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Subject: search.filters.subject.incisional hernia

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    LAPAROSCOPIC INCISIONAL HERNIA REPAIR IN OBESE PATIENT: A CASE REPORT
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2013)
    Mitevski, Aleksandar
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    Inoduction. Laparoscopic repair of ventral-incisional hernia is increasing compared to open technique. It has become a safe method, with low complications and cost comparable with open techniques. Shorter recovery and length of hospital stay are also associated with laparoscopic repair, especially among obese patients. Case report. We present a case of a 42-year-old patient with BMI (Body Mass Index) of 44. He has had three previous open operations for incisional hernia, the last one being two years ago. We performed a laparoscopic IPOM (Intraperitoneal Onlay Mesh) repair with composite mesh using transfascial (transabdominal) sutures and tacks (staples). Conclusions. Low rate of conversion, minimal perioperative morbidity and low recurrence indicate safety in obese and morbidly obese patients treated with laparoscopic approach.
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    TRANSVERSUS ABDOMINIS RELEASE: A CASE REPORT
    (Association of Albanian Medical Doctors in Macedonia, 2020-08)
    Aleksandar Mitevski
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    Ilija Milev
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    Nikola Trokovski
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    Petar Markov
    Introduction: Patients with large abdominal wall defects experience significant deformity, pain and decreased energy due to a loss of normal abdominal wall mechanics, severely impacting their quality of life.Reconstructive techniques for complex ventral hernia repair are numerous but most of them are unable to achieve the goals of hernioplasty. Posterior component separation with transverses abdominis muscle release (TAR) is a novel approach that offers a solution for complex ventral hernias. Case: A 59 year old patient was admitted to our hospital for treatment of clinically and radiologically verified incisional hernia with 20% loss of domain characteristics, acquired after cesarean section and hysterectomy. Discussion/Conclusion: Typical reconstructive techniques may struggle to reestablish abdominal domain and to create a lasting repair. Posterior component separation with transversus abdominis release is a novel technique that offers a durable solution to a variety of complex ventral hernias.The lack of sufficient tissue requires the insertion of prosthetic material or transposition of autologous material to bridge the fascial gap.Retromuscular or sublay hernia repair with mesh has proven to be a durable technique for ventral hernia defects, and completely avoids subcutaneous flap elevation. TAR allows for significant posterior rectus fascia advancement, wide lateral dissection, preservation of the neurovascular supply, avoids subcutaneous tissue undermining and provides a large space for mesh sublay which allowsfor bilaminarin growth of the mesh.
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    Парцијална хернијација на црниот дроб низ инцизионален дефект на предниот абдоминален ѕид
    (Македонско лекарско друштво = Macedonian medical association, 2016-01)
    Антонио Глигориевски
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    Introduction. Ventral hernias are quite common, but liver herniation is an extremely rare case. This type of abdominal protrusion of part of the liver usually occurs through incisional weak spots on the abdominal wall. Incisional herniation of the liver usually occurs 2 to 3 years after an abdominal operation consequently leading to focal weakness of the abdominal wall. Case report. We present an extremely rare case of incisional herniation of part of the left and smaller part of the right liver lobe in a woman aged 64 years, as a consequence of a previous open cholecystectomy, creating a focal abdominal wall weakness. Abdominal CT scan was performed. Analysis of the CT scans, as well as of the reconstruction made in the coronal and sagittal plane was performed. Herniation of the left and the smaller part of the right liver lobe through an incisive focal weakness of the right upper quadrant of the abdominal wall was detected. Discussion. Incisional hernias are delayed complications of abdominal surgery. They can occur anywhere on the abdominal wall and are more frequently encountered in a vertical than in a transverse incision. Typically, incisional hernias occur during the first months following surgery, but later occurrence has been reported as well. Herniation of the liver through the anterior abdominal wall is an extremely rare condition and usually related to previous surgery on the upper abdomen. Due to its rarity it is both a diagnostic and therapeutic challenge. Conclusion. We can conclude that there is a connection between liver herniation through the upper abdominal wall and a previously performed open abdominal surgery. CT is the method of choice for diagnosis of liver herniation through the anterior abdominal wall.