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HERNIA
Incisional hernias are very common.
They are the second most common type of hernia after inguinal hernias. Approximately 4 million laparotomies are performed in the United States annually, 2-30% of them resulting in incisional hernia.
Incisional hernias after laparotomy are related to poorly or not at all closure of the fascia which leads to poor healing and involve technical and biological factors.
Approximately 50% of all incisional hernias develop or present within the first 2 years following surgery, and 74% occur within 3 years.
1. Symptoms such as pain and abdominal enlargement
2. Risk of incarceration, especially hernia sacs with a small neck that contain bowel
3. Suitable size – The best candidates are small to moderate-sized hernias in which the contents can be easily reduced and port-site hernias.
Laparoscopy requires general endotracheal anesthesia.
This repair is performed under no tension.
The patient is placed in a supine position for almost all hernia repairs. If the hernia is an epigastric defect, the lithotomy position with stirrups is also used. Arms are tucked to the sides. If the defect is not midline, the surgeon should stand on the opposite site of the hernia.
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