V-044 ABDOMINAL WALL RECONSTRUCTION OF A POST-HEMIPELVECTOMY INCISIONAL HERNIA: AT THE LIMITS OF WHAT IS POSSIBLE

Abstract Incisional hernias in patients with bone defects are a real challenge. There is very little evidence of how to repairing them. Clinical Case 56-year-old patient. He underwent left external hemipelvectomy for osteosarcoma the iliac 2012 and nephrectomy 2013. The patient presents an inguinal right thigh root bulge progressive growth severe pain limited mobility. In past month, he was unable walk. Physical examination: defect, defect large lateral bulge. Preoperative CT scan: atrophy abdominal musculature, absence hemipelvis, hip prosthesis pseudocapsule, lumbar area. Surgery Dissection hernia sacs retroperitoneal/preperitoneal dissection performed, cranially retrodiaphragmatic area, medially linea alba, posteriorly spine caudally pelvis. wall reconstructed polyglycolic acid trimethylene carbonate mesh reinforce polypropylene that envelops visceral sac fixed pubis pseudocapsule prosthesis. postoperative period, presented pulmonary thromboembolism surgical wound infection. discharged on 17th day. One year after surgery, asymptomatic, has continent discrete bulging. Preperitoneal makes it possible solve complex defects, even defects.