关键词: 复杂腹壁疝, 腹腔镜

Abstract:

Value of laparoscopic operation in the treatment of complex ventral hernia        YANG Shuo，CHEN Jie. Department of Hernia and Abdominal Wall Surgery, Chaoyang Hospital of Capital Medical University，Beijing 100043, China
Corresponding author：CHEN Jie，E-mail：chenjiejoe@sina.com
Abstract    Complex ventral hernia is the ventral hernia which is huge and (or) combined with a lot of complications. The cases of complex ventral herniain should be classified and underwent therapy measures respectively. For the cases of huge ventral hernia, initiative volume reduction should be performed during operation; the intra-abdominal pressure should be detected after operation to prevent ACS (abdominal compartment syndrome); the laparoscopic technique should be used for the fixation of the mesh.  For the multiple ventral hernia, IPOM (intraperitoneal onlay mesh technique) should be performed to repair hernia rings and occult hernia could be found by the laparoscope. For the irreducible and incarcerated hernia, hybrid technique (laparoscope combined with open surgery) with part-absorbable meshes should be performed to prevent the postoperative infection. For the recurrent ventral hernia, IPOM should be also performed and occult hernias were detected. For the cases of ventral hernia combined with infection and intestinal fistula, the debridement by open operation should be performed in order to remove infection; the part-absorbable meshes should be placed to repair the defects; the laparoscope should be performed to prevent the the accident injury; the antibiotics should be applied in perioperative period. For the ventral hernia located in specific positions (including marginal ventral hernia),  the tacks and sutures fixation should be used to ease the difficulty level of mesh fixation.

Key words: complex ventral hernia, laparoscope