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828 Prevention and treatment of incisional hernia after laparotomy in gynecologic oncology. Abdominal wall closure with mesh
  1. Ana Conde Adán,
  2. Rafael Navarro,
  3. Carmen Yelo,
  4. María F Chereguini,
  5. Sonsoles Alonso,
  6. Virginia Corraliza,
  7. María Cuadra,
  8. María Luisa Argente and
  9. Javier De Santiago
  1. MD Anderson Cancer Center, Madrid, Spain


Introduction/Background Incisional hernia is a frequent complication after gynecologic oncology surgeries.

Gynecologist do not receive appropriate training in abdominal wall closure, so we consider this video could be useful for learning and reviewing this topic.

Methodology We will show through this video different approaches of abdominal wall closure to prevent and treat incisional hernia.

Results Continuous suture with slowly absorbable monofilament using small bites is the best technique to perform an effective abdominal wall closure.

In woman with risk factors, such us obesity, previous laparotomies, diabetes, smokers, collagenopathies, or tumor infiltrating abdominal wall a mesh can be considered.

We present 4 videos.

  • Case 1– Onlay technique, the mesh is located over the fascia.

  • Case 2– Sublay technique, the mesh is located over the posterior sheet of rectus muscle fascia. Extirpation of previous mesh and reinforcement of abdominal wall.

  • Case 3– Hernia sac resection and mesh.

  • Case 4– Tumor infiltration of abdominal wall; tumor resection, component separation technique and mesh.

Conclusion Gynecologist oncologist must be familiar with mesh placement.

Incisional hernia can be preventable using abdominal wall closure recommendations and meshes if needed.

Disclosures None.

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