Laparoscopic Ventral Hernia Repair
Web-site of Laparoscopic surgery
Surgeon: Mark Pleatman, MD
Laparoscopic Ventral Hernia Repair
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This is a small ventral hernia just to the left of the midline in an obese woman who had an open cholecystectomy many years ago. It has become larger in size and causes discomfort.
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The sac is now being everted for excision.
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The sac is now being excised
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The hernia sac is being inserted into a Pleatman Sac for retrieval
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A Gore-Tex dual-mesh patch measuring 8 by 12 cm. in size is taken and prepared by tying sutures to all four corners. It is layed out on the anterior abdominal wall at the intended location, and marks are made at each corner. The patch is then inserted into the abdominal cavity. An emergency needle (Made by Ranfac) is then inserted through one of the marks on the abdomen and used to grasp a suture.
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The needle is re-inserted through the same puncture-site, though at a different angle, and the other end of the suture is retrieved. The sutures are tied together, anchoring the patch to the fascia. This step is then repeated at the other three corners.
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A hernia stapler is then used to secure the patch sides to the fascia.
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The completed repair is shown. One can see marks made on the patch to help orienting the patch so the adhesion-resistant side is left facing the viscera.
