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Recurrent Hernia Prevention and Treatment - part 5

Chúng tôi sẽ làm một thử nghiệm với Rotterdam về thoát vị rốn tìm kiếm bạn sẽ làm gì trong 2-thoát vị cm hoặc 1-cm thoát vị. Tôi không biết cho dù bạn có sử dụng một lưới trong trường hợp đó. Chỉ có rất ít bằng chứng, và chúng ta phải ngẫu nhiên những bệnh nhân này. Khoai tây: Trong nghiên cứu của chúng tôi, chúng tôi khuyên từ bỏ khâu sửa chữa. | 165 VI How to Create a Recurrence After Incisional Hernia Repair Simons I think there is a place for randomizing the small hernias suture vs. mesh. We are going to do a trial with Rotterdam on umbilical hernia looking for what do you do in 2-crn heeniasorl-crn Wrmas.I dorit know whether yoii have lo usem mesh intdatcase. There is only little evidence and eve rVoaldrandomizetheee patients. inourst ecr abaend nds eeen-. Now you say that when you have to do a suture repair you have to dp in id theffliawingway. eOnybeyouehoalSr go one step further and say never do suture repair and follow thefts smgtt iy fun. serioudproClems. a-there any indication for doing suture repair in the first place It dived so d one shrnzld neaer de it anyway. Simons An yon ttứking aVeusohe mmsfpeedtwe treirp ment Halm Yea.dodpetha ifm-oparogna trentrnentisr ftrr better choice than the suture repair. Simons l tídnk in asymptornaticpaSients there to a lot of room for non-operative treatment. Don t operate on cornplarn anlm egoge hemur send them home also because the risks don t outweigh the benefit. SimOns-Coverierithdmeehdllteyingfoelnie0sieabaomi-nal wall over the mesh vs. leaving the defect as it was or onlyapproxirnahngit. 0 ynuleaveadehect doynu suture the borders ofthedaiia tothernesh ordoỵouịas t stick to sgpiiesOO.gpa ttitpae aePMM d Flament In my opinion slvsurr ofths tissue mnfront eg the mesh So prevent conSacdbefween the skin and the mesh. Sdneetirnesifwe want. to dose the muse s we use some rrlnxingindsions butuot vergr often. We use anything we nan e.g.a smaS amourf aftitegeM sac but we never stitch the limits of the abdominal wall to the prosth i em. Snnn. nsdbtedeg . w . ne nan-dsn . 0 leave a defect after the Rives-Stoppa-Flament repair Flament If we give enough tension on the prosthesis we usually close the fascia in all cases. mng-ortSdTne Rivrs technipge in i hand ofcx produces extsemddfteod results Thereare no national surveys wedontreaItyndR iwhatdroportio nf general sure