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