Irving Jorge, MD, Victor Maciel, MD, Henry J Lujan, MD. Mount Sinai Hospital, Jackson South Community Hospital, Miami, FL
Objective: Recently, some authors have advocated closure of the hernia defect prior to mesh placement so as to recreate the abdominal wall. Advantages cited include increased mesh overlap, more physiologic repair, improved functional results, better cosmesis, less seroma, and decreased recurrence. We describe a simple way to close the hernia defect utilizing the Endostitch 10mm Suturing Device (Covidien, Norwalk, CT) during laparoscopic ventral hernia repair with mesh
Description and Methods: On select ventral hernias, we performed a primary approximation of the fascial edges of the hernia defect with the Endostitch device using 0 ethibond sutures. Several interrupted figure of eight sutures are placed with the Endostitch, and then, tied with a knot pusher to provide the appropriate tension. After closing the defect primarily, a mesh is placed and secured by using both trans-fascial suture and tack fixation. When suture closing the hernia defect, the pneumoperitoneum can be decreased as needed to assist in placing the sutures.
Preliminary Results: We have performed 4 laparoscopic ventral hernias with primary fascial approximation using the Endostitch device. We had previously been approximating the fascia using an extracorporeal technique with a suture passer. Defects closed with our new technique ranged from 2-4 cm in diameter. We found using the Endostitch device to be easier and faster. Short-term clinical results have been favorable.
Session: Emerging Technology Poster
Program Number: ETP030
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