Hernia Content Review Reviewer Name* Title*Copy and Paste the title of this activity. HiddenInventory ID Number Hiddentype Access Instructions To access this video, visit the site below and log in with the following credentials: username:sagesreview password:foregut Leave the Institution ID blank Access Instructions To access this video, visit the site below and log in with your sages.org account: Please review this content item based on the Hernia Pathway Goals and Objectives . HiddenIs this content relevant to the Foregut Masters Pathway* Relevant Somewhat Relevant Not Relevant HiddenIs this content relevant to any of the below Masters Pathways?*Select all that apply Acute Care Surgery Bariatric Biliary Colorectal Flexible Endoscopy Hernia Leadership & Professional Development Liver Pancreas Robotics Difficulty Level*Select the level to which this content applies. Select All that Apply. Select All Competency: Equip the surgeon with the requisite knowledge of preoperative patient considerations, intraoperative surgical options, technical skills, and post-operative issues related to MIS ventral hernia repair Proficiency Level: Equip the surgeon with the requisite knowledge of the anatomical and other patient considerations to perform MIS inguinal hernia repair Mastery Level: Equip the surgeon with the requisite knowledge of preoperative patient considerations, intraoperative surgical options, technical skills, and post-operative issues related to MIS repair of recurrent or atypical abdomenal hernias Competency LevelCompetency Goals*Select whether the content relates to either Goal or Objective topics. Select All the Apply. Select All Pre-operative patient selection: Equip the surgeon with the requisite knowledge of the anatomical and other preoperative patient considerations to plan an MIS ventral hernia repair Pre-operative procedure selection: Provide the surgeon with an in-depth knowledge of the current surgical options for MIS ventral hernia repair Intra-Op: Demonstrate the necessary knowledge and skills to perform an MIS ventral hernia repair Post-Op: Manage post operative issues in MIS ventral hernia patients Competency Level: Pre-Operative Patient Selection Objectives*Select the objectives covered by this content. Select All the Apply. Select All Identify the key anatomic landmarks of the anterior abdominal wall Given a hernia location, name anatomic structures that may be encountered when dissecting to achieve adequate mesh overlap Identify patient-related conditions or comorbidities that may make MIS repair favorable over other modalities. Competency Level: Pre-operative Procedure Selection Objectives*Select the objectives covered by this content. Select All the Apply. Select All Describe the different anatomic planes in which mesh can be placed during an MIS ventral hernia repair List considerations that influence selection of an appropriate plane for mesh placement Describe the major categories of mesh (biologic, permanent, composite, and heavy/medium/lightweght), along with the major advantages or disadvantages of each Describe the available options for mesh fixation in MIS ventral hernia repair Competency Level: Intra-Op Objectives*Select the objectives covered by this content. Select All the Apply. Select All List options for peritoneal access when performing an MIS ventral hernia repair, given a spescific hernia location and patient operative history Describe strategies for safe adhesiolysis including the use of surgical energy Describe techniques for primary fascial closure of the defect Calculate an appropriate mesh size for a given defect Outline key operative steps for an MIS ventral hernia repair with mesh in the intraperitoneal onlay (IPOM) position Competency Level: Post-Op Objectives*Select the objectives covered by this content. Select All the Apply. Select All Describe the causes and management of acute post-operative pain vs chronic post-hernia pain Describe the diagnosis and management of a post-operative seroma Describe the diagnosis and management of a post-operative hematoma Describe the diagnosis and management of a post-operative mesh infection Proficiency LevelProficiency Goals*Select whether the content relates to either Goal or Objective topics. Select All the Apply. Select All Pre-Op: Equip the surgeon with the requisite knowledge of the anatomical and other pre-operative patient considerations to perform MIS inguinal hernia repair Intra-Op: Assist the surgeon in acquiring the required knowledge and operative skills to perform MIS inguinal hernia repair Post-Op: Manage post-operative issues in MIS inguinal hernia repair Proficiency Level: Pre-Op Objectives*Select the objectives covered by this content. Select All the Apply. Select All List at least 1 absolute contraindication to MIS inguinal hernia repair List at least 9 patient factors that increase the technical difficulty of MIS inguinal hernia repair Describe the equipment necessary for performance of MIS inguinal hernia repair Describe a strategy for choosing between TAPP and TEP inguinal hernia repair for an individual patient List at least 4 key components of the informed consent for MIS inguinal hernia repair Proficiency Level: Intra-Op Objectives*Select the objectives covered by this content. Select All the Apply. Select All Identify at least 7 key anatomic landmarks during performance of MIS inguinal hernia repair Explain the borders of dissection required to obtain a "critical view" during MIS inguinal hernia repair Describe at least 3 key features of the implant used for MIS inguinal hernia repair Describe the appropriate room layout, patient positioning, and port placement for MIS inguinal hernia repair Describe the location and extent of the initial peritoneal incision for TAPP inguinal hernia repair Explain at least 1 technique for mesh placement and fixation List at least 3 options for peritoneal flap closure during TAPP inguinal hernia repair Describe the anatomic locations of direct, indirect, femoral, and obturator hernias Explain the technique for dissection and reduction of the hernia sac for direct, indirect, femoral, and obturator hernias Explain a strategy for the technical management of the following scenarios during MIS inguinal hernia repair:intra-operative bleeding, bowel injury, bladder injury, large hernia sac, incarcerated contents, peritoneal tear during TEP Repair, inability to obtain peritoneal coverage of the mesh during TAPP repair Proficiency Level: Post-Op Objectives*Select the objectives covered by this content. Select All the Apply. Select All List at least 3 patient factors that increase the risk of post-operative complications following MIS inguinal hernia repair Describe the use of an ERAS protocol for post-operative management following MIS inguinal hernia repair Describe a strategy for the post-operative management of seroma or hematoma List at least 2 risk factors for post-operative urinary retention following MIS inguinal hernia repair Describe a strategy for management of post-operative mesh infection Explain the diagnostic workup for suspected recurrent inguinal hernia Compare and contrast acute versus chronic post-operative groin pain, and list at least 2 causes for each Describe a strategy for management of chronic groin pain following MIS inguinal hernia repair Mastery LevelMastery Goals*Select whether the content relates to either Goal or Objective topics. Select All the Apply. Select All Pre-Op: Equip the surgeon with the requisite knowledge of the anatomical and other preoperative patient considerations to perform MIS repair of recurrent or atypical abdomenal hernia Intra-Op: Assist the surgeon in acquiring the required knowledge and operative skills to perform MIS repair of recurrent or atypical abdomenal hernia Post-Op: Manage post-operative issues in MIS repair of recurrent or atypical abdominal hernia Mastery Level: Pre-op Objectives*Select the objectives covered by this content. Select All the Apply. Select All Identify the key anatomic landmarks of the anterior abdominal wall Given an atypical hernia location, name anatomic structures that may be encountered when dissecting to achieve adequate mesh overlap Identify patient-related conditions or comorbidities that may make MIS repair the preferred approach Understand how prior operative techniques that have been employed, as well as location of prior mesh placement may affect the choice of operative approach List considerations that influence the selection of open versus MIS approach Describe the different anatomic planes in which mesh can be placed during an MIS recurrent or atypical ventral hernia repair Describe the key features of biomaterials used for hernia repair Describe the characteristics of (permanent and non-permanent) barrier-coated mesh Compare the characteristics of heavyweight, medium weight, and lightweight synthetic materials Mastery Level: Intra-op Objectives*Select the objectives covered by this content. Select All the Apply. Select All Given a hernia location and patient operative history, describe the process for safe and effective peritoneal access if utilizing MIS approach Given a clinical scenario and a planned mesh location, identify an appropriate biomaterial to use for repair Outline the key operative steps required to perform an atypical or redo hernia repair Describe the pros and cons of partial versus complete mesh removal of previously placed mesh at the time of redo hernia repair Given a defect size, calculate an appropriate mesh size to achieve adequate overlap to minimize recurrence Describe management strategies where primary defect closure may not be successful Describe the available options for mesh fixation in atypical or redo hernia repair Describe anatomic limitations for mesh fixation in atypical hernia repairs List the evidence-based pros and cons for available options for mesh fixation in atypical or redo hernia repair Given a clinical scenario, identify the need to alter the approach or convert to an open procedure Mastery Level: Post-op Objectives*Select the objectives covered by this content. Select All the Apply. Select All Describe the causes and management of acute post-operative pain vs chronic post-hernia pain Describe the diagnosis and management of a pos-toperative seroma Describe the diagnosis and management of a post-operative hematoma Describe the diagnosis and management of a post-operative mesh infection General CommentsPlease list any general comments regarding this content.EmailThis field is for validation purposes and should be left unchanged.