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2. Title

3. Title
• Conventional versus Prophylactic Mesh
placement technique of midline
laparotomy: A comparative study.
Dr. Kameshwar
Assistant Professor
-Dr. Pradeep Pande
Associate Professor
Deptt. Of Surgery

4. Abstract

5. Abstract
Background and Objectives
• The midline laparotomy is frequently used
for abdominal surgeries.
• Main complication is incisional hernia.
• The objective of this study is to compare
Mesh Placement Technique with
conventional Mass closure technique in
preventing the incisional hernia

6. Introduction

7. Introduction
• Introduction: The median laparotomy is
frequently used by abdominal surgeons to
gain rapid and wide access to the abdominal
cavity with minimal damage to nerves,
vascular structures and muscles of the
abdominal wall. However, incisional hernia
remains the most common complication
after median laparotomy, with reported
incidences varying between 2-20%1.

8. Introduction
• Median laparotomies and incisional hernias
have been subject of investigation for a long
period of time already. Although a lot is
known about patient related risk factors and
suture materials, technical risk factors such
as suture techniques have not been
investigated thoroughly 2.

9. Materials and Methods

10. Materials and Methods
Trial Design
• This trial has been designed as a
prospective, double-blind, randomized
controlled trial, in which Prophylactic
Mesh placementTechnique will be
compared with the conventionally used
large bites mass closure technique for the
closure of midline laparotomy.

11. Materials and Methods
• 100 consecutive patients reporting to the
department of General Surgery of BRK
Memorial Medical College in whom
midline laparotomy is indicated will be
included in this study.
• These 100 patients will be randomized into
two groups of 50 each.

12. Materials and Methods
• Group A patients will be managed by
conventional closure of the midline incision
• GroupB patients will be managed by Mesh
placement technique.
• One year after surgery the patients will be
examined for the complication of incisional
hernia clinically and sonographically.

13. Results: Outcome parameters

14. Results: Outcome parameters
Primary outcome
• Primary outcome will be incisional hernia
occurrence within one year after surgery,
either clinically and/or ultrasonographically
detected.

15. Results: Outcome parameters
Secondary outcomes
• Postoperative complications
• Pain
• Quality of life
• Cost effectiveness

16. Conclusions:

17. Conclusions:
• The trial will provide level 1b evidence to
support the preference for either a
Prophylactic Mesh placementTechnique
or for the conventionally used large bites
technique

18. Participants

19. Participants
• Participants: Patients undergoing midline
laparotomy in BRK Memorial Medical
College Jagdalpur will be included in this
study .

20. Inclusion criteria:

21. Inclusion criteria:
• Patients undergoing midline laparotomy in
BRK Memorial Medical College Jagdalpur .

22. Exclusion criteria

23. Exclusion criteria
• None

24. Analysis

25. Analysis
• Differences between randomized groups
will be tested with appropriate statistical
methods

26. Conclusion

27. Conclusion
• This trial is a comparative studyof
Conventional versus Prophylactic Mesh
placement technique of midline laparotomy
closure.

28. Bibliography

29. Bibliography
• Muysoms FE, Detry O, Vierendeels
T, Huyghe M, Miserez M, Ruppert
M, Tollens T, Defraigne JO, Berrevoet

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