For repair and prophylaxis of abdominal wall hernia with extraperitoneal mesh position

and/or

For repair of umbilical hernia with extraperitoneal mesh position.

1239

Abdominal wall hernia and Umbilical hernia

Optimally adapted tri-elasticity
Because of its tri-elasticity, which is adapted to the anatomical and biomechanical properties (dynamometry) of the human abdominal wall, DynaMesh®-CICAT provides the highest possible degree of patient comfort


Optimal incorporation of the mesh
Following in-vivo incorporation, mesh implants have a tendency to “shrinkage”.DynaMesh®-CICAT has a high effective porosity of 61 %, enabling excellent incorporation of the mesh implant.Moreover, in the course of incorporation the use of the proven and highly biocompatible polymer PVDF contributes to a low degree of scarring.The optimal incorporation of the DynaMesh®-CICAT implant post-operatively,reduces the risk of shrinkage and recurrence.


The MILOS technique to repair abdominal wall and umbilical hernias with DynaMesh®-CICAT and EndoTORCH

  1. Skin incision 2 to max. 5 cm via hernial orifice (Fig. A).
  2. Display of hernial defect and preparation of the hernia sac.
  3. Optional: minimal opening of the hernia sac allowing for manual probing, followed by open or laparoscopic adhesiolysis.
  4. The peritoneum is freed up approx. 2 cm from the linea alba in a circular pattern and the posterior layer of the rectus muscle is freed.
  5. The posterior layer of the rectus muscle is opened laterally on both sides (instrument: EndoTORCH ) (Fig. B) about 1 cm from the medial border of the rectus muscle (Fig. C).
  6. Using long slim retractors and under endoscopic monitoring, the posterior layer of the rectus sheath is freed laparoscopically from the rectus muscle. In the midline endoscopically assisted dissection is performed in the preperitoneal plane: The peritoneum is freed up from the linea alba.
  7. The further totally extraperitoneal preparation is performed through the hernia, either under direct vision with laparoscopic instruments or with endoscopic assistance.
  8. The posterior layer of the rectus sheath generally remains open with a completely closed midline peritoneum.
  9. Placement and spreading of the DynaMesh®-CICAT mesh implant in the extraperitoneal cavity as a double roll and without skin contact.
  10. Closure of the hernia defect over the mesh implant under minimal tension (Fig. D).11. Fixation of the DynaMesh®-CICAT me
  11. Fixation of the DynaMesh®-CICAT mesh implant is only required if the hernia defect cannot be completely closed and there is bridging of the hernia defect.

Optimal handling

  • The special anti-slip surface of the DynaMesh®-CICAT ensures the mesh stays in position and enables optimal handling.
  • DynaMesh®-CICAT is marked with green lines, which indicate the required orientation (cranio-caudal)
  • The light tube for the MILOS technique (Mini Less Open Sublay technique) was developed with Mr Wolfgang Reinpold, consultant at the Wilhelmsburger Groß-Sand Hospital, Hamburg, specially for laparoscopic-assisted treatment of abdominal wall hernias.

Product range

Abdominal wall hernia

 

Allow for sufficient overlap when selecting mesh size. – (P) Prophylaxis

DynaMesh®-CICAT Size: d 10 cm round PV090010F3 Unit = 1 EA / BX
DynaMesh®-CICAT Size: 15 cm x 15 cm PV091515F3 Unit = 3 EA / BX

longitudinal:

DynaMesh®-CICAT Size: 10 cm x 35 cm(P) PV091035F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 15 cm x 25 cm PV091525F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 15 cm x 25 cm PV091525F5 Unit = 5 EA / BX
DynaMesh®-CICAT Size: 15 cm x 30 cm PV091530F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 18 cm x 40 cm PV091840F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 20 cm x 30 cm PV092030F2 Unit = 2 EA / BX
DynaMesh®-CICAT Size: 20 cm x 30 cm PV092030F5 Unit = 5 EA / BX
DynaMesh®-CICAT Size: 30 cm x 45 cm PV093045F1 Unit = 1 EA / BX
DynaMesh®-CICAT Size: 30 cm x 45 cm PV093045F3 Unit = 3 EA / BX
DynaMesh®-CICAT Size: 45 cm x 60 cm PV094560F1 Unit = 1 EA / BX

transversal:

DynaMesh®-CICAT Size: 40 cm x 20 cm PV094020F1 Unit = 1 EA / BX

DynaMesh®-CICAT visible Size: 20 cm x 30 cm PV162030F1 Unit = 1 EA / BX

 

Umbilical hernia

Allow for sufficient overlap when selecting mesh size.

DynaMesh®-CICAT Size: 05 cm x 06 cm PV090506F5 Unit = 5 EA / BX
DynaMesh®-CICAT Size: d 10 cm round PV090010F3 Unit = 3 EA / BX
DynaMesh®-CICAT Size: 10 cm x 10 cm PV091010F3 Unit = 3 EA / BX
DynaMesh®-CICAT Size: 15 cm x 15 cm PV091515F3 Unit = 3 EA / BX
DynaMesh®-CICAT visible Size: 05 cm x 06 cm PV160506F5 Unit = 5 EA / BX



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