V-033 LATERAL INCISIONAL HERNIA. IPSILATERAL ENDOSCOPIC TRANSVERSUS ABDOMINAL RELEASE AND PREPERITONEAL REPAIR

Abstract We present the clinical case of a 58 year old patient with left subcostal incisional hernia, years after an emergent aortic thrombectomy and aortobifemoral bypass. The physical examination revealed lateral bulge near anterior axillary line. CT findings showed 5 cm defect without significant muscular atrophy. An endoscopic ipsilateral transversus abdominal release (TAR) preperitoneal mesh repair was successfully performed. 1: Port placement. used one 10 mm port two ports in near-midline position. 2: Retrorectal Bogros space dissection. Locating arcuate line opening posterior rectus sheath we then proceeded (in down to up direction). 3: Hernia After hernial sac is identified opened it explore peritoneal cavity possible adhesions if encountered. 4: Full Once dissection finished, fully completed TAR order achieve satisfactory for 5: Defect closure. performed two-plane resorbable continuous barbed suture. 6: Mesh measured surgical insert tailored lay fixation or drain. Clinical outcome: discharged on postoperative day 1 took acetaminophen 3 times daily 48 hours, due good pain control. On first followup (10 days) had resumed usual activities, driving already back work. He advised avoid heavy efforts.