Kristen E Elstner, MBBS, MS1, John W Read, FRANZCR2, Peter H Cosman, FRACS2, Anita Jacombs, MBBS, PhD1, Omar Rodriguez-Acevedo, MBBS1, Nabeel Ibrahim, FRACS, FACS1. 1Hernia Institute Australia, Edgecliff, Australia, 2Macquarie University Hospital, Sydney, Australia
INTRODUCTION: Despite recent advances in the operative management of complex ventral hernia, these remain a significant challenge for surgeons. Closure of large defects in the unprepared abdomen can have serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. Certain features of complex ventral hernias make repair particularly technically challenging and time consuming, such as massive size of fascial defect, unusual hernia location, involvement of other abdominal wall structures, and previous tissue damage.
METHODS: An illustrative series of clinical cases will be used to provide an introduction to the repair of complex ventral hernias. Utilizing three-dimensional volume rendering CT imaging techniques, a step-by-step guide to the operative repair of a variety of complex ventral hernias will be presented.
RESULTS: Ventral hernias to be examined include traumatic hernias involving extensive tissue damage, massive ventral hernias with defects >20cm in width, hernias requiring additional procedures such as wiring of ribs, and hernias in difficult locations such as flank hernias. Specific techniques such as individually tailoring mesh size, transfascial mesh fixation and transcutaneous fascial defect closure will be discussed. All hernias in this series have been repaired laparoscopically or laparoscopic-open-laparoscopic (LOL) with transcutaneous fascial closure and intra-peritoneal mesh placement. There have been no hernia recurrences to date.
CONCLUSION: This series aims to offer a guide to the operative repair of unusual and complex ventral hernias.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80073
Program Number: P055
Presentation Session: Poster (Non CME)
Presentation Type: Poster
