By Feliciano Crovella, Giovanni Bartone, Landino Fei
Incisional hernia surgical procedure has witnessed very important advances over fresh years, not just so far as the pathophysiological and etiopathogenetic points are involved, but additionally from a technical viewpoint. This booklet offers an replace on incisional hernia surgical ideas. It comprises chapters on man made prostheses, biomaterials and robotics. Surgeons, surgical citizens, and clinical scholars will locate the knowledge during this quantity very worthwhile of their day-by-day perform.
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Extra info for Incisional Hernia (Updates in Surgery)
21). Under constant pressure, the load that the sheath is to bear is proportional to the surface under pressure and it increases by the squares of the distance between anchorages, with a tension that is regulated by the law of Laplace. Under equal load, the flexing effect depends not only on the distance between anchorages but also on their involution caused by the prolonged pressure. Under normal conditions, parietal contraction provokes a shrinking of the abdominal cavity and a consequent reduction in the curve range.
29) Fascial structures prevail in the inguinal region while, especially in men, the muscular component is poor: this explains the considerable incidence of hernias due to weakness in the male inguinal area. Fig. 29 Keith’s shutter effect at the level of the deep inguinal ring. 1, Internal inguinal ring, 2, myoaponeurotic transversus arch; 3, iliopubic tract; 4, Cooper’s ligament; 5, inferior epigastric vessels; 6, round ligament of uterus; 7-7’, external iliac vessels. Modified from  36 Francesco Ruotolo et al.
Towards the posterior lumbar wall, it blends with the front lamina of the thoracolumbar fascia and in the inguinal area it has a bilaminar aspect with dense thickenings. The fascia is made up of a membranous layer of rather loose connective tissue with neither aponeurotic nor muscular elements and is variable in consistency. It is more solid in the sub-umbilical site, where it plays an important role of continence, and split in the inguinal area where the front and back laminae delimit a space in which the inferior epigastric vessels run.