Juan Carlos Ortiz Calle Md. BA Mgr.
General Surgery Specialist
Training Course in Avanzada Laparoscopic Surgery Corrientes Argentina
Training Course in Abdominal Wall Surgery Fundación Santa Fe Bogotá Colombia
Professor at the University of Cuenca Chair of General Surgery
Staff surgeon at the Santa Ana Surgical Medical Center
Surgeon of the HEJCA Liver and Kidney Transplantation team
Hernia pathology is a subject that encompasses discussions in academic and technological fields, both due to its impact on frequency and complications and work disability. The creation of new diagnostic techniques and surgical approach, both open and laparoscopic, has presented a singular activity in relation to other pathologies.
The incisional hernia (HI) is the exit of the peritoneum, accompanied or not by abdominal viscera, through a weakened area of the abdominal wall, due to a surgical or traumatic procedure, other than the natural orifices through which primary ventral hernias emerge.
The frequency of presentation of abdominal incisional hernia is from 3 to 13% after conventional surgery and from 0.8 to 2.8% by laparoscopy, in common procedures such as cholecystectomies or appendectomies, 50% of IH develop in the first two years after surgery. surgical procedure.
Since 1836, there are records of surgical techniques for the correction of abdominal IH, exponents such as Doctor Goñi Moreno in 1947 described the technique of progressive pneumoperitoneum, for abdominal hernias with loss of right to dwelling, between 1970 and 1980 the biological theory of hernias. (Peacock, Read). In 1989, Dr. Lichtenstein revolutionized hernia surgery using the "tension-free plasty" technique; in 1993, Le Blanc described laparoscopic hernia repair.
Undoubtedly, laparoscopic or minimally invasive techniques offer greater advantages in terms of shorter operating time, incidence of seromas, hematomas, wound infection, hospitalization time, which allow an early return to normal activities and work; To a large extent, the use of high-resolution cameras and ports (the place where the instruments enter) with a diameter of 5mm or less reduce postoperative pain. The use of synthetic intra-abdominal meshes with macroporous structures facilitate the growth of new tissue, produce the "plug" effect and not a "patch" by redistributing intra-abdominal pressure (Pascal's principle), with the virtue of being in direct intestinal contact through a non-stick coating.
Laparoscopic hernioplasty is a novel, accessible surgical technique that has been performed at our Santa Ana surgical medical center for 14 years with low recurrence and morbidity and mortality rates.