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Matthew P. Lungren Michael R.B. Evans
Editors
Laparoscopic and
Clinical Medicine
Robotic Incisional
Covertemplate
Hernia Repair
Subtitle for
Current Considerations
Clinical Medicine Covers T3_HB
Karl A. LeBlanc
Second Edition
Editor
123
123
Laparoscopic and Robotic Incisional Hernia Repair
Karl A. LeBlanc
Editor
Laparoscopic and Robotic Incisional Hernia Repair
Current Considerations
Editor
Karl A. LeBlanc Surgeons Group of Baton Rouge Our Lady of the Lake Physicians Group Baton Rouge, LA USA
ISBN 978-3-319-90736-9 ISBN 978-3-319-90737-6 (eBook)
https://doi.org/10.1007/978-3-319-90737-6
Library of Congress Control Number: 2018950840
© Springer International Publishing AG, part of Springer Nature 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
Printed on acid-free paper
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To my wife and best friend, Zinda. Your support and affection throughout my career has allowed me to do what I love and love what I do.

Preface

The laparoscopic repair of incisional hernias continues to grow. There are a number of changes that have occurred since the rst procedure in 1991. The multiplicity of meshes has provided the surgeon many different materials with which to choose. There have been adaptions of different devices that are attached to the products to make the insertion and/or xation easier than in the past. The xation of these prostheses continues to undergo further rene­ment as new devices are introduced.
As with any common procedure in the armamentarium of the surgeon, there have been and continue to be areas of discussion or controversy. The limits and benets of the procedure are an area of constant debate. It is gener­ally agreed that the reduction in infectious complications is consistent. Newer areas of conversation are the need to close the fascial defect in all cases and the location of the mesh itself. Historically the intraperitoneal location was accepted but this is now being challenged and the placement in the preperito­neal space is gaining in popularity. The short- and long-term benets of this opinion will require more time.
The most signicant change to the laparoscopic approach has been the use of the surgical robot. This device has allowed the surgeon to close the defect more easily and more effectively. Additionally, it provides a platform to more easily perform the preperitoneal dissection and the posterior component sep­aration. There has been a very rapid growth of this modality in the repair of all hernias. It is hoped that the adoption of this technology does not result in the lack of attention to the important tenets of the ventral and incisional her­nia repair.
Laparoscopic and Robotic Incisional Hernia Repair—Current Considerations has brought some of the current thought leaders together to
author the chapters to detail the art and science of this operation. I have spe­cically selected the topics of the chapters to provide sound advice and rec­ommendations to the practicing surgeon. It is meant to be a resource for both the seasoned laparoscopic surgeon and the novice. I do hope that we have achieved this goal.
Baton Rouge, LA KarlA.LeBlanc
vii

Acknowledgments

I wish to extend my sincere gratitude to all of the authors that have taken the time and effort to contribute to this work. Without their support, this would not have become the textbook that I strived to achieve.
I do want to also thank Springer Medical Publishers for allowing me the ability of making this book a reality and providing Elise Paxson as my Developmental Editor. She has been invaluable to the development and pro­duction of this excellent textbook.
ix

Contents

1 Overview ofPast, Present, andFuture ofIncisional
Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Karl A. LeBlanc
2 Preoperative Considerations Prior toMinimally Invasive
Ventral Incisional Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . 7
Deepa V. Cherla and Mike K. Liang
3 Preoperative Optimization andEnhanced Recovery After
Surgery Protocols inVentral Hernia Repair . . . . . . . . . . . . . . . 21
Sean B. Orenstein and Robert G. Martindale
4 Overview ofLaparoscopic/Robotic Technical Aspects . . . . . . . 33
Philip E. George, Benjamin Tran, and Brian P. Jacob
5 Implants Used forHernioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Karl A. LeBlanc
6 Laparoscopic Closure ofFascial Defect . . . . . . . . . . . . . . . . . . . 85
Vashisht Madabhushi and J. ScottRoth
7 Intraoperative Considerations forLaparoscopy . . . . . . . . . . . . 91
David Earle
8 Intraoperative Considerations forRobotic Repair . . . . . . . . . . 103
Ryan M. Juza, Jerome R. Lyn-Sue, and Eric M. Pauli
9 Endoscopic andLaparoscopic Techniques ofMinimally
Invasive Components Separation forAbdominal Wall
Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Zachary Sanford, Shyam S. Jayaraman, H. RezaZahiri, and Igor Belyansky
10 Robotic Component Separation . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Clayton C. Petro and Yuri W. Novitsky
11 Lumbar Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Omar Yusef Kudsi and James Avruch
xi
xii
12 Parastomal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
J. Tyler Watson and Karl A. LeBlanc
13 Postoperative Management
(Routine andComplex Situations) . . . . . . . . . . . . . . . . . . . . . . . 163
Shirin Towgh and Desmond T. K. Huynh
14 Management ofAdverse Events During
Laparoscopic andRobotic Hernia Repair . . . . . . . . . . . . . . . . . 169
Ciara R. Huntington, Jonathan D. Bouchez, and David A. Iannitti
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Contents

Contributors

JamesAvruch, MD Department of General Surgery, St. Elizabeth Medical Center, Boston, MA, USA
IgorBelyansky, MD, FACS Department of Surgery, Anne Arundel Medical Center, Annapolis, MD, USA
Jonathan D. Bouchez, MD Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
DeepaV.Cherla, MD Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA
Basking Ridge, LA, USA
DavidEarle, MD, FACS Tufts University School of Medicine, Boston, MA, USA
Philip E. George, MD Department of Surgery, Mount Sinai Hospital of NewYork, Icahn School of Medicine, New York, NY, USA
Ciara R. Huntington, MD Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
Desmond T.K. Huynh, MD Cedars-Sinai Medical Center, Los Angeles, CA, USA
David A. Iannitti, MD, FACS Division of Hepatobiliary and Pancreatic Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
Brian P. Jacob, MD Department of Surgery, Mount Sinai Hospital of NewYork, Icahn School of Medicine, New York, NY, USA
ShyamS.Jayaraman, MD Department of Surgery, Anne Arundel Medical Center, Annapolis, MD, USA
RyanM.Juza, MD Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA
Omar Yusef Kudsi, MD, MBA, FACS Department of Surgery, Good Samaritan Medical Center, Tufts University School of Medicine, Brockton, MA, USA
xiii