Skip to main content

Long-Term Outcome of 254 Complex Incisional Hernia Repairs Using the Modified Rives-Stoppa Technique



Repair of complex incisional hernias poses a major challenge.


The aim of this study was to review the outcomes of the modified Rives-Stoppa repair of complex incisional hernias using a synthetic prosthesis.


We reviewed patients undergoing a modified Rives-Stoppa repair of complex incisional hernias from 1990 to 2003. Patients were followed through clinic visits and mailed questionnaires. Follow-up data were complete in all patients (mean 70 months, range 24–177 months), and 87% of patients completed a mailed questionnaire. Primary outcome included mortality, morbidity, and hernia recurrence. Secondary outcome measures were duration of hospital stay, long-term abdominal wall pain, and self-reported patient satisfaction.


Altogether, 254 patients underwent a modified Rives-Stoppa repair. Among them, 60% had a significant co-morbidity, and 30% had one or more previously failed hernia repairs. Mortality was zero, and overall morbidity was 13% (wound infection 4%, prosthetic infection 3%, seroma/hematoma 4%). The overall hernia recurrence rate was 5%, including explantation of mesh because of infection. Wound/prosthetic infection was predictive for hernia recurrence (31% vs. 4%, p = 0.003). Among the respondents, 89% reported overall satisfaction with their repair.


The Rives-Stoppa repair of complex incisional hernias using synthetic prosthetic materials is safe with a low recurrence rate (5%) and high patient satisfaction. Postoperative wound infection is a risk factor for hernia recurrence.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? Ann Surg 237:129–135

    PubMed  Article  Google Scholar 

  2. Mudge M, Hughes LE (1985) Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg 72:70–71

    PubMed  Article  CAS  Google Scholar 

  3. Cassar K, Munro A (2002) Surgical treatment of incisional hernia. Br J Surg 89:534–545

    PubMed  Article  CAS  Google Scholar 

  4. Van der Linden FT, van Vroonhoven TJ (1988) Long-term results after surgical correction of incisional hernia. Neth J Surg 40:127–129

    PubMed  Google Scholar 

  5. Langer S, Christianson J (1985) Long-term results after incisional hernia repair. Acta Chir Scand 151:217–219

    PubMed  CAS  Google Scholar 

  6. Koller R, Miholic J, Jakl RJ (1997) Repair of incisional hernias with expanded polytetratfluoroethylene. Eur J Surg 163:261–266

    PubMed  CAS  Google Scholar 

  7. Luijendijk RW, Hop WC, van den Tol MP, et al. (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398

    PubMed  Article  CAS  Google Scholar 

  8. Burger JWA, Luijendijk RW, Hop WCJ, et al. (2004) Long-term follow-up of randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585

    PubMed  Google Scholar 

  9. Girotto JA, Chiaramonte M, Menon NG, et al. (2003) Recalcitrant abdominal wall hernias: long-term superiority of autologous tissue repair. Plast Reconstr Surg 112:106–114

    PubMed  Article  Google Scholar 

  10. de Vries Reilingh TS, van Goor H, Rosman C, et al. (2003) “Components separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37

    PubMed  Article  Google Scholar 

  11. Disa JJ, Goldberg NH, Carlton JM, et al. (1998) Restoring abdominal wall integrity in contaminated tissue-deficient wounds using autologous fascia grafts. Plast Reconstr Surg 101:979–986

    PubMed  Article  CAS  Google Scholar 

  12. Vargo D (2004) Components separation in the management of the difficult abdominal wall. Am J Surg 188:633–637

    PubMed  Article  Google Scholar 

  13. LeBlanc KA, Booth WV, Whitaker JM, et al. (2001) Laparoscopic incisional and ventral herniorraphy: our initial 100 patients. Hernia 5:41–45

    PubMed  Article  CAS  Google Scholar 

  14. Temudom T, Siadati M, Sarr MG (1996) Repair of complex giant or recurrent ventral hernias by using tension-free intraparietal prosthetic mesh (Stoppa technique): lessons learned from our initial experience (fifty patients). Surgery 120:738–743, discussion 743–744

    PubMed  Article  CAS  Google Scholar 

  15. Stoppa R, Louis D, Henry X, et al. (1985) [Postoperative eventrations: apropos of a series of 247 surgically treated patients.] Chirurgie 111:303–305

    PubMed  CAS  Google Scholar 

  16. Stoppa R, Henry X, Verhaeghe P, et al. (1981) [Trends in the surgical treatment of chronic dehiscences of the abdominal walls.] Bull Acad Natl Med 165:493–501

    PubMed  CAS  Google Scholar 

  17. Rives J, Stoppa R, Fortesa L, et al. (1968) [Dacron patches and their place in surgery of groin hernia: 65 cases collected from a complete series of 274 hernia operations.] Ann Chir 22:159–171

    PubMed  CAS  Google Scholar 

  18. Rives J, Pire JC, Flament JB, et al. (1977) [Treatment of large eventrations (apropos of 133 cases).] Minerva Chir 32:749–756

    PubMed  CAS  Google Scholar 

  19. Bendavid R (2004) The unified theory of hernia formation. Hernia 8:171–176

    PubMed  Google Scholar 

  20. Jansen PL, Mertens PrP, Schumpelick V, et al. (2004) The biology of hernia formation. Surgery 136:1–4

    PubMed  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Michael G. Sarr.

Additional information

This work was presented in part at the 47th Annual Meeting of the Society for Surgery of the Alimentary Tract during Digestive Disease Week, Los Angeles, CA, May 2006. The abstract was published in Gastroenterology 2006;130:A891.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Iqbal, C.W., Pham, T.H., Joseph, A. et al. Long-Term Outcome of 254 Complex Incisional Hernia Repairs Using the Modified Rives-Stoppa Technique. World J Surg 31, 2398–2404 (2007).

Download citation

  • Published:

  • Issue Date:

  • DOI:


  • Chronic Obstructive Pulmonary Disease
  • Hernia Repair
  • Incisional Hernia
  • Rectus Muscle
  • Hernia Recurrence