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Surgery Shelf Exam Sample Question 1

A 55-year-old male presents to the office with a large midline incisional hernia after undergoing an exploratory laparotomy for trauma 15 years ago. He is becoming increasingly symptomatic and desires repair. The defect measures 15 cm x 8 cm. You consent him for an open bilateral component separation and mesh placement. During initial fascial incision, you find that he has dense adhesions, and 5 full thickness enterotomies are made incidentally. There is some spillage of succus, and full thickness repairs are performed successfully in each of these locations. How would you proceed at this point?

  • AAbort the hernia repair
  • BBridging polyglactin (Vicryl) mesh
  • CBilateral component separation without mesh
  • DBilateral component separation with biologic mesh
  • EBilateral component separation with permanent mesh

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