IPOM Umbilical Hernia Repair by VIPRO II Mesh

Aaradhya Sharma

https://www.laparoscopyhospital.com/SERV01.HTM  Laparoscopic umbilical hernia repair has largely replaced the open method. The purpose of this video is to demonstrate the laparoscopic umbilical hernia repair using two-port with intraabdominal VIPRO II mesh fixation with transabdominal absorbable suture technique and demonstrate that it is feasible, efficient, and safe. Methods. The two-port technique was used and the umbilical defect was closed using transabdominal VIPRO II mesh was placed intra-abdominally and fixed to the abdominal wall using a transabdominal suture. Results.   Laparoscopic umbilical hernia repair with intraabdominal mesh fixation using absorbable sutures offers an efficient, safe, and effective repair for an umbilical hernia.  For more information please contact:  World Laparoscopy Hospital  Cyber City, Gurugram, NCR DELHI  INDIA 122002  Phone & WhatsApp: +919811416838, + 91 9999677788

Transcript

00:00Hello friends. This is a case of paramedical headband.

00:08And we will use Vipromesh here. This is the palmer's point.

00:12So generally what we do, 2 cm above the palmer's point over the costal margin.

00:18We stretch the abdominal wall below.

00:22And after that there is one small stab wound given on the palmer's point.

00:27Then with the various needle you will point it towards the stomach.

00:32So that it will not puncture the splenic flexor of colon.

00:37Irrigation test.

00:40Suction test.

00:43And then hanging drop test will be done.

00:46It is important that stomach should must have nasogastric tube.

00:51And after insuffilation we will put the trocar.

00:55That also will be pointed towards the stomach.

00:58Now we can see here.

01:00Little omentum is adhered.

01:03And the content of the hernia first has to be separated out.

01:08This can be done very easily.

01:13If you will just merge in little bit harmonic you will cut the adhesions.

01:19And then assistant also help you from above.

01:23To push the content down.

01:25To push the video down.

01:37To push the video down.

01:47Slowly all the content of the hernia has to be pulled out, this is important before fixation

02:04of the mess.

02:34You should avoid tearing the momentum, an assistant must try to reduce the content

03:04from outside.

03:05Now we can see almost all the momentum is out.

03:10Just little adhesion from the peritoneum of the sac is there.

03:15That adhesiolysis will be performed.

03:57typo Why Collonna.

03:58Bye it.

03:59Here you can take care care should be taken that when you are reducing the content and a

04:10cat by your left finger from outside, accidentally there should not be any injury to the skin.

04:18Otherwise there may be an infection of the mess.

04:23now all the content is out and here is the hernia as we know up to three four centimeter hernia we

04:30don't do the closure of the defect it is not necessary just you can do the mesh fixation

04:38and automatically here we will use vipro 2 this is a composite mesh but it is less expensive

04:46and this is from ethicon you will put the center of the mesh over the center of the defect and 22

04:55centimeter lateral to the margin you can give one marking after that white hill will be attached

05:01to the all four corner and mesh is introduced to the palmer's point

05:08now corners of the mesh will be fixed by the trans facial fixation

05:13that will be done by either cobbler's needle or suture passer breaking it from above the skin prick

05:22should be same and the rectus prick should be at different places

05:30this way corner suture you can apply

05:33once the corner suture is fixed

05:48all the four corners after that you can use tacker

06:04trans facial fixation together with the tacker application is a very good technique of hernia surgery

06:14and that will reduce the number of tacker which is used

06:18because all the corner of the mesh will be fixed by trans facial fixation that will also make it sure

06:25that mesh should be placed bilateral symmetrical

06:32you have to apply two row of the tacker one is outer crowning another is inner crowning

06:40outer crowning at 22 centimeter distance and inner crowning over the margin of the defect

06:47and that way entire mesh can be nicely securely placed so thank you very much for watching this video

06:55this was a simple case of paramilical hernia have a nice day

07:14you

Category

Transcript

Recommended