Abstract
Introduction: Giant hernias induce changes which reduce the quality of life of patients and make their surgical management complex. Adequate preoperative preparation of the patient guarantees good postoperative progress. It is necessary to avoid resorting to a technique of separation of the compartments during the cure. Here we report the case of a patient who benefited a successful cure using the Ramirez technique. Observation: We report the case of a 60-year-old patient admitted to an outpatient clinic for abdominal swelling evolving for 30 years without the notion of trauma gradually increasing in volume. The interrogation and physical examination led to the diagnosis of a giant white line hernia with incarceration. A preoperative assessment and a preanesthetic consultation were carried out. Intraoperatively, the cecum, transverse colon, sigmoid, jejunum and greater omentum were incarcerated in the bag. After adhesiolysis we proceeded to resect the bag and cure it using the Ramirez technique. The consequences were simple and the patient was discharged on day 4 after her dressing and was seen on day 15, 1 month, 3 months and 1 year. The patient benefited from the placement of an abdominal compression sheath for 3 months. Conclusion: Success in the management of prosthetic material in the absence of prosthetic material depends on good preoperative preparation and the mastery of certain surgical techniques.
Highlights
Giant hernias induce changes which reduce the quality of life of patients and make their surgical management complex
Success in the management of prosthetic material in the absence of prosthetic material depends on good preoperative preparation and the mastery of certain surgical techniques
A giant hernia is defined by a collar width greater than 10 cm [1]
Summary
All patients with giant hernias must be assessed and optimized. In 1990 Ramirez described a technique which will bear his name: the components separation or separation of compartments. It consists of the incision of the tendon of the external oblique beyond the line semi-lunar [5] and the incision of the posterior sheath of the right muscles. The purpose of this work is to report an observation of a patient operated for giant hernia of the white line with incarceration by the technique of Ramirez with success
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