Presentation is loading. Please wait.

Presentation is loading. Please wait.

Self Check (Part 5) Questions: Component Separation 1 Ventral Hernia Repair Component Separation.

Similar presentations


Presentation on theme: "Self Check (Part 5) Questions: Component Separation 1 Ventral Hernia Repair Component Separation."— Presentation transcript:

1 Self Check (Part 5) Questions: Component Separation 1 Ventral Hernia Repair Component Separation

2 Component Separation Learning Objectives 2 After completing this section, you will be able to: State the purpose for using the component separation technique in ventral hernia repair procedures Select the appropriate surgical instrument and perform each step of component separation Name the surgical instruments being used in the surgery Evaluate whether or not additional advancement of component separation is necessary Suggest two methods of additional advancement List the steps required to perform each method of component separation additional advancement Ventral Hernia Repair Component Separation

3 Self Check: Question 1 3 Ventral Hernia Repair What is the purpose for performing a component separation in ventral hernia procedures? Select all that apply. It speeds up the hernia repair surgery It provides stronger tissues with which to attach the mesh It enables the rectus abdominal muscles to reach each other so they can be sutured together to cover the defect Post-surgical abdominal function is maintained – most patients are able to rotate their body after healing Component Separation

4 Self Check: Question 2 4 Ventral Hernia Repair Which surgical instruments are used in the component separation when the external oblique muscle is being separated from the internal oblique muscle? Select all that apply. Kocher clamps are being used to pull the tissue tautly Electrocautery is being used to dissect the tissues from each other A Right-Angle clamp is being used to guide the electrocautery Surgical scissors are used to snip and separate the tissues from each other Component Separation

5 Self Check: Question 3 5 Ventral Hernia Repair What are the two methods used for additional advancement of component separation if the two rectus abdominis muscles do not reach each other? Select all that apply. Posterior Sheath Elevation Anterior Sheath Elevation External Oblique Muscle Elevation Internal Oblique Muscle Elevation Component Separation

6 Self Check: Question 4 6 Ventral Hernia Repair When is it necessary to use additional advancement techniques for component separation? Select only one answer. When about one or two more centimeters will enable the rectus abdominis fasciae to meet comfortably When the rectus abdominis fasciae meet comfortably When the external oblique muscle cant be separated from the internal oblique muscle When the defect is smaller than one to two centimeters Component Separation

7 Self Check: Question 5 7 Ventral Hernia Repair Which procedure provides the most advancement after performing the component separation? Select only one answer. Separating the external oblique muscle from the abdominal wall Making an incision in the middle of the rectus abdominis sheath Separating the anterior sheath from the rectus abdominis muscle laterally Separate the posterior sheath from the rectus abdominis muscle medially Component Separation

8 Self Check: Results [questions component separation] 8 Ventral Hernia Repair Component Separation

9 Self Check (Part 5) Questions: Onlay Position 9 Ventral Hernia Repair Onlay Position

10 Onlay Position Learning Objectives 10 Ventral Hernia Repair Onlay Position After completing this section, you will be able to: Perform the steps to implant the Strattice® Tissue Matrix using the Onlay (Overlay) position Identify the appropriate surgical condition in which Strattice® Tissue Matrix can be positioned in the Onlay position Explain how to prepare the Strattice® Tissue Matrix before proceeding with the implant Explain how the Strattice® Tissue Matrix will be sutured and to which tissues Name advantages of using the Onlay position

11 Self Check: Question 1 11 Ventral Hernia Repair What is the other term to used to describe implantation of the Strattice® Tissue Matrix in the Onlay position? Select only one answer. Underlay Inlay Sublay Overlay Onlay Position

12 Self Check: Question 2 12 Ventral Hernia Repair Which surgical condition is necessary in order to place the Strattice® Tissue Matrix in the onlay position? Select only one answer. Before the rectus abdominis fasciae has been closed with sutures After the rectus abdominis fasciae has been closed with sutures When the hernia defect is so large, that the rectus abdominis fasciae cannot be sutured together Only if the patient has an infection around the site of the hernia Onlay Position

13 Self Check: Question 3 13 Ventral Hernia Repair Which statements are true when preparing Strattice® Tissue Matrix for implantation? Select all that apply. The mesh must soak in either sterile saline solution or sterile Lactated Ringers solution prior to implantation The mesh must soak in either sterile saline solution or dextrose 5% solution prior to implantation The mesh must soak in the solution at room temperature for 4 hours prior to implantation The mesh must soak in the solution at room temperature for 2 minutes prior to implantation Onlay Position

14 Self Check: Question 4 14 Ventral Hernia Repair What is the purpose of using quilting stitches after the Strattice® Tissue Matrix has been sutured on the sides, top and bottom? Select all that apply. The quilting stitches secure the mesh to the rectus abdominis fascia, thereby reducing tension on the closure It is less likely that fluid that gets between the mesh and the rectus abdominis fasciae will lift the mesh upwards Fewer stitches on the sides are needed The risk of infection is reduced Onlay Position

15 Self Check: Question 5 15 Ventral Hernia Repair Sometimes a mesh is not used in hernia repair. Which of the following are advantages for using a mesh in repairing hernias? Select all that apply. The mesh provides added support of the closure, thereby helping to reduce tension on the sutures holding the fasciae together The mesh reinforces the weakness that was created when the external oblique fascia were divided The risk of incisional hernia recurrence secondary to hernia surgery may be reduced The implanted mesh may enhance the function of the external oblique muscles on both sides by pulling the muscles toward the midline Onlay Position

16 Self Check: Results [onlay procedure] 16 Ventral Hernia Repair Onlay Position

17 Self Check (Part 5) Questions: Retrorectus Underlay Procedure 17 Ventral Hernia Repair Retrorectus Underlay/Sublay Position

18 18 Ventral Hernia Repair Onlay Position After completing this section, you will be able to: Perform the steps to implant the Strattice® Tissue Matrix using the retrorectus underlay (sublay) position Identify the appropriate surgical condition in which Strattice® Tissue Matrix can be positioned in the retrorectus underlay position Identify the two types of sutures that can be used when stitching the mesh laterally to the anterior rectus sheath Name the advantage of implanting the Strattice® Tissue Matrix the retrorectus underlay position Retrorectus Underlay/Sublay Position Learning Objectives

19 Self Check: Question 1: Retrorectus Underlay Procedure 19 Ventral Hernia Repair What is the other term to used to describe implantation of the Strattice® Tissue Matrix in the underlay position? Select only one answer. Onlay Inlay Sublay Overlay Retrorectus Underlay/Sublay Position

20 Self Check: Question 2: Retrorectus Underlay Procedure 20 Ventral Hernia Repair Which surgical condition is necessary in order to place the Strattice® Tissue Matrix in the retrorectus underlay position? Select all that apply. After the rectus abdominis fasciae has been closed with sutures When the hernia defect is so large, that the rectus abdominis fasciae cannot be sutured together When the rectus fasciae meet comfortably at the midline Before the rectus abdominis fasciae has been closed with sutures Retrorectus Underlay/Sublay Position

21 Self Check: Question 3: Retrorectus Underlay Procedure 21 Ventral Hernia Repair What two types of sutures can be used when stitching the mesh laterally to the anterior rectus sheath? Select all that apply. Apex suture Quilting suture Running horizontal mattress suture Interrupted figure of eight suture Retrorectus Underlay/Sublay Position

22 Self Check: Question 4: Retrorectus Underlay Procedure 22 Ventral Hernia Repair What is the advantage of using the retrorectus underlay position for implanting the mesh in repairing hernias? Select one answer. The procedure takes less time because there is less suturing involved Less mesh is required Theres an additional layer of closure : the mesh can be positioned between the sutured posterior retrorectus fasciae and the sutured anterior rectus sheath Theres less chance of infection Retrorectus Underlay/Sublay Position

23 Self Check: Results [Retrorectus Underlay Procedure ] 23 Ventral Hernia Repair Onlay Position

24 Self Check (Part 5) Questions: Underlay Technique in the Intraperitoneal Position Procedure 24 Ventral Hernia Repair Strattice® Underlay Technique in the Intraperitoneal Position

25 Underlay Technique in the Intraperitoneal Position Learning Objectives 25 Ventral Hernia Repair After completing this section, you will be able to: Perform the steps to implant the Strattice® Tissue Matrix using the underlay procedure in the intraperitoneal position Identify the appropriate surgical condition in which Strattice® Tissue Matrix would be implanted using the underlay technique in the intraperitoneal position State the number of centimeters the edges of the abdominis muscles should overlap with the mesh Calculate the size of the mesh to be measured, given the width of the defect Identify the two types of suture techniques that can be used when securing the mesh as a bridge in the intraperitoneal position Strattice® Underlay Technique in the Intraperitoneal Position

26 Self Check: Question 1: Underlay Technique in the Intraperitoneal Position Procedure 26 Ventral Hernia Repair When would it be necessary to perform a ventral hernia surgery using the underlay technique in the intraperitoneal position? Select only one answer. When the rectus abdominis muscles meet comfortably at the midline After the rectus abdominis muscles have been sutured together When the rectus abdominis muscles dont meet comfortably at the midline When the defect is small Strattice® Underlay Technique in the Intraperitoneal Position

27 Self Check: Question 2: Underlay Technique in the Intraperitoneal Position Procedure 27 Ventral Hernia Repair How many centimeters (cm) should the edges of the rectus abdominis muscles overlap with the Strattice® mesh? Select only one answer. 1-2 cm 3-5 cm 6-10 cm More than 10 cm Strattice® Underlay Technique in the Intraperitoneal Position

28 Self Check: Question 3: Underlay Technique in the Intraperitoneal Position Procedure 28 Ventral Hernia Repair How wide should the Strattice® mesh be cut if the size of the defect is 10 cm wide? Select only one answer. 10 cm cm cm cm Strattice® Underlay Technique in the Intraperitoneal Position

29 Self Check: Question 4: Underlay Technique in the Intraperitoneal Position Procedure 29 Ventral Hernia Repair Which of the following statements is/are true when implanting the mesh in the underlay intraperitoneal position? Select all that apply. Strattice® Underlay Technique in the Intraperitoneal Position The mesh can be implanted using interrupted figure-of-eight sutures all around or with running horizontal mattress sutures laterally The mesh lays flush against the peritoneum The mesh is positioned between the posterior retrorectus fascia and the anterior rectus sheath The mesh can act as a bridge if the rectus abdominal muscles dont meet each other comfortably at the midline

30 Self Check: Results [ Underlay Technique in the Intraperitoneal Position Procedure] 30 Ventral Hernia Repair Strattice® Underlay Technique in the Intraperitoneal Position


Download ppt "Self Check (Part 5) Questions: Component Separation 1 Ventral Hernia Repair Component Separation."

Similar presentations


Ads by Google