Simple solution to a common issue in MIS hernia repair. Managing posterior sheath/peritoneal defects with a falciform rotational flap. Full video with narration: #OHSUHernia #HerniaGeeks

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Nobody's gonna get confused why textbooks say that video surgery offers better visualization than open, not in this era 😆 Doing art on the ceiling like Michelangelo without the back pain.

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates I’m mostly just removing old popcorn ceilings and putting up fresh sheets of drywall.

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates That's f---ing brilliant. Can't wait to utilize this.

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Thank you for watching. Let me know how it goes!

@NandoEnriqueTV @AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Brilliant!

@NandoEnriqueTV @AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Legit only became comfortable with this once I saw you were using falciform to reconstruct the PV during robotic whipple. Abbass falciform recon > Nikolian falciform rotation, p < 0.00000001.

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates 👏👏 great work V!

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Serious question. Can you bill separately for that?

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Tissue transfer codes are generally for open procedures but some surgeons have had success with using them during MIS cases. Good content on hernia billing at AHS this year by @geoeph—one of the best lectures on billing I’ve been present for. @ColumbiaSurgery @NovitskyYuri

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Love this! I’ve also thought about doing this at the hiatus when I use mesh for wide defects just as an extra layer of native tissue behind the esophagus

@AzarowKen @tsikitis @OrensteinSean @MBosleyMD @herniabarbie @BehindTheKnife @AmericanHernia @SAGES_Updates Some have done an extended dissection with posterior rectus sheath included for buttressing the hiatus. Generally think it’s a bad idea. If doing that, would recommend some component of mesh reinforcement of the posterior sheath disruption on the abdominal wall.