1、Laparoscopic Hernia Repair:Incisional / Ventral and InguinalWhat is a Hernia? DEFECT IN THE FASCIA The fascia is the strength layer surrounding the abdominal cavity A defect in that layer allows intra-abdominal contents (i.e. fat, intestines) to bulge through the defect.Where Do Hernias Occur? Abdom
2、inal Wall At a previous surgical incision At the umbilicus Above the umbilicus (epigastrium) In the inguinal region (groin)Who Requires Treatment? Pain or Discomfort Enlarging Hernias Intestinal Obstruction Nausea, Vomiting, Abdominal Distention Incarceration or Strangulation Hernia Contents are tra
3、pped and painful Abdominal Pain and/or a Painful Bulge Blood Supply to trapped contents may be compromisedPreoperative Work-up Evaluation by Surgeon Physical Examination CT Scan May or may not be needed At the discretion of the surgeonSurgical Technique Key Components: Reduce the hernia contents “Pa
4、tch” the defect in the fascia with Mesh Mesh is incorporated into the abdominal wall by the body Reinforces the defect in the fascia Secure the Mesh to the abdominal wall Prevent movement of the mesh prior to incorporationLaparoscopic Ventral Hernia10555Laparoscopic PortsHerniaLaparoscopic Inguinal
5、Hernia105Laparoscopic PortsHerniaHernia5Ventral Hernia DefectMesh Used to Patch Defect Mesh Secured to Abdominal Wall Completed Repair Complications Bleeding Mesh Infection Injury to Adjacent Organs RecurrenceAdvantages Decreased Wound Complications Potentially, theorize decrease recurrences; exposes entire undersurface to identify small defects that lead to recurrences Laparoscopic repair can diagnose the “Swiss cheese” hernias Effective modality for recurrent hernias that have been repaired anteriorly (Open)
