By Michael J. Rosen MD FACS
Atlas of stomach Wall Reconstruction, edited through Michael J. Rosen, bargains finished insurance at the complete variety of stomach wall reconstruction and hernia fix. grasp laparoscopic maintenance, open flank surgical procedure, mesh offerings for surgical fix, and extra with top quality, full-color anatomic illustrations and scientific intra-operative photos and video clips of approaches played by means of masters. In print and on-line at www.expertconsult.com, this certain atlas presents the transparent assistance you must take advantage of powerful use of either in general played and new and rising surgical strategies for stomach wall reconstruction.
- Tap into the event of masters from video clips demonstrating key moments and strategies in stomach wall surgery.
- Manage the whole variety of remedies for stomach wall problems with assurance of congenital in addition to bought problems.
- Get a transparent photo 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 easiest present details at the variety of fabrics on hand for surgical repair.
- Access the absolutely searchable contents and movies on-line at www.expertconsult.com.
Master quite often played in addition to new and rising surgical strategies for stomach wall reconstruction
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Additional resources for Atlas of Abdominal Wall Reconstruction
3-1). A careful preperitoneal dissection provides the needed landmarks for appropriate fixation to lessen the chance of postoperative recurrence. 2. Subxiphoid Hernia 42 s I dentification of the costal margins and xiphoid process provide the laparoscopic bounds of transabdominal fixation for repair of subxiphoid hernias (Fig. 3-2). Generous overlap of the mesh over the diaphragm helps provide adequate coverage of the fascial defect in lieu of superior fixation. Chapter 3 • Laparoscopic Repair of Atypical Hernias: Suprapubic, Subxiphoid, and Lumbar 43 Rectus muscles Inferior epigastric vessels Medial umbilical folds Inguinal ligament Median umbilical ligament Symphysis pubis Cooper’s ligaments Round ligament Bladder Peritoneum External iliac vessels Figure 3-1.
Pearls/Pitfalls s atients with poor skin quality should not be offered a laparoscopic ventral hernia repair. P Many times the adhesions to the underlying fat or viscera provide blood supply to the compromised skin. Skin loss may result postoperatively, leaving the mesh exposed. s Leakage of gas at a trocar site or trocars that repeatedly fall out during a prolonged case can be quite frustrating. Replacing the leaking or loose trocar with a balloon-tipped trocar to reestablish a seal against the abdominal wall can save significant time and insufflation gas.
S Several safe methods for initial access have been described. A cut-down technique works very well. Through a small incision in the upper quadrant, each layer of the abdominal wall is divided down to the peritoneum. The peritoneum can be sharply entered with a scalpel or bluntly penetrated with the finger to gain safe access to the abdominal cavity. The optical trocar can be used safely in the upper quadrant just below the rib line as well. Some surgeons prefer the Veress needle. The best technique is the one the surgeon is most comfortable and familiar with.