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1、What is a Hernia?DEFECT IN THE FASCIAThe fascia is the strength layer surrounding the abdominal cavityA defect in that layer allows intra-abdominal contents(i.e.fat,intestines)to bulge through the defect.第1页/共14页Where Do Hernias Occur?Abdominal WallAt a previous surgical incisionAt the umbilicusAbov
2、e the umbilicus(epigastrium)In the inguinal region(groin)第2页/共14页Who Requires Treatment?Pain or DiscomfortEnlarging HerniasIntestinal ObstructionNausea,Vomiting,Abdominal DistentionIncarceration or StrangulationHernia Contents are trapped and painfulAbdominal Pain and/or a Painful BulgeBlood Supply
3、to trapped contents may be compromised第3页/共14页Preoperative Work-upEvaluation by SurgeonPhysical ExaminationCT ScanMay or may not be neededAt the discretion of the surgeon第4页/共14页Surgical TechniqueKey Components:Reduce the hernia contents“Patch”the defect in the fascia with MeshMesh is incorporated i
4、nto the abdominal wall by the bodyReinforces the defect in the fasciaSecure the Mesh to the abdominal wallPrevent movement of the mesh prior to incorporation第5页/共14页Laparoscopic Ventral Hernia10555Laparoscopic PortsHernia第6页/共14页Laparoscopic Inguinal Hernia105Laparoscopic PortsHerniaHernia5第7页/共14页V
5、entral Hernia Defect第8页/共14页Mesh Used to Patch Defect 第9页/共14页Mesh Secured to Abdominal Wall 第10页/共14页Completed Repair 第11页/共14页ComplicationsBleedingMesh InfectionInjury to Adjacent OrgansRecurrence第12页/共14页AdvantagesDecreased Wound ComplicationsPotentially,theorize decrease recurrences;exposes entire undersurface to identify small defects that lead to recurrencesLaparoscopic repair can diagnose the“Swiss cheese”herniasEffective modality for recurrent hernias that have been repaired anteriorly(Open)第13页/共14页感感谢您的您的观看。看。第14页/共14页