Laparoscopic resection of inguinal recurrence of myxoid liposarcoma

This video demonstrates the single port laparoscopic treatment of a right indirect inguinal hernia in a 21-year-old male patient using the E.K. Glove port. This video will show the polypropylene mesh fixation and the repair of the peritoneal flaps performed exclusively by hand suturing.

The description of the transabdominal preperitoneal approach (TAPP) covers all aspects of the surgical procedure used for the management of inguinal hernia.
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: hernia types, Nyhus classification, laparoscopic classification, exposure and exploration, incision of peritoneum, preperitoneal dissection, hernia sac dissection, preperitoneal space, the mesh, mesh placement, fixing the mesh, closing the peritoneum.
Consequently, this operating technique is well standardized for the management of this condition.

Seroma formation represents one of the most common complications after laparoscopic ventral and incisional hernia repair. In this key lecture, Dr. Bonjer looks into the management of hernia defects in order to prevent seroma formation.

Introduction: Prolapse stands for one of the most common complications of colostomy (>10%). Parastomal incisional hernia also represents 10 to 50% of complications. When both are present, the Sugarbaker technique represents a good indication due to mesh repair and pseudo-subperitonization, which can manage both prolapse and hernia. The laparoscopic modified Sugarbaker technique can be performed laparoscopically even in case of multiple previous laparotomies.
Clinical case: We report the case of a 71-year-old male patient presenting with parastomal incisional hernia and stomal prolapse after multiple abdominal procedures for ulcerative colitis, including rectosigmoidectomy, Hartmann procedure for anastomotic leak, left extended colectomy and stomal transposition for ischemic necrosis. An intra-abdominal proctectomy was attempted to manage the recurrence of colitis on the rectal stump. However, this attempt proved unsuccessful, and a local abdominoperineal resection was performed. Due to symptomatic hernia and prolapse, the laparoscopic Sugarbaker modified surgical technique with intraperitoneal onlay mesh (IPOM) repair is performed to manage prolapse by pseudo-subperitonization and to manage hernia using an IPOM repair. As shown in this video, this technique is safe, reproducible, and effective.

This video demonstrates a TAPP repair for a doubly recurrent inguinal hernia. The difficulties encountered due to the previous attempts at repair are shown as well as how they are supervened.

In this lecture, Dr. Morales Conde briefly outlines laparoscopic ventral hernia repair in complex locations (including lumbar, suprapubic, subcostal, subxiphoid, and parastomal hernias). He presents technical difficulties and complex anatomy in the lumbar area. The importance of appropriate identification of all nerves for mesh fixation is essential to prevent inguinodynia. The author also develops this identification issue based on the experience of surgeons, taking into account the indications and diagnostic imaging techniques and corresponding defect reconstructions based on anatomical landmarks in order to prevent recurrence and avoid complications.