Primrose S, McClaren M, Slater K
Department of Surgery, Princess Alexandra Hospital, Brisbane, QLD, Australia.
J Abdom Wall Surg. 2024 Sep 20;3:13434. doi: 10.3389/jaws.2024.13434. eCollection 2024.
Complex abdominal wall hernias represent a significant reconstructive challenge to the general surgeon. In patients with loss of abdominal domain, standard surgical techniques such as anterior component separation or transversus abdominus muscle release may not allow for primary fascial closure. In complex ventral wall hernias, visceroabdominal disproportion may need to be addressed prior to an attempt at hernia repair. Tissue expanders placed in the intermuscular space is a novel technique used to increase intraabdominal volume and safely allow reduction of viscera with subsequent closure of the myofascia. We present the case of an adult patient with complications of an untreated congenital omphalocele who underwent a successful two stage operation using tissue expanders in the abdominal wall combined with anterior component separation.
复杂腹壁疝对普通外科医生来说是一项重大的重建挑战。在腹腔容积丧失的患者中,诸如前入路成分分离或腹横肌松解等标准手术技术可能无法实现一期筋膜闭合。在复杂的腹壁疝中,在尝试修补疝之前可能需要解决内脏与腹腔比例失调的问题。置于肌间隙的组织扩张器是一种用于增加腹腔容积并安全地将内脏复位从而随后闭合肌筋膜的新技术。我们报告了一例患有未经治疗的先天性脐膨出并发症的成年患者,该患者接受了腹壁组织扩张器联合前入路成分分离的成功两阶段手术。