RT Book, Section A1 Seymour, Neal E. A1 Bell, Robert L. A2 Brunicardi, F. Charles A2 Andersen, Dana K. A2 Billiar, Timothy R. A2 Dunn, David L. A2 Hunter, John G. A2 Matthews, Jeffrey B. A2 Pollock, Raphael E. SR Print(0) ID 1117751390 T1 Abdominal Wall, Omentum, Mesentery, and Retroperitoneum T2 Schwartz's Principles of Surgery, 10e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071796743 LK accesssurgery.mhmedical.com/content.aspx?aid=1117751390 RD 2024/10/03 AB There are important anatomic differences in the rectus sheath structures above and below the arcuate line. The laminae of the internal oblique, which contribute to both the anterior and (along with the transversus abdominis) posterior rectus above the arcuate line, only contribute to the anterior sheath below the arcuate line. There is no aponeurotic posterior covering on the lower portion of the rectus muscles.Rectus diastasis is associated with abdominal wall bulging consequent to separation of the rectus abdominis muscles in the midline. It does not represent a hernia, and surgical interventions for this condition are of questionable, if any, clinical benefit.When resection of abdominal wall desmoid tumors is undertaken, it must be recognized that failure to achieve negative margins is associated with an extremely high risk of local recurrence of the tumor.Primary repair of ventral incisional hernias is associated with unacceptably high failure rates, and repair using other approaches, such as use of prosthetic mesh, is preferred.The addition of the closed videoscopic technique to components separation procedures has been associated with a significant decrease in the incidence of local wound complications.Potential benefits of laparoscopic incisional hernia repairs compared to open repairs with mesh include shorter hospitalization, lower risk of wound complications, and better abdominal wall function. A lower recurrence rate benefit remains controversial.Surgical treatment of sclerosing mesenteritis is most often undertaken to confirm diagnosis and to rule out neoplasm as the cause of a mesenteric mass. Resection possibilities are limited by the extensiveness of the process as well as by the questionable benefit in most cases.Potential surgical interventions in retroperitoneal fibrosis include operative biopsy to rule out neoplasm, ureteral stent placement, open or laparoscopic ureterolysis, and endovascular interventions for iliocaval occlusion.