This is particularly true if previous synthetic mesh repair has been attempted. This is an alternative technique to the therapeutic arsenal. Jose Gerilherme minossi, carlos antonio caramori, celso viera de sanza leite, leriz eduardo nausse. Find articles by Richard H. Unfortunately, comparing reported results is difficult and potentially misleading due to significant variations in terminology, patient selection and the operative technique employed. Annals of Surgery ; 4: Please review our privacy policy.

Gaspar de Jesus Lopes Filho. Open in a separate window. The presence of seroma was considered as the main outcome. Anatomical depiction of the triangle of Petit from the thesis view. The high density mesh with micropores presents lower risk of mesh-tissue adhesion but it presents encapsulation risk and foreign body reaction, it results in less integration of the mesh to the tissue and can lead to chronic pain. Seroma in laparoscopic ventral hernioplasty. Discussion Incisional hernia repair still poses a challenge to surgeons as a function of its high rate of complications, among which seroma and surgical wound infection stand out 2.

Twelve-year experience with expanded polytetrafluoroethylene in the repair of abdominal wall defects. We council our patients preoperatively that in the event of a difficult adhesiolysis and enterotomy repair, there may be a need to abandon patch placement and that this may result in a higher chance of recurrence. Heavy weight meshes have a larger surface area and they produce more intense foreign body reaction.

incisional hernia thesis

Operative Technique As with the open repair, there is still significant variation in patch material selection, in the description of patch fixation to the abdominal wall and in the amount of patch overlap to the defect Table 6.

The three recurrences reported herein are used to emphasize key steps in surgical technique that we feel will have an impact on the success of LIVH. In fact, some reports include different closure techniques and even different patch materials inciaional their cases.


The most widely used procedure to prevent seroma formation consists of the placement of drains in the subcutaneous tissue; thdsis, several studies indicated that drains not only fail to prevent hernai formation but may even increase the risk of infection 34. Two recent reports on monopolar electrosurgery highlight the problem of dissection of adhered bowel loops away from the abdominal wall.

Seroma in laparoscopic ventral hernioplasty. Long-term complications associated with prosthetic repair of incisional hernias. This is particularly true if previous synthetic mesh repair has been attempted. She is without recurrence at 22 months. Discussion Some features are important when choosing the adequate kind of mesh.


The skin was sutured with a continuous suture of polyamide 4. Equipment needed for TAP block ultrasound probe not shown. Use of progressive tension sutures in components separation: Hernia Apr;19 2: Outcomes All the participants were clinically assessed by the attending staff to detect postoperative complications, seroma formation and surgical site infection, especially on postoperative PO days one, three, five, seven, and Share Email Print Feedback Close.

Most common presenting complaint was midline infra-umbilical swelling with cough impulse and reducibility positive.

Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial

The tacks had pulled out in many locations, with the mesh completely disrupted into the hernia defect. South medical journal,Vol. Unfortunately, comparing reported results is difficult and potentially misleading due to significant variations in terminology, patient selection and the operative technique employed. Ventral hernia, Laparoscopy, Laparoscopic surgical procedures, Minimally invasive surgery. Paper 1 Laparoscopic wall hernia repair: The participants were randomised immediately after mesh fixation by a computer-based random number generator and incisiobal to the two intervention groups.


The results of the inferential comparison hermia that both group 1 drains and group 2 progressive tension sutures exhibited the same profile Table 1.

Some authors, such as Thesi C, highlights the importance of fixing the mesh to the aponeurosis with running sutures of absorbable polyglactin to prevent the formation of dead space and complications The data was collected and analyzed. Surgical Clinics of North America: Individuals with primary or recurrent incisional hernia were assessed at HUOP, and those with longitudinal or transverse ventral hernia secondary to a previous surgical incision, measuring 5 to 15 cm after dissection thessis the hernial sac and classified as large or very large according to Chevrel’s classification, were considered to be eligible Lucky On Thirteenth Attempt!

incisional hernia thesis

This represents one of the three recurrences. Clinical seroma was defined as a visible bulge or fluctuation without signs of infection, subclinical seroma was defined as the absence of detectable abnormalities on physical examination but the presence of any volume of fluid collection on abdominal wall ultrasound, and seroma was defined as all occurrences of fluid collection detected on ultrasound. How these factors specifically influence complication rates and overall outcomes is largely undetermined.

The material was processed to be included in paraffin, and histological cuts of 5. Chevrel technique for midline incisional hernia: