Omphalocele is a rare congenital malformation which is a herniation of the abdominal viscera into the base of the umbilical cord. We experienced a ruptured large omphalocele of short duration which contained of intestines, stomach, liver and speen without major of additional anomalies. He was repaired with the simple skin converage as a part of second staged operation. He had an eventful postoperative course but wad discharged on the 52th postoperative days with the good condition and with the plan of repair of ventral hernia about 1 year. Here, the literature on omphalocele was reviewed with the experienced case briefly.
Hernia, Umbilical* ; Hernia, Ventral ; Intestines ; Liver ; Skin ; Stomach ; Umbilical Cord ; Viscera

BACKGROUND: The survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall. METHODS: We performed a chart review of five cases treated in our institution. RESULTS: Five patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case. CONCLUSIONS: Patients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects.
Abdominal Muscles ; Abdominal Wall* ; Fascia ; Gastroschisis ; Hernia, Umbilical ; Hernia, Ventral ; Humans ; Infant, Newborn ; Rectus Abdominis ; Survival Rate ; Tissue Expansion Devices

OBJECTIVETo review the treatment of repair gastroschisis with autogenous umbilical cord in 13-year and evaluate its effect.

METHODSTwenty-two newborns who underwent the repair gastroschisis with autogenous umbilical cord between 1992 and 2005. The physical growth, intelligence measuring, area of operation in abdomen in the survived 18 cases were observed and followed-up.

RESULTSEighteen patients recovered uneventfully, survival rate is 82%, their growth is well. They all developed incisional hernia near the operation, 9 cases recovered himself, 2 cases was operated to repair the abdominal hernia, 7 cases is under observed.

CONCLUSIONSThe material is adopted easily in the operating, autogenous umbilical cord is elastic tissue and no toxicity could relax the abdominal press effectively after the operation, the survival rate is high.

Female ; Follow-Up Studies ; Gastroschisis ; surgery ; Hernia, Ventral ; etiology ; Humans ; Infant, Newborn ; Male ; Postoperative Complications ; Umbilical Cord ; transplantation

Umbilical preservation can be challenging, particularly in complex cases involving simultaneous ventral hernia repair and abdominoplasty. Although the umbilicus serves no functional purpose, removal of the umbilicus can draw unwanted attention to the abdominal area and can cause emotional distress to patients. There are several well documented options for umbilical reconstruction. We present a new umbilical reconstruction technique relevant for such cases. This neoumbilicoplasty allows for preservation of the original umbilicus with relocation and reconstruction using local flaps. The technique is relatively simple and the time needed is minimal. The result is a natural, well positioned umbilicus using the principles of spare part surgery.
Abdominoplasty ; Hernia, Ventral ; Herniorrhaphy ; Humans ; Umbilicus

Repair of lower abdominal incisional hernia is always a surgical challenge. TAPE technique has been described for the repair of supra-pubic midline incisional hernia with satisfactory outcome. Its indication can be extended for treatment of non-midline lower abdominal hernia. Peritoneal incision is created just below the hernia defect with pre-peritoneal dissection to expose supra-pubic preperitoneal space with Cooper's ligament exposed. Non-adhesive mesh then placed over preperitoneal space and partially intra-peritoneally, and cover the whole extra-peritoneal space prepared to ensure enough overlapping. Mesh is fixed by tackers for intra-peritoneal part, most inferior fixation points were at peritoneal incision line. Extra-peritoneal part of meshes is fixed at the safety zone and covered up by the peritoneal flap to avoid mesh migration. Fixation of the meshes at the lateral aspects were facilitated by the peritoneal flap and subsequent fibrosis and adhesion to the extra-peritoneal structures in cases of lateral lower abdominal hernia. Repair of midline and lateral lower abdominal incisional hernia with this novel modified technique with prosthetic mesh is safe and effective. A larger case series and longer follow-up is required for validation of this technique.
Fibrosis ; Follow-Up Studies ; Hernia ; Hernia, Abdominal ; Hernia, Ventral* ; Incisional Hernia ; Ligaments

Since large-scale popularization of the surgical treatment of hernia in the 1990s, China has made great process in the field of hernia and abdominal wall surgery. In the treatment of incisional hernia of abdominal wall, a relatively complete system has been established in China, for instance, the formulation of guidelines, the purpose of incisional hernia treatment, the principle of surgical treatment, the choice of surgical methods, the improvement of material application, standardized treatment process, optimized management system. Common procedures of incisional hernia are open operations, including direct repair suture, bridging repair, and separation techniques of tissue construction. Meanwhile, the laparoscopic repair develops quickly in China as well. Compared with Western countries however, we still have a long way in overall level, for instance, treatment innovation, data integrity accumulation, quality control, technical innovation, new materials research, and monitoring of side-effects of implant materials. What we should consider and pay attention to is how to further develop hernia surgery and make it sustainable. Based on surgical experiences of incisional hernia in China, this paper intends to share the modern knowledge of incisional hernia and abdominal wall surgery.
Abdominal Wall ; China ; Hernia ; Hernia, Ventral ; Herniorrhaphy ; Humans ; Incisional Hernia ; surgery ; Laparoscopy ; Surgical Mesh

Two children with spigelian hernias are presented in this report. The etiopathogenesis and surgical anatomy of these rare hernias were discussed. Our cases are the fourth and fifth cases of spigelian hernia (SH) in patients under 2 years of age. Surgical intervention is indicated in all cases of SH because of the danger of strangulation of the bowel.
Case Report ; Hernia, Ventral/*diagnosis ; Human ; Infant ; Male

Hernia, Ventral ; surgery ; Humans ; Laparoscopy ; methods ; Surgical Mesh

Female ; Hernia, Ventral ; surgery ; Humans ; Laparoscopy ; methods ; Middle Aged

Direct suture repair with mesh reinforcement is the main surgical procedure in ventral hernia repair. The best place for mesh implantation is retromuscular space which means sublay. The most commonly used techniques are open sublay and laparoscopic IPOM repair. But open sublay repair may cause more trauma to the abdominal wall and result in more infections. Laparoscopic IPOM repair carries an increased risk in bowel injury, mesh-related complications and postoperative pain. Germany surgeon Reinpold developed a new technique defined as "MILOS concept" by combining the advantages of open sublay and laparoscopic IPOM repair. This technique uses mini or less incision hybrid with endoscopic technique to accomplish minimally invasive sublay repair. The MILOS operation has the advantages of less operative trauma, fewer postoperative complications, low recurrence rate and high economic efficiency. "MILOS concept" has been applied with several modifications by using endoscopic technique (EMILOS and eTEP) or robotic surgery. This new minimal invasive ventral hernia repair technique is accepted and applied in clinical practice by most surgeons worldwide. Several literatures already reported that this procedure had very good surgical outcomes, and confirmed its value in further popularization.
Hernia, Ventral ; surgery ; Herniorrhaphy ; Humans ; Laparoscopy ; Postoperative Complications ; Surgical Mesh