Atlas of Abdominal Wall Reconstruction by Michael J. Rosen MD FACS

By Michael J. Rosen MD FACS

Atlas of belly Wall Reconstruction, edited by way of Michael J. Rosen, deals finished insurance at the complete diversity of stomach wall reconstruction and hernia fix. grasp laparoscopic maintenance, open flank surgical procedure, mesh offerings for surgical fix, and extra with top of the range, full-color anatomic illustrations and medical intra-operative images and movies of systems played by way of masters. In print and on-line at www.expertconsult.com, this exact atlas presents the transparent suggestions you must take advantage of powerful use of either quite often played and new and rising surgical ideas for stomach wall reconstruction.

  • Tap into the adventure of masters from movies demonstrating key moments and strategies in stomach wall surgery.
  • Manage the whole diversity of remedies for belly wall issues with assurance of congenital in addition to received problems.
  • Get a transparent photograph of inner buildings because of top of the range, full-color anatomic illustrations and medical intra-operative photographs.
  • Make optimum offerings of surgical meshes with the simplest present details at the variety of fabrics to be had for surgical repair.
  • Access the absolutely searchable contents and movies on-line at www.expertconsult.com.

Master generally played in addition to new and rising surgical ideas for belly wall reconstruction

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Sample text

If the previous mesh contains a polypropylene or polyester component that becomes directly exposed to the bowel, there is not a plane of dissection. Attempts to mobilize the bowel off the adherent mesh will result in an enterotomy. In this situation, the mesh should be cut down off of the abdominal wall, leaving a swatch of prosthetic attached to the bowel (Fig. 2-5). Certainly, conversion to open is mandatory, if there is any concern for a bowel injury. Some cases of intense adhesion formation to the prosthetic may require a bowel resection.

This often can be done with electrosurgical current; however, meticulous hemostasis should be confirmed at the conclusion of this step (Figs. 3-11 and 3-12). s The mesh is fixated just below the costal margins bilaterally and allowed to drape generously over the diaphragm (Fig. 3-13). If the defect abuts the xiphoid process, adequate overlap can be challenging. We do not suture around ribs because of the risk of severe chronic pain, nor do we advocate placing tacks above the costal margin because of the risk of pericardial injury.

Pearls/Pitfalls s  atients must understand the potential risks associated with these repairs. A complete disP cussion of the potential outcomes and management strategies for any neurovascular injury is paramount. s The decision to mobilize the preperitoneal space in the laparoscopic repair of suprapubic hernias should be made preoperatively to ensure that adequate equipment and expertise are available for success. Unlike mobilization of the preperitoneal space during laparoscopic transabdominal preperitoneal inguinal hernia repair, this maneuver can be very difficult in the repair of suprapubic hernias.

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