c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Laparoscopic Ventral Hernia Repair: 1

A D V E R T I S E M E N T

   
 

Moderate to large size abdominal wall hernias can be a challenge to repair. Incisional hernias and recurrent hernias often present with complex "Swiss cheese" defects. Primary repair of even moderate size defects has a high recurrence rate due to tension, and patch repair in contact with abdominal viscera has historically been complicated by adhesion formation and enteric fistulae. Newer material such as expanded polytetrafluoroethylene (ePTFE) combined with laparoscopy may offer better prospects for a safe, lasting repair.     

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Laparoscopic Ventral Hernia Repair: 2

A D V E R T I S E M E N T

   
 

Insufflation should be done as far as possible from the hernia defect, usually between mid-clavicular and anterior axillary line for central defects. Although some surgeons insufflate the abdomen using the Veress needle as shown here, the possibility of adhesions putting the bowel at increased risk may make the Hassan open technique more prudent.      

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Laparoscopic Ventral Hernia Repair: 3

A D V E R T I S E M E N T

   
 

A 10 mm port is used for the camera (30 or 45 degree scope) and for introducing the patch, and two 5 mm ports may suffice. Additional ports may be placed as needed.       

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This page was last modified on 3/21/2000.