Ventral hernia repair

Ventral hernia repair

Anesthesia type	General
Airway	ETT
Lines and access	PIV
Monitors	Standard
Primary anesthetic considerations
Preoperative
Intraoperative	Avoid coughing with extubation Consider deep extubation
Postoperative
Article quality
Editor rating	In development
User likes	0

Ventral hernia repair is a procedure to correct ventral hernias, which are a common complication of intraabdominal surgery. Even after surgical repair, incisional hernias may return. Some ventral hernias can be congenital.

Preoperative management

Patient evaluation

System	Considerations
Airway
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

• None

Operating room setup

• Standard

Patient preparation and premedication

• Standard

Regional and neuraxial techniques

• TAP block can be considered for large/open procedures

Intraoperative management

Monitoring and access

• Standard monitors
• One peripheral IV is usually sufficient

Positioning

• Supine, arms usually out for open procedures

Maintenance and surgical considerations

• Standard laparoscopic concerns (peritoneal stretch response with insufflation, OG tube to suction out stomach prior to insufflation, etc)
• Open procedures are usually quicker and easier for surgeons

Emergence

• Avoid coughing with emergence, as increased intraabdominal pressure can stress the incision.
  • Consider deep extubation
• Some surgeons place abdominal binder before vs. after emergence, which are tight and can cause some restriction with breathing.

Postoperative management

Potential complications

• Infection involving the prosthetic biomaterial (mesh)
• Postoperative ileus seromas
• DVT
• Dehiscence with profound coughing during emergence

Procedure variants

	Laparoscopic	Open
Unique considerations
Position	Supine	Supine, arms usually out
Surgical time	Approximately 30 minutes longer than open	1-2 hours
EBL	Minimal
Postoperative disposition	PACU	PACU
Pain management	Not usually significantly painful	Consider TAP block if large incision/extensive
Potential complications