Using the Alfapump® to control ascites enabling elective umbilical hernia repair: A case report
Natasha A Sioda1, Hugo E Vargas2, Jill L Weidknecht3
1Department of General Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA. sioda.natasha@mayo.edu.
Summary
Umbilical hernia repair is challenging with refractory ascites. The alfapump® device controlled ascites in one patient, enabling successful hernia repair without complications.
Area of Science:
- Abdominal Surgery
- Gastroenterology
- Medical Devices
Background:
- Medically refractory ascites presents significant challenges for surgical interventions like umbilical hernia repair.
- Optimizing ascites control preoperatively is crucial for improving post-operative outcomes in these patients.
Purpose of the Study:
- To present a case where the alfapump® device was used to manage medically refractory ascites.
- To demonstrate the feasibility of performing elective umbilical hernia repair after alfapump® implantation.
Main Methods:
- A 70-year-old male patient with medically refractory ascites and a recurrent symptomatic umbilical hernia underwent alfapump® implantation.
- The patient's ascites was managed post-implantation, followed by a robotic umbilical hernia repair.
Main Results:
- The alfapump® effectively controlled the patient's ascites during outpatient follow-up.
- The patient successfully underwent robotic umbilical hernia repair without recurrence or complications.
Conclusions:
- Managing medically refractory ascites is a significant surgical challenge.
- The alfapump® may serve as a viable option for controlling ascites, facilitating elective hernia repair.
Related Concept Videos
01:02Long-patch Base Excision Repair
Since the discovery of the two BER pathways, there has been a debate about how a cell chooses one pathway over the other and the factors determining this selection. Numerous in vitro experiments have pointed out multiple determinants for the sub-pathway selection. These are:
01:34ATP Driven Pumps II: P-type Pumps
The P-type pumps are a large family of integral membrane transporter ATPases. They are divided into five major types based on substrate specificity, from I to V.
A typical P-type pump has three cytosolic domains: nucleotide-binding (N), phosphorylation (P), and activator (A) domains. These domains are connected to the membrane-spanning helices by short amino acid segments. ATP hydrolysis and covalent phosphoenzyme intermediate formation are crucial parts of the catalytic cycle. At the highly...
A typical P-type pump has three cytosolic domains: nucleotide-binding (N), phosphorylation (P), and activator (A) domains. These domains are connected to the membrane-spanning helices by short amino acid segments. ATP hydrolysis and covalent phosphoenzyme intermediate formation are crucial parts of the catalytic cycle. At the highly...
01:30ATP Driven Pumps III: V-type Pumps
V-type pumps are ATP-driven pumps found in the vacuolar membranes of plants, yeast, endosomal and lysosomal membranes of animal cells, plasma membranes of a few specialized eukaryotic cells, and some prokaryotes. They are also known as the V1Vo-ATPase, that couple ATP hydrolysis to transport protons against a concentration gradient.
The peripheral or cytosolic V1 domain with eight subunits is involved in ATP hydrolysis. The integral or transmembrane V0 domain containing at least five subunits...
The peripheral or cytosolic V1 domain with eight subunits is involved in ATP hydrolysis. The integral or transmembrane V0 domain containing at least five subunits...
01:28Bioreactor Controls-I
Maintaining optimal conditions within fermenters is essential for maximizing microbial productivity and ensuring process efficiency. This lesson focuses on key parameters—temperature, foam, pH, carbon dioxide, oxygen, and pressure—and their precise measurement and control strategies in fermentation systems.Temperature ControlTemperature regulation is critical due to the exothermic nature of many fermentation processes. In small laboratory fermenters, temperature is commonly monitored using...