雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Endoscopic component separation method with mesh extraction : A treatment for post-incisional hernia repair mesh infection Katsuhito SUWA 1 , Ken HANYU 1 , Toshiaki SUZUKI 1 , Tomoyoshi OKAMOTO 1 , Nobuo OMURA 2 , Katsuhiko YANAGA 2 1Department of Surgery, Daisan Hospital, Jikei University School of Medicine 2Department of Surgery, Jikei University School of Medicine Keyword: Component separation法 , 内視鏡手術 , 腹壁瘢痕ヘルニア pp.97-101
Published Date 2014/1/15
DOI https://doi.org/10.11477/mf.4426101051
  • Abstract
  • Look Inside
  • Reference

Component separation method(CSM) is an effective technique for incisional hernia repair even with large orifice or in contaminated environment. Recently, endoscopic CSM(ECSM) has been reported to be more effective than open CSM in terms of preventing skin flap necrosis or wound infection. We present a case of post-incisional herniorrhaphy mesh infection, which was successfully repaired by ECSM with simultaneous mesh extraction. Transverse incision, measuring 1.5cm, was made on the skin 1cm caudal to the tip of the 11th rib and 3cm lateral to the external edge of the rectus abdominis muscle. The external oblique muscle was separated bluntly to expose the surface of the internal oblique fascia. A balloon dissector was introduced into the space between external and internal oblique muscles. The balloon was then inflated to dissect both muscles. The cavity was made cranial to the costal arch, caudal to the inguinal ligament, medial to the lateral boarder of the rectus abdominis muscle, and lateral to the posterior axillary line. The balloon dissector was removed and replaced by a 10mm balloon-tipped trocar, and the newly created space was then insufflated with carbon dioxide to maintain intraluminal pressures of 15mmHg. Two additional trocars were placed into the cavity. The external oblique aponeurosis was then divided with electrocautery 1 cm lateral to the edge of the rectus abdominis muscle from the costal arch to the inguinal ligament. This procedure was then performed on the opposite side to achieve a complete component release, so that the midline abdominal wall defect could be easily closed.


Copyright © 2014, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

基本情報

電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

関連文献

もっと見る

文献を共有