TY  - CHAP
M1  - Book, Section
TI  - Repair of Ventral Hernia, Laparoscopic
A1  - Ellison, E. Christopher
A1  - Zollinger, Jr., Robert M.
A1  - Pawlik, Timothy M.
A1  - Vaccaro, Patrick S.
A1  - Bitans, Marita
A1  - Baker, Anthony S.
PY  - 2022
T2  - Zollinger’s Atlas of Surgical Operations, 11e
AB  - Ventral  hernias  in  the  anterior  abdominal  wall  include  both  spontaneous  or  primary  hernias  (e.g.,  umbilical,  epigastric,  and  spigelian)  and,  most  commonly,  incisional  hernias  after  an  abdominal  operation.  Small  primary  ventral  hernias  less  than  1  cm  in  diameter  are  often  closed  successfully  with  primary  tissue  repairs.  However,  larger  ones  have  a  recurrence  rate  of  up  to  30%–40%  when  a  tissue  repair  alone  is  performed.  It  is  estimated  that  up  to  40%  of  all  abdominal  operations  result  in  an  incisional  hernia.  This  explains  the  predominance  of  such  hernias.  The  use  of  mesh  has  revolutionized  the  repair  of  abdominal  wall  hernias,  affording  patients  decreased  recurrence  in  the  long  term.  The  development  of  dual-sided  mesh  has  allowed  for  intraperitoneal  placement  posterior  to  the  hernia  defect.  These  meshes  present  an  intraperitoneal  surface  to  minimize  adhesions  and  a  bare  side  for  adherence  and  incorporation  into  the  peritoneum  and  posterior  abdominal  wall.  The  dual-sided  meshes  can  be  placed  laparoscopically  for  many  ventral  hernias,  but  very  large  hernias  or  those  associated  with  extensive,  dense  intra-abdominal  adhesions  (e.g.,  peritoneal  dialysis,  prior  peritonitis,  multiple  previous  prostheses)  are  relative  contraindications.  The  main  advantage  of  laparoscopic  ventral  hernia  repair  is  reduced  surgical-site  infections.  Patients  should  be  counseled  to  expect  seroma  formation  that  usually  resolves  with  time.  Finally,  laparoscopic  repair  enables  the  detection  and  repair  of  multiple  defects—a  common  finding  in  midline  incisional  hernias.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/25
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1187822938
ER  -