Incisional and Parastomal Hernia Prevention

Chapter

Abstract

Incisional hernias occur commonly following abdominal operations with an incidence of approximately 10–20% and are the most common complication of laparotomy. Those developing incisional hernia frequently require further operations, either elective or emergent with significant costs to the healthcare system. Those requiring fecal diversion with either colostomy or ileostomy are at risk for development of not only incisional hernia but also parastomal hernia at a rate approaching 50%. Strategies to identify patients at risk for these hernias are required in order to develop preventative treatments. The use of prophylactic mesh has been studied in patients deemed at increased risk for the development of incisional hernia including those undergoing bariatric surgery, abdominal aortic aneurysm repair, and gastrointestinal surgery with significant reductions in incisional hernia rates and rare mesh complications. Similarly, the placement of mesh at the site of a newly created stoma has proven efficacy in the reduction in the incidence of parastomal herniation. Although the ideal technique for placement of prophylactic mesh has not been clearly elucidated, the concept of hernia prevention has the potential to dramatically improve surgical outcomes and enhance quality of life for thousands of patients each year.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of GI/Minimally Invasive SurgeryStritch School of Medicine, Loyola University Medical CenterMaywoodUSA
  2. 2.Center for Minimally Invasive Surgery, Gastrointestinal Surgery, University of KentuckyLexingtonUSA

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