Книга_926_Библиотеки_им_академика_М_И_Перельмана

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<<< < Предыдущая 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 3940 / 4040

412

Index

Intradermal injection, 71 Intraparietal hernia, 231 Intraperitoneal mesh, 241, 263, 381, 399, 401, 402 Intraperitoneal onlay mesh (IPOM), 42 Invasive separation technique, minimally, 237 IPOM-Plus, 273–274

closure of defect, 274

placement of mesh, 274 da Vinci Xi, 274–275 deﬁnition, 273 pearls, 275 surgical technique

adhesiolysis, 274

docking, 274

patient positioning, 273

trocar placement, 273–274

Ischemia, 287, 310 Isoforms of COX, 148

Kaplan Meier curves, 16 Kaplan–Meier method, 16 Keyhole technique, 349 Kidney rest, 264 Kittner dissector, 228 Kocher clamps, 226

on linea alba, 234

Kocher forceps, 121, 123 Kugel approach, 112–113 Kugel mesh, 113, 116 Kugel patch™, 112

Lacuna vasorum, 33 Lacunar ligament, 32, 33, 81 Laparoendoscopic, 119 Laparoscopic balloon-assisted subfascial approach, 243 Laparoscopic defect closure technique, 279–283, 296 Laparoscopic hernia repair, 225 Laparoscopic herniologist, 127 Laparoscopic inguinal hernia, 91, 96, 110, 223 Laparoscopic inguinal herniorraphy, 119 Laparoscopic (LAP) repairs, 80 Laparoscopic mesh repairs, 82 Laparoscopic repair, 172–173 Laparoscopic shoelace closure, 279 Laparoscopic technique, 76, 368 Laparoscopic transabdominal preperitoneal (TAPP)

history, 91 operative technique, 92–94 peritoneal incision, 92 preoperative considerations, 91–92 Versus TEP, 94–96

Laparoscopic ventral hernia, 283 Laparoscopic ventral hernia repair (LVHR), 277–279, 282, 284, 402 Laparostomy, 340 Laparotomy, 195, 249, 256, 288, 310, 324, 325, 331, 334,

339, 342, 349

closure operative factors, 190

LaPlace’s law, principles of, 234 Lateral femoral cutaneous nerve, 147 Lateral mesh tails, 75 Law of LaPlace, 277, 278, 283 Layered closure, 190

Lean, 7 Lecture-style instruction methods, 377 Lichtenstein repair, 89, 116 Lichtenstein technique, 81, 116, 137, 138, 142 Lichtenstein tension-free hernioplasty, 69–72, 74–76

associated risks and complications, 75

chronic pain, 75 mortality rate, 75 nerve identiﬁcation, 75

visceral injury, 75 beneﬁts, 77 materials, 69–70 modiﬁcations and evolution of operation, 75–76

postoperative mesh shrinkage, 75

undersized mesh, 76 operative steps, 71–75

external oblique aponeurosis, 71, 74, 75

ilioinguinal nerve, 71

internal oblique aponeurosis, 71, 74

penrose drain, 72

spermatic cord, 71, 72, 74 operative technique, 70–71

anesthesia and sedation, 71

positioning and preparation, 70 postoperative management, 75 preoperative management, 69

Lichtenstein-Amid Hernia Clinic, 69, 71 Lightweight mesh, 143 Linea alba, 250, 251, 277, 294, 295, 298, 306, 317–320, 323, 334,

382–386, 388 Linea semilunaris, 234–239, 255, 301, 317, 319, 320, 383 Lines of Langerhans, 307 Liposomal bupivacaine, 83, 88 Local anesthesia, 55, 57–58, 64

European Hernia Society, 47 external oblique aponeurosis, 58 inguinal ligament, 45 laparoscopic approach, 44 open approach, 44 open inguinal hernia, 44 patient selection, 43–44 pros and cons, 46

Loss of domain, 353, 354

deﬁnition, 353 hernia with

management of, 354 surgery, 354

pathophysiology, 354 Low- and middle-income countries (LMICs), 368 Low-cost mesh, 368–369 Low-density polyethylene homo-polymer (LDPE), 368 Low resource countries, 368 L-type voltage-gated calcium channel, 148 Lumbar hernias, 293 Lysis, 226 Lysyl oxidase (LOX), 1

Macroporous polypropylene mesh, 227 Magnetic resonance imaging (MRI), 35, 37, 38, 147, 148, 317 Magnetic resonance (MR) neurography, 38 Marfan’s syndrome, 2 Marlex mesh, 42, 197 Maryland dissector, 132 Maryland forceps, 130

Index

413

Mass closure, 190 Matrix metalloproteinases (MMPs), 1, 3 McVay technique, 81 Mechanical ﬁxation methods, 223 Medial fossa, 32 Medication classes, 148 Medicines and Healthcare products Regulatory Agency (MHRA), 368 Meditation, 151 Mesh, 37, 42, 53, 54, 63, 65, 94, 95, 109–113, 115, 116, 132, 141, 142,

144, 155, 156, 158, 160, 211, 216, 249–251, 253, 258, 259, 263, 266, 267, 269, 278, 319–321, 325, 326, 335, 339, 341,

349, 350 bone anchor ﬁxation of mesh, 302–303 coated polyester mesh, 308 excision, 401–402 ﬁxation, 125, 130, 138, 139 infections, 396–403 insertion, 125 lightweight vs. heavyweight, 142–143 material and structure, 396 overview, 308 position, 399–400 salvage, 396–397 sandwich repair, 253 techniques, 79 tissue sealant ﬁxation, 302 trimmed, 85 type, 350, 397–399

Mesh-based repair, 76 Mesh repairs, hernia, 81–83, 172

combined anterior and posterior repair, 82–83 laparoscopic mesh repairs, 82 mesh plug repairs, 81–82 onlay, 81 pre-peritoneal mesh repairs, 82

Meshoma, 158–160 Metabolic control, 203 Methicillin-resistant Staphylococcus aureus (MRSA), 205, 395, 396

infection, 88

Methicillin-sensitive S. aureus (MSSA), 205 Meticulous glycemic control, 206 Metzenbaum scissors, 122 Microvascular disease, 253 Midline fascial closure, 215 Midline hernias, 250, 251, 253, 293 Milk of magnesia, 88 Minimally invasive component separation with inlay bioprosthetic

mesh (MICSIB), 237

Minimum inhibitory concentration (MIC), 205 Minnesota Multiphasic Personality Inventory-2 (MMPI-2

) test, 144 Missed hernias, 56 Mitek bone anchors, 303 Modern hernia surgery, 225 Modiﬁed Carolina Comfort Scale (MCCS™), 18 Modiﬁed subfascial approach, 245 Modiﬁed Ventral Hernia Working Group, 212–214, 217 Morgagni hernias

clinical anatomy, 268–269 docking, 269–270 operative steps, 270–271 patient positioning, 269–270 peritoneal incision, 270 port placement, 270

trocar placement, 269–270 Mortality, Lichtenstein hernia repair, 75 Mosquito net mesh, 368, 369

Multifactorial pain, 144 Multimodal approach, 150 Multiple organ systems, maladjustment, 354 Multiport surgery, 124 Muscle paralysis, 362 Muscle-splitting approach, 112 Muscular system physical therapy, 151 Musculature, 182 Mushrooming hernia, 310, 312 Mycobacterium fortuitum, 88 Myofascial advancement, 221 Myofascial deformity, 317, 318 Myoﬁbroblast, 3 Myo-pectineal oriﬁce (MPO), 79, 84, 132

mesh covering, 85 mesh over, 87

Nahas classiﬁcation, 317, 318 Narrow-necked direct hernia, 72 National Health and Nutrition Examination Survey, 367 National Surgical Quality Improvement Program (NSQIP), 206, 256,

289, 290 Natural oriﬁce transluminal endoscopic surgery (NOTES), 119 n-butyl-2 cyanoacrylate (NB2C), 143 Negative pressure wound therapy (NPWT), 336–338, 341, 342, 396,

399–401

incisional, 259 string-of-pearls technique, 260

traditional, 259 Neovascularization, 258 Nerve blocks, 150, 155 Nerves, 142, 147, 157 Nerve trauma, 80 Neurectomy, 152, 157, 158, 160 Neurilemma, 157 Neuroanatomy, 156, 158 Neuroleptic medications, 148 Neuropathic groin pain, 156 Neuropathic pain, 143, 148, 155–158, 160 Neurotransmitters, 148 Neurovascular anatomy

nerves, 183

vessels, 183–184 New England Journal of Medicine, 205 Nicotine patch, 202 Nociceptive pain, 143, 155, 160 Nonabsorbable monoﬁlament suture, 75 Nonoperative approach, 155–156 Nonoperative management, 305, 306, 310 Non-sliding hernia, 72 Nonsteroidal anti-inﬂammatories (NSAIDs), 148, 155 Nuovo metodo operativo per la cura dell’ernia inguinale, 41 Nutrition therapy, 203, 207

Obese patient, 196 Obesity, 25, 55, 178, 201–202, 207, 215, 256, 263, 290, 318, 323 Oblique aponeurosis, 255 Occult hernias, 56 Occult inguinal hernias, 36, 38, 39 Odds ratio (OR), 348 Onlay graft, 112 Onlay mesh, 253, 295, 319

414

Index

Onlay technique, 288 Onlay ventral hernia repair

vs. adhesive ﬁxation, 219 clinical data, 220–221 with ﬁbrin glue ﬁxation, 221–223 outcomes of, 223 overview, 219

principles and biomechanics of, 219–220 Onstep technique, 115 Open abdomen, 253 Open Abdomen Advisory Panel (OAAP), 331, 332, 340 Open abdomen treatment, 336–340

abdominal closure and wall, 339–340

fascial closure, 339, 340 abdominal compartment syndrom, 332–334 complications, 340–342 component separation, 340 DCS, 334 deﬁnition and indications, 331–334 Esmarch closure, 335 intra-abdominal hypertension, 332–334 nutritional considerations, 342 overview, 331 planned ventral hernia, 335 silos, 335 skin closure and loose packing, 334–335 skin grafting, 335 temporary abdominal closure, 334–339

ABRA

, 337–339 artiﬁcial burr, 337 mesh and hernia, 339 NPWT, 336–337

zipper closure, 335

Open anterior components separation technique

challenges and pitfalls, 236 evolution, 234 outcomes, 236 overview, 234

technique, 234–236 Open minimal repair (OMR), 167 Open recurrent hernia, 156 Open repair, 171–172 Operation Hernia, 370 Operative technique

ECS

endoscopic subcutaneous CS approach, 245–247 modiﬁed subfascial approach, 245 transfascial approach, 244

Lichtenstein, 70–71

anesthesia and sedation, 71

positioning and preparation, 70 Opioid-based medications, 148, 149 Opioids, 9, 149, 155 Orchialgia, 157–160 Outcomes, 79–81

for open anterior compartment separation technique, 236 Overlay mesh, 256 Oval-shaped pocket, 112 Oxcarbazepine, 148

PACU, 10 Pain, 147, 151

approach, 147

classiﬁcation, 147

Panniculectomy, 256–257 Pantaloon hernia, 23, 24 Parastomal hernia (PH), 195, 279, 345

diagnose, 345–346 incidence, 345–346 mesh types, 350 overview, 196–197, 345 prevention, 350 QoL and indications for surgery, 347 stoma, 347–348 symptoms, patient information and risk factors, 346–347 treatment, 348–350

use of prophylactic mesh in prevention, 197 Paravasal nerves, 158 Paravasal neurectomy, 160 Pascal’s principle, 82 Patient care process, 11 Patient-related risk factors, 189–190 Patient reported outcome measurement (PROM), 18 Patient selection, onlay technique, 221 Pearls, 275 Pectineal ligament, 32 Penrose drain, 72, 84, 86 Perforator preserving component separation technique

challenges and pitfalls, 238

evolution, 237

outcomes, 238

overview, 237

technique, 238 Peripheral nerve, 151 Peritoneal defect, 96 Peritoneal ﬂap, 249–254, 299 Peritoneal incision, 92 Peritoneal sac, 111 Peritoneography, 35 Periumbilical region, 238 Pew Research Center, 373 Pfannenstiel incisions, 296, 324 Pharmacologic therapies, 155 Pig model ﬁbrin glue, 223 Pinch test, 257 Plication, 318–321 Plug and Patch (PP) techniques, 76 Pneumoperitoneum, 92, 125–126, 282, 302 Polyglactin mesh, 326 Polypropylene mesh, 69, 82, 132, 133, 142, 227, 301, 302, 310, 319,

335, 397

bilayer connected, 82 Polypropylene (PP), 396–401 Polysoft™ mesh, 110, 113, 114 Polysoft™ patch technique, 115 Polytetraﬂuoroethylene (e-PTFE), 350 Porcine model, 381 Posterior component separation, 225, 226, 231, 248 Posterior component separation-transversus abdominus release

(PCS-TAR), 244

Posterior inguinal wall, 58

division, 55–56

reconstruction, 60–62 Posterior rectus sheath, 234 Postpartum patients, 317 Poupart ligament, 29 Pragmatic neurectomy, 72 Pregabalin, 148 Pregnancy, 312–313 Prehabilitation, 207

Index

415

Preoperative metabolic preparation, 203–204 Preperitoneal approach, 109 Preperitoneal fascia, 124 Preperitoneal fat, 313 Pre-peritoneal mesh repairs, 82 Preperitoneal plane, 228, 264–266, 272, 301, 303, 385 Pre-peritoneal repairs, 80 Pre-peritoneal space (PPS), 55, 56, 58–60, 80–82, 86, 109–112,

115, 116, 142, 266, 268, 296, 301, 306, 307, 310, 383, 385,

388, 390 Pre-transversalis plane, 228 PRIMAAT trial, 193 Primary closure, 243, 244 Primary suture repair (PSR), 196 Principles of hernia repair, 79 Principles of LaPlace’s law, 234 Processus vaginalis, 29, 30, 33 Progressive preoperative pneumoperitoneum (PPP), 353, 354, 358

clinical case, 357–359 complications, 356–357 loss of domain

deﬁnition, 353 hernia surgery with, 354 management of hernia with, 354

pathophysiology, 354 objectives, 354–355 physiology, 355–356 preparing for, 356 technique, 356

Progressive tension sutures (PTS), 258 Prolene hernia system (PHS), 76, 81–83

application of PHS overlay, 86–87 insertion technique, 83 low failure rate of, 89 overlay tails, 84 preparation and insertion of PHS underlay, 84–86

Prolene mesh, 368 Prolene suture, 86, 87, 282 Prophylactic mesh, 197 Prophylactic mesh augmentation (PMA), 192–193, 195–197

Propofol

, 83 Prostatectomy, 25 Prostatic hypertrophy, 25 Prosthetic mesh, 69, 395–397

infection, 395, 396, 402, 403

sheet, 70 Psoas muscle, lateral edge, 228, 231 Psychological treatments, 151 Pubic inguinal pain syndrome (PIPS), 141 Pubic-related groin pain, 164 Pubic tubercle (PT), 80 Pubis, 56, 59, 61 Pulmonary disease, 323, 324 Pumpkin teeth technique, 258 PVDF, 350

Quadratus lumborum muscle, 301 Quality-adjusted life-year (QALY), 290 Quality of life (QoL), 48, 345, 347

™

CCS

, 18 generic scores, 18 patient reported outcomes measurement, 18–21

Ramirez component separation technique, 234 Ramirez’ principles, 220 Randomized controlled trials (RCTs), 76, 127, 142, 143, 203,

206, 350 Rath classiﬁcation, 317, 318 Ray-tec sponge, 84 Rebound HRD Shield™, 114 Rebound mesh™, 114 Rectal cancer, 347, 349, 350 Rectangular ﬂap technique, 258 Rectopectoralis ﬂap, 236 Rectus abdominis, 81 Rectus abdominis muscles, 234, 236, 252, 294, 317, 319, 321, 348 Rectus-internal oblique-transversus abdominis ﬂap, 233 Rectus muscles, 41, 109, 111, 115, 143, 212, 215, 250, 253,

254, 275, 348 Recurrences, 15–16

men, 62 primary inguinal hernias, 63

women, 62 Recurrent inguinal hernias, 125 Reductionist scientiﬁc method, 7, 8 Regional anesthetic, 45–46 Rehabilitation, 167 Replicable inguinal hernia repair, 69 Resolvins and protectins, 203 Retroinguinal space, 268 Retromuscular dissection, inferior, 228 Retromuscular hernia repair, 225, 231

effectiveness of, 226 Retromuscular mesh, 197, 215, 399 Retromuscular space, 250–252, 384, 397 Retrorectus dissection, 227 Retrorectus hernia repair, 319

indications, 225–226

outcomes, 231

pearls, 231

technical description, 226–231 Retrorectus-only hernia repair, 225 Retrorectus-only Rives–Stoppa repair, 226, 228 Retrorectus space, 294 Retro-rectus techniques, 225 Retrosternal hernias, 269 Retzius, space of, 267, 268 Ribonucleic acid (RNA), 204 Richardson retractors, 226 Richter’s hernias, 75 Rives repair, 219, 223 Rives–Stoppa approach, 231, 288, 381, 382, 388 Rives–Stoppa repair, 225, 226, 231 Rives–Stoppa ventral hernia repair, 241 Rives–Stoppa–Wantz repair, 225 Robotic hernia repair, 303 Robotic inguinal hernia

controversies, 134

future directions, 134

literature, 131–134

myopectineal oriﬁce, 132

port set up, 130

rationale, 129

techniques, 129–131 Robotic retromuscular hernia repair, 392 Robotic retromuscular VHR (rRMVHR), 381, 386

416

Index

Robotic transabdominal preperitoneal (rTAPP), 263

atypical hernias, 267 docking, 265 morgagni hernias, 268–271 port position, 265 preoperative considerations, 263 small mid-abdominal incisional hernia, 264–267 suprapubic hernias, 267–268 surgical anatomy, 263 umbilical, 264–267

Robotic ventral hernia repairs (rVHR), 385–387, 389–393

double-dock approach, 382–385 operative setup, 383 outcomes, 386–388 overview, 381–382 patient selection, 382 single-dock techniques (see Single-dock techniques) surgical technique, 382

trocar placement and docking, 383 Robotics Surgery Collaboration, 378 Rolled-up mesh plug repair, 81

Sac, 250, 252, 253, 257, 263, 265, 268, 279, 280, 282 Saddle bag hernia, 23 Salvage mesh, 396–397, 399, 403 Sandwiches mesh, 251, 253 Sandwich technique, 349 Sanitary mobile surgical platforms, 369 Scarpa’s fascia, 83, 258, 260 Scrotum, 33 Sedation, 57 Seroma, 16, 17, 65, 124, 201, 219, 220, 249, 250, 255, 258, 259, 279,

283, 288, 320 Serotonin norepinephrine reuptake inhibitors (SNRIs), 149, 155 Shoelace technique, 215 Shoelacing defect, 278 Short-acting local anesthetic, 148 Short-Form 36 (SF-36), 18 Short Tau Inversion Recovery (STIR), 38 Shouldice Hospital, 54, 56, 63–65 Shouldice repair, 54–57, 62, 63, 66 Shouldice technique, 83, 84 Silo closure, 341 Silos, 335 Single-dock preperitoneal approach, 382 Single-dock techniques

epigastric, 386, 390 epigastric and suprapubic repair, 386 preperitoneal repair, 386 retromuscular approach, 385–386, 388, 389

suprapubic repair, 386, 391 Single incision laparoscopic (SIL), 119, 122, 123 Single incision laparoscopic surgery (SILS), 119, 127, 128 Six Sigma, 7 Skin, 30

excision, 256

incision, 111

necrosis, 255

preparation, 204–205, 207, 244 Skin management, 256–258

panniculectomy, 256–257 Sliding hernia, 84 Small congenital type 1 indirect hernia, 80 Small mid-abdominal incisional hernia, 264–267

Smoking, 4, 9, 10, 25, 26, 202, 207, 253, 256, 263, 306, 307, 313, 323 Smoking cessation, 69 Social media in hernia repair

background, 373 collective experience in real time, 377–378 IHC, 373–377 interactive learning, 377 interdisciplinary collaboration, 378–379

research and quality improvement potential, 378 Somatic pain, 155 Spermatic cord, 30, 41, 58, 62, 71, 72, 74, 81, 83, 87 Spermatic fascia, 31 Spigelian hernia belt, 124 Spinal anesthesia, 45–47, 110

pros and cons, 46 Spinal cord stimulation, 151 Split-thickness skin graft (STSG), 335, 336, 339 Sportsman hernia, 141 S-Shaped retractors, 122, 123 Stainless steel, 56 Staphylococcus aureus, 88, 205, 207, 395, 396, 403 Statistical tools, 7 Steadman’s medical dictionary, 147 Sterile gauze, 115 Steristrips

, 87 Stitch size, 190 STITCH-trial, 325 Stoma, 195, 196, 213, 346–351 Stoma-QoL score, 347 String-of-pearls technique, 260 Sub-aponeurotic injection, 72 Subcostal hernias, 296 Subcutaneous approach, 243 Subcutaneous dissection, 239 Subcutaneous skin ﬂap, creation of, 221 Subcuticular layer, 259 Subdermal tissue, 71 Subfascial approach, 243–245 Sublay mesh, 225, 249, 277, 308, 319 Subxiphoid defects, 279 Subxiphoid fat pad, 230 Subxiphoid hernias, 294

laparoscopic repair, 295–296 open repair, 294–295 overview, 293–296 subcostal hernias, 296

surgical anatomy, 294 Sugarbaker technique, 279, 349 Superﬁcial epigastric vessels, 83 Superﬁcial fascia, 32 Superﬁcial wound drainage, 88 Superior hypogastric plexus block, 151 Superior subxiphoid dissection, 230 Superior tension, 226 Supplemental Perioperative Oxygenation (Hyperoxia), 206 Suprapubic hernias, 267, 300, 302, 386, 391

anterior view, 297

computed tomography scan, 297

defects, 279

docking, 267, 268

laparoscopic repair, 298–299

open repair, 298

open view, 297

operative steps, 267–268

overview, 296–299

patient positioning, 267

Index

417

port position and docking, 268 surgical anatomy, 297–298

trocar placement, 267 Supravesical fossa, 32 Surgeons, 80

expertise, 80

hernia, 80

lack of experience, 81 Surgery, pain, 152 Surgical Infection Society (SIS), 205 Surgical site infection (SSI), 17, 18, 201, 203, 204, 206, 248, 255,

307, 310, 395–397, 399–403

Surgical site occurrences (SSOs), 17–18, 178, 201, 202, 213, 219,

399, 402 Suture-based laparoscopic repair of V/I hernias, 219 Suture ﬁxation, 131, 133 Suture length, 190 Suture length to wound length ratio (SLWL), 325 Suture-less “umbrella plug” repair, 82 Suture materials, 190, 192 Sutures, 56, 60–62, 73, 74, 251, 252, 255, 258, 268, 271, 279, 280,

282, 296, 298, 299, 310, 314, 318, 319, 324–326, 331, 334,

340, 341, 349 Suture techniques, 79, 81 Sympathetic injection, 150, 151 Symptomatic hernias, 91 Symptomatology, 155, 197 Symptomology, 201, 321 Synthetic mesh, 215, 216, 339, 399, 402

Tailored approach, 53, 225 Tailored surgery, hernia, 80 T-cell mediated antibody, 206 Telescopic dissection, 122, 124–125 Temporary abdominal closure (TAC), 332, 341 Tension-free concept, 42 Tension-free onlay mesh repair, 81 Tension-free technique, 69 Tension reduction, 9 Testicular atrophies, 65 Testicular vessels, 83 Three-dimensional structural architecture, 396 Three-dimensional ultrasonography (3D), 345, 350 Time-to-event analysis, 16 Tissucol/Tisseel for Mesh ﬁxation in Lichtenstein hernia repair

(TIMELI) trial, 76 Tissue-based techniques, 69 Tissue expansion, 259 Topical agents, medication, 148, 149 Topiramate, 148 Totally extra-peritoneal (TEP) repair, 46, 82, 95, 119, 122–124, 127,

128, 134, 137–139, 142, 143, 156, 173 Tramadol, 155 Trans-abdominal pre-peritoneal (TAPP) repair, 82, 127–129, 131,

137–139, 142, 143, 156, 167, 172, 263 Transfascial approach, 244 Transfascial stitch, 296 Transfascial sutures, 296, 298–300, 302, 303 Transforaminal epidural injection, 150 Transinguinal approach, 111 Transinguinal Polysoft™, 113–114 Transinguinal preperitoneal repair (TIPP), 113, 116, 156 Transoperative pneumoperitoneum, 355, 358

Transrectus Sheath Preperitoneal Mesh Technique (TREPP), 114–115 Transversalis fascia (TF), 30, 33, 41, 42, 44, 55, 81, 82, 84, 86, 156,

263, 301

layers of, 84

Transversus abdominis, 32, 80, 81, 86, 227, 228, 230, 231, 252

division/dissection of, 231 muscle, 30, 32, 41, 295, 298, 383, 385–387

Transversus abdominis release (TAR), 9, 223, 225, 382, 383, 385, 386

completed, 229 indications, 225–226 initiation of, 229 outcomes, 231 pearls, 231 procedure, 228–231

technical description, 226–231 Transversus abdominus plane (TAP), 9 Trendelenburg position, 111, 120, 122, 125, 130 Triangular ﬂaps, 256 Tricyclic antidepressants (TCA), 148, 155 Triple neurectomy, 157–159 Triple P-triangle, 15, 16

Triport

device placement of inner ring, 123 preparation, 123

Trocar, 130, 264, 295, 382–384, 386, 390 Type 2 indirect hernias, 88 Type 3 recurrent hernia, 88

Ultrapro Hernia System

Ultrapro

, 89

(UHS), 89, 111–112

Ultrasonic device, ECS, 246 Ultrasonography (US), 35–37 Ultrasound, 317 Umbilical hernia, 92, 264–267, 285, 310–313, 320

elective presentation, 305–310 future needs, 313–314 laparoscopic, 308 open, 308 overview, 305 special circumstances

acute, 310 cirrhosis, 311–312 concomitant repair, 311

pregnancy, 312–313 steps in open, 309 treatment algorithm, 312, 313

Umbilical port, 92, 93 Umbilical wound, 126 Umbiliconeoplasty, 258 Umbilicus, 258 Underlay graft, 112 Underlay technique, 288 Undeserved areas, hernia repair, 368–370

epidemiology, 367–368 operative technique, 368–370

logistics and education, 369–370

low-cost mesh, 368–369

studies, 370

surgeons, 369, 370

Unilateral hernia repair, 71 Unilateral hernias, 109 Unilateral subcutaneous ECS, 246 UpToDate™, 377

418

Index

Urinary retention, 45, 138, 139 USA Health Insurance Portability and Accountability

Act (HIPAA), 374 User generated content (UGC), 373 US Food and Drug Administration, 361

Vancomycin, 205, 207 Vas deferens, 53, 54, 110, 124, 158 Ventral hernia, 8, 10–12, 17, 21, 186–187, 204, 205, 207, 211, 241,

243, 249, 273, 285, 288–290, 305, 308–310

acute presentation, 287 classiﬁcation systems, 211–214 diagnosis, 286–287 epigastric hernia, 306 European Hernia Society, 212 example of CQI applied, 9–11 management strategies, 305 natural history, 285–286 primary, 306 stage, 214–216 staging system, 211, 214 surgical management, 287–290

contaminated operative ﬁeld, 289–290 laparoscopic repair, 288–289 management of bowel obstruction, 289

open repair, 288 umbilical hernia, 306 ventral incisional hernia, 306

Ventral Hernia Outcomes Collaborative, 307 Ventral Hernia Pain Questionnaire (VHPQ), 18–19 Ventral hernia repair (VHR), 178, 201–203, 277, 387, 388, 395–400,

402, 403

principles of, 233

techniques of, 219

Ventral Hernia Working Group (VHWG), 17, 212–214, 217

modiﬁed, 214 Ventral incisional hernia, 317 Ventral/incisional (V/I) hernia repair, 219, 220

suture-based laparoscopic repair, 219 Verbal Rating Scale (VRS), 18

Vicryl

, 83

Vicryl mesh, 319

Vicryl

suture, 131 2-0, 86, 87 3-0, 87

Visceral pain, 155 Visual Analogues Scale (VAS), 18 Vypro II Visor mesh™, 111

Wallerian degradation, 155 WHO Safe Surgery Initiative, 370 Wittmann™ Patch, 337, 338, 341 Wound dehiscence, 17 Wound healing process, 3–4, 255, 257, 259

Xiphoid process, 269, 279, 293–296

Yankauer suction, 238

Zipper closure, 335, 341

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