V-041 ENTEROCUTANEOUS FISTULA TAKEDOWN AND VENTRAL HERNIA REPAIR WITH PREPERITONEAL MESH

Abstract In this video, we present a 48-year-old otherwise healthy man with history of perforated appendicitis status post exploratory laparotomy and appendectomy, complicated by an intraabdominal abscess requiring re-exploration subsequent midline wound dehiscence, incisional ventral hernia, enterocutaneous fistula managed drain. Plastic surgery performed split thickness skin graft his wound, drain was kept in place until surgery. The patient taken to the operating room for takedown open repair hernia. We entered abdomen midline, far away from fistula. After lysing omental bowel adhesions, identified patient's entering small exiting about 10 cm distally. removed resection, including entry exit points drain, stapled side-to-side antiperistaltic anastomosis. Preperitoneal planes were developed bilaterally, peritoneum rearranged over partially closed omentum. placed biologic mesh into preperitoneal plane secured it transfascial sutures. then multilayer closure fascia dermis negative pressure dressing wound. discharged on postoperative day 4 after tolerating regular diet having full return function. summary, video demonstrates several important operative techniques our approach complex case.