Wiki hernia size defect

[CCANTER]

I was wanting to make sure I determine the hernia defect size correctly
would i add 4 + 4 +3= 11 total

An incision was made over the superior part of the chevron incision for about 7 cm on both sides. Electrocautery was used to take this incision down to the level of the fascia and hernia defects. 1 defect was identified on the right side which was about a 4 cm x 2 cm defect. On the left side, there were 2 small defects and the intervening fascia was divided to make a common defect of about 4 cm x 3 cm. There was a 3 to 4 cm fascial bridge between the 2 defects. The fascial edges were cleaned up and the plane developed on the underside of the fascia clearing off the preperitoneal fat from the underside of the fascia. The subcutaneous fat was incised to free up mobility at the level of the fascia in order to close it without tension. An 8 cm round Ventralex mesh was chosen.

 

[csperoni]

Here is a good article from ACS describing all the 2023 changes, which includes this diagram to clarify:

It sounds to me like you have 2 sizes.
4cm on right
4cm on left (2 small combined measuring 4cm total like figure 2 above)
Your overall scenario seems like Figure 3 - 4cm plus 4cm, with an intact fascial bridge between them. The intact fascia is not also added.
This seems like 8cm total.

EDIT:
As pointed out below by @RaveenaS , my statement to add just the 2 sizes was incorrect as they are not remote hernias separated by 10cm or more of intact fascia.
The correct calculations would be:
4cm right plus 3cm between plus 4cm left = 11cm

 

[RaveenaS]

I was wanting to make sure I determine the hernia defect size correctly
would i add 4 + 4 +3= 11 total

An incision was made over the superior part of the chevron incision for about 7 cm on both sides. Electrocautery was used to take this incision down to the level of the fascia and hernia defects. 1 defect was identified on the right side which was about a 4 cm x 2 cm defect. On the left side, there were 2 small defects and the intervening fascia was divided to make a common defect of about 4 cm x 3 cm. There was a 3 to 4 cm fascial bridge between the 2 defects. The fascial edges were cleaned up and the plane developed on the underside of the fascia clearing off the preperitoneal fat from the underside of the fascia. The subcutaneous fat was incised to free up mobility at the level of the fascia in order to close it without tension. An 8 cm round Ventralex mesh was chosen.

Your math is correct for the total defect size being 11cm.
If the fascial bridge between the two defects were equal to or greater than 10cm, then you would only be adding the measure of the two separate defects, which would have been 8cm, but the bridge is documented at maximum 4cm, so it's included in the measurement of total defect.

 

[csperoni]

Your math is correct for the total defect size being 11cm.
If the fascial bridge between the two defects were equal to or greater than 10cm, then you would only be adding the measure of the two separate defects, which would have been 8cm, but the bridge is documented at maximum 4cm, so it's included in the measurement of total defect.

THANK YOU for correcting me. This is why having multiple people participate in the forum is great. Everyone has something to learn!!
This is a case of - do what my references tell you to do, and not what I state. I will edit my answer above.