Adhesions between the hernia contents and the sac are sharply divided, using a minimal energy source to decrease the risk of bowel injury. Following adhesiolysis, the bowel should be thoroughly examined for injuries. An unrecognized enterotomy can result in severe consequences.
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Once the hernia contents have been reduced, detached and examined for injuries, the extent of the defect is assessed. External palpation combined with internal visualization can be used to assess the defect size and location externally to the abdomen.
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