Considering the patient medical history and the associated challenges we took necessary
precautions and employed surgical techniques to address these complexities.
During the procedure, bowels were immediately underneath the skin of abdomen, and were
densely adhered to the mesh & adjacent structures. There was also a large subcutaneous fluid
collection. We went about separating the bowels from the mesh with extreme surgical care. It
was difficult, but we dissected with excellence.
Because of fine dissection and removal of adhesions with mesh, we could avoid a further major
surgery like resection of bowels and its anastomosis. The abdominal muscular wall defect was
closed primarily in a single layer and 15*15 cm mesh was placed in diamond shape, over the
closed defect. This was an onlay mesh repair. Drain was kept in subcutaneous area and skin
incision was closed. An incidental finding of an ovarian cyst was managed appropriately.
Post surgery period was uneventful and drain was removed 3 days after surgery.