Complications - Incisional hernia repair with open, retromuscular mesh augmentation

  1. Intraoperative Complications

    • Intraoperative bleeding

      Especially of the epigastric vessels or their branches at the lateral edge of the rectus sheath

      Therapy: immediate suturing/bleeding control
       
    • Bowel injury during adhesiolysis

      Prophylaxis: careful, layer-by-layer dissection, if necessary, start dissection in an area free of defects, from there visualize the fascial defect and the hernia contents. Early opening of the hernia sac.

      Deserosations must be recognized and immediately oversewn.

      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

      Therapy: TAR (transversus abdominis release), abdominal wall component separation according to Ramirez or possibly bridging technique
Postoperative complications

Rebleeding/Hematoma Ultrasound monitoring, puncture if size progresses. Hemoglobin-relevant reblee

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