M5 Incisional Hernia | Figure 1

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M5 Incisional Hernia

History of Present Illness

A female patient in her 60s presents with a symptomatic swelling in the suprapubic region. She reports local discomfort and a visible bulge that increases with physical activity. The patient has no history of acute complications such as bowel obstruction or skin changes over the hernia site.

Imaging and Planning

A preoperative planning protocol was conducted using a computed tomography scan of the abdomen and pelvis. The imaging confirmed a suprapubic ventral hernia with a fascial defect measuring 3 cm in its largest diameter. The content of the hernia sac was identified as preperitoneal fat without evidence of visceral involvement.

Surgical Management

The patient is scheduled for an open surgical repair. The surgical plan consists of a retromuscular mesh placement, utilizing the sublay technique. This approach involves the dissection of the retromuscular space to provide a robust reinforcement of the lower abdominal wall while ensuring that the mesh remains isolated from the intraperitoneal contents.

Similar cases

Data: 50-year-old male Comes for evaluation for umbilical hernia Physical examination: Incarcerated umbilical hernia, 3x3cm hernial sac. Tenderness on palpation. Ultrasound confirms the presence of a hernia with a 2cm defect containing the omentum. Hernia repair is performed with 8x10cm retromuscular polypropylene mesh. Photo 1. Hernia Photo 2. Omentum Photo 3. Closed posterior aponeurosis Photo 4. Retromuscular mesh

Male patient in his 60s Chief Complaint: Persistent serous drainage through the umbilical scar. History: The patient had a history of liver cirrhosis and previous umbilical hernia repair with mesh placement. He later developed persistent serous exudate through the umbilical scar, associated with local discomfort. Diagnostic Workup: Abdominal CT scan revealed recurrent umbilical hernia with evidence of meshoma at the previous surgical site. Diagnosis: Recurrent umbilical hernia with meshoma after prior mesh repair. Treatment: Surgical management included mesh explantation and abdominal wall reconstruction using a retromuscular repair technique.

Male in his 50s Medical history: incisional abdominal hernia repair with mesh. patient reports that the hernia was repaired with a "special" mesh to prevent adhesions. He came because pain and volume increase in the previous surgery area (image 1) Preoperative protocol: ct scan demonstrated incisional hernia and an apparent meshoma Treatment: abdominal wall exploration explant of previous mesh due to meshoma (image 2) hernia repair with retromuscular mesh Image 3. postoperative consultation

Male, 30 years old Medical History: 1. Right inguinal hernia Right inguinal TAPP Recurrence of right inguinal hernia Mesh infection Laparoscopic abscess drainage Persistent infection Anterior drainage and use of negative pressure wound therapy 2. Umbilical hernia Mesh repair Mesh infection Anterior drainage Current Diagnosis: Recurrent right inguinal hernia Midline incisional hernia and diastasis recti Preoperative Protocol: Abdominal CT scan: Incisional hernia and right inguinal hernia Treatment: TAP block Rives Stoppa with retromuscular mesh Right Lichtenstein