Complex giant incisional hernia repair with intraperitoneal mesh: A case report
| Autor: | Rafael Palencia, Agustín E. Pinsak, René M. Palacios Huatuco |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Enterocutaneous fistula
Laparoscopic surgery medicine.medical_specialty Incisional hernia medicine.medical_treatment Case Report Intraperitoneal mesh Open surgery 03 medical and health sciences 0302 clinical medicine Laparotomy medicine Poor wound healing business.industry Composite mesh Incisional hernia repair General Medicine medicine.disease Surgery surgical procedures operative 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business Abdominal surgery Large incisional hernia |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Introduction and importance An incisional hernia is one of the most frequent complications after abdominal surgery, with an estimated incidence of 2–20% after midline laparotomy. They are often caused by poor wound healing. We present the case of a complex giant incisional hernia that was repaired by implanting an intraperitoneal mesh. Case presentation A 63-year-old man with obesity, hypertension, and multiple previous laparotomies, who developed a complex giant incisional hernia (xipho-pubic > 10 cm wide). An open technique repair was decided with the introduction of a large mesh (Parietex ™ Composite) in an intraperitoneal position, covering a 25 × 16 cm hernial ring. After two years, the patient continues to be followed due to a low-output distal enterocutaneous fistula. Clinical discussion Currently, there is no technique or approach that has become a gold standard for ventral incisional hernia repair. The introduction of an intraperitoneal mesh with two surfaces by laparotomy is recommended when there are contraindications for laparoscopic surgery, for example in obese patients, and patients with multiple previous laparotomies. However, it has been reported to be a complex technique with an enterocutaneous fistula rate of 0.3–4%. Conclusion The introduction of a composite mesh represents an alternative surgical technique for the repair of giant incisional hernias. Highlights • An incisional hernia is one of the most common complications of abdominal surgery. • Strengthening the abdominal wall requires the use of mesh. • There is no standard technique for ventral incisional hernia repair. • The introduction of an intraperitoneal mesh represents an alternative in complex giant hernias. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|