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Incisional and Parastomal Hernia Prevention

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Management of Abdominal Hernias

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Abstract

Incisional hernias occur commonly following abdominal operations with an incidence of approximately 10–20% and are the most common complication of laparotomy. Those developing incisional hernia frequently require further operations, either elective or emergent with significant costs to the healthcare system. Those requiring fecal diversion with either colostomy or ileostomy are at risk for development of not only incisional hernia but also parastomal hernia at a rate approaching 50%. Strategies to identify patients at risk for these hernias are required in order to develop preventative treatments. The use of prophylactic mesh has been studied in patients deemed at increased risk for the development of incisional hernia including those undergoing bariatric surgery, abdominal aortic aneurysm repair, and gastrointestinal surgery with significant reductions in incisional hernia rates and rare mesh complications. Similarly, the placement of mesh at the site of a newly created stoma has proven efficacy in the reduction in the incidence of parastomal herniation. Although the ideal technique for placement of prophylactic mesh has not been clearly elucidated, the concept of hernia prevention has the potential to dramatically improve surgical outcomes and enhance quality of life for thousands of patients each year.

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Author information

Authors and Affiliations

  1. Division of GI/Minimally Invasive Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA

    Sofiane El Djouzi MD, MS, FRCS, FACS

  2. Center for Minimally Invasive Surgery, Gastrointestinal Surgery, University of Kentucky, Lexington, KY, USA

    J. Scott Roth MD, FACS

Authors
  1. Sofiane El Djouzi MD, MS, FRCS, FACS
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  2. J. Scott Roth MD, FACS
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Correspondence to J. Scott Roth MD, FACS .

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Editors and Affiliations

  1. Surgeons Group of Baton Rouge of Our Lady of the Lake Physician Group, Baton Rouge, Louisiana, USA

    Karl A. LeBlanc

  2. Peninsula College of Medicine and Dentistry (Emeritus), Plymouth, United Kingdom

    Andrew Kingsnorth

  3. North Devon District Hospital, Barnstaple, United Kingdom

    David L. Sanders

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El Djouzi, S., Roth, J.S. (2018). Incisional and Parastomal Hernia Prevention. In: LeBlanc, K., Kingsnorth, A., Sanders, D. (eds) Management of Abdominal Hernias. Springer, Cham. https://doi.org/10.1007/978-3-319-63251-3_4

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  • DOI: https://doi.org/10.1007/978-3-319-63251-3_4

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