Staged Laparoscopic Ventral and Incisional Hernia Repair When Faced With Enterotomy or Suspicion of an Enterotomy
| Autor: | Patricia L. Turner, Anselm Tintinu, Wenceslaus Asonganyi |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Enterotomy Laparotomy medicine Humans Hernia Laparoscopy Contraindication Aged Aged 80 and over medicine.diagnostic_test business.industry Abdominal Infection General surgery General Medicine Middle Aged medicine.disease Hernia repair Hernia Ventral Endoscopy Surgery Intestinal Perforation Female business |
| Zdroj: | Journal of the National Medical Association. 104:202-210 |
| ISSN: | 0027-9684 |
| Popis: | Enterotomy is a significant complication of laparoscopic ventral or incisional hernia repair (LVHR) and can be devastating if missed. Enterotomy occurs in 2.6% of patients undergoing LVHR and is missed 21.8% of the time. Controversy exists regarding the management of known or potential enterotomies. Approaches for managing recognized enterotomies during hernia repair are usually employed immediately; in a nonstaged fashion; and include laparoscopic enterotomy repair with immediate LVHR, laparotomy for repair of enterotomy with concomitant LVHR, or conversion to laparotomy for both enterotomy and hernia repair. The staged approach for managing recognized or potential enterotomies is less commonly employed and involves lapa- roscopic repair of enterotomy, admission, and delayed but definitive laparoscopic hernia repair in the same hospitaliza- tion. The presence of known or potential enterotomies during LVHR presents a difficult problem and may be a contraindication for immediate placement of prosthetic because of increased risks posed for abdominal infection, reopera- tion, prosthetic removal, hernia recurrence, and death. The staged approach—with a 2- to 5-day delay—represents a safe solution to this challenging problem. We present 4 cases managed via staged approach due to an enterotomy, risk factors, and suspicion for missed or delayed enteroto- mies augmented by a review of the literature. |
| Databáze: | OpenAIRE |
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