videowidth=\"640\"height=\"480\"controllsList=\"nodownload\"poster=\"https://www。不屈腕痛.ro/pdfs/video/Victor_Gheorghe_Radu_L3W3_切口_疝。jpg\"style=\"margin-top:-20px;\"sourcesrc=\"https://www。不屈腕痛.ro/pdfs/video/Victor_Gheorghe_Radu_L3W3_切口_疝。mp4\"type=\"video/mp4\"您的浏览器不支持视频标记。/视频简介:Rives-Stoppa手术已成为腹侧疝修复的首选方法,该技术的原理同样适用于使用eTEP(增强视图完全腹膜外)方法的微创手术。看来,eTEP方法在减少术后疼痛方面提供了出色的结果,更快的恢复,腹壁重建术(AWR)患者的住院时间较短。重要的是要注意,这个程序有一些禁忌症。总的来说,腹腔镜eTEP可能不适用于大疝和工作空间有限的领域缺失的病例。在这种情况下,替代方法,比如使用机器人平台,可考虑确保腹壁重建(AWR)有足够的工作空间。机器人平台可以通过使用机器人手臂作为“腹腔镜升降机”来创建工作空间,\"启用要执行的AWR。案例报告:在这种情况下,我们有一名65岁的女性患者,BMI为28.5,表现为巨大的切口疝和LOD.该疝位于右侧腹,发生在Jalaguier切口后。CT扫描提供了有关疝气大小的有价值的信息,腹腔的剩余体积,和疝囊的内容。根据这些放射学细节,使用Sabbagh方程确认了LOD诊断,显示疝体积占总腹膜体积的46.47%。根据位置,缺陷的大小,切口疝的EHS分类,这种情况的诊断是L3右W3的复杂切口疝,LOD。在这种情况下,优化方案涉及化学松弛,是指将肉毒杆菌毒素A(BTA)注射到腹部的大外侧肌肉中。这在手术前大约6周进行。基于会诊期间疝气的成功复位,已决定使用机器人eTEP-TAR技术进行腹壁重建(AWR)手术.结论:术后病程良好,随着患者经历早期主动动员,减轻疼痛,排便提前恢复.患者在手术后的第二天出院。
video width=\"640\" height=\"480\" controls controlsList=\"nodownload\" poster=\"https://www.revistachirurgia.ro/pdfs/video/Victor_Gheorghe_Radu_L3W3_Incisional_Hernia.jpg\" style=\"margin-top: -20px;\" source src=\"https://www.revistachirurgia.ro/pdfs/video/Victor_Gheorghe_Radu_L3W3_Incisional_Hernia.mp4\" type=\"video/mp4\" Your browser does not support the video tag. /video Introduction: The Rives-Stoppa procedure has emerged as the preferred method for ventral hernia repair, and the principles of this technique are similarly applied in minimally invasive surgery using the eTEP (enhanced view totally extraperitoneal) approach. It appears that the eTEP approach offers excellent outcomes in terms of less post-operative pain, faster recovery, and shorter hospital stays for patients undergoing abdominal wall reconstruction (AWR). It\'s important to note that there are some contra-indications of this procedure. In general, laparoscopic eTEP may not be suitable for cases with large hernias and loss of domain where the working space is limited. In such cases, alternative approaches, such as using a robotic platform, may be considered to ensure an adequate working space for abdominal wall reconstruction (AWR). A robotic platform can create a working space by using the robotic arms as a \"laparo-lift,\" enabling the AWR to be performed. Case Report: In this case, we have a 65-year-old female patient with a BMI of 28.5 who presents with a large incisional hernia with LOD. This hernia is located on the right flank and occurred after a Jalaguier incision. The CT scan provided valuable information regarding the size of the hernia, the remaining volume of the abdominal cavity, and the content of the hernia sac. Based on these radiological details, the LOD diagnosis was confirmed using the Sabbagh equation, which revealed that the hernia volume accounted for 46.47% of the total peritoneal volume. Based on the location, size of the defect, and the EHS classification for incisional hernias, the diagnosis for this case is a Complex incisional hernia of L3 right W3 with LOD. The protocol for optimization in this case involves chemo-relaxation, which refers to the injection of botulinum toxin A (BTA) into the large lateral muscles of the abdomen. This is done approximately 6 weeks before the surgery. Based on the successful reduction of the hernia during the consultation, the decision has been made to perform the Abdominal Wall Reconstruction (AWR) procedure using the robotic eTEP-TAR technique. Conclusion: The post-operative course was favorable, with the patient experiencing early active mobilization, reduced pain, and early return of bowel movement. The patient was discharged the day after the surgery.