<< Back to the abstract archive
Feasibility of Neurotized Abdominal Wall Transplantation, an Anatomic Study
Jacob Lammers DO, Nicholas Jarvis MD, Robert Siska MD, Daniel Bahat MD, Risal Djohan MD
Cleveland Clinic Foundation
2025-01-08
Presenter: Jacob Lammers DO
Affidavit:
certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The work represents original contributions by the resident, as reviewed and confirmed by the program director.
Director Name: Raymond Isakov
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Intro: Total abdominal wall transplantation (AWT) is an treatment for loss of domain after visceral transplantation. Rozen et al described the innervation to the rectus abdominus using nerve stimulation in patients undergoing autologous, abdominally based reconstruction, demonstrating multiple small nerve branches would contract small transverse segments of the muscle. Larger nerves (diameter ≥0.5 cm) could contract the entire width and 50-100% of the vertical length of the rectus muscle. In 18 of 20 cases, a large nerve at the arcuate line supplied the entire rectus muscle. We present the feasibility of neurotizing the abdominal wall musculature in AWT with a cadaver study.
Methods:
A cadaveric study was conducted on five specimens. The abdominal wall was dissected laterally bilaterally to find the innervating nerves from T7-L1. Caliper measurements were analyzed using ANOVA to evaluate variations in nerve diameters. Correlation analyses were performed to assess relationships between nerve dimensions and the potential for effective neurotization.
Results:
3 cadavers were female. 2 were male. The average age and height was 84 and 66 inches, respectively. No significant differences between the nerve diameters between the cadavers were found (p = 0.26). The average nerve size per level from T7-L1 was 1.9 mm, 1.6mm, 1.8 mm, 1.6 mm, 1.8 mm, 2.0 mm, and 1.5 mm.
Conclusion:
Our anatomical study is consistent with previous studies in showing that a larger nerve is found at the level of the arcuate line (T12) and according to previous data, neurotization at this level should support an AWT.
