腹腔镜疝修补术英文.pptx

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 umbilicusAbove 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 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 into 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Ventral 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