Laparoscopic hernia repair, IPOM following lower laparotomy

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Authors

Prof. Dr. med. Dieter Berger

Klinikum Mittelbaden

Determining the mesh size

Before establishing the pneumoperitoneum, the edge of the scar plus sufficient overlap is traced in all directions, thereby determining the size of the mesh.
Since in this case the fascia defect extends mostly to the right, the mesh must be placed asymmetrically.
Establishing pneumoperitoneum and inspecting the abdominal cavity

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After previous gynecologic surgery via lower midline laparotomy, establish pneumoperitoneum through a Verres needle in the untouched right upper quadrant; another option would be a mini-laparotomy.
Insert a threaded 10 mm trocar and inspect the abdominal cavity.