Open Incisional Hernia Repair with Mesh and Unilateral Posterior Component Separation with Excision of Unstable Scar

1. Introduction

2. Incision and Flap Dissection with Excision of Unstable Scar

3. Midline Incision, Access to the Abdominal Cavity, and Adhesiolysis

4. Hernia Sac Resection, Retromuscular Dissection, and TAR on the Left

5. Hernia Sac Resection and Retromuscular Dissection on the Right

6. Assessing Tension on the Posterior and Anterior Sheaths

7. Irrigation, Hemostasis, and Further Lysis of Adhesions

8. Placement of Seprafilm to Prevent Adhesions

9. Posterior Rectus Sheath Closure

10. Mesh Placement with Tisseel

11. Anterior Rectus Sheath Closure

12. Post-op Remarks