Recurrent Incisional Hernia due to Pseudomyxoma Peritonei

Pseudomyxoma peritonei is a rare but challenging neoplastic disease which is characterized with intraperitoneal mucinous-gelatinous fluid accumulation. It rarely presents as a mass mimicking abdominal wall hernias A recurrent incisional hernia due to pseudomyxoma peritonei is presented here. A 60-year-old female patient had been operated on for a left mucinous ovarian cyst 20 cm in diameter in 1998. Mucinous material had disseminated into interloop spaces through the right subdiaphragmatic region. Total abdominal hysterectomy + bilateral salpingooophorectomy and peritoneal toilet had been performed. She was rehospitalized for abdominal distention and a 4 cm defect over the incision and underwent a hernia repair using polypropylene mesh in 2001. Abdominal distention recurred to give a rise to an incisional hernia in 2006. She was reoperated for decompression and repair, but nothing could be done because of sticky adhesions and the incision were simply closed. The patient was referred to our department for operation. A prosthetic hernia repair with 30 × 30 cm polypropylene mesh was performed. The patient was discharged on the postoperative 5th day following an uneventful recovery. However, she died of disseminated disease after 18 months

Instant Abdominal Wall Reconstruction with Biologic Mesh following Resection of Locally Advanced Colonic Cancer

We present a case of immediate abdominal wall reconstruction with biologic mesh following the resection of locally advanced colonic cancer. The tumor in the right colon did not respond to neoadjuvant chemotherapy. Surgical enbloc excision, including excision of the invasion in the abdominal wall, was achieved, and the defect was reconstructed with porcine dermal collagen mesh. The patient was discharged with no complication, and adaptation of the mesh was excellent at the six-month followup

A simple modified technique for repair of umbilical hernia in patients undergo laparoscopic cholecystectomy. Report of 10 cases

Introduzione e scopo. L’ernia ombelicale spesso si associa a colelitiasi. È possibile realizzare la plastica dell’ernia dopo la colecistectomia in un unico tempo laparoscopico. Descriviamo una semplice modifica tecnica utile in questi casi. Pazienti e metodi. La tecnica modificata è stata realizzata in 10 pazienti sottoposti a colecistectomia laparoscopica. Effettuata la colecistectomia, l’incisione del trocar periombelicale è prolungata verso l’ombelico. Si riporta quindi il sacco erniario in cavità e con 1-2 punti di sutura si avvicinano i bordi fasciali del difetto erniario, sempre attraverso l’incisione realizzata per l’introduzione del trocar. Una mesh in polipropilene viene quindi posizionata direttamente sulla superficie peritoneale (onlay) e fissata ai quattro punti cardinali, a coprire il difetto erniario e l’incisione per il trocar dell’ottica (overlap). Risultati. Non abbiamo registrato alcuna complicanza delle incisioni addominali né recidive a un follow-up mediano di 23 mesi (range 6-40). Conclusioni. Questa semplice modifica tecnica è particolarmente utile in centri con esperienza di videolaparocolecistectomia nei quali la riparazione laparoscopica dell’ernia ombelicale non è invece pratica frequente o mancano materiali e strumentazione specifici per realizzarla