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Pyloromyotomy is a surgical procedure in which a portion of the muscle fibers of the pyloric muscle are cut. This is typically done in cases where the contents from the stomach are inappropriately stopped by the pyloric muscle, causing the stomach contents to build up in the stomach and unable to be appropriately digested.
Sleeve gastrectomy or vertical sleeve gastrectomy, is a surgical weight-loss procedure, typically performed laparoscopically, in which approximately 75 - 85% of the stomach is removed, [1] [2] along the greater curvature, [3] which leaves a cylindrical, or "sleeve"-shaped stomach the size of a banana.
A hypertrophic scar is a cutaneous condition characterized by deposits of excessive amounts of collagen which gives rise to a raised scar, but not to the degree observed with keloids. [1] Like keloids, they form most often at the sites of pimples, body piercings , cuts and burns.
When removal of a polyurethane band is involved (polyurethane was predominantly used in the 1980s and 90s), it likely has built substantial scar tissue that must also be removed, depending on how long since the VBG took place. Removal of the staples involves stitching back together the previously separated parts of the stomach.
Vertical pyloromyotomy scar (large) 30 hrs post-op in a one-month-old baby Horizontal pyloromyotomy scar 10 days post-op in a one-month-old baby Horizontal pyloromyotomy scar 35 years post-op in a three-month-old baby. Infantile pyloric stenosis is typically managed with surgery; [18] very few cases are mild enough to be treated medically.
Surgery can help alleviate skin contractures in the form of skin grafts and removal of hypertrophic scars. [8] [6] For hypertrophic scars, timing is important when considering surgery, as over time scars will mature and may show decreased contractures along with flattening, softening, and repigmentation without surgical intervention. [8]
Prevention of keloid scars in patients with a known predisposition to them includes preventing unnecessary trauma or surgery (such as ear piercing and elective mole removal) whenever possible. Any skin problems in predisposed individuals (e.g., acne, infections) should be treated as early as possible to minimize areas of inflammation.
The alkaline environment causes the retained gastric tissue to produce acid, which may result in ulcers in a rare complication known as retained antrum syndrome. All patients lose weight after gastrectomy, although the extent of weight loss is dependent on the extent of surgery (total gastrectomy vs partial gastrectomy) and the pre-operative BMI.