Incisional Epigastric and Umbilical Hernias Flashcards
What percentage of patients with a midline laparotomy will develop an incisional hernia?
13%
T/F: Epigastric hernias are congenital
FALSE
T/F: Umbilical hernias are usually congenital
TRUE
What is a key technical feature of all abdominal hernia repairs?
Complete dissection to identify all fascial edges
Incisional hernia defects larger than what size should always be repaired with mesh?
4 cm
What percentage of incisional hernias repaired without mesh will recurr?
25-50%
What percentage of incisional hernias repaired with mesh will recurr?
10-25%
What does an underlay repair entail?
Application of mesh to undersurface of abdominal wall with transfascial sutures
What is eponym given to an underlay repair with transfascial sutures?
Stoppa repair
What does an inlay incisional hernia repair entail?
Opening of posterior rectus sheath, closure of posterior fascia, placement of mesh posterior to rectus muscle, closure of anterior sheath
How many centimeters of overlap should be used with a mesh repair?
4-5 cm
In order to stimulate tissue ingrowth into mesh, it is important to ensure mesh in contact with what anatomic layer?
Fascia (not fat)
Closure of fascial defect in a laparoscopic repair is thought to be associated with reduction of what complicaiton?
Seroma formation
What does component separation entail?
Incision of the external oblique aponeurosis 1 cm lateral to the rectus sheath, separation of aponeurosis from internal oblique
T/F: Biologic mesh can successfully be used as a bridge, sewn to either fascial edge, with acceptable recurrence rates
FALSE
