Abstract
Repair of a large abdominal wall incisional hernia is a difficult surgical problem with recurrence being a common complication. In addition, other complications such as hematomas, seromas, and sinus formation result from the use of foreign material. A new technique to obviate these complications was used in 60 patients with large incisional hernias repaired over the last 15 years. Marlex® polypropylene mesh was used for repair, sandwiched between 2 layers of peritoneum of the overstretched hernia sac. There was no operative mortality and no recurrence in follow up from 3 years to 7 years. Postoperative complications encountered could be managed conservatively, without necessitating any major surgical procedure or mesh removal.
Résumé
La cure des éventrations de volume important est un problème chirurgical difficile en raison du taux élevé de récidive et de complications en rapport avec l'utilisation de matériel étranger, telles que les hématomes, séromes et/ou fistules. Une nouvelle technique, destinée à minimiser ces complications, a été utilisée chez 60 patients pendant ces 15 dernières années. Elle consiste en l'insertion “en sandwich” d'une plaque de polypropylene (Marlex*), entre le péritoine et le sac d'éventration étalé. La mortalité a été nulle. Aucune récidive n'a été observée avec un suivi de 3 à 7 ans. Toutes les complications post-opératoires ont pu Être traitées de faÇon conservative, sans avoir recours ni à une intervention chirurgicale majeure ni à l'ablation de la plaque.
Resumen
La reparación de las grandes hernias incisionales del abdomen constituyen un problema quirÚrgico difícil y la recurrencia es un fenómeno comÚn, además de otras complicaciones que se derivan del uso de material foráneo, taies como hematomas, seromas, formación de fistulas cutáneas, etc. Una nue va técnica para obviar estas complicaciones es analizada en 60 pacientes con grandes hernias incisionales reparadas en los Ultimos 15 años. Se utilizó la malla de Marlex (polipropileno) para la reparación, colocada en “sandwich” entre dos capas de peritoneo del sobredistendido saco herniario. No se presentó mortalidad operatoria, ni recurrencia en un seguimiento de 3 a 7 años; las complicaciones postoperatorias fueron manejadas en forma conservadora, sin que requirieran procedimientos quirÚrgicos mayores ni remoción de la malla.
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Matapurkar, B.G., Gupta, A.K. & Agarwal, A.K. A new technique of “Marlex®-peritoneal sandwich” in the repair of large incisional hernias. World J. Surg. 15, 768–770 (1991). https://doi.org/10.1007/BF01665314
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DOI: https://doi.org/10.1007/BF01665314