Yang Pc George, Tung Lm Karen
Department of Surgery, Hong Kong Adventist Hospital, Hong Kong.
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
Asian J Endosc Surg. 2016 Nov;9(4):344-347. doi: 10.1111/ases.12295.
Intraperitoneal onlay mesh repair is a current technique for laparoscopic repair of ventral and incisional hernias. However, the placement of synthetic mesh intraperitoneally may potentially lead to mesh-induced complications such as adhesive intestinal obstruction, enterocutaneous fistula, or even mesh erosion into organs. Inspired by the concept of laparoscopic inguinal hernia repair, we developed a novel technique: preperitoneal onlay mesh repair (PPOM). This involves placing the mesh in the preperitoneal plane to help eliminate mesh-induced complications.
Our first case of PPOM was performed on a 54-year-old woman who developed a complex incisional hernia after multiple abdominal operations. The total size of the hernia defect was 8 × 13 cm. The peritoneal flap was carefully created with synthetic mesh placed on the preperitoneal plane, and then it was completely closed with sutures. The patient had an uneventful recovery except for a small seroma.
We herein report the first case of incisional hernia successfully treated by this novel technique, PPOM. We explain the reasons to perform PPOM, the advantages it offers, and why we named this novel technique "PPOM."
腹膜内补片修补术是目前腹腔镜修补腹直肌旁疝和切口疝的一种技术。然而，将合成补片放置于腹膜内可能会导致补片相关并发症，如粘连性肠梗阻、肠皮肤瘘，甚至补片侵蚀器官。受腹腔镜腹股沟疝修补术概念的启发，我们开发了一种新技术：腹膜前补片修补术（PPOM）。这包括将补片放置在腹膜前平面以帮助消除补片相关并发症。
我们首例PPOM手术是在一名54岁女性患者身上进行的，该患者在多次腹部手术后出现了复杂的切口疝。疝缺损的总面积为8×13厘米。小心制作腹膜瓣，将合成补片放置在腹膜前平面，然后用缝线完全缝合。除了一个小的血清肿外，患者恢复顺利。
我们在此报告首例通过这种新技术PPOM成功治疗的切口疝病例。我们解释了进行PPOM的原因、它所提供的优势，以及我们为何将这种新技术命名为“PPOM”。
