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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1303_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Preface
- •Acknowledgments
- •Contents
- •Contributors
- •References
- •Abbreviations
- •Introduction
- •Laparoscopic Repair
- •Current Surgical Robot Repair
- •Future Surgical Robotic Systems
- •Introduction
- •Patient Clinical History
- •Tobacco Use
- •Surgical History
- •Hernia Characteristics
- •Defect Size
- •Location
- •Contaminated Ventral Hernia Repairs
- •Primary Ventral Hernias
- •Existing Evidence Comparing Surgical Platforms
- •Open Versus Laparoscopic Incisional Hernia Repair
- •Open Versus Robotic Hernia Repair
- •Laparoscopic Versus Robotic Incisional Hernia Repair
- •References
- •Introduction
- •Preoperative Optimization
- •Obesity
- •Smoking
- •Diabetes
- •Surgical Site Infection
- •Perioperative Antibiotics
- •Postoperative Blood Glucose Management
- •Multimodal Pain Control
- •Early Enteral Feeding
- •References
- •Primary Suture Repair
- •Laparoscopic Repair
- •Mesh-Based Repair: Materials
- •Mesh-Based Repair: Technique
- •Component Separation
- •Single Incision/Port Surgery
- •Robotic Incisional Hernia Repair
- •References
- •Introduction
- •Absorbable Prosthetic Biomaterials
- •Biologic Products
- •Bovine Products
- •Cadaveric Products
- •Porcine Products
- •Hybrid Products
- •Flat Prosthetic Products
- •Miscellaneous Flat Products
- •Combination Flat Synthetic Prosthetics
- •Stomal Products
- •Fixation Devices
- •References
- •Introduction
- •Techniques
- •Recurrence
- •Seroma Formation
- •Patient Satisfaction
- •References
- •Recommended Reading
- •Introduction
- •Access
- •Mesh Fixation
- •Mesh Coverage
- •References
- •Introduction
- •Operating Room Setup
- •Patient Positioning
- •Nesting
- •Abdominal Wall Thickness
- •Instrumentation
- •Inguinal Hernias
- •Ventral Hernias
- •Atypical Hernias
- •Abdominal Access
- •Inguinal Hernia
- •Ventral Hernia
- •Defect Closure
- •Instrument Issues
- •Mesh Sizing, Delivery, Fixation
- •Inguinal Hernia
- •Ventral Hernia
- •No Peritoneal Flap or Poor Flap
- •Operative Complications
- •Guided Instrument Exchanges
- •Arm Collisions
- •Avulsion Injuries
- •Bleeding
- •Contact Injuries
- •References
- •Introduction
- •Posterior Layer
- •Anterior Layer
- •Mesh Placement
- •Transabdominal Approach
- •Postoperative Management
- •Future Directions
- •References
- •10: Robotic Component Separation
- •eTEP Access
- •Upper Midline Defect
- •Lower Midline Defects
- •Transversus Abdominis Release
- •Closure
- •Patient Selection
- •rTAR Operative Details
- •Postoperative Care
- •Outcomes
- •References
- •11: Lumbar Hernia Repair
- •Introduction
- •Epidemiology
- •Etiology/Pathogenesis
- •Anatomy
- •Operative Technique
- •Patient Positioning
- •Trocar Placement
- •Defect Closure
- •Peritoneum Closure
- •Postoperative Care
- •References
- •Suggested Reading
- •12: Parastomal Hernia Repair
- •Introduction
- •Parastomal Hernia Repair Considerations
- •Laparoscopic Technique
- •Robotic Technique
- •Postoperative Management
- •Results
- •References
- •Enhanced Recovery After Surgery
- •The Abdominal Wall
- •Handling Abdominal Contents
- •Mesh Placement
- •References
- •Introduction
- •Intraoperative Adverse Events
- •Acute Medical Intraoperative Adverse Events
- •General Anesthesia
- •Intraoperative Fluid Overload
- •Carbon Dioxide Embolism During Laparoscopy
- •Intraoperative Cardiopulmonary Arrest
- •Acute Surgical Intraoperative Adverse Events
- •Hemorrhage
- •Intraoperative Decision-Making After Iatrogenic Enterotomy
- •Postoperative Adverse Events
- •Common Postoperative Complications After Hernia Repair
- •Chronic Pain After Suprapubic Ventral or Inguinal Hernia Repair
- •Chronic Pain After Ventral Hernia Repair
- •Mesh Infection
- •Hernia Recurrence
- •Conclusion
- •References
- •Index

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, specically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microlms 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 specic 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 afliations.
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 renement 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 benets 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 benets of this
opinion will require more time.
The most signicant 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 specically 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 KarlA.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 ofPast, Present, andFuture ofIncisional
Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Karl A. LeBlanc
2 Preoperative Considerations Prior toMinimally Invasive
Ventral Incisional Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . 7
Deepa V. Cherla and Mike K. Liang
3 Preoperative Optimization andEnhanced Recovery After
Surgery Protocols inVentral Hernia Repair . . . . . . . . . . . . . . . 21
Sean B. Orenstein and Robert G. Martindale
4 Overview ofLaparoscopic/Robotic Technical Aspects . . . . . . . 33
Philip E. George, Benjamin Tran, and Brian P. Jacob
5 Implants Used forHernioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Karl A. LeBlanc
6 Laparoscopic Closure ofFascial Defect . . . . . . . . . . . . . . . . . . . 85
Vashisht Madabhushi and J. ScottRoth
7 Intraoperative Considerations forLaparoscopy . . . . . . . . . . . . 91
David Earle
8 Intraoperative Considerations forRobotic Repair . . . . . . . . . . 103
Ryan M. Juza, Jerome R. Lyn-Sue, and Eric M. Pauli
9 Endoscopic andLaparoscopic Techniques ofMinimally
Invasive Components Separation forAbdominal Wall
Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Zachary Sanford, Shyam S. Jayaraman, H. RezaZahiri,
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 andComplex Situations) . . . . . . . . . . . . . . . . . . . . . . . 163
Shirin Towgh and Desmond T. K. Huynh
14 Management ofAdverse Events During
Laparoscopic andRobotic Hernia Repair . . . . . . . . . . . . . . . . . 169
Ciara R. Huntington, Jonathan D. Bouchez,
and David A. Iannitti
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Contents

Contributors
JamesAvruch, MD Department of General Surgery, St. Elizabeth Medical
Center, Boston, MA, USA
IgorBelyansky, 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
DeepaV.Cherla, MD Department of Surgery, University of Texas Health
Science Center at Houston, Houston, TX, USA
Basking Ridge, LA, USA
DavidEarle, MD, FACS Tufts University School of Medicine, Boston, MA,
USA
Philip E. George, MD Department of Surgery, Mount Sinai Hospital
of NewYork, 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 NewYork, Icahn School of Medicine, New York, NY, USA
ShyamS.Jayaraman, MD Department of Surgery, Anne Arundel Medical
Center, Annapolis, MD, USA
RyanM.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
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