OR Setup for an Open Incisional Hernia Repair with Mesh (South College, Knoxville, TN)
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Successful surgical treatment of incisional hernias after abdominal surgery depends in part on the creation and maintenance of the sterile field. Optimal arrangement of surgical instrumentation and organization of the sterile field are important elements that can impact surgical outcomes and patient safety. This educational video covers sterile field preparation, including back table and Mayo stand arrangement, preparation for the initial surgical count with a circulator, and mesh management. This setup shown here presents how to arrange forceps by type/usages, and establish specific zones for sharps. The initial surgical count includes all sponges, sharps, and instruments according to current surgical safety guidelines. The goal of this educational video is to demonstrate how surgical technologists create and maintain the sterile field and prepare for the initial surgical count to support efficient surgical operations and patient safety.
Abdominal surgery patients face a 4–15% chance of developing incisional hernias, which represent the most frequent long-term complication after laparotomy procedures.1–3 Hernia formation through surgical incisions occurs when tissue healing fails, leading to abdominal wall weakness that allows organs to protrude through the compromised area. The standard treatment for incisional hernia repair now uses mesh reinforcement because it decreases recurrence rates and produces better long-term results.4–7
The surgical technologist plays a critical role in hernia repair operations. Proper operating room setup, instrument organization, and sterile field management contribute to the success of surgical procedures.
While surgical treatment of incisional hernias has evolved, open repair techniques continue to serve as a method of choice for complex cases with large defects.7
This video demonstrates an organized operating room setup method that achieves multiple learning objectives. The initial surgical count is an essential part of surgical safety protocols and decreases the possibility of retained surgical items from occurring. The implementation of "safety zones" for sharp instruments benefits all members of the perioperative team. These designated zones decrease the risk of needlestick injuries. The setup protocol demonstrates efficient workflow and offers important educational material for surgical technology students and working professionals. This step-by-step setup, combined with detailed explanations, provides students and practicing professionals with a useful learning resource for hernia repair surgeries.
Nothing to disclose.
References
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- Gignoux B, Bayon Y, Martin D, et al. Incidence and risk factors for incisional hernia and recurrence: retrospective analysis of the French national database. Colorectal Dis. 2021;23(6). doi:10.1111/codi.15581
- Le Huu Nho R, Mege D, Ouaïssi M, Sielezneff I, Sastre B. Incidence and prevention of ventral incisional hernia. J Visc Surg. 2012;149(5). doi:10.1016/j.jviscsurg.2012.05.004
- Saha T, Wang X, Padhye R, Houshyar S. A review of recent developments of polypropylene surgical mesh for hernia repair. OpenNano. 2022;7. doi:10.1016/j.onano.2022.100046
- Tran HM, MacQueen I, Chen D, Simons M. Systematic review and guidelines for management of scrotal inguinal hernias. J Abdom Wall Surg. 2023;2. doi:10.3389/jaws.2023.11195
- Muysoms FE, Antoniou SA, Bury K, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015;19(1). doi:10.1007/s10029-014-1342-5
- Sánchez RS, Mayagoitia JC. Update on complex incisional hernia. Revista Hispanoamericana de Hernia. 2022;10(4). doi:10.20960/rhh.00450
Cite this article
Morris S. OR setup for an open incisional hernia repair with mesh (South College, Knoxville, TN). J Med Insight. 2025;2025(558). doi:10.24296/jomi/558
