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Plastica per laparocele sovrapubico

Patient 73, female, previously operated for hysterectomy.
size 15x15 cm wall defect. Location
deli operators:
- First operator to the left
- Cameraman to the left of the previous
- Instrument to the right patient at the end of the lower
position for display
- the main to the right of the patient at the hip
- the second left for the instrumentalist
bladder catheter (CH 16) Socks
antitrombo

Wire Suture & Blades

• Blade 10 x 1 for normal access
• Blade 11 x 1 for entry needle Bercy
• absorbable 3 / 0 x 1 for cute
• Prolene 0 or 1 x 2 if you need to reduce the defect before placing the prosthesis
• spinal needle Black defining the perimeter of the defect

Garrison

• Copritelecamera
• dermographic pencil for marking the perimeter of the defect
• 1 x 10 ml syringe for local anesthesia (Naropin 10)
• Naropin 10 x 1 flc
• Prosthetics dedicated high softness and adaptability ETHICON ® PhisioMESH ™
• Protak 5mm (30 points)

Annotations

• control column video
• when applying the fixing points of the prosthesis, it is necessary to lower the intra-abdominal pressure of 8 mm / Hg

bed and Positions

• supine, arms abduced
• patient on board left / right of the bed according to the position of surgeon
• Once the pneumoperitoneum, the patient was placed in moderate Trendelenburg and lateralized by the operator

Description of

1. Access supra-umbilical, with trocar 10, the optical input (scalpel, two Halstead, scissors, Halstead, tobacco pouch, trocar)
2. Inflation at 3 liters / min and patient positioning
3. pararectal additional access right and esinistro


4. Exploration of the peritoneal cavity, defect isolation, lysis of peritoneal adhesions with bipolar scissors and Johanne. Dissection of the bladder and placement of the prosthesis after the bladder was inflated with 200 ml. Sol of FIS. catheter through the hemostasis control
6. Delimitation of the perimeter with spinal needle and pencil dermographic. Measurement of larger diameters. Preliminary Correction of the defect with prolene needle Bercy and 0
7. Change gloves
8. Preparation of the implant (depending on the surgeon's choice) and insertion through a trocar 10.
9. Lowering of intra-abdominal pressure of 8 mm.Hg.
10. positioning and deployment of the prosthesis, along the lines indicated by the prosthesis, with the help of two Johanne.
11. prosthesis fixation points Protak
12. count of instruments and garzame
13. deli access closure after infiltration Naropin 10 1 fl.