V-053 USE OF HYBRID LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY (LIRA-TECHNIQUE) IN COMPLEX VENTRAL HERNIAS
| Autor: | E Licardie, G Eleuterio, L Navarro, A Bellido, J Suárez-Grau, S Morales-Conde |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | British Journal of Surgery. 109 |
| ISSN: | 1365-2168 0007-1323 |
| Popis: | Aim The hybrid approach (HA) to ventral hernias (VH), combining the laparoscopic and open approaches, is not very common at present. The great contribution of this approach is that it combines the advantages of the minimally invasive approach with the advantages of the open approach, making it possible to correct aesthetic defects and major skin and subcutaneous problems. Material & Methods 40-year-old-man with previous surgery for supraumbilical hernia, with placement of a supraaponeurotic mesh with hernia recurrence and chronic infection with a meshoma. Physical examination revealed VH of 5–8cm in transverse diameter and 10cm in vertical diameter. A CT-scan showed a 6.5cm transverse supraumbilical recurrent hernia with a fatty content. Results A laparoscopic approach was performed, revealing an 8×8cm supraumbilical defect in the abdominal cavity with no adhesions. A midline repair was performed according to the principles of the LIRA technique by performing a posterior fascial flap 2cm above the edges of the defect: the midline was reinforced with a loop-suture. An intra-abdominal mesh was placed and fixed with tackers and fibrin glue. In the open procedure, the chronic sinus, meshoma, excess skin and hernial sac were removed. Conclusions The treatment of complex abdominal hernias is a field in constant evolution. The HA aims to solve the skin problems associated with laparoscopic repairs alone. The use of intraperitoneal on-lay meshes combined with the use of open approach for excision of the sac and remaining skin tissue allows a complete and effective treatment of complex hernias. |
| Databáze: | OpenAIRE |
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