Tag Archives: recurrent

PUBLISHED: Extralevator Abdominoperineal Resection (APR) for Recurrent Anal Cancer With an En Bloc Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy and Total Vaginectomy With Permanent Colostomy Formation and Pelvic Floor Reconstruction Using a Right Rectus Abdominis Flap

Extralevator Abdominoperineal Resection (APR) for Recurrent Anal Cancer With an En Bloc Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy and Total Vaginectomy With Permanent Colostomy Formation and Pelvic Floor Reconstruction Using a Right Rectus Abdominis Flap
Zoe Garoufalia, MDSteven D. Wexner, MD, FACS
Cleveland Clinic Florida

This video provides a step-by-step, detailed demonstration of this extensive surgical procedure performed on a 53-year-old female patient with recurrent anal cancer after initial chemoradiotherapy. The surgical technique is thoroughly illustrated, emphasizing the importance of proper anatomical planes, multidisciplinary coordination, and reconstructive considerations.

PUBLISHED: Open Onlay Hernia Repair for Recurrent Incisional Hernia

Open Onlay Hernia Repair for Recurrent Incisional Hernia
Samuel J. Zolin, MDEric M. Pauli, MD, FACS, FASGE
Penn State Health Milton S. Hershey Medical Center

An 80-year-old patient underwent an open onlay repair of a recurrent incisional hernia. This approach was chosen due to the patient’s prior retromuscular repair, age, history of adhesions, and religious preference against blood products. Following safe abdominal entry and adhesiolysis, a subcutaneous pocket extending 5 centimeters in all directions from the hernia was created. Fascia was closed using mesh-suture and a 12 x 12-centimeter macroporous, medium-weight polypropylene mesh was secured to the anterior fascia with staples and fibrin glue. A subcutaneous drain was placed. This case highlights the utility of an onlay approach for selected circumstances.