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3dmax Light Mesh: Technique Guide

3DMLight Tech Guide

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nautilixx
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236 views

3dmax Light Mesh: Technique Guide

3DMLight Tech Guide

Uploaded by

nautilixx
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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3DMax Light Mesh

Catalog
Number

Quantity

0117310

Description

Size

1/cs.

Left, Medium

3.1" x 5.3" (7.9 cm x 13.4 cm)

0117311

1/cs.

Left, Large

4.1" x 6.2" (10.3 cm x 15.7 cm)

0117312

1/cs.

Left, Extra-Large

4.8" x 6.7" (12.2 cm x 17.0 cm)

0117320

1/cs.

Right, Medium

3.1" x 5.3" (7.9 cm x 13.4 cm)

0117321

1/cs.

Right, Large

4.1" x 6.2" (10.3 cm x 15.7 cm)

0117322

1/cs.

Right, Extra-Large

4.8" x 6.7" (12.2 cm x 17.0 cm)

q
q

Please add the 3DMax Light Mesh to my preference card.


I would like to have the 3DMax Light Mesh in stock.

Surgeons Signature ________________________________________________


Purchase Order Number_ ___________________________________________
Catalog Number___________________________________________________
Date_ _________________________________ Quantity___________________

Davol Inc. Subsidiary of C. R. Bard, Inc. 100 Crossings Boulevard


Warwick, RI 02886 1.800.556.6275 www.davol.com
Medical Services & Support 1.800.562.0027
Please consult product labels and inserts for any indications, contraindications,
hazards, warnings, precautions and instructions for use.
3DMax, Bard, Davol and SorbaFix are trademarks and/or registered trademarks of
C. R. Bard Inc.

Copyright 2010, C. R. Bard, Inc. All rights reserved. MM3DLTG

Anatomically-shaped large pore polypropylene mesh.

Technique Guide

Totally Extraperitoneal Approach


Transabdominal Preperitoneal Approach

Bard shapes the futur e o f h e r n i a


repair with a new lig h t e r - w e i g h t
versi on of our 3 D Max Me sh

The techniques presented herein are for


informational purposes only. The decision of
which technique to use in a surgical application
lies with the surgeon based on patient profile and
previous surgical experience.

3DMax Light Mesh

Table of Contents
Benefits of 3DMax Light Mesh. . . . . . . . . . . . . . . . . . . . . 2-3
Mesh Introduction Technique. . . . . . . . . . . . . . . . . . . . . . . . 4
Totally Extraperitoneal Approach. . . . . . . . . . . . . . . . . . . . 5-9
Transabdominal Preperitoneal Approach . . . . . . . . . . . 10-17
Indications, Contraindications,
Warnings and Precautions. . . . . . . . . . . . . . . . . . . . . . . 18-19

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

B e n e f i t s o f 3 DM ax L ig h t M es h

See L aparoscopic I n g u i n a l
H erni a Repai r i n a Who le Ne w Li gh t.

4
5

Unique:

3D shape developed by a laparoscopic surgeon.

Designed to conform to the inguinal anatomy.

Contour minimizes buckling that may be seen


with flat mesh.

Design may reduce the need for fixation.

Medial orientation marker

Crest corresponds to axis of inguinal ligament

Notch aligns with external iliac vessels

Lateral point facilitates alignment

Sealed edge facilitates mesh placement

Precise:

Sealed edge and medial orientation marker


facilitate accurate placement and positioning.

Built-in memory maintains shape.

Lighter Weight:

Less than 50% of the weight of 3DMax Mesh.

Lighter-weight monofilament polypropylene mesh.

Large pore knit provides excellent visibility.

3DMax Light Mesh Overview

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

Totally Extr aperi toneal A ppro ach

M e sh In t rodu ction Techniqu es

Due to its lightweight nature, 3DMax Light Mesh is


easy to deploy. The mesh does not need to be rolled
around the grasper as it has a low profile.
Grasp either the medial or lateral edge of mesh, then
deploy through trocar. If grasping the medial edge,
direct the umbilical trocar to the pubic tubercle. If
grasping laterally, direct the umbilical trocar laterally.
This will facilitate easy placement.

Identification

After the preperitoneal space is created and insufflated,


a right indirect inguinal hernia is identified by the
presence of a hole at the internal ring.

Use an appropriate sized trocar to allow mesh to slide


down the trocar with minimal force.

Mesh Introduction

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

Dissection of Hernia Sac

Dissection of Preperitoneal Space

Dissect the hernia sac off the spermatic cord


structures.

Perform a wide dissection of the preperitoneal


space, locating Coopers ligament.

Ensure the hernia sac is completely reduced.

The space should be large enough to


accommodate the 3DMax Light Mesh.

Totally Extraperitoneal Approach

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

Position the 3DMax Light Mesh such that the


notch is placed over the external iliac vessels.

The crest of the mesh will correspond to the


inguinal ligament.

Positioning

The blue medial orientation marker facilitates


accurate alignment.

Totally Extraperitoneal Approach

Placement

The top edge of the 3DMax Light Mesh is


positioned far enough anteriorly to cover the
direct space.

If mechanical fixation is used, constructs may be


placed at the pubic tubercle, Coopers ligament,
and the iliopubic tract inferiorly and anteriorly to
the rectus muscle.

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

Tr a n sa b d o m i n al Prep eritoneal Ap p ro ach

Identification of Landmarks

A right indirect inguinal hernia is identified by the


presence of a hole at the internal ring.

10

Transabdominal Preperitoneal Approach

Creation of Peritoneal Flap

A transverse incision is made along the peritoneum to


access the preperitoneal space.

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

11

Indentification

Identify the indirect hernia sac. Much of the sac may


already be reduced.

12

Transabdominal Preperitoneal Approach

Dissection of Hernia Sac

Dissect any remaining sac off the spermatic cord


structures.

Ensure the hernia sac is completely reduced.

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

13

14

Dissection of Preperitoneal Space


Perform a wide dissection of the preperitoneal
space so that it is large enough to accommodate
the 3DMax Light Mesh.

 osition the 3DMax Light Mesh such that the


P
notch is placed over the external iliac vessels.

The crest of the mesh will correspond to the


inguinal ligament.

 he blue medial orientation marker facilitates


T
accurate alignment.

Idenitify and expose Coopers ligament.

Transabdominal Preperitoneal Approach

Positioning

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

15

Placement

Ensure 3DMax Light Mesh covers the entire


myopectineal orifice.

16

Transabdominal Preperitoneal Approach

Reapproximation of Peritoneum

 eapproximate the peritoneal flap with the


R
SorbaFix Absorbable Fixation System.

Reduction of intraabdominal pressure may


facilitate the reapproximation.

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

17

Indications:

Precautions:

The 3DMax Light Mesh is indicated for use in the


reinforcement of soft tissue where weakness exists, such
as the repair of hernia defects.

1. Please read all instructions prior to use.

Contraindications:

3. Do not cut or reshape the 3DMax Light Mesh as


this may affect its effectiveness.

1. Literature reports that there may be a possibility for


adhesion formation when polypropylene mesh is
placed in direct contact with the bowel or viscera.
2. Do not use polypropylene mesh in infants
and children, whereby future growth will be
compromised by use of such material.

Warnings:

2. Only physicians qualified in appropriate surgical


techniques should use this prosthesis.

4. Use an appropriate sized trocar to allow mesh to slide


down the trocar with minimal force.
5. If fixation is used, Bard permanent or absorbable
fixation devices or nonabsorbable monofilament
sutures are recommended to properly secure the
device. If other fixation devices are used, they must
be indicated for use in hernia repair.

1. This device is supplied sterile. Inspect the packaging


to be sure it is intact and undamaged prior to use.
2. This device is for single use only. Do not resterilize
or reuse any portion of the 3DMax Light Mesh.
3. The use of any permanent mesh or patch in a
contaminated or infected wound could lead to
fistula formation and/or extrusion of the prosthesis.
4. If an infection develops, treat the infection
aggressively. Consideration should be given
regarding the need to remove the mesh. An
unresolved infection may require removal of
the device.
5. To prevent recurrences when repairing hernias, the
prosthesis should be large enough to extend beyond
the margins of the defect.
6. To avoid injury, careful attention is required if
fixating the mesh in the presence of nerves and
vessels.

18

Indications, Contraindications, Warnings, Precautions

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

19

Notes:

20

Notes:

3DMax Light Mesh Laparoscopic Inguinal Hernia Repair Technique Guide

21

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