By Michael J. Rosen MD FACS
An very important assessment on stomach wall reconstruction for the final health care professional! subject matters will contain preoperative optimization of a ventral hernia sufferer, prevention of incisional hernias, laparoscopic ventral hernia fix, open ventral hernia fix, bizarre hernias, epigastric and umbilical hernias, parastomal hernia fix, flap reconstruction, artificial mesh, scientific results of biologic mesh, pediatric hernias, takedown of enterocutaneous fistula, a assessment of laparoscopic as opposed to open inguinal hernia, and extra!
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Additional info for Abdominal Wall Reconstruction, an Issue of Surgical Clinics,
The surgical treatment of gastroschisis and omphalocele has undergone some advancement with the use of various silos and meshes. Laparoscopic Versus Open Inguinal Hernia Repair Leandro Totti Cavazzola and Michael J. Rosen The laparoscopic approach to inguinal hernia surgery is safe and reliable. It has a similar recurrence rate as open tension-free mesh repair. Because the laparoscopic approach has less chronic postoperative pain and numbness, fast return to normal activities, and decreased incidence of wound infection and hematoma, it should be considered an appropriate approach for inguinal hernia surgery.
Without commenting on the merits of these changes, the net result of this for most programs was a marked decrease of exposure to patients for all residents to some degree but even more impactful on PGY-1 residents. Also lost substantially, but perhaps less often written about, was the decreased ability (because of work hour constraints, not other regulations) for a senior resident to serve as “teaching assistants,” a role that most certainly focuses the mind of many surgeons. The trainees have changed as well.
To the significance of a high SL to WL ratio must now be added the importance of closing wounds with small stitches. Thus, methods must be found to implement an adequate suture technique regarding both these factors. To achieve this, it is probably wise to focus on surgeons in training and teach them a proper technique during the early period of their education. In Sweden, the British Basic Surgical Skills Course has been adopted and slightly modified to be compatible with Swedish conditions. During this mandatory course, all Swedish residents in surgery are taught the principles outlined in this article.
Abdominal Wall Reconstruction, an Issue of Surgical Clinics, by Michael J. Rosen MD FACS