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dr hakan gök
açıklama
herhangi bir şirket ile anlaşmam yok!
- Karın duvarı bütünlüğünü sağlar.
- Organ/yer kaybını düzeltir.
- Karın duvarı fonksiyonlarını geri kazandırır.
- Linea alba yeniden oluşur ve fasyal defekt kapanır.
- Vaskülarizasyon ve inervasyonu korur.
- Kalıcı bir onarım sağlar.
- Gerilimsizdir.
- Karın yarası primer kapanır.
Komplike Karın Duvarı Fıtığı: Katmanlarına ayırma ne yapar?
 2006 -2009 42 organ/yer kaybı olan hasta.
 26,1 ay median takip süresi.
 23,8% komplikasyon.
 4,7% yineleme.
- Transversus Abdominis (TA) kası, karının korsesidir. Bir kemer gibi görev yapar. Karın içi
basıncını ortaya çıkarır ve torakolumbar fasya üzerinden kasnak gerilimi yapar.
- TA kasının medialden kesilmesi ve diseksiyonu; kasın karın yan duvarından uzaklaşma-
sına ve ortaya yaklaşmasına, beraberinde rektus abdominis kası ve arka fasya kompleksi-
nin de ortaya ilerlemesine neden olur.
TAR nasıl çalışır?
- Linea alba’nın yeniden oluşturulmasında etkili.
- Viseral kesenin dev yama ile takviyesi.
- Deri flebi yok.
- Fizyolojik ve dinamik karın duvarının yeniden oluşturulması.
- Güvenli ve etkili.
TAR avantajları
- Deri flebi yok.
- Lateralde gevşeklik ve fıtık riski yok.
- Yama için en iyi boşluk.
- Yama enfeksiyonu riski az.
- Çok geniş bir hasta grubuna uygulanabilir.
TAR x Anterior KA
1
Dr Filip Muysoms’un izniyle!
2
3
4
5
6
7
8
9
- Açık yaklaşım
- Minimal invaziv teknikler
- Lap-TAR
- eTEP-TAR
- RoboTAR
TAR yaklaşım seçenekleri
VIDEO
Her hastada orta hattın kapatılması ve periton boşluğuna yama koymaktan kaçınma
konusundaki takıntımız, orta hat fıtıklarının tedavisinden daha da zor olabilecek,
karmaşık yanal fıtık hastalıkları yaratabilir!
Dr Mike Rosen, Cleveland, USA

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Novitsky's TAR

  • 2. açıklama herhangi bir şirket ile anlaşmam yok!
  • 3. - Karın duvarı bütünlüğünü sağlar. - Organ/yer kaybını düzeltir. - Karın duvarı fonksiyonlarını geri kazandırır. - Linea alba yeniden oluşur ve fasyal defekt kapanır. - Vaskülarizasyon ve inervasyonu korur. - Kalıcı bir onarım sağlar. - Gerilimsizdir. - Karın yarası primer kapanır. Komplike Karın Duvarı Fıtığı: Katmanlarına ayırma ne yapar?
  • 4.
  • 5.  2006 -2009 42 organ/yer kaybı olan hasta.  26,1 ay median takip süresi.  23,8% komplikasyon.  4,7% yineleme.
  • 6. - Transversus Abdominis (TA) kası, karının korsesidir. Bir kemer gibi görev yapar. Karın içi basıncını ortaya çıkarır ve torakolumbar fasya üzerinden kasnak gerilimi yapar. - TA kasının medialden kesilmesi ve diseksiyonu; kasın karın yan duvarından uzaklaşma- sına ve ortaya yaklaşmasına, beraberinde rektus abdominis kası ve arka fasya kompleksi- nin de ortaya ilerlemesine neden olur. TAR nasıl çalışır?
  • 7. - Linea alba’nın yeniden oluşturulmasında etkili. - Viseral kesenin dev yama ile takviyesi. - Deri flebi yok. - Fizyolojik ve dinamik karın duvarının yeniden oluşturulması. - Güvenli ve etkili. TAR avantajları
  • 8. - Deri flebi yok. - Lateralde gevşeklik ve fıtık riski yok. - Yama için en iyi boşluk. - Yama enfeksiyonu riski az. - Çok geniş bir hasta grubuna uygulanabilir. TAR x Anterior KA
  • 10. 2
  • 11. 3
  • 12. 4
  • 13. 5
  • 14. 6
  • 15. 7
  • 16. 8
  • 17. 9
  • 18.
  • 19.
  • 20.
  • 21.
  • 22. - Açık yaklaşım - Minimal invaziv teknikler - Lap-TAR - eTEP-TAR - RoboTAR TAR yaklaşım seçenekleri
  • 23. VIDEO
  • 24. Her hastada orta hattın kapatılması ve periton boşluğuna yama koymaktan kaçınma konusundaki takıntımız, orta hat fıtıklarının tedavisinden daha da zor olabilecek, karmaşık yanal fıtık hastalıkları yaratabilir! Dr Mike Rosen, Cleveland, USA

Editor's Notes

  1. 1
  2. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  3. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  4. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  5. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  6. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  7. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  8. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  9. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  10. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  11. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  12. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!
  13. Basically we can define four main factors. The Patient factor, like age or habits, e.g. Smoking. The surgeon. This could for example include the surgeons expierence in a certain procedure. The surgical technique that will be used. Some techniques may be more suitable or not suitable for a patient. And finally the selection of the mesh. To cover all this in one presentation we would probably be together for hours. Our focus today is the Mesh Selectoin to improve patiant outcome. Questions: Who decides on the mesh selection? Who is responsible for the clinical outcome? Mesh decision is a clinical decision!