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Incisional hernia repair using Stoppa technique

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Presentation on theme: "Incisional hernia repair using Stoppa technique"— Presentation transcript:

1 Incisional hernia repair using Stoppa technique
Incisional hernia repair using Stoppa technique. Upper abdominal incisional hernias can be repaired with mesh extending above the coastal margins. Transfascial sutures secure the mesh ­circumferentially (A, B). Lower incisional hernias extend into the pelvis and the visceral sac holds the lower aspect of the mesh in place with the patient in the upright position; only a retropubic suture secures the lower aspect of the mesh (C). (Adapted with permission from: Wantz GE. Atlas of Hernia Surgery. New York, NY: Raven Press; 1991.) Source: Bioprosthetic and Prosthetic Materials in Abdominal Wall Reconstruction and Hernia Repair, Radical and Reconstructive Gynecologic Cancer Surgery Citation: Bristow RE, Chi DS. Radical and Reconstructive Gynecologic Cancer Surgery; 2015 Available at: Accessed: November 15, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved

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Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From.

Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From.
Dissection of the distal ureter. (A) Urinary bladder

Dissection of the distal ureter. (A) Urinary bladder
Intraperitoneal view of polytetrafluoroethylene mesh used for laparoscopic ventral incisional hernia repair. The mesh is in place on the posterior aspect.

Intraperitoneal view of polytetrafluoroethylene mesh used for laparoscopic ventral incisional hernia repair. The mesh is in place on the posterior aspect.
Intraperitoneal view of expanded polytetrafluoroethylene mesh used for laparoscopic ventral incisional hernia repair. The mesh is in place on the posterior.

Intraperitoneal view of expanded polytetrafluoroethylene mesh used for laparoscopic ventral incisional hernia repair. The mesh is in place on the posterior.
Mapleson D circuit. Note that the fresh gas inlet (FGI) is distal to the adjustable pressure-limiting (APL) valve and proximal to the patient end. (Reproduced.

Mapleson D circuit. Note that the fresh gas inlet (FGI) is distal to the adjustable pressure-limiting (APL) valve and proximal to the patient end. (Reproduced.
A. Layers of the abdominal wall in an anterior open approach to hernia repair. B. Identification of indirect and direct hernia sacs once the spermatic.

A. Layers of the abdominal wall in an anterior open approach to hernia repair. B. Identification of indirect and direct hernia sacs once the spermatic.
Annular suturing techniques. A. Interrupted sutures. B

Annular suturing techniques. A. Interrupted sutures. B
The defect is converted to a parallelogram with angles of 60 and 120 degrees, and the flap is designed accordingly. (Adapted from Morrow CP, Curtin JP.

The defect is converted to a parallelogram with angles of 60 and 120 degrees, and the flap is designed accordingly. (Adapted from Morrow CP, Curtin JP.
Laparoscopic inguinal hernia repair (A→D). (Used with permission of Dr

Laparoscopic inguinal hernia repair (A→D). (Used with permission of Dr
Transection of the utero-ovarian ligament

Transection of the utero-ovarian ligament
Wedge resection of ear: (a) method of ear block with local anaesthesia infiltrated subcutaneously; (b) wedge of ear removed; (c) suturing in layers Source:

Wedge resection of ear: (a) method of ear block with local anaesthesia infiltrated subcutaneously; (b) wedge of ear removed; (c) suturing in layers Source:
Incidence of CIN2 and 3 and cervical cancer

Incidence of CIN2 and 3 and cervical cancer
An above-knee artificial leg invented by Ambroise Paré (mid-16th century). (From Paré A: Oeuvres Complétes, Paris, 1840, with permission from the National.

An above-knee artificial leg invented by Ambroise Paré (mid-16th century). (From Paré A: Oeuvres Complétes, Paris, 1840, with permission from the National.
Preperitoneal repair of bilateral inguinal hernia using Stoppa technique (giant prosthetic repair of visceral sac). The synthetic mesh is placed between.

Preperitoneal repair of bilateral inguinal hernia using Stoppa technique (giant prosthetic repair of visceral sac). The synthetic mesh is placed between.
Adapted from Weiss et al. J Am Coll Cardiol. 1998;31:

Adapted from Weiss et al. J Am Coll Cardiol. 1998;31:
The myometrium is incised carefully to avoid cutting the fetal head

The myometrium is incised carefully to avoid cutting the fetal head
(Reproduced with permission from Jemal A, et al: Cancer statistics, 2008. CA Cancer J Clin 58:71, 2008.) Source: Chapter 17. The Breast, Schwartz's Principles.

(Reproduced with permission from Jemal A, et al: Cancer statistics, CA Cancer J Clin 58:71, 2008.) Source: Chapter 17. The Breast, Schwartz's Principles.
Ludwig Rehn, a surgeon from Frankfurt, Germany, who performed the first successful suture of a human heart wound. (Reproduced with permission from Mead.

Ludwig Rehn, a surgeon from Frankfurt, Germany, who performed the first successful suture of a human heart wound. (Reproduced with permission from Mead.
The H double advancement flap: (a) excision of tumour with planned flaps; (b) pulling the flaps together; (c) flaps sutured to repair defect Source: Skin.

The H double advancement flap: (a) excision of tumour with planned flaps; (b) pulling the flaps together; (c) flaps sutured to repair defect Source: Skin.
Reproduced with permission from Chang JB, Stein TA

Reproduced with permission from Chang JB, Stein TA

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