Laparoscopic Ventral Hernia Repair

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS
  • Any ventral hernia that could be repaired by using an open tension-free mesh repair
CONTRAINDICATIONS
  • Poor cardiorespiratory function
  • Inability to tolerate general anesthesia
  • Relative contraindications for laparoscopic repair of ventral hernias:
      • Previous intraperitoneal mesh
      • Incarcerated hernias
      • Active wound infection or open wound on abdomen
      • Loss of abdominal domain
EQUIPMENT
  • Anesthetic unit
  • Operating table
  • Instrument table
  • Laparoscopic unit
  • Two monitors
ANATOMY
  • Lateral abdominal wall: Three different muscular layers; superficial to deep: external oblique, internal oblique, and transversus abdominis
  • Anterior abdominal wall: Rectus abdominis muscles
  • Rectus sheath: Aponeurosis of lateral muscles around rectus abdominis
  • Arcuate line: Point below which the posterior rectus sheath is absent, located 3 to 6 cm below the umbilicus

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Clear liquid diet, advance to a regular as tolerated
  • Early ambulation
  • Pain control
  • Pulmonary toilet
COMPLICATIONS
  • Ileus
  • Seroma
  • Suture site pain
  • Bleeding
  • Missed or delayed bowel injury
  • Recurrence
RESULT ANALYSIS
  • Several comparative studies of laparoscopic and open ventral hernia repair suggest that laparoscopic incisional hernia repair results in fewer postoperative complications, a lower infection rate, and decreased hernia recurrence.
  • Unlike most laparoscopic procedures, laparoscopic ventral hernia repair is more painful than expected.
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