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Fixation-free incisional hernia repair in the elderly: our experience with a tentacle-shaped implant

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Abstract

Background

Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair.

Aims

In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias. The results of a fixation-free incisional hernia repair carried out in elderly patients using a tentacle-shaped implant are reported herewith.

Methods

A tentacle-shaped flat mesh with a large central body and integrated arms was used to repair incisional hernia in 23 elderly patients. The mesh was placed fixation-free and secured in place through the friction exerted by the tentacles. All tentacle straps were positioned with a special passer needle. Implant placement was preperitoneal in 18 patients and retromuscular sublay in five.

Results

In a follow-up of 18 to 59 months (mean 36 months), four seromas occurred. Postoperative fast track helped avoid the typical complications affecting this patient subset. No infection, hematoma, chronic pain, mesh dislocation or recurrence have been reported to date.

Discussion

The tentacle strap system allowed for reduced skin incision thus minimizing surgical trauma and ensuring easier and faster implant placement.

Conclusion

The tentacle arms of the implant ensured mesh stability and broad defect overlap. Besides a very low complication rate, none of the typical postoperative complications of aged patients occurred.

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Author information

Authors and Affiliations

  1. Department of General Surgery and Emergency, University of Palermo, Palermo, Italy

    Giorgio Romano

  2. Department of General Surgery, University of Cagliari, Cagliari, Italy

    Pier Giorgio Calò, Enrico Erdas, Fabio Medas, Luca Gordini & Francesco Podda

  3. Postgraduate School of General Surgery, University of Cagliari, Cagliari, Italy

    Giuseppe Amato

  4. via M. Rapisardi 66, 90144, Palermo, Italy

    Giuseppe Amato

Authors
  1. Giorgio Romano
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  2. Pier Giorgio Calò
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  3. Enrico Erdas
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  4. Fabio Medas
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  5. Luca Gordini
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  6. Francesco Podda
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  7. Giuseppe Amato
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Corresponding author

Correspondence to Giuseppe Amato.

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Conflict of interest

All authors listed have contributed sufficiently to the project to be included as authors, and to the best of our knowledge. No grants or financial supports have been provided for the research.GA is the developer of the implant described in the report. The other authors have no conflict of interest.

Ethical approval

Ethic commission approval is available. All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Romano, G., Calò, P.G., Erdas, E. et al. Fixation-free incisional hernia repair in the elderly: our experience with a tentacle-shaped implant. Aging Clin Exp Res 29 (Suppl 1), 173–177 (2017). https://doi.org/10.1007/s40520-016-0651-1

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  • DOI: https://doi.org/10.1007/s40520-016-0651-1

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