General Surgery Case Presentation

Sundeep Guliani

• 62 yo female with unobstructing symptomatic right flank hernia

• PSH: Hysterectomy, vaginal prolapse repair both via pfannenstiel incisions

Cont

• OR – Lap Assisted– Swiss cheese pelvic hernias – Incarceration reduce laparoscopically– Right flank open primary hernia repair– Laparoscopic placement of mesh

• POD 4 – N,V,Abd distention -> CT scan

Re-exploration

• Via lower midline incision, primary repair hernia defect

• DC POD 5

• 27 pts with average 188 cm hernia defect evaluated

• Found repair was technically feasible but often required very large mesh

• Follow up short but no operative complications

Teaching points/Issues

• Small defect vs large

• These type of hernias are technically challenging