The description of a multidisciplinary intervention of General Surgery, Imaging and Physical and Medical Rehabilitation from Hospital Beatriz Ângelo (HBA), to solve a rare situation of complex incisional hernia with loss of domain, ensured the internist Beatriz Pereira Gonçalves , who is presently undergoing the general surgery internship in this hospital, the award of Best Poster, in the 1 st National Meeting of the Portuguese Society of Hernia and Abdominal Wall. In the poster presented by the physician, reporting the first case of complex incisional hernia with loss of domain treated at HBA , the multidisciplinary work of the team of surgeons Francesco Della Nave and Cátia Cunha is described, together with Imaging specialist Jaime Calha and Physical and Medical Rehabilitation specialist, Ana Rolo Duarte . According to the description of the clinical case made in this poster, distinguished in the first place, the surgical intervention was performed with a minimally invasive technique, despite the extension of the hernia, with an estimated volume of over 20% the volume of the peritoneal cavity. Therefore, it required a multidisciplinary approach – from Physical and Medical Rehabilitation, to create preoperative relaxation of the large abdominal muscles (by injection of A-botulinum toxin), and Imaging, by placing a catheter in the abdominal cavity with CT viewing – in order to allow the performance of progressive preoperative pneumoperitoneum (PPP), in the 10 days preceding the surgery. These two preoperative approaches aimed to gradually increase the capacity of the abdominal cavity, so that it could “lodge” again the herniated guts, thus allowing to perform the surgery – an incisional hernioplasty through IPOM “plus” laparoscopy. Also according to the presentation by Beatriz Pereira Gonçalves, the combined therapies allowed not only a minimally invasive surgical approach, with all the known benefits of this kind of approach, but also reduced the probability of postoperative respiratory insufficiency. In the 1 st National Meeting of the Portuguese Society of Hernia and Abdominal Wall , which took place on the 19 and 20 November at Grande Hotel do Luso, gathering specialists in this specific area of General Surgery from all over the country, were also presented a video an another poster reporting clinical cases of pathology of the abdominal wall, treated by the same HBA team with minimally invasive techniques.
