thanks in adavance
Report of operation
After an appropriate time out and following a chloroprep prep, the patient was draped.A curvilinear incision was made at the umbilicus A small umbilical defect was noted and plans to repair that at completion of the groins was planned the right rectus sheath was exposed. This was opened transversely. The rectus was retracted exposing the posterior sheath. A balloon dilator was placed in the preperitoneal space and deployed.This was removed and replaced with a cuffed trochar. Preperitoneal insufflation was instilled at low pressure both groins were dissected and repaired in a similar fashion The right groin was approached first,. Via two 5 mm trochars placed in the midline direct hernias was identified
The cord structures were dissected to assure that the peritoneum was reflected above the groin. A 3D Max mesh was placed in the groin and tacked in place with an Sorbafix tacker. On the other side a direct hernia was seen and repaired as previously described The preperitoneal space was anesthetized With 20 cc of marcaine. The ports were removed.
The umbilical skin was raised as a flap and the
hernia sac was separated from the umbilical skin. This was
everted and reduced. Redundant tissue was amputated at the fascial level and sent for pathology The umbilical defect was small and it was elected to close this primarily with interrupted 2-0 Maxon Next the skin of the umbilicus was tacked to the underlying fascia with 3-0 Vicryl The skin incisions were closed with 4-0 Vicryl subcuticular, as well
as benzoin and Steri-Strips.
The estimated blood loss was less
than 30 mL. The sponge, instrument, and needle counts were
correct. The patient tolerated the procedure well and was
prepared for transport to the recovery room in satisfactory
condition.