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Detection of recurrent hernia and intraabdominal adhesions following incisional hernia repair: a functional cine MRI-study

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Abstract

Background

To non-invasively identify incisional hernia repair implanted synthetic meshes with MRI, and also focusing on the evaluation of postsurgical complications such as adhesions.

Methods

A total of 43 patients underwent either laparoscopic intraperitoneal onlay-mesh or open abdominal wall repair using preperitoneal layers. The patients were examined using a true-fast-imaging-with-steady-state-precession (trueFISP)-sequence in transverse/sagittal orientation with a section-by-section dynamic depiction of induced visceral slide. A 9-segment-abdominal-map was used to document the adhesion location/type. The MR-images were analysed regarding hernia relapse, layer-morphology, rectus-abdominis muscle-condition, and abdominal wall mobility. In 12 patients pre- and postsurgery-MRI was performed.

Results

Time range between surgery and examination was 6–36 months. In all laparoscopy-patients the meshes were identified. For open surgery the mesh was not visualized in 20, but was seen in 6 cases. A total of 11 cases showed a recurrent hernia. Seventy intraabdominal adhesions were detected. Fifteen patients had restricted mobility. 20 patients showed an rectus-abdominis-muscle-asymmetry. Comparing pre- and post-op-MRI, 6 out of 8 patients with open repair showed thick scar-plaques. Three patients with open repair had new adhesion-formations postoperatively.

Conclusion

Functional cine MRI is suitable for follow-up studies in patients after hernia repair to detect and evaluate the implanted meshes. Typical complications like intestinal adhesions and abdominal wall dysmotility can be assessed as well.

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Authors and Affiliations

  1. Department of Clinical Radiology, Hospital Großhadern, Ludwig Maximilians University Munich, Marchioninistrasse 15, Munich, 81377, Germany

    S. Kirchhoff, M. F. Reiser & A. Lienemann

  2. Department of Surgery, Hospital Innenstadt, Ludwig Maximilians University Munich, Nussbaumstrasse 30, Munich, 80336, Germany

    R. Ladurner & T. Mussack

  3. Department of Sports Orthopedic Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 97, Munich, 81241, Germany

    C. Kirchhoff

Authors
  1. S. Kirchhoff
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  2. R. Ladurner
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  3. C. Kirchhoff
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  4. T. Mussack
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  5. M. F. Reiser
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  6. A. Lienemann
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Correspondence to S. Kirchhoff.

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Kirchhoff, S., Ladurner, R., Kirchhoff, C. et al. Detection of recurrent hernia and intraabdominal adhesions following incisional hernia repair: a functional cine MRI-study. Abdom Imaging 35, 224–231 (2010). https://doi.org/10.1007/s00261-009-9505-z

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  • DOI: https://doi.org/10.1007/s00261-009-9505-z

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