Abstract
IntroductionPrimary fascial closure can be a challenging step during a laparoscopic intraperitoneal onlay mesh (IPOM) repair for a ventral hernia. Case presentationWe present here a novel technique of using intravenous (IV) cannula as an alternative to suture passer for fascial closure during laparoscopic IPOM repair for a 59-year-old patient with an incisional ventral hernia. The placement of non-absorbable sutures for fascial closure was done with the help of a 14 gauge IV cannula instead of a transfascial suture passer. The rest of the procedural steps were the same as a standard laparoscopic IPOM repair. The patient's post-operative recovery was uneventful. DiscussionPrimary fascial closure during a laparoscopic IPOM hernia repair can be done either by intracorporeal or extracorporeal techniques, using interrupted or continuous sutures. We propose a novel alternative to suture passer in primary fascial closure. IV cannulas are widely available in hospital settings. The advantage of using an IV cannula instead of a suture passer is that they are widely available. Its single-use also eliminates the risk of transmissible diseases, and as it has a smaller diameter than suture passer, it requires a lower insertion force for successful placement. ConclusionAn IV cannula may be used as a more economical alternative to a transfascial suture passer. This technique is easily reproducible and does not violate the principles of primary fascial defect closure in laparoscopic ventral hernia repair.
Highlights
Primary fascial closure can be a challenging step during a laparoscopic intraperitoneal onlay mesh (IPOM) repair for a ventral hernia
There is evidence to suggest the benefits of primary fascial closure during laparoscopic IPOM repair such as reduced seroma formation
Up to 20% of patients develop incisional hernias after a midline laparotomy, and the incidence is doubled if the index operation is complicated by surgical site infection [1]
Summary
Primary fascial closure can be a challenging step during a laparoscopic intraperitoneal onlay mesh (IPOM) repair for a ventral hernia. CASE PRESENTATION: We present here a novel technique of using intravenous (IV) cannula as an alternative to suture passer for fascial closure during laparoscopic IPOM repair for a 59-year-old patient with an incisional ventral hernia. DISCUSSION: Primary fascial closure during a laparoscopic IPOM hernia repair can be done either by intracorporeal or extracorporeal techniques, using interrupted or continuous sutures. The advantage of using an IV cannula instead of a suture passer is that they are widely available. CONCLUSION: An IV cannula may be used as a more economical alternative to a transfascial suture passer. This technique is reproducible and does not violate the principles of primary fascial defect closure in laparoscopic ventral hernia repair
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