- Intraoperative Bleeding
Especially of the epigastric vessels or their branches at the lateral edge of the rectus sheath
Therapy: immediate suturing/hemostasis
- Bowel Injury During Adhesiolysis
Prophylaxis: careful, layer-by-layer dissection, if necessary, start dissection in the defect-free area, from there display the fascial defect and the hernia contents. Early opening of the hernia sac.
Serosal tears must be recognized and immediately sutured.
In the case of transmural lesions, the location (small intestine-large intestine) and the amount of bowel content leakage are crucial, possibly postponing the mesh implantation.
- Inability to Close the Anterior Rectus Sheath
Bridging Technique: In the event that the anterior fascial layers cannot be completely united, fixation of the fascial edges on the mesh already placed in the sublay position with a continuous non-absorbable suture in the sense of partial anterior bridging is permissible. If a large hernia is treated with a dorsal fascial closure, a sublay mesh in a retromuscular position, and a minimal residual bridging of the anterior fascia is achieved, and a primary skin closure is obtained, a satisfactory result can be expected.