Laparoscopic ventral hernia repair with mesh
PREOPERATIVE DIAGNOSIS
Ventral hernia.
POSTOPERATIVE DIAGNOSIS
Ventral hernia.
PROCEDURE
Laparoscopic ventral hernia repair with mesh.
ANESTHESIA
General.
ESTIMATED BLOOD LOSS
Minimal.
COMPLICATIONS
None.
DISPOSITION
To the PACU in stable condition.
OPERATIVE NOTE
The patient was brought to the operative suite, placed supine on operating table. After adequate general anesthesia had been achieved, the abdomen is prepped and draped in usual sterile fashion. Then, using a #15 blade, a mid abdominal incision was made and a Veress needle was inserted. The abdomen was then insufflated with CO2 to create a pneumoperitoneum and then a 5 mm bladeless trocar was inserted to the abdomen using the laparoscope in the right upper quadrant. With laparoscope inserted, four additional trocars were inserted to the abdomen under direct visualization, two in left upper quadrant, one in the right lower quadrant and one 12 mm trocar in the right mid abdomen laterally. Then, attention was turned to the anterior abdominal wall. There was noted to be a ventral hernia containing omentum. There was no evidence of bowel involvement. The omental adhesions were then taken down using the Sonicision. Once this was completed, an 8 inch round Ventralight mesh was introduced into the abdomen and then the balloon for the mesh was inflated and the mesh was then secured over the hernia defect and covered the anterior abdominal wall. The mesh covered more than 4-5 cm circumferentially around the defect and once the mesh was in proper position, and appropriately tacked with the absorbable tackers, the balloon was removed. Then, the pneumoperitoneum was released and the skin incision were then all closed with staples. Sterile dressings were applied. The needle, sponge, instrument counts were correct at the end of the case. The patient tolerated the procedure well and transferred to the PACU in stable condition.
Ventral hernia.
POSTOPERATIVE DIAGNOSIS
Ventral hernia.
PROCEDURE
Laparoscopic ventral hernia repair with mesh.
ANESTHESIA
General.
ESTIMATED BLOOD LOSS
Minimal.
COMPLICATIONS
None.
DISPOSITION
To the PACU in stable condition.
OPERATIVE NOTE
The patient was brought to the operative suite, placed supine on operating table. After adequate general anesthesia had been achieved, the abdomen is prepped and draped in usual sterile fashion. Then, using a #15 blade, a mid abdominal incision was made and a Veress needle was inserted. The abdomen was then insufflated with CO2 to create a pneumoperitoneum and then a 5 mm bladeless trocar was inserted to the abdomen using the laparoscope in the right upper quadrant. With laparoscope inserted, four additional trocars were inserted to the abdomen under direct visualization, two in left upper quadrant, one in the right lower quadrant and one 12 mm trocar in the right mid abdomen laterally. Then, attention was turned to the anterior abdominal wall. There was noted to be a ventral hernia containing omentum. There was no evidence of bowel involvement. The omental adhesions were then taken down using the Sonicision. Once this was completed, an 8 inch round Ventralight mesh was introduced into the abdomen and then the balloon for the mesh was inflated and the mesh was then secured over the hernia defect and covered the anterior abdominal wall. The mesh covered more than 4-5 cm circumferentially around the defect and once the mesh was in proper position, and appropriately tacked with the absorbable tackers, the balloon was removed. Then, the pneumoperitoneum was released and the skin incision were then all closed with staples. Sterile dressings were applied. The needle, sponge, instrument counts were correct at the end of the case. The patient tolerated the procedure well and transferred to the PACU in stable condition.
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