Laparoscopic Repair of Ventral Incisional Hernias
MEDICAL ANIMATION TRANSCRIPT: Your doctor may recommend laparoscopic surgery to repair a ventral incisional hernia. A ventral incisional hernia can be seen as an abnormal bulge beneath the skin of your abdomen. The bulge may be your intestines, which are located inside your abdomen. A thin membrane called the peritoneum covers most of your abdominal organs, including your intestines. Your abdominal muscles surround the peritoneum and your skin covers the abdominal wall. These three layers cushion and protect your internal organs. If you have had abdominal surgery in the past, a ventral hernia may appear at the site of your surgical scar. Here, your intestine pushes through a weakened spot in the tissue between your abdominal muscles creating a bulge beneath your skin. The peritoneal tissue surrounding the herniated intestine is called the hernia sac. If your hernia is not repaired, complications may occur. For example, the hernia opening may trap a loop of your intestine, which can partially or completely block passage of its contents resulting in a condition called intestinal obstruction. Symptoms such as pain, vomiting, and constipation may occur. Intestinal obstruction may cause strangulation, a condition in which blood flow is cut off to your intestine. As a result, a segment of your intestine may die. To begin the procedure your surgeon will make a small incision in your abdomen, then place a small tube called a port into the incision. Your surgeon will pump carbon dioxide gas through the port into your abdomen, expanding it to allow him or her to see your abdominal organs more easily. Next, your surgeon will make another incision and insert another small port. Through this port your surgeon will insert a laparoscope, which is a tiny camera that projects images onto a monitor to guide your surgeon's work. While viewing the surface of your abdomen, your surgeon will make two more incisions and insert two more ports. Next, your surgeon will insert narrow surgical instruments through these ports to begin the repair. Scar tissue from previous operations will be removed if necessary. Then your surgeon will cut away the hernia sac, allowing your intestine to return to its proper location in your abdomen. The hernia defect will be closed with sutures. Next, your surgeon will cover this area with a piece of mesh. At the end of the procedure, your surgeon will remove the instruments. The incisions will be closed with sutures or skin glue and covered with skin closure tape. If there are complications with your laparoscopic procedure, your surgeon will switch to an open procedure with a larger incision.