Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bard Level 1 Training > Ventral Hernias > Flashcards

Ventral Hernias Flashcards

0
Q

What are OVHR 5 techniques?

A 
Tissue to Tissue
Onlay
Retro-muscular
Pre-peritoneal
Intra-abdominal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Advantages of tissue-to-tissue repair

A

Simple

Inexpensive

No foreign body introduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Disadvantages of tissue-to-tissue technique?

A

Tension on suture line

Can’t see other defects

Not suitable for large defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Advantages of onlay technique?

A

Simple

Inexpensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Disadvantages of onlay technique?

A

Numerous sutures to secure mesh

Inability to see other defects

Infection - mesh too close to skin
Lateral dissection - increased seroma - increase time required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Advantages of retro-muscular/pre-peritoneal repair?

A

Pascal’s law

Less risk of infection - mesh further away from skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Disadvantages of retro-muscular/pre-peritoneal repair?

A

Lateral dissection - increased seroma - increased time

Potential issues with suture placement

Inability to see other defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Best OVHR technique?

A

Intra-abdominal placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Advantages of intra-abdominal technique?

A

Pascal’s law

Less risk of mesh becoming infected - furthest away from skin

Can locate additional defects***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Disadvantages of intra-abdominal repair?

A

Increased risk of bowel injury***

Must compromise the peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Advantages of LVHR?

A

Deep placement - Pascal’s Law

Quicker recovery

Minimally invasive

Quicker recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Disadvantages of Lap repair technique?

A

Technically challenging

Expensive

Adhesiolysis - increases time

Risk of intra-abdominal injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is it important to have an adhesion barrier for mesh placed in the intra-abdominal cavity?

A

To protect the bowel from adhering to the mesh until the peritoneum grows back.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Davol’s permanent adhesion barrier

A

ePTFE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Davol’s absorbable adhesion barrier?

A

Sepra technology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the disadvantages of using 100% ePTFE products?

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What benefit does the original Composix offer?

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Composix EX Advantages

A

Rapid tissue in-growth - due to monofilament polypropylene

Prevents bowel adhesions with ePTFE barrier

Overlap prevents adhesions to the edge of polypropylene with ePTFE barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Composix LP advantages

A
  • Rapid tissue in-growth with uncoated monofilament polypropylene
  • LOW PROFILE enables all sizes to be inserted into a trocar / large pore mesh
  • prevents bowel adhesions with ePTFE barrier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why was Composix LP developed?

A

Surgeons wanted mesh to fit through trocar easier.

Surgeons are interested in lighter weight, large pore mesh.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the benefit of Composix LP over Composix EX?

A

Comes with an introducer tool to assist with rolling and introducing mesh through trocar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the key differences between Composix EX and LP?

A

LP has 15% larger pores and 50% lighter weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe technique for Composix EX and LP.

11 steps

A
  1. Place ports
  2. ID defect
  3. Reduce hernia and take down adhesions
  4. Measure defect and determine proper mesh size
  5. Pre place center stitch
  6. Roll mesh 7. Deploy through trocar
  7. Position mesh 9. Fixate in opposing corners
  8. Fixate perimeter 11. Fixate double crown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the benefit of PGA fibers?

A

Provides added strength to repair during incorporation into abdominal wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe features and benefits of hydrogel barrier.

A

Minimizes tissue attachment to prosthesis

Allows complete peritoneal growth over mesh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Advantages of Ventralight ST

A

Rapid tissue in-growth with monofilament polypropylene

Provides added strength to repair with PGA fibers

Prevents bowel adhesions with Sepra Technology

Proven Sepra brand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Features and benefits of SepraMesh IP

A

1 layer of uncoated monofilament polypropylene for rapid tissue in-growth

PGA fibers bind polypropylene to Sepra barrier to provide added strength to repair

Proven Sepra technology prevents bowel adhesions and absorbs in 30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Materials used in SepraMesh IP and Ventralight ST

A

1 layer of uncoated monofilament polypropylene

PGA fibers

Sepra technology with hydrogel barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Describe lap technique for using Ventralight ST and SepraMesh IP

12 steps

A
  1. Place ports 2. ID defect
  2. Reduce hernia and take down adhesions
  3. Measure defect and determine proper mesh size
  4. Hydrate mesh 6. Roll mesh
  5. Insert mesh through trocar
  6. Position mesh below defect
  7. Fixate in opposing corners 10. Fixate permimeter
  8. Fixate double crown
  9. Deflate and close
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the difference between SepraMesh IP and Ventralight ST?

A

50% lighter weight

15% larger pore size

Lighter color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe Echo PS positioning system

A

Low profile, thermoplastic polyurethane (TPU) coated nylon balloon pre-attached to Ventralight ST or Composix LP

31
Q

Which 2 products can come attached to Echo PS?

A

Ventralight ST and Composix LP

32
Q

What purpose Echo PS serve in LVHR

A

Serves as 3rd arm of doctors. Reduces the frustration involved in placing the mesh.

33
Q

What is the surgeon targeting strategy for Echo PS?

A

Go to your current customers first who are satisfied with Ventralight mesh

Once you have practiced and perfected your pitch, go after competition.

34
Q

Describe the technique for using Echo PS.

A
  1. Verify all components
  2. Hydrate ST 3. Roll with introducer tool
  3. Deploy through trocar
  4. Pull inflation tube up through center of defect
  5. Assemble inflation device
  6. Inflate balloon 8. Position mesh over defect
  7. Initial fixation 10. Deflate by cutting inflation tube at skin level 11. Remove balloon from mesh
  8. Pull balloon up to trocar and remove both together 13. Finish fixation
35
Q

Advantages of Echo PS

A

Easy insertion

Effortless placement

Positioning and assisted fixation

36
Q

Describe design of Ventrio and Ventrio ST

A

2 layers of uncoated monofilament polypropylene forming positioning pocket

Absorbable PDO ring - causes patch to spring open and lie flat

ePTFE barrier

37
Q

Advantages/ benefits of Ventrio/Ventrio ST

A

Provides the benefits of a lap repair through ease of an open approach

Time savings

Proven shorter patient recovery

Proven low complication and recurrence rate

38
Q

Describe Ventrio ST technique

A
  1. Incision
  2. Id the defect 3. Reduce hernia
  3. Take down adhesions
  4. Clear area 5-7 cm and determine patch size
  5. Hydrate and roll (only for ST)
  6. Insert patch 8. Check patch popped open
  7. Pretension fascia 9. Fixate quadrants
  8. Fixate mesh perimeter 11. Suture bites in pocket 12. Close fascia. Close wound
39
Q

What are the advantages of the Ventrio technique?

A

Provides the benefits of lap repair through ease of open approach

40
Q

Describe the design of Ventralex and Ventralex ST

A

2 layers of uncoated monofilament polypropylene forming positioning pocket and straps (standard pore)

Permanent PET ring - causes to spring open

ePFTE barrier OR ST adhesion barrier

41
Q

List features and advantages of Ventralex

A

Encourages rapid tissue in-growth with uncoated monofilament polypropylene

Facilitates proper placement, positioning and fixation with positioning pocket and straps

PDO ring allows patch to open and lay flat to maintain it’s shape

ePTFE minimizes tissue attach,net to mesh’s posterior

Proven #1 prosthetic for umbilical hernia repair on the market

42
Q

Features and advantages of Ventralex ST.

A

Encourages rapid tissue in-growth with uncoated monofilament polypropylene

Facilitates proper placement, positioning and fixation with positioning pocket and straps

PDO ring allows patch to open and lay flat to maintain it’s shape

Proven Sepra Technology adhesion barrier

Proven #1 prosthetic for umbilical hernia repair on the market

43
Q

What are the indications for using Ventralex

A

Open umbilical hernia repairs

44
Q

Describe technique for using Ventralex

A
  1. Incision 2. Id defect 3. Excise and reduce
  2. Clear area 2x size of the defect
  3. Fold and insert
  4. Patch pops open, pull up on straps
  5. Ensure patch is laying flat 8. Pull straps apart
  6. Suture in quadrants
  7. Suture straps then cuts straps
  8. Close fascia
45
Q

Describe Sepra Technology

A

Prevents bowel adhesions

Absorbs in 30 days or less

Hydrogel swells to protect adhesions to edge of mesh

Proven Sepra brand

46
Q

Describe Ethicon Proceed surgical Mesh

A

(Thick cream mesh with blue stripes)
Polypropylene mesh

PDO encapsulates mesh and provides bonding agent to adhesion barrier

ORC - absorbable adhesion barrier

47
Q

Weaknesses of Ethicon Proceed

List 3

A
  • PDO Bonds mesh to ORC (adhesion barrier) and also Inhibits tissue growth

***ORC - states should not be used in presence of blood

No design to help with open repairs

48
Q

Davol product to position against Ethicon Proceed

A

Ventrio ST

49
Q

Describe Ethicon Proceed Ventral Patch PVP

A

(Thick cream round mesh with blue stitching)
Multi-filament polyester

Vicryl mesh encapsulated in PDO

Inner rings PDO

Straps and posterior Proceed

50
Q

Weaknesses/Disadvantages of Ethicon PVP

A

Limited clinic data

Contains proceed

Only 2 sizes - no large

Lacks design features like Ventralex

51
Q

Davol product to position against Ethicon PVP

A

Ventralex ST

52
Q

Describe Ethicon Physiomesh

A

(Lightweight, large pore with stripe down middle)

Layers Monocryl, PDS, Monocryl

Polypropylene mesh

53
Q

Describe Ethicon Physiomesh weaknesses

A

No data

Monocryl on both sides

No adhesion barrier overlap

Lacks design features to open repair

May be too lightweight

54
Q

Davol product to position against Ethicon Physiomesh

A

Ventralight ST

55
Q

Covidien Parietex Composite mesh

Weaknesses/disadvantages

A

…

56
Q

Davol products to position against Covidien Parietex Composite mesh

A

Ventralex ST with Echo PS

57
Q

Describe Covidien Parietex Composite

A

…

58
Q

Describe Covidien Parietex OS mesh

A

…

59
Q

Describe Covidien Parietex OS mesh

Weaknesses

A

…

60
Q

Covidien Parietex Composite Ventral Patch

Describe

A

…

61
Q

Covidien Parietex Composite Ventral Patch

Weaknesses

A

…

62
Q

Covidien Accusmesh positioning system

Describe

A

…

63
Q

Covidien Accumesh PS

Weaknesses

A

…

64
Q

Davol product to sell against Covidien Parietex Composite Ventral Patch

A

…

65
Q

Davol product to sell against Covidien Parietex OS

A

….

66
Q

Covidien Symbotex

Describe

A

(White large pore, blue tear drop)

Monofilament polyester

67
Q

Covidien Symbotex

Weaknesses

A

…

68
Q

Davol product to sell against Covidien Symbotex

A

Ventralight ST

SepraMesh IP

69
Q

Iannitti white paper - strength of tissue attachment to mesh after ventral hernia repair with synthetic composite mesh in a porcine model

A

Results - 74% of tissue in-growth occurs within first 2 weeks after surgery

Uses - casts doubt on competitive products where interstices are covered - how much in-growth is achieved

70
Q

Iannitti - techniques and outcomes of abdominal incisional hernia repair using synthetic mesh - report of 455 cases

A

R - low recurrence rate, low early infection rate

Uses - defend ePTFE - clinical data showing good outcomes
Ventrio/ ST open technique
Relating product design to technique to good outcomes

71
Q

Burger white paper - evaluation of new prosthetic meshes for ventral hernia repair

A

R- SepraMesh and panetex are best options

U - positioning Sepra against competition

72
Q

Voeller white paper - Ventralex Mesh in umbilical/epigastric hernia repairs

A

U - clinical proof of efficacy of Ventralex

- positioning and defending Ventralex

73
Q

Gilliam white paper

A

….

74
Q

Archer Poster - single arm, single center, retrospective study with prospective follow-up of LVHR utilizing SepraMesh

A

U - proves efficacy of SepraMesh

Bard Level 1 Training (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions