from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm, mm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY
from reportlab.platypus import PageBreak

OUTPUT = "/tmp/workspace/hernia-notes/Hernia_Surgery_Notes.pdf"

# ── colour palette ──────────────────────────────────────────────────────────
NAVY   = colors.HexColor("#1B3A5C")
TEAL   = colors.HexColor("#1A7A7E")
AMBER  = colors.HexColor("#E07B39")
LGREY  = colors.HexColor("#F2F5F9")
MGREY  = colors.HexColor("#D0D8E4")
WHITE  = colors.white
BLACK  = colors.black
GREEN  = colors.HexColor("#2E7D32")
RED    = colors.HexColor("#C62828")
PURPLE = colors.HexColor("#6A1B9A")

# ── styles ──────────────────────────────────────────────────────────────────
styles = getSampleStyleSheet()

def S(name, **kw):
    return ParagraphStyle(name, parent=styles["Normal"], **kw)

title_style    = S("Title2",   fontSize=18, textColor=WHITE,   alignment=TA_CENTER,
                   fontName="Helvetica-Bold", spaceAfter=2)
sub_style      = S("Sub",      fontSize=9,  textColor=MGREY,   alignment=TA_CENTER,
                   fontName="Helvetica", spaceAfter=6)
h1_style       = S("H1",       fontSize=13, textColor=WHITE,   fontName="Helvetica-Bold",
                   spaceAfter=4, spaceBefore=4, leftIndent=6)
h2_style       = S("H2",       fontSize=10.5, textColor=NAVY,  fontName="Helvetica-Bold",
                   spaceAfter=2, spaceBefore=6)
body_style     = S("Body",     fontSize=8.5, textColor=BLACK,  fontName="Helvetica",
                   spaceAfter=2, leading=12, alignment=TA_JUSTIFY)
small_bold     = S("SmBold",   fontSize=8,   textColor=NAVY,   fontName="Helvetica-Bold")
cell_hdr       = S("CellHdr",  fontSize=8.5, textColor=WHITE,  fontName="Helvetica-Bold",
                   alignment=TA_CENTER)
cell_body      = S("CellBody", fontSize=8,   textColor=BLACK,  fontName="Helvetica",
                   alignment=TA_LEFT, leading=11)
cell_body_c    = S("CellBodyC",fontSize=8,   textColor=BLACK,  fontName="Helvetica",
                   alignment=TA_CENTER, leading=11)
bullet_style   = S("Bullet",   fontSize=8.5, textColor=BLACK,  fontName="Helvetica",
                   leftIndent=12, firstLineIndent=-10, spaceAfter=1, leading=12,
                   bulletIndent=4)
note_style     = S("Note",     fontSize=7.5, textColor=PURPLE, fontName="Helvetica-Oblique",
                   spaceAfter=2)
mnemonic_style = S("Mnemo",    fontSize=9,   textColor=GREEN,  fontName="Helvetica-Bold",
                   spaceAfter=2, leading=13)

def colored_heading(text, bg=NAVY, style=h1_style):
    tbl = Table([[Paragraph(text, style)]], colWidths=[17.5*cm])
    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("ROUNDEDCORNERS", [4]),
        ("TOPPADDING",    (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING",   (0,0), (-1,-1), 8),
    ]))
    return tbl

def section_header(text, bg=TEAL):
    return colored_heading(text, bg=bg)

def bullet(txt):
    return Paragraph(f"• {txt}", bullet_style)

def b(txt):
    return f"<b>{txt}</b>"

def bi(txt):
    return f"<b><i>{txt}</i></b>"

def red(txt):
    return f'<font color="#C62828">{txt}</font>'

def grn(txt):
    return f'<font color="#2E7D32">{txt}</font>'

def amb(txt):
    return f'<font color="#E07B39">{txt}</font>'

# ── document ─────────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    OUTPUT, pagesize=A4,
    leftMargin=1.5*cm, rightMargin=1.5*cm,
    topMargin=1.5*cm, bottomMargin=1.5*cm
)
story = []

# ============================================================
#  TITLE BANNER
# ============================================================
title_tbl = Table([[Paragraph("HERNIA SURGERY — QUICK REFERENCE", title_style)],
                   [Paragraph("Diaphragmatic Hernias • Abdominal Wall Reconstruction • Component Separation", sub_style)]],
                  colWidths=[17.5*cm])
title_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), NAVY),
    ("TOPPADDING",    (0,0), (-1,-1), 10),
    ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ("LEFTPADDING",   (0,0), (-1,-1), 10),
    ("ROUNDEDCORNERS", [6]),
]))
story += [title_tbl, Spacer(1, 8)]

source_note = Paragraph(
    f"<i>Based on {b('Sabiston Textbook of Surgery 21e')}, {b('Bailey & Love 28e')}, "
    f"{b('Current Surgical Therapy 14e')}, {b('Schwartz Principles of Surgery 11e')}</i>",
    S("SrcNote", fontSize=7.5, textColor=colors.grey, alignment=TA_CENTER))
story += [source_note, Spacer(1, 6)]

# ============================================================
#  PAGE 1 — DIAPHRAGMATIC HERNIA CLASSIFICATION
# ============================================================
story.append(section_header("1. CLASSIFICATION OF DIAPHRAGMATIC HERNIAS"))
story.append(Spacer(1, 4))

# Classification table
cls_data = [
    [Paragraph(b("Type"), cell_hdr),
     Paragraph(b("Name"), cell_hdr),
     Paragraph(b("Location"), cell_hdr),
     Paragraph(b("Sac?"), cell_hdr),
     Paragraph(b("Key Features"), cell_hdr)],

    [Paragraph("I", cell_body_c),
     Paragraph("Sliding hiatus hernia", cell_body),
     Paragraph("Gastro-oesophageal junction + part of stomach slide into chest", cell_body),
     Paragraph(grn("Yes (lax)"), cell_body_c),
     Paragraph("Most common (95%). GOR, heartburn. Rarely requires surgery.", cell_body)],

    [Paragraph("II", cell_body_c),
     Paragraph("Para-oesophageal (rolling) hernia", cell_body),
     Paragraph("Fundus herniates beside fixed GOJ", cell_body),
     Paragraph(grn("Yes"), cell_body_c),
     Paragraph("5%. Obstruction/strangulation risk. Elective repair advised.", cell_body)],

    [Paragraph("III", cell_body_c),
     Paragraph("Mixed (sliding + rolling)", cell_body),
     Paragraph("Both GOJ and fundus herniate", cell_body),
     Paragraph(grn("Yes"), cell_body_c),
     Paragraph("Most common para-oesophageal type in practice.", cell_body)],

    [Paragraph("IV", cell_body_c),
     Paragraph("Intrathoracic stomach / large defect", cell_body),
     Paragraph("Large hiatus; colon, spleen may also herniate", cell_body),
     Paragraph(grn("Yes"), cell_body_c),
     Paragraph("Organoaxial volvulus risk. Urgent/emergent repair.", cell_body)],

    [Paragraph("CDH\n(Bochdalek)", cell_body_c),
     Paragraph("Posterolateral (Bochdalek) hernia", cell_body),
     Paragraph("Left posterolateral (pleuroperitoneal canal defect)", cell_body),
     Paragraph(red("No"), cell_body_c),
     Paragraph("Most common CDH (75–90%). Neonatal respiratory distress. Bowel in chest.", cell_body)],

    [Paragraph("CDH\n(Morgagni)", cell_body_c),
     Paragraph("Anterior (Morgagni) hernia", cell_body),
     Paragraph("Right parasternal (foramen of Morgagni)", cell_body),
     Paragraph(grn("Yes"), cell_body_c),
     Paragraph("2–3% of CDH. Often diagnosed late/incidentally in adults.", cell_body)],

    [Paragraph("Traumatic", cell_body_c),
     Paragraph("Post-traumatic diaphragmatic hernia", cell_body),
     Paragraph("Any site; left-sided more common (70%)", cell_body),
     Paragraph(red("No"), cell_body_c),
     Paragraph("Blunt/penetrating trauma. May present acutely or years later (latent phase).", cell_body)],
]

cls_tbl = Table(cls_data, colWidths=[1.3*cm, 3.2*cm, 4.0*cm, 1.4*cm, 6.6*cm])
cls_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), NAVY),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [LGREY, WHITE]),
    ("GRID",          (0,0), (-1,-1), 0.4, MGREY),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 4),
    ("ROUNDEDCORNERS",[3]),
]))
story += [cls_tbl, Spacer(1, 6)]

# Mnemonic box
mn_data = [[Paragraph(
    f'{b("MNEMONIC — Types")} &nbsp;&nbsp; '
    f'{grn(b("\"Slides, Rolls, Mixes, Huge\""))} = Type I, II, III, IV hiatus hernias<br/>'
    f'{grn(b("\"Big, Anterior, Trauma\""))} = Bochdalek / Anterior (Morgagni) / Traumatic (non-hiatus)<br/>'
    f'{amb(b("Left > Right"))} for both Bochdalek CDH and traumatic diaphragmatic hernia (liver protects right side)',
    mnemonic_style)]]
mn_tbl = Table(mn_data, colWidths=[17.5*cm])
mn_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), colors.HexColor("#F0FFF0")),
    ("BOX",           (0,0), (-1,-1), 1, GREEN),
    ("TOPPADDING",    (0,0), (-1,-1), 6),
    ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ("LEFTPADDING",   (0,0), (-1,-1), 8),
    ("ROUNDEDCORNERS",[4]),
]))
story += [mn_tbl, Spacer(1, 8)]

# ============================================================
#  POST-TRAUMATIC DIAPHRAGMATIC HERNIA — Surgical management
# ============================================================
story.append(section_header("2. POST-TRAUMATIC DIAPHRAGMATIC HERNIA — Surgical Management"))
story.append(Spacer(1, 4))

story.append(Paragraph(
    f"{b('Background:')} Traumatic diaphragmatic rupture occurs in ~3–5% of major blunt abdominal trauma "
    f"and ~10–15% of penetrating wounds. Left-sided in 70% (liver protects right). "
    f"Three phases: {b('Acute')} (at injury), {b('Latent')} (silent, months–years), {b('Obstructive')} (visceral strangulation).",
    body_style))
story.append(Spacer(1, 4))

# Phase table
phase_data = [
    [Paragraph(b("Phase"), cell_hdr),
     Paragraph(b("Timing"), cell_hdr),
     Paragraph(b("Presentation"), cell_hdr),
     Paragraph(b("Approach"), cell_hdr)],
    [Paragraph(b("Acute"), cell_body_c),
     Paragraph("Hours–days post trauma", cell_body),
     Paragraph("Haemothorax, respiratory distress, bowel sounds in chest, NG tube in chest on CXR, CT diagnosis", cell_body),
     Paragraph("Transabdominal (laparotomy) — control associated injuries first; diaphragm repair done concurrently", cell_body)],
    [Paragraph(b("Latent"), cell_body_c),
     Paragraph("Weeks to years", cell_body),
     Paragraph("Vague chest/abdominal pain, incidental CXR finding, GI symptoms, dyspnoea", cell_body),
     Paragraph("Elective repair; laparoscopic preferred if no dense adhesions", cell_body)],
    [Paragraph(b("Obstructive"), cell_body_c),
     Paragraph("Variable", cell_body),
     Paragraph("Acute bowel obstruction/strangulation, ischaemia, sepsis", cell_body),
     Paragraph("Emergency laparotomy; bowel resection if non-viable; thoracotomy if adhesions prevent abdominal access", cell_body)],
]
phase_tbl = Table(phase_data, colWidths=[2.2*cm, 2.8*cm, 5.5*cm, 7.0*cm])
phase_tbl.setStyle(TableStyle([
    ("BACKGROUND",     (0,0), (-1,0), TEAL),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [LGREY, WHITE, colors.HexColor("#FFF3E0")]),
    ("GRID",           (0,0), (-1,-1), 0.4, MGREY),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",     (0,0), (-1,-1), 4),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 4),
    ("LEFTPADDING",    (0,0), (-1,-1), 4),
    ("ROUNDEDCORNERS", [3]),
]))
story += [phase_tbl, Spacer(1, 5)]

# Operative steps
story.append(Paragraph(b("Operative Steps — Transabdominal (Laparotomy) Approach"), h2_style))
steps = [
    f"{b('Position:')} Supine; GA with double-lumen tube if thoracic extension anticipated.",
    f"{b('Incision:')} Midline laparotomy (or left subcostal for isolated left-sided injury).",
    f"{b('Explore abdomen:')} Identify associated injuries — spleen, liver, bowel, major vessels; control haemorrhage first.",
    f"{b('Reduce herniated contents:')} Gently reduce stomach/colon/spleen from chest; assess viability.",
    f"{b('Decompress chest:')} Clear haemothorax/haemopneumothorax; place chest drain if needed.",
    f"{b('Trim defect edges:')} Debride any devitalised diaphragmatic tissue.",
    f"{b('Primary repair (preferred):')} Interrupted non-absorbable sutures (Prolene 0/1-0) in figure-of-8 or horizontal mattress fashion; tension-free closure.",
    f"{b('Mesh reinforcement:')} If defect is large, chronic/fibrotic, or tension-free closure not possible — use synthetic (Prolene/PTFE) or biological mesh for patch repair.",
    f"{b('Drain:')} Intercostal tube to drain residual haemothorax/pneumothorax.",
    f"{b('Thoracoabdominal approach:')} Used when abdominal exposure alone is inadequate (right-sided injuries, dense thoracic adhesions in delayed cases).",
]
for s in steps:
    story.append(bullet(s))

story.append(Spacer(1, 4))

# Laparoscopic approach
story.append(Paragraph(b("Laparoscopic Approach (Elective/Latent Phase)"), h2_style))
lap = [
    "Ports: 10 mm umbilical camera + two 5 mm working ports (left or right side).",
    "CO₂ insufflation aids visualization; may need low pressure (8–10 mmHg) to avoid tension pneumothorax.",
    "Careful lysis of adhesions between herniated viscera and thoracic structures.",
    "Reduce all herniated contents; assess viability.",
    "Primary intracorporeal suture repair (non-absorbable) — possible for defects < 5 cm.",
    "Mesh patch for large or chronic defects; tack/sutured in place.",
    "Convert to open if dense adhesions, non-reducible viscera, or haemodynamic instability.",
]
for l in lap:
    story.append(bullet(l))

story.append(Spacer(1, 4))
story.append(Paragraph(
    f'{red(b("KEY POINT:"))} In the acute trauma setting, diaphragm repair is always '
    f'secondary to damage control — {b("control haemorrhage first")}. '
    f'Bilateral injuries occur in 2%; always inspect both domes.',
    note_style))

# ── PAGE BREAK ──────────────────────────────────────────────────────────────
story.append(PageBreak())

# ============================================================
#  PAGE 2 — ABDOMINAL WALL RECONSTRUCTION
# ============================================================
story.append(title_tbl)
story.append(Spacer(1, 8))
story.append(section_header("3. ABDOMINAL WALL RECONSTRUCTION (AWR)"))
story.append(Spacer(1, 4))

story.append(Paragraph(
    f"{b('Definition:')} AWR refers to the restoration of structural and functional continuity of the "
    f"musculofascial complex of the abdominal wall in patients with complex ventral/incisional hernias, "
    f"enterocutaneous fistulae, loss of domain, or open abdomens (Sabiston 21e, Ch. 37).",
    body_style))
story.append(Spacer(1, 4))

# Indications
story.append(Paragraph(b("Indications for AWR"), h2_style))
indic = [
    "Complex/recurrent incisional hernias with loss of abdominal domain",
    "Contaminated fields (enterocutaneous fistula, infected mesh, stoma reversal)",
    "Open abdomen after damage control surgery (OA/VAC-treated patients)",
    "Giant ventral hernias where primary closure is impossible",
    "Failed prior hernia repairs",
]
for i in indic:
    story.append(bullet(i))
story.append(Spacer(1, 4))

# Preoperative optimisation
story.append(Paragraph(b("Preoperative Optimisation (MANDATORY before elective AWR)"), h2_style))
opt_data = [
    [Paragraph(b("Factor"), cell_hdr), Paragraph(b("Target / Action"), cell_hdr)],
    [Paragraph("Smoking", cell_body), Paragraph("Cessation ≥ 4–6 weeks; urine cotinine screening", cell_body)],
    [Paragraph("Diabetes", cell_body), Paragraph("HbA1c < 7%; tight perioperative glucose control", cell_body)],
    [Paragraph("Obesity", cell_body), Paragraph("BMI < 35 preferred; bariatric surgery if severe", cell_body)],
    [Paragraph("Nutrition", cell_body), Paragraph("Prealbumin > 20 mg/dL; protein-calorie optimisation", cell_body)],
    [Paragraph("Infection", cell_body), Paragraph("Clear all active infection/fistula before elective repair", cell_body)],
    [Paragraph("MRSA", cell_body), Paragraph("Decolonise carriers; use vancomycin prophylaxis periop", cell_body)],
    [Paragraph("CT scan", cell_body), Paragraph("Essential preoperative mapping of defect, residual muscle, vessels", cell_body)],
]
opt_tbl = Table(opt_data, colWidths=[3.5*cm, 14*cm])
opt_tbl.setStyle(TableStyle([
    ("BACKGROUND",     (0,0), (-1,0), NAVY),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [LGREY, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.4, MGREY),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",     (0,0), (-1,-1), 3),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 3),
    ("LEFTPADDING",    (0,0), (-1,-1), 5),
    ("ROUNDEDCORNERS", [3]),
]))
story += [opt_tbl, Spacer(1, 5)]

# Mesh position table
story.append(Paragraph(b("Mesh Position Options in AWR"), h2_style))
mesh_data = [
    [Paragraph(b("Position"), cell_hdr),
     Paragraph(b("Location"), cell_hdr),
     Paragraph(b("Advantages"), cell_hdr),
     Paragraph(b("Disadvantages"), cell_hdr)],
    [Paragraph("Onlay", cell_body_c),
     Paragraph("Anterior to anterior rectus sheath", cell_body),
     Paragraph("Easy access; no bowel contact", cell_body),
     Paragraph("High SSO, wound complications, recurrence", cell_body)],
    [Paragraph("Inlay\n(Bridge)", cell_body_c),
     Paragraph("Defect edge to edge — no fascial closure", cell_body),
     Paragraph("Used when fascia cannot be approximated", cell_body),
     Paragraph(red("Highest recurrence; worst functional results"), cell_body)],
    [Paragraph("Sublay\n(Retrorectus)", cell_body_c),
     Paragraph("Posterior to rectus, anterior to posterior sheath (Rives-Stoppa)", cell_body),
     Paragraph("Protected by posterior sheath; large overlap; preferred", cell_body),
     Paragraph("More dissection; longer OR time", cell_body)],
    [Paragraph("IPOM\n(intraperitoneal)", cell_body_c),
     Paragraph("Inside peritoneal cavity", cell_body),
     Paragraph("Simple laparoscopic access", cell_body),
     Paragraph("Bowel adhesion/erosion; anti-adhesive coating needed", cell_body)],
    [Paragraph("Preperitoneal", cell_body_c),
     Paragraph("Between peritoneum and posterior sheath", cell_body),
     Paragraph("Good overlap, away from bowel", cell_body),
     Paragraph("Difficult access in scarred fields", cell_body)],
]
mesh_tbl = Table(mesh_data, colWidths=[2.3*cm, 4.0*cm, 5.2*cm, 6.0*cm])
mesh_tbl.setStyle(TableStyle([
    ("BACKGROUND",     (0,0), (-1,0), AMBER),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [LGREY, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.4, MGREY),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",     (0,0), (-1,-1), 3),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 3),
    ("LEFTPADDING",    (0,0), (-1,-1), 4),
    ("ROUNDEDCORNERS", [3]),
]))
story += [mesh_tbl, Spacer(1, 5)]

story.append(Paragraph(
    f'{b("Rives-Stoppa-Wantz repair")} (retrorectus sublay) and {b("TAR")} (transversus abdominis release) '
    f'are the preferred techniques in AWR — both restore a {b("dynamic abdominal wall")} with mesh in the '
    f'retromuscular plane, outside the peritoneal cavity. (Sabiston 21e, Ch. 37)',
    note_style))

# ── PAGE BREAK ──────────────────────────────────────────────────────────────
story.append(PageBreak())

# ============================================================
#  PAGE 3 — COMPONENT SEPARATION TECHNIQUE
# ============================================================
story.append(title_tbl)
story.append(Spacer(1, 8))
story.append(section_header("4. COMPONENT SEPARATION TECHNIQUE IN VENTRAL HERNIA REPAIR"))
story.append(Spacer(1, 4))

story.append(Paragraph(
    f"{b('Definition:')} Component separation = creation of myofascial advancement flaps to allow "
    f"medialization of the rectus muscles and tension-free midline fascial closure in large ventral hernias. "
    f"Originally described by {b('Ramirez et al. in 1990')} (anterior technique).",
    body_style))
story.append(Spacer(1, 4))

# Overview comparison table
story.append(Paragraph(b("Anterior vs Posterior Component Separation — At-a-Glance"), h2_style))
comp_data = [
    [Paragraph(b("Feature"), cell_hdr),
     Paragraph(b("Anterior (EOR/ACS)"), cell_hdr),
     Paragraph(b("Posterior (TAR)"), cell_hdr)],
    [Paragraph("Layer released", cell_body_c),
     Paragraph("External oblique muscle/aponeurosis", cell_body),
     Paragraph("Transversus abdominis muscle", cell_body)],
    [Paragraph("First described", cell_body_c),
     Paragraph("Ramirez, 1990", cell_body),
     Paragraph("Novitsky, 2012", cell_body)],
    [Paragraph("Advancement per side", cell_body_c),
     Paragraph("~3–10 cm (debated)", cell_body),
     Paragraph("~5–8 cm additional (retromuscular space)", cell_body)],
    [Paragraph("Mesh position", cell_body_c),
     Paragraph("Onlay / sublay", cell_body),
     Paragraph("Retromuscular (retrorectus/pre-peritoneal)", cell_body)],
    [Paragraph("Wound morbidity", cell_body_c),
     Paragraph(red("High (large skin flaps → devascularisation)"), cell_body),
     Paragraph(grn("Lower (no large skin flaps)"), cell_body)],
    [Paragraph("Perforator preservation", cell_body_c),
     Paragraph("Standard: disrupted. Endoscopic: preserved", cell_body),
     Paragraph(grn("Preserved"), cell_body)],
    [Paragraph("Best for", cell_body_c),
     Paragraph("Moderate defects; limited mesh experience", cell_body),
     Paragraph("Large/giant/recurrent; contaminated fields", cell_body)],
]
comp_tbl = Table(comp_data, colWidths=[3.5*cm, 7.0*cm, 7.0*cm])
comp_tbl.setStyle(TableStyle([
    ("BACKGROUND",     (0,0), (-1,0), PURPLE),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [LGREY, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.4, MGREY),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",     (0,0), (-1,-1), 4),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 4),
    ("LEFTPADDING",    (0,0), (-1,-1), 4),
    ("ROUNDEDCORNERS", [3]),
]))
story += [comp_tbl, Spacer(1, 5)]

# ANTERIOR - step by step
story.append(Paragraph(b("A. Anterior Component Separation (Ramirez Technique) — Step by Step"), h2_style))
ant_steps = [
    f"{b('Incision:')} Midline laparotomy; reduce hernia sac; lyse adhesions to anterior abdominal wall.",
    f"{b('Skin flaps:')} Develop subcutaneous flaps between anterior rectus fascia and subcutaneous fat, "
    f"extending laterally to the {b('linea semilunaris')} bilaterally.",
    f"{b('External oblique release:')} Incise the external oblique aponeurosis {b('2 cm lateral to the linea semilunaris')}. "
    f"Extend superiorly over the rib cage and inferiorly to the inguinal ligament.",
    f"{b('Develop plane:')} Open the avascular plane between external oblique and internal oblique muscles.",
    f"{b('Posterior sheath:')} Optionally incise posterior rectus sheath at linea alba edge for additional release.",
    f"{b('Fascial closure:')} Reapproximate the linea alba with running slow-absorbable (PDS) or permanent suture; "
    f"defects up to 10–20 cm can be closed.",
    f"{b('Mesh reinforcement:')} Place mesh (typically onlay or sublay) over the repair with ≥ 5 cm overlap.",
    f"{b('Drains:')} Subcutaneous drains in the large skin flap spaces (high seroma/SSO risk!).",
    f"{b('Endoscopic modification (eMST):')} Avoids large skin flaps; tunnels under the subcutaneous fat to "
    f"release external oblique — preserves periumbilical perforators, reduces wound morbidity.",
]
for s in ant_steps:
    story.append(bullet(s))
story.append(Spacer(1, 5))

# POSTERIOR — step by step
story.append(Paragraph(b("B. Posterior Component Separation with TAR (Novitsky/Rives-Stoppa) — Step by Step"), h2_style))
post_steps = [
    f"{b('Incision:')} Midline laparotomy; reduce hernia; enter and develop the retrorectus space bilaterally.",
    f"{b('Retrorectus dissection:')} Develop the plane between posterior rectus sheath and rectus muscle from "
    f"xiphoid to pubis and laterally to the linea semilunaris.",
    f"{b('TAR (Transversus Abdominis Release):')} At the lateral edge of the rectus, the {b('posterior rectus sheath')} "
    f"(composed partly by TAM) is incised. The transversus abdominis muscle is divided, opening the "
    f"{b('preperitoneal/retroperitoneal space')} — a continuous avascular plane extending far laterally.",
    f"{b('Lateral dissection:')} This plane is developed lateral to the epigastric vessels, beneath the "
    f"neurovascular bundles (T7–L1); preserving these maintains the innervation of the rectus muscle.",
    f"{b('Posterior closure:')} Posterior rectus sheath + peritoneum is closed as one layer with running absorbable suture, "
    f"creating a large retromuscular pocket for mesh.",
    f"{b('Mesh placement:')} A {b('large lightweight synthetic mesh')} (e.g. 30×30 cm) is placed in the retromuscular "
    f"space; {b('no fixation sutures needed')} — intraabdominal pressure holds it.",
    f"{b('Anterior closure:')} The linea alba is re-approximated with continuous slowly-absorbable suture.",
    f"{b('No large skin flaps:')} SSO rates significantly lower than anterior component separation.",
]
for s in post_steps:
    story.append(bullet(s))
story.append(Spacer(1, 5))

# Advancement amounts (key table)
story.append(Paragraph(b("Expected Fascial Advancement per Side (Sabiston 21e / Novitsky data)"), h2_style))
adv_data = [
    [Paragraph(b("Manoeuvre"), cell_hdr),
     Paragraph(b("Advancement (cm/side)"), cell_hdr),
     Paragraph(b("Total potential closure"), cell_hdr)],
    [Paragraph("Posterior rectus sheath release alone", cell_body),
     Paragraph("1–2 cm", cell_body_c),
     Paragraph("~2–4 cm", cell_body_c)],
    [Paragraph("Anterior CS (external oblique release)", cell_body),
     Paragraph("3–10 cm", cell_body_c),
     Paragraph("~6–20 cm", cell_body_c)],
    [Paragraph("TAR (posterior CS)", cell_body),
     Paragraph("Additional 3–5 cm on top of retrorectus", cell_body_c),
     Paragraph("~10–20+ cm total", cell_body_c)],
]
adv_tbl = Table(adv_data, colWidths=[7.5*cm, 4.5*cm, 5.5*cm])
adv_tbl.setStyle(TableStyle([
    ("BACKGROUND",     (0,0), (-1,0), TEAL),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [LGREY, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.4, MGREY),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING",     (0,0), (-1,-1), 4),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 4),
    ("LEFTPADDING",    (0,0), (-1,-1), 5),
    ("ROUNDEDCORNERS", [3]),
]))
story += [adv_tbl, Spacer(1, 5)]

# Final mnemonic
mn2_data = [[Paragraph(
    f'{b("MNEMONIC — Component Separation Steps")} ({grn(b("\"SEEDS-M\""))})<br/>'
    f'{grn("S")}kin flaps / {grn("E")}xternal oblique incised 2 cm lateral to semilunar line / '
    f'{grn("E")}xtend from rib to inguinal ligament / {grn("D")}evelop EO-IO plane / '
    f'{grn("S")}uture fascia / {grn("M")}esh reinforcement<br/>'
    f'<br/>'
    f'{b("TAR mnemonic")} ({grn(b("\"RTTPCM\""))}): '
    f'{grn("R")}etrorectus → {grn("T")}AR (transversus divided) → {grn("T")}unnel laterally → '
    f'{grn("P")}osterior sheath closed → {grn("C")}olossal mesh placed → {grn("M")}idline closed',
    mnemonic_style)]]
mn2_tbl = Table(mn2_data, colWidths=[17.5*cm])
mn2_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), colors.HexColor("#F0FFF0")),
    ("BOX",           (0,0), (-1,-1), 1, GREEN),
    ("TOPPADDING",    (0,0), (-1,-1), 6),
    ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ("LEFTPADDING",   (0,0), (-1,-1), 8),
    ("ROUNDEDCORNERS",[4]),
]))
story += [mn2_tbl, Spacer(1, 5)]

# Complications
story.append(Paragraph(b("Complications of Component Separation"), h2_style))
comp_c = [
    f"{b('Wound complications:')} Seroma (30–50%), wound infection, skin flap necrosis — especially with anterior CS",
    f"{b('Hernia recurrence:')} Lower with posterior/TAR + mesh vs anterior CS alone",
    f"{b('Denervation:')} TAR risks lateral cutaneous nerve injury if dissection goes too far; anterior CS risks flap ischaemia",
    f"{b('Mesh infection:')} Synthetic mesh in contaminated field — consider biological mesh (acellular dermal matrix)",
    f"{b('Enterotomy:')} Adhesiolysis risk; bowel resection may be needed",
]
for c in comp_c:
    story.append(bullet(c))

story.append(Spacer(1, 6))
story.append(Paragraph(
    f"Sources: Sabiston Textbook of Surgery 21e (Ch. 37 Abdominal Wall, Ch. 56 Thorax/Diaphragm) • "
    f"Bailey & Love's Short Practice of Surgery 28e • Current Surgical Therapy 14e (Novitsky et al.) • "
    f"Schwartz Principles of Surgery 11e • Fischer's Mastery of Surgery 8e",
    S("Footer", fontSize=7, textColor=colors.grey, alignment=TA_CENTER)))

# ── BUILD ────────────────────────────────────────────────────────────────────
doc.build(story)
print("PDF generated:", OUTPUT)