By, Dr Harsh Sheth, Bariatric Surgeon in Mumbai
I. OVERVIEW
A ventral (abdominal) hernia refers to any protrusion of intestine or other tissue through a weakness or gap in the abdominal wall. Umbilical and incisional hernias are specific types of ventral hernias.One of the risks associated with hernia repair surgery is that the hernia can return. If the hernia repair fails and the hernia reappears, this is referred to as a recurrent hernia.
II. Doctor Name
III. Patient Details
Age : 28, Male
IV. Symptoms
Swelling and pain around the navel, 1 year after a previous umbilical hernia repair.
V. Test Performed
CT scan of the abdomen (plain) which suggested a recurrent umbilical hernia 5.5*
3.8 cm in size in the umbilical and infra-umbilical region
VI. Diagnosis
Recurrent ventral hernia
VII. Treatment
Laparoscopic e-TEP RS repair of a recurrent ventral hernia
VIII. Description of the Treatment
The patient presented with 2 previous repairs of an umbilical hernia without placing a mesh. He had a recurrence of the hernia after both surgeries and presented to us for definitive management.
The patient underwent a CT scan which showed an increase in size of the umbilical hernia with small intestine and omentum as contents of the hernia.
He wanted a definitive repair with no chances of future recurrence.
He was offered a newer modality of abdominal wall reconstruction, the laparoscopic extended Totally Extra-peritoneal (e-TEP) Rives-Stoppa (RS) approach, wherein a space was created between the muscle and the inner lining of the abdomen to place a large 30*20 cm medium weight mesh to prevent any future recurrence. The patient did well post-operatively and was discharged on post-operative day 1. He followed up at 3 months and is happy with the result.
IX. Post Treatment Guidelines
To avoid lifting heavy weights (<5kg) for 3 months.
X. Images
