A 67 yrs old lady who underwent LAR for Rectal Ca 10 days ago came back because "guts came out of the place where the rubber tape was before". Upon examination this very unusual finding was seen.
A. Transillumination and finger depression of the abdominal wall confirm juxtaposition of the inflated stomach and the anterior abdominal wall. B. The site selected will generally be approximately halfway between costal margin and umbilicus.
Method of mesh fixation with a suture passer. Use the suture passer to introduce the suture through the musculofascial layer, the mesh, and then back out through all layers as a mattress suture. Use four to eight mattress sutures to anchor the mesh, depen
Sagittal view of extraperitoneal dissection. A space is developed between peritoneum and abdominal wall. Note that the bladder is mobilized downward.
Surgeon using nondominant (left) hand to palpate the head of the stapler/tacking device through the anterior abdominal wall, thus verifying stapler/tacking device position relative to external landmarks and providing counterpressure.