Repair of giant incisional abdominal wall hernias using open intraperitoneal mesh
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Very large and complex incisional hernias, especially those involving loss of abdominal wall, present a particular challenge to the surgeon.
The open intraperitoneal technique was used prospectively for the repair of incisional hernias in a selected group of patients with large defects, often those with major loss of abdominal wall, overweight patients, and previous failures of incisional repair.
Materials and methods
Between 1 January 1999 and 31 December 2005, out of 275 patients operated on for incisional hernia repair, 61 of them, most of whom were obese with multiorificial recurrent or giant hernias and contraindicated for laparoscopy, were treated using an open intraperitoneal mesh technique. There were 50 females and 11 males, with a mean age of 61. The median ASA score of the group was 2.3, with a mean BMI of 34 kg/m2 and a mean hernia surface of 182 cm2. Sixty-four percent of the patients had undergone one or more previous incisional hernia repairs.
Mean operating time was 130 min, with an average hospital stay of 13 days. None of the patients died. Postoperative complications occurred in 21% of the patients; most of which were minor, but two cases (3.3%) developed deep abscesses requiring surgery and removal of the mesh. A recurrence rate of 5% was found after a mean follow-up of 35 months (8–88).
Open intraperitoneal mesh repair appears to be a good option for the treatment of complex incisional hernia (at least 10 cm in diameter or multiorificial) in obese patients contraindicated for laparoscopy.
KeywordsGiant incisional hernia Intraperitoneal mesh repair Open surgery
- 4.Chrysos E, Athanasakis E, Saridaki Z, Kafetzakis A, Dimitriadou D, Koutsoumpas V, Chalkiadakis G, Xynos E, Zoras O (2000) Surgical repair of incisional ventral hernias: tension-free technique using prosthetic materials (expanded polytetrafluoroethylene Gore-tex dual mesh®). Am Surg 66:679–682PubMedGoogle Scholar
- 17.Becouarn G, Szmil E, Leroux C, Arnaud JP (1996) Cure chirurgicale des éventrations post opératoires par implantation intra péritonéale d’un treillis de Dacron: à propos de 160 cas opérés. J Chir 133:229–232Google Scholar
- 26.Balique JG, Benchetrit S, Bouillot JL, Flament JB, Gouillat C, Jarsaillon P, Lepere M, Mantion G, Arnaud JP, Magne E, Brunetti F (2005) Intraperitoneal treatment of incisional and umbilical hernias using an innovative composite mesh: four-year results of a prospective multicenter clinical trial. Hernia 9:68–74PubMedCrossRefGoogle Scholar