Kesava Reddy Mannur
Homerton University Hospital, UK
Keynote: Surgery Curr Res
BACKGROUND: Incisional hernias develop in the repairs of the large umbilical hernias in almost 50% and recurrence in the repair of the incisional hernias in almost 80%. We looked at the results of our method of repair to see how good it is METHOD: I describe a technique where the hernia is repaired by combined laparoscopicand open closure of the defect where it is more than 3 cm andopen closure of the defect where it is more than 3cm. Laparoscopy is first perfomed and remove all the adhesions and reduce all the contents of the hernia into the abdominal cavity. Then the hernia is tackled by open method. The skin could be excised if really required. The sac is excised. The edges of the hernia are trimmed. Many interrupted far near sutures applied and the edges are brought together with a continuous suture no â??1â??PDS suture and the interrupted sutures are tied. An appropriate size mesh is inserted into abdomen and fixed to the anterior abdominal wall with â??Protackâ?? stapler and some sutures. A subcutaneous drain is inserted. The skin wounds are closed with clips or sutures as required. A pressure dressing applied. Results: 27 repaired by combined open and laparoscopic method and 47 by percutaneous and laparoscopic methods. Theseroma was minimal in 5 patients in combined open and none in percutaneous ones. There was no recurrence of hernias up to now Discussion: I strongly feel that the hernias have to be repaired by combined Laparoscopic and open/percutaneous means.
Kesava Mannur FRCS biodata: Has been a consultant surgeon for 22years. Started Laparoscopic work at the Royal London Hospital in 1999 and Bariatric surgery in 1998. Performed more than Published a number of papers and presented in numerous national and international conferences and similarly demonstrated live surgery - laparoscopic and bariatric surgeries. Has been consultant surgeon and director of bariatric surgery at Homerton University Hospital, London since 2003. Regularly conducts Bariatric surgery training courses and Bariatric surgery symposia since 2010. Member of BOMSS (British obesity and metabolic surgery) council and NICE advisory committee.
Email: kmannur@gmail.com
