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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1498_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Preface
- •Contents
- •Contributors
- •Developing an Academic Hernia Program
- •Summary
- •References
- •History
- •Self-Fixation Mesh
- •Absorbable Mesh
- •Biologic Mesh
- •References
- •Synthetic Overview
- •Polypropylene
- •Mesh Utilized in Tension-Free Repairs
- •Preperitoneal Mesh
- •Polyester
- •Polytetra fl uoroethylene
- •Barrier Prosthetics and Composite Prosthetics
- •Biologic Prosthetics
- •Summary
- •References
- •Post-Herniorrhaphy Inguinodynia
- •Groin Neuroanatomy
- •Operative Technique
- •References
- •Lichtenstein Cylindrical Plug
- •Gilbert Plug and Swatch
- •Bard PerFix Plug
- •Complications of the Plug-Patch
- •Millikan Modi fi ed Mesh-Plug Hernioplasty
- •Atrium ProLite Mesh and ProLoop
- •Ethicon Ultrapro Plug and Patch
- •Gore Bioabsorbable Hernia Plug
- •Lessons Learned and Opinions
- •References
- •6.: Technique: Laparoscopic TEP
- •Indications
- •Contraindications
- •Patient Positioning and Room Setup
- •Pertinent Anatomy
- •Operative Approach
- •Complications
- •Vascular Injuries
- •Nerve Injury
- •Other
- •Conclusions
- •Suggested Reading
- •Anatomy
- •Preoperative Considerations
- •Intraoperative Setup
- •Operative Technique: TAPP
- •Operative Technique: IPOM
- •Complications
- •Further Reading
- •8.: Strangulated Inguinal Hernia
- •Pathophysiology
- •Presentation and Diagnosis
- •Operative Approaches
- •Choice of Prosthetic
- •Special Considerations: Obturator Hernia
- •Summary
- •Suggested Reading
- •Introduction
- •Femoral Hernia Facts
- •Diagnosis
- •Femoral Approach
- •Inguinal Approach
- •Preperitoneal Approach
- •Surgical Caveats
- •Results
- •Commentary
- •References
- •The Evolution of the Laparoscopic Technique
- •TEP and TAPP
- •References
- •Complications
- •Bowel Obstruction
- •Urological Complications
- •Postoperative Pain
- •Recurrence
- •Mesh Infections
- •TAPP Vs. TEP
- •TAPP Vs. Open for Recurrent Hernias
- •Cost
- •References
- •Embryology
- •Anatomy
- •Vas Deferens
- •Pampiniform Venous Plexus
- •Arteries
- •Hydrocele Formation
- •Nerves
- •Conclusions
- •Suggested Reading
- •Laparoscopic Inguinal Complications
- •Risk Reduction Strategy
- •Placement of the First Trocar
- •Nerves
- •The Posterior Perspective
- •Cord Complications
- •Complications of Spermatic Cord Injury
- •Ischemic Orchitis
- •Testicular Atrophy
- •Ductus (Vas) Deferens Injury
- •Testicular Ptosis
- •Scrotal Hematoma
- •Placement of Working Trocars
- •Dissection of the Preperitoneal Space
- •Dissection of Hernial Sac
- •Mesh Placement and Fixation
- •Closure of the Port
- •Conclusion
- •References
- •Incidence
- •Bladder Anatomy and Physiology
- •Risk Factors
- •Patient-Speci fi c Factors
- •Anesthesia
- •Technical Considerations
- •Intravenous Fluid Administration
- •Postoperative Pain and Analgesia
- •Diagnosis and Treatment
- •References
- •Factors Related to the Previous Repair
- •Site of the Incision
- •Postoperative Course of the Previous Repair
- •Factors Related to the Recurrence
- •Type
- •Number of Defects
- •Site
- •Size
- •Number of Previous Operations/Recurrences
- •The Presence of a Sac
- •Techniques Used for Recurrent Inguinal Hernia
- •Classi fi cations and Therapeutic Deductions
- •Recommendations and Indications
- •Conclusion
- •References
- •Background
- •Presentation
- •Differential Diagnosis
- •Imaging
- •Pathophysiology
- •Management Options
- •Surgical Technique
- •Surgical Outcomes
- •Postoperative Care and Rehabilitation
- •Summary
- •References
- •The Arguments for TAPP or TEP
- •Learning Curve
- •Argument: TAPP Is Easier to Learn than TEP
- •Operative Time
- •Conversion
- •Argument: TEP often requires conversion to TAPP.
- •Cost
- •Intraoperative Complications
- •Pain
- •Summary
- •References
- •Indications and Contraindications
- •Operative Technique
- •Operative Steps for Totally Extraperitoneal Repair
- •Fixation of the Mesh
- •Fixation Versus No Fixation
- •Conclusion
- •References
- •Laparoscopic Inguinal Hernia Repair
- •Transabdominal Preperitoneal (TAPP) Repair
- •Totally Extraperitoneal (TEP) Repair
- •Open Inguinal Hernia Repair
- •LIH Versus TFR
- •Repair or No Repair?
- •What Repair, Laparoscopic or Open?
- •Anesthesia
- •Early Complications
- •Late Complications
- •Recurrence
- •Chronic Pain
- •Contralateral Hernia
- •Cost-Effectiveness
- •Future Pelvic Surgery
- •Recommendations
- •Watchful Waiting
- •Open Repair
- •Laparoscopic Repair
- •Laparoscopic or Open Repair
- •References
- •Tissue Repair Versus Mesh Repair
- •Choice of Mesh Repair
- •Conclusion
- •References
- •Prevention
- •Manual Reduction
- •Primary Suture Repair
- •Component Separation
- •Mesh-Based Repair
- •Advent of Laparoscopy
- •Strategies for Contaminated Cases
- •Conclusion
- •References
- •Background: History of Mesh Implants
- •The Ideal Situation
- •Current State of the Art
- •Host Response to Foreign Material
- •Material Basics
- •Mesh Weight (Density)
- •Mesh Pore Size
- •Animal Experimentation of Mesh–Tissue Interface
- •Clinical Observations and Explant Findings
- •Does the Patient Matter?
- •Summary
- •References
- •Comorbid Conditions and Considerations
- •Surgical History
- •Morbid Obesity
- •Smoking
- •Diabetes
- •Pulmonary Disease
- •Cardiac Disease
- •Chronic Constipation and Urologic Conditions
- •Surgeon Experience and Institutional Capabilities
- •Summary
- •Preoperative Workup
- •Cardiac Testing
- •Laboratory Studies
- •Radiographic Imaging
- •Informed Consent
- •Perioperative Considerations
- •Postoperative Planning
- •Abdominal Compartment Syndrome
- •Atelectasis/Pneumonia
- •Deep Venous Thrombosis and Pulmonary Embolism
- •Enterotomy
- •Paralytic Ileus
- •Pain Management
- •Summary
- •References
- •The Evolution of Damage Control Surgery
- •Other Indications for the Open Abdomen
- •Patient Comorbidities
- •Treatment Options: The Open Abdomen
- •Delayed Primary Fascial Closure
- •Fascial Bridge Closure
- •Acute Components Separation
- •Treatment Options: Planned Ventral Hernia
- •Treatment Options: Abdominal Wall Reconstruction
- •Conclusion
- •References
- •Background on Hernia Mesh for Ventral Repair
- •Current Mesh Materials
- •Coatings
- •Resorbable Mesh Materials
- •Choosing the Best Mesh
- •Future of Hernia Mesh Materials
- •References
- •Biologic Prosthetics
- •Material Source
- •Material Processing
- •The Biology of Biologic Mesh
- •Current Indications
- •Limitations
- •Conclusion
- •References
- •Indications and Relative Contraindications
- •Technique
- •Open Exposure of the External Oblique
- •External Oblique Division and Separation
- •Posterior Rectus Sheath
- •The Anterior Rectus Sheath and Linea Alba
- •Outcomes
- •Conclusion
- •References
- •28.: Endoscopic Component Separation
- •Indications and Contraindications
- •Patient Preparation and Room Setup
- •Patient Positioning
- •Trocar Position of Endoscopic Component Separation
- •Open Mesh Placement
- •Retrorectus Placement
- •Complications
- •Suggested Readings
- •History of Laparoscopic Ventral Hernia Repair
- •Patient Selection
- •Operative Setup
- •Abdominal Access
- •Adhesiolysis and Hernia Reduction
- •Hernia Sizing and Mesh Selection
- •Mesh Insertion and Fixation
- •Outcomes
- •Conclusion
- •References
- •30.: Loss of Abdominal Domain
- •De fi nitions
- •Pathophysiology and Biomechanics
- •Causes and Challenges
- •Morbidity of Loss of Domain
- •Evaluation
- •General Preoperative Considerations
- •Volume Measurement
- •Preoperative Preparation
- •Preoperative Progressive Pneumoperitoneum
- •Effects of Progressive Pneumoperitoneum
- •Surgical Techniques
- •Prosthetic Mesh Reinforcement
- •Preperitoneal Reinforcement
- •Mesh Fixation
- •Biologic Mesh for Loss of Domain
- •Separation of Components
- •Tissue Grafts and Abdominoplasty
- •Reconstruction in a Contaminated Field
- •Staged Repair with Serial Excisions
- •Laparoscopic Repair
- •Outcomes and Complications
- •Postoperative Management
- •Long-Term Outcomes
- •References
- •Drains
- •Binders
- •Pain Pumps
- •Conclusion
- •References
- •Anatomy
- •Pathophysiology
- •Prevention
- •Management
- •Conclusion
- •References
- •33.: Recurrent Incisional Hernia Repair
- •Scope of the Problem
- •Etiology and Pathophysiology of Recurrence
- •Speci fi c Challenges
- •Modi fi ed Rives-Stoppa Repair
- •Laparoscopic Recurrent Incisional Hernia Repair
- •Component Separation
- •Special Techniques
- •Summary
- •References
- •34.: Chronic Mesh Infections
- •Presentation
- •Biomaterials
- •Microbiology
- •Management
- •References
- •Prosthetic Mesh as a Cause of Adhesions
- •Conclusions
- •Summary
- •References
- •De fi nitions
- •Incidence
- •Causes of Chronic Pain
- •Sutures, Tacks, and Glue
- •Laparoscopic Versus Open Repair
- •Effects of Mesh
- •Other Theories
- •Time Course of Chronic Pain
- •Patient Satisfaction
- •Pain Assessment
- •Treatment
- •Techniques for Prevention
- •Summary
- •References
- •37.: Enterotomy During Hernia Repair
- •Incidence
- •Diagnosis
- •Management
- •Occult Enterotomy/Bowel Injury
- •Avoidance
- •Conclusion
- •References
- •De fi nition
- •Physiology
- •Presentation
- •Prevention
- •Treatment
- •References
- •Bene fi ts of Laparoscopy in Ventral Hernia Repair
- •Drawbacks of Traditional LVHR
- •Goals of Repair
- •Defect Closure
- •Technical Considerations and Outcomes
- •Defect Closure: Who Needs It?
- •References
- •Technical Considerations
- •Practical Advantages
- •Modi fi cations
- •Mesh Fixation
- •Functional Repair Results
- •Cosmetic Repair Results
- •Conclusion
- •References
- •Management
- •Conclusion
- •References
- •Open Component Separation Technique
- •Endoscopic Component Separation Technique
- •Indications for CST
- •Need for Wound Revision
- •Need for Mesh Explantation
- •Presence of Ostomy
- •Need for Panniculectomy
- •Presence of Abdominal Contamination
- •Intraoperative Assessment of Tension
- •References
- •Principles of Mesh Fixation
- •Absorbable Suture
- •Absorbable Fasteners
- •Covidien: AbsorbaTack™
- •Bard Davol: SorbaFix™ and PermaSorb™
- •Ethicon: Securestrap™
- •Fibrin Sealants
- •Baxter Healthcare: Tisseel™ and Artiss™
- •Clinical Use of Absorbable Fixation Materials
- •Inguinal Hernia Repair
- •Incisional/Ventral Hernia Repair
- •Conclusion
- •References
- •Ventral Hernia Repair Reinforcement
- •Modi fi cations During Manufacture
- •Collagen Cross-linking
- •Scaffold Fenestration
- •De Novo Scaffold Properties
- •Appropriate and Inappropriate Indications for Use
- •Prophylaxis for Parastomal Hernias
- •Bridging Abdominal Wall Defects
- •References
- •Open Repair
- •Laparoscopic Repair
- •Laparoscopic Technique


The SAGES Manual
of Hernia Repair


The SAGES Manual
of Hernia Repair
Brian P. Jacob, MD, FACS
Mount Sinai School of Medicine, NY, USA
Bruce Ramshaw, MD, FACS
Transformative Care Institute, Daytona Beach, FL, USA
Editors

Editors
Brian P. Jacob, MD, FACS
Mount Sinai School of Medicine
Mount Sinai Medical Center
New York, NY, USA
Bruce Ramshaw, MD, FACS
Transformative Care Institute
Advanced Hernia Solutions
Department of General Surgery
Daytona Beach, FL, USA
ISBN 978-1-4614-4823-5 ISBN 978-1-4614-4824-2 (eBook)
DOI 10.1007/978-1-4614-4824-2
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012948968
© Springer Science+Business Media New York 2013
This work is subject to copyright. All rights are reserved by the Publisher, whether the
whole or part of the material is concerned, specifically the rights of translation, reprinting,
reuse of illustrations, recitation, broadcasting, reproduction on microfilms 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. Exempted from this legal reservation are brief excerpts in connection with
reviews or scholarly analysis or material supplied specifically for the purpose of being
entered and executed on a computer system, for exclusive use by the purchaser of the work.
Duplication of this publication or parts thereof is permitted only under the provisions of the
Copyright Law of the Publisher’s location, in its current version, and permission for use
must always be obtained from Springer. Permissions for use may be obtained through
RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under
the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the
date of publication, neither the authors nor the editors nor the publisher can accept any
legal responsibility for any errors or omissions that may be made. The publisher makes no
warranty, express or implied, with respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)

v
Preface
The evolution of abdominal wall hernia repair, both inguinal and
ventral, continues as we begin the second decade of the twenty- fi rst
century. There is an ongoing in fl ux of new techniques, new prosthetics
and devices, and new hernia programs, each designed to optimize
outcomes for our patients. Tomorrow’s techniques and work fl ows will
certainly be different than those we are utilizing today. With patient
outcomes paramount, it is important to capture and summarize the
current trends and debates into one manual that is easily accessible for all
hernia surgeons. This new SAGES Manual of Hernia Repair provides
practicing surgeons with immediate access in one handbook to many
acceptable current ideas and strategies regarding hernia repair.
Each time we repair a hernia, the technique we choose and the mesh
we implant will vary, based not just on surgeon experience but also on
the individual patient we are trying to help. As surgeons lead the effort to
implement evidence-based algorithms to de fi ne and improve patient care
and outcomes, this manual can be used as a reference when considering
a particular management strategy for hernia patients. We have added a
unique section called Current Debates where readers can capture current
opinions on many of the ongoing debates of this time period.
We want to genuinely thank all of the contributors for their hard work in
preparing these manuscripts for this book, which we dedicate to all of the
family members and colleagues who unconditionally support each of us.
New York, NY, USA Brian P. Jacob
Daytona Beach, FL, USA Bruce Ramshaw


vii
Contents
Part I Essentials of Inguinal Hernia
1 Establishing a Hernia Program and Follow-Up Regimen:
A Complex Systems Design for Care and Improvement ......... 3
Bruce Ramshaw
2 Prosthetic Choice in Open Inguinal Hernia Repair .................. 19
Lisa C. Pickett
3 Prosthetic Choice in Laparoscopic Inguinal Hernia Repair ..... 27
Emily L. Albright and J. Scott Roth
Part II Techniques for Inguinal Hernia Repair
4 Technique: Lichtenstein ........................................................... 41
David C. Chen and Parviz K. Amid
5 Technique: Plug and Patch ....................................................... 55
Carl Doerhoff
6 Technique: Laparoscopic TEP ................................................. 71
Guy Voeller and Benjamin S. Powell
7 Technique: Laparoscopic TAPP and IPOM ............................. 81
William S. Cobb IV
8 Strangulated Inguinal Hernia ................................................... 91
Jonathan P. Pearl and E. Matthew Ritter
9 Femoral Hernia ......................................................................... 103
Daniel E. Swartz and Edward L. Felix
Part III Outcomes and Complications Following
Inguinal Hernia Repair
10 Results of Laparoscopic Repair of Inguinal Hernia ................. 117
Daniel Marcus

viii
Contents
11 Outcomes After Transabdominal Preperitoneal
Inguinal Hernia Repair ............................................................. 123
Nicole Fearing and Kimberly Ponnuru
12 Cord Structure Complications in Inguinal Hernia Surgery ...... 133
Aaron M. Lipskar and Mark A. Reiner
13 Intraoperative Complications During Laparoscopic
Hernia Repair ........................................................................... 143
Davide Lomanto and Rajat Goel
14 Urinary Retention After Laparoscopic Inguinal
Hernia Repair ........................................................................... 157
David A. McClusky III
15 Recurrent Inguinal Hernia: The Best Approach ....................... 167
Abe Fingerhut and Mousa Khoursheed
16 Athletic Groin Pain and Sports Hernia ..................................... 181
Nathaniel Stoikes and L. Michael Brunt
Part IV Current Debates in Inguinal Hernia Repair
17 TAPP vs. TEP ........................................................................... 197
Alfredo M. Carbonell II
18 Fixation Versus No Fixation in Laparoscopic TEP
and TAPP ................................................................................. 203
Viney K. Mathavan and Maurice E. Arregui
19 Laparoscopic Versus Open Repair for the
Uncomplicated Unilateral Inguinal Hernia .............................. 213
Pradeep Pallati and Robert J. Fitzgibbons Jr.
20 Polyester, Polypropylene, ePTFE for Inguinal Hernias:
Does It Really Matter? ............................................................. 231
Dmitry Oleynikov and Matthew Goede
Part V Essentials of Ventral and Incisional
Hernia Repair
21 Evolution of Incisional and Ventral Hernia Repair .................. 243
Malini D. Sur and L. Brian Katz

ix
Contents
22 Tissue Ingrowth: The Mesh–Tissue Interface:
What Do We Know So Far? ..................................................... 253
Gregory J. Mancini and A. Mariah Alexander
23 Patient Comorbidities Complicating a Hernia Repair:
The Preoperative Workup and Postoperative Planning ............ 271
Scott Philipp
24 What Is a Complex Abdominal Wall? ...................................... 283
Mickey M. Ott and Jose J. Diaz Jr.
Part VI Techniques for Ventral and Incisional
Hernia Repair
25 Synthetic Prosthetic Choices in Ventral Hernia Repair ............ 299
Sheila A. Grant
26 Biologic Prosthetics: What Are They
and How Do They Interact with the Body? ............................. 311
Gina L. Adrales and Elizabeth Honigsberg
27 Open Component Separation for Abdominal
Wall Reconstruction ................................................................. 323
David Earle
28 Endoscopic Component Separation ......................................... 333
Michael J. Rosen
29 Technique: Laparoscopic Ventral/Incisional Hernia Repair ..... 341
Archana Ramaswamy
30 Loss of Abdominal Domain ..................................................... 353
Victor B. Tsirline, Igor Belyansky, David A. Klima,
and B. Todd Heniford
31 Drains, Pain Pumps, and Abdominal Binders .......................... 371
Chris Edwards
Part VII Outcomes and Complications Following
Ventral and Incisional Hernia Repair
32 Skin Necrosis After Open Component Separation:
Prevention and Management .................................................... 381
Jignesh V. Unadkat and Dinakar Golla
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