V-048 COMBINED ETEP AND OPEN APPROACH FOR M4 AND L3 VENTRAL HERNIA AFTER COMPLICATED INGUINAL HERNIA REPAIR

Abstract We present the case of a 49 y-o woman with previous open inguinal hernia repair superficial surgical site infection during immediate postoperative period. She required debridement and negative pressure therapy. Ten months after surgery she persisted discharge inflammatory changes. The preoperative CT-scan revealed misplaced mesh chronic changes in right hypogastric region. An M4 3,5cm diameter defect lateralized 13×5×10cm sac was also observed. A combined eTEP approach for removal retrorectus proposed. Retrorectus dissection began at left rectus muscle, using two 5 mm trocars crossover contralateral Hasson trocar placed. M4-5W2 L3 omental fat partial bladder sliding into posterior fascia fibrotic laterally retracted. After contents were fully mobilized, TAR necessary order to close peritoneum obtain an adequate placement. 25×20cm polypropylene placed retrorectal space. Using incision, previously infected removed silver coated below anterior fascia. patient discharged on third day her one month follow up visit uneventful. conclude that this hybrid can provide placement via eTEP, by less invasive approach.