allowing the womb (uterus) to recover more quickly. The drug ulipristal acetate is sometimes used for this purpose too. But removing individual fibroids isn't a good idea if it might cause too much scarring in the womb, or if the risk of bleeding during or after surgery is too high. Plus, it isn't always absolutely certain that the symptoms will improve after surgery. Hysterectomy (surgical removal of the womb) is then an option – or possibly another non-surgical treatment approach such as uterine artery embolization (UAE, sometimes also called uterine artery embolization, or UFE). Uterine artery embolization cuts off the blood supply to the fibroid.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 16, 2017

In laparoscopic surgery, surgery is performed through small incisions using long instruments and video cameras. To create a working and viewing space in the abdomen, carbon dioxide (CO2) is insufflated to separate the abdominal wall from internal organs. Traditionally, unheated CO2 is used but there has been suggestions that heated CO2 may prevent hypothermia. Hypothermia has been associated with heart attacks, abnormal heart rhythms, increased infections, decreased clotting ability and increased blood loss. We aimed to investigate the role of heated compared with cold CO2 in laparoscopic abdominal surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 19, 2016

Laparotomy, an incision through the abdominal wall to access the abdominal cavity, is performed for a variety of surgical procedures. Incisional hernia, infection, dehiscence (an opening of the wound or muscle layers) and chronic drainage from the wound, are potential complications of this procedure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Stress urinary incontinence is loss of urine when coughing, laughing, sneezing or exercising. Damage to the muscles that hold up the bladder may cause it. About a third of adult women may have urine leakage, and about a third of these may have problems bad enough to require surgery. A significant amount of a woman's and their family's income can be spent on management of stress urinary incontinence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 25, 2017

Surgery can very effectively reduce the problems associated with a benign enlarged prostate. It is considered if other treatments don't provide enough relief, or if the enlarged prostate keeps causing medical problems such as urinary tract infections. But surgery often has side effects. Most men who have a benign enlarged prostate aren't in urgent need of surgery. They can take their time to carefully consider the pros and cons. There are various possible reasons for deciding to have surgery. For instance: The prostate-related problems may be very distressing, and other treatments may not have led to a big enough improvement.The enlarged prostate may frequently cause other medical problems, such as recurring urinary tract infections or bladder stones.Treatment with medication may not be possible for medical reasons. The decision will also greatly depend on how the man feels about the potential benefits and harms of a procedure. Although surgery is very effective, it can lead to complications such as ejaculation problems.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 25, 2018

Laparoscopic appendicectomy is used in treating appendicitis and can be achieved using several skin incisions in the abdominal wall, or more recently with a single skin incision through which instruments are introduced into the peritoneal cavity. Since no randomised control trials of single incision versus conventional multi‐incision laparoscopic surgery for appendicectomy could be found, the efficacy and safety of the two approaches could not be analysed in this review. There is a need for randomised control trials of single incision laparoscopic appendicectomy for appendicitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 6, 2011

In the right lower part of the abdomen there is a small blind ending intestinal tube, called appendix. Inflammation of the appendix is called appendicitis and is usually acute in onset. Appendicitis is most frequent in children and young adults. Most cases require emergency surgery, in order to avoid rupture of the appendix into the abdomen. During the operation, called appendectomy, the inflamed appendix is surgically removed. The traditional surgical approach involves a small incision (about 5 cm or 2 inches) in the right lower abdominal wall. Alternatively, it is possible to perform the operation by laparoscopy. This operation, called laparoscopic appendectomy, requires 3 very small incisions (each about 1 cm or 1/2 inch). The surgeon then introduces a camera and some instruments into the abdomen and removes the appendix as in the conventional operation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 6, 2010

Diverticular disease is a condition in which the inner layer of the intestinal wall (mucosa) protrudes through weak points in the muscular layer of the wall, forming small pouches (diverticula) that bulge out of the large bowel. The inflammation of diverticula is defined as diverticulitis. Diverticulitis is more common in the sigmoid colon than in the other tracts of the large bowel. In Western countries, diverticular disease is very common, affecting about 60% of the population over 70 years of age. Most individuals with diverticular disease have no symptoms or experience only mild pain in the lower abdomen, accompanied by a slight change in bowel habits. Individuals with acute diverticulitis may experience pain in the lower abdomen and other symptoms such as fever, nausea, vomiting, and shivering. Diverticulitis generally is treated medically with antibiotics and diet. However, for individuals who experience recurrent abdominal pain or complications, surgical resection of the affected bowel segment is required; this can be performed through conventional open or laparoscopic surgery techniques.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 25, 2017

There has been a lot of debate in the surgical literature about the best way to surgically access the infrarenal abdominal aorta during an operation to repair an abdominal aortic aneurysm (AAA; a ballooning of an artery (blood vessel) which occurs in the major artery in the abdomen (aorta)). Two approaches are commonly used: the retroperitoneal (RP) approach and the transperitoneal (TP) approach. Both approaches appear to have advantages and disadvantages. Many trials comparing RP and TP aortic surgery have been published with conflicting results. The aim of this Cochrane review is to assess the effectiveness and safety of the TP versus RP approach for planned surgical open AAA repair on mortality, complications, hospital stay and blood loss.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 5, 2016

We reviewed the evidence about the effect of using either a scalpel (knife) or electrosurgery in surgical operations on the abdomen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 14, 2017

The peritoneum is the inner lining of the abdomen (tummy). After surgery, when closing the abdomen, some surgeons stitch the peritoneum together because they think this increases the strength of the wound. Others do not stitch the peritoneum together because they think it is unnecessary, increases operating costs through use of additional stitching material, increases operating time, and may increase pain. So, whether to close the peritoneum, and method of closure (continuous running stitches versus interrupted stitches) are controversial in operations not related to childbirth. We addressed these controversies by performing a thorough search of the medical literature for trials that compared closing and not closing the peritoneum after abdominal operations not related to childbirth. We included only randomised controlled trials without limiting trials according to language or year of publication, or number of participants in the study. Two review authors independently identified the trials and extracted information.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 4, 2013

Tubal ligation or sterilisation ( tying the tubes ) is a common method of fertility regulation. It is usually done by using the following methods: mini‐laparotomy ( through a small cut in the abdomen ), laparoscopy ( "keyhole" surgery ‐ through a tube inserted through the umbilicus ( belly button ) or a very small cut ), or culdoscopy ( using a tube, but through the vagina ). The review found that overall, laparoscopy had fewer complications than mini‐laparotomy, but it requires more sophisticated expensive equipment and greater skills. Culdoscopy has higher rates of complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 19, 2004

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