cm-rom
Forum Replies Created
-
I would recommend mesh based repair if she is symptomatic or if the hernia is growing in size..
Hernia is growing in size: is it the sack or the defect? Or both?
Presuming it is omentum that’s adherent to the sack (MRI), not fully incarcerated, can someone expect to reach an equilibrium of sack’s volume at one point? How would someone weight the risk of omentum gangrene/ischemia or even possible bowel/mesentery absorption into the hernial sack, in such cases where defect is ~ 1.5 inches? What is the trigger to crossover from watchful waiting before it is too late? Is there a golden ratio between sack volume/sack neck implied?Thank you!
-
Dr. Towfigh, thank you for the reply – I am watching your activity with great interest.
The reason I’m constantly scratching my head is: let us presume that you have waited a few years: no pain no drama – the defect of the fascia is relatively small (less than 3mm as indicated by the CT scan) and it stays the same while you avoid jumping high/coughing strongly – what is the probability that anything else but the omentum to fill your hernia sac? Omentum should be smart enough to fill the gap, to avoid the bowel (which is 2-2.5mm for a grown up) to protrude the defect, correct? Is this omentum or the pre-peritoneal fat affected by the abdominal muscles constriction? My understanding is that we are able to travel to the moon but we are partially able to understand how this organ works or how to solve issues related to the peritoneum hurt induced adherences…. -
Can you please elaborate further on the reasons making the mesh slip/move when sutured to the muscular structures around the fascia defect, considering a reasonable shrink rate (currently achievable with the new introduced materials)?
-
There are no similar studies with the same accuracy (at least I wasn’t able to find one) on ventral post incisional (para umbilical/epigastric) for watchful waiting emergency admission prognosis. What is your perspective on this? Would you apply a “no go” management (in case of no pain/no defect advance/no cosmetic reasons) for ventral post incisional hernias? Does the size of the defect matter in this case?