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Hernia

, Volume 20, Issue 4, pp 527–530 | Cite as

Proposed technique for open repair of a small umbilical hernia and rectus divarication with self-gripping mesh

  • B. J. Privett
  • M. Ghusn
How-I-Do-It

Abstract

Introduction

There are a group of patients in which umbilical or epigastric hernias co-exist with rectus divarication. These patients have weak abdominal musculature and are likely to pose a higher risk of recurrence following umbilical hernia repair. We would like to describe a technique for open repair of small (<4 cm) midline hernias in patients with co-existing rectus divarication using self-adhesive synthetic mesh. The use of a self-adhesive mesh avoids the need for suture fixation of the mesh in the superior portion of the abdomen, allowing for a smaller skin incision.

Results

In 173 patients, preperitoneal self-fixating mesh has been used for the repair of midline hernias <4 cm in diameter. In 58 of these patients, the mesh was extended superiorly to reinforce a concurrent divarication.

Discussion

The described technique offers a simple option for open repair of small midline hernias in patients with co-existing rectus divarication, to decrease the risk of upper midline recurrence in an at-risk patient group. This initial case series is able to demonstrate a suitably low rate of recurrence and complications.

Keywords

Umbilical hernia Rectus divarication Self-gripping mesh 

Notes

Acknowledgments

The authors would like to thank Savo Djukic from Covidien for the illustrations.

Conflict of interest

BP reports non-financial support from Covidien, during the conduct of the study. MG reports non-financial support from Covidien, during the conduct of the study and personal fees and support outside the conduct of this study.

References

  1. 1.
    Christoffersen MW, Helgstrand F, Rosenberg J, Kehlet H, Bisgaard T (2013) Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study. World J Surg 37(11):2548–2552. doi: 10.1007/s00268-013-2160-0 CrossRefPubMedGoogle Scholar
  2. 2.
    Hickey F, Finch JG, Khanna A (2011) A systematic review on the outcomes of correction of diastasis of the recti. Hernia 15(6):607–614. doi: 10.1007/s10029-011-0839-4 CrossRefPubMedGoogle Scholar
  3. 3.
    Kohler G, Luketina RR, Emmanuel K (2015) Sutured repair of primary small umbilical and epigastric hernias: concomitant rectus diastasis is a significant risk factor for recurrence. World J Surg 39(1):121–126 (discussion 127). doi: 10.1007/s00268-014-2765-y
  4. 4.
    Kulhanek J, Mestak O (2013) Treatment of umbilical hernia and recti muscles diastasis without a periumbilical incision. Hernia 17(4):527–530. doi: 10.1007/s10029-013-1047-1 CrossRefPubMedGoogle Scholar
  5. 5.
    Prasad P, Tantia O, Patle NM, Khanna S, Sen B (2011) Laparoscopic transabdominal preperitoneal repair of ventral hernia: a step towards physiological repair. Indian J Surg 73(6):403–408. doi: 10.1007/s12262-011-0366-7 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  1. 1.The Tweed HospitalTweed HeadsAustralia
  2. 2.School of MedicineGriffith UniversityGold CoastAustralia
  3. 3.John Flynn Private HospitalTugunAustralia

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