Ventral hernia

Expanded poly(tetrafluoro ethylene) (ePTFE) CORE-TEX W.L. Core Associates, Flagstaff, USA Regenerative membrane, osteoconductive membrane, large diameter aortic, and carotid vascular grafts, tension-free repair of ventral incisional hernia orbital reconstruction, facial reconstruction, rhinoplasty... 

Poly(propylene) is one of the biocompatible, biostable polymer used widely in clinical applications ranging from sutures to load-bearing implants (Figure 18.1b). Poly(propylene) has fiber-forming characteristics and has been used in the treatment of ventral incisional hernia [22,23]. Poly(propylene) has excellent stiffness and strength when compared to polyethylene [24]. Superior mechanical performance in fatigue and temperature resistance offers sufficient mechanical property even at body temperature and able to bear millions... 

Ventral hernia covers all protrusions through anterior and anterolateral abdominal wall, excluding groin hernias. It is suggested by the patient s clinical history and is well seen on physical examination however, the patient s history may be atypical and physical examination may be limited in obese patients, in patients with severe abdominal pain or distension, in small hernias or with hernias located in uncommon sites (Spangen 1975 Mufid et al. 1997). In certain clinical situations it may be necessary to relate the symptoms to the ventral hernia or, it may be necessary to know whether the ventral hernia is... 

Fig. 5.3. a Scan of the anterior abdominal wall with Valsalva manoeuvre shows the ventral hernia containing the bowel loops (BO) and the defect in the fascia (arrows), b Fatty epigastric hernia with herniation of the properitoneal fat (arrows), c Spigelian hernia shows the defect marked by calipers lateral to the rectus muscle (R) and the contents (BO) limited anteriorly by the Spigelian fascia (arrow), d Richter s type umbilical hernia shows fluid-filled hernial sac (arrowheads) and irreducible herniation of only a part of the circumference of the bowel (arrow), which showed wriggling peristaltic movement in real time... 

Some ventral hernias are not seen at rest and are brought into view with only one of the manoeuvers. When the hernia is seen at rest, an attempt is made to slide the contents into the abdomen to know if the hernia is reducible. Sonography readily differentiates other conditions that mimic ventral hernia such as lipoma, metastasis, suture granuloma, abscess or endometriosis. Umbilical hernia is a type of ventral hernia that occurs through the weak umbilicus. Fatty epigastric hernia is protrusion of the properitoneal fat through a defect in the linea alba. 

Fig.5.4a-d. Complicatedhernia.aAfferentloop obstruction shows the transition between the dilated intraabdominal loop (BO) and collapsed loop in inguinal hernia (arrow), b Efferent loop obstruction shows dilated bowels in ventral hernia (BO) with transition between the dilated loop in hernia and collapsed intraabdominal loop at the neck of the sac (arrow), c Tensely distended loop is devoid of air in a ventral hernia due to closed loop obstruction, d Strangulated loop of bowel (BO) in a ventral hernia shows thick walls... 

Liang RJ, Wang HP, Huang SP, Wu MS, Lin JT (2001) Color Doppler sonography for ventral hernias in patients with acute abdomen preliminary findings. J Clin Ultrasound 29 435-440... 

Skaane P, Skjennald A (1989) Ultrasonic features of ileocecal intussusception.) Clin Ultrasound 17 590-593 Spangen L (1975) Ultrasound as a diagnostic aid in ventral abdominal hernia. J Clin Ultrasound 3 211-213 Su MY, Lien JM, Lee CS, Lin DY, Tsai MH (2001) Acute jejunogastric intussusception report of five cases. Chang Gung Med J 24 50-56... 

Butler, C. E Navarro, F. A., and Orgill, D. P. (2001), Reduction of abdominal adhesions using composite collagen-GAG implants for ventral hernia repab, J. Biomed. Mater. Res. 58(l) 75-80. 

Helton WS, Fisichella PM, Berger R, Horgan S, Espat Nl, Abcarian H. Short-term outcomes with small intestinal submucosa for ventral abdominal hernia. Arch Surg 2005 140(6) 549-62. 

Vorst AL, Kaotzanis C, Carbonell AM, Franz MG. Evolution and advances in laparoscopic ventral and incisional hernia repair. World J Gastrointest Surg 2015 7(ll) 293-305. 

Gaertner WB, Bonsack M, Delaney J. Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg 2007 11(10) 1275-85. 

Deeken CR, Mehnan L, Jenkins ED, Greco SC, FriseUa MM, Matthews BD. Histologic and biomechanical evaluation of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral incisional hernia repair. JAm Coll Surg 2011 212(5) 880-8. 

Rosen Ml. Polyester-based mesh for ventral hernia repair Is it safe Am J Surg 2009 197(3) 353-9. 

Primus FE, Harris HW. A critical review of biologic mesh use in ventral hernia repairs under contaminated conditions. Hernia 2013 17(l) 21-30. 

Won EJ, Lehman EB, Gelezke A, Tangel MR, Matsushima K, Brunke-Reese D, et al. Association of postoperative hyperglycemia with outcomes among patients with complex ventral hernia repair. JAMA Surg 2015 150(5) 433-40. 

Raftopoulos I, Courcoulas AP. Outcome of laparoscopic ventral hernia repair in morbidly obese patients with a body mass index exceeding 35kg/m. Surg Endosc 2007 21(12) 2293-7. 

Nicast Ltd Israel http //www.nicast com/ PM, CS AVfio vascular access graft, NovaMesh ventral hernia mesh Needleless (drum) or Needle US7112293 B2 Own design... 

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