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Background The European and American guidelines recommend that symptomatic umbilical hernias (UHs) are repaired using an open approach with a preperitoneal flat mesh. However, the standard treatment procedure for large UH in patients with extreme obesity is yet to be established. Here, we present the first case of a patient with morbid obesity undergoing laparoscopic UH repair using needlescopic instruments and an intraperitoneal onlay mesh plus repair (IPOM plus). Case presentation A 29-year-old man, who was classified as morbidly obese (body mass index, 36.7 kg/m2) noticed a reducible nontender mass in the umbilical region and was subsequently diagnosed with an UH, with a diameter of 4 cm. Laparoscopic IPOM plus repair was planned using a needlescopic method for a large UH in the patient with morbid obesity. A 3-mm rigid laparoscope was mainly used in the procedure. After a 12-mm trocar and two 3-mm trocars were inserted, fascial defect closure was performed using intracorporeal suturing with 0 monofilament polypropylene threads. Then, IPOM was performed laparoscopically using an 11.4-cm round mesh coated with collagen to prevent adhesions. The operative time and blood loss were 57 min and 1 g, respectively. The postoperative course was uneventful. Conclusions Reduced-port laparoscopic surgery using needlescopic instruments and an IPOM plus technique is a minimally invasive and convenient combination option for large UH in a patient with morbid obesity.
Left paraduodenal hernia treated by single-incision laparoscopic surgery: a case report, Surgical Case Reports
Left paraduodenal hernia treated by single-incision laparoscopic surgery: a case report, Surgical Case Reports
Akira Sasaki's research works Iwate Medical University, Morioka and other places
Single-port Versus Multiport Laparoscopic Cholecystectomy: A Prospective Randomized Clinical Trial
Needlescopic surgery for large umbilical hernia in a patient with morbid obesity using intraperitoneal onlay mesh with fascial defect closure: a case report, Surgical Case Reports
Needlescopic surgery for very low rectal cancer with no abdominal skin incision - Fukuoka - 2020 - Asian Journal of Endoscopic Surgery - Wiley Online Library
a) The retrorectal space was completely opened, (b) a composite mesh
Laparoscopic Pediatric Inguinal Hernia Repair; Intracorporeal Purse-String Suture Using Needlescopic 2-mm Instruments. - Abstract - Europe PMC
PDF) Needlescopic suturless repair of congenital inguinal hernia: A randomized controlled study
111616 PDFs Review articles in HERNIA
Images showing operative findings: (a) an incision over the 5-mm wound
