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

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Abstract

Background

Repair of complex incisional hernias poses a major challenge.

Aim

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

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic College of Medicine, 200 First Avenue SW, Rochester, MN, 55905, USA

    Corey W. Iqbal, Tuan H. Pham, Anthony Joseph, Jane Mai, Geoffrey B. Thompson & Michael G. Sarr

Authors
  1. Corey W. Iqbal
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  2. Tuan H. Pham
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  3. Anthony Joseph
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  4. Jane Mai
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  5. Geoffrey B. Thompson
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  6. Michael G. Sarr
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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.

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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). https://doi.org/10.1007/s00268-007-9260-7

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  • DOI: https://doi.org/10.1007/s00268-007-9260-7

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