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Incisional Hernia, Different Approaches, The Defect Size Is the Referee
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| Author:
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ADIL SHAKER AL TAMIMI, ISRAA ABDUL WAHED DHEEB
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| Abstract:
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Objectives: To compare three different method of incision hernia repair in terms of post operative complications Background: Wide spectrum of surgical repairs have been innovated for incisional hernia . Success of surgery for incisional hernia will be largely dependent upon the presence of tension free repair which was dramatically promoted by the emergence of prosthetic mesh as a substitute for the architectural loss of the abdominal wall. Materials: Two hundred twelve patients with midline incisional hernia were managed by preperitoneal mesh hernioplasty. Patients were categorized into three groups in relation to the index surgery, two different approach to the pre peritoneal space were used and three different producers of mesh repair were adopted.
Results: Incisional hernias developed after laparotomy for traumatic causes predominate 63%. The pre peritoneal double mesh bridge repair was the most frequent repair used 53%. The reason for the initial laparotomy appeared to have a highly significant effect on the subsequent size of hernia defect and the type of repair. The size of hernia facial defect was the main significant factor that affect the subsequent method of repair. The trans rectus pre peritoneal approach appeared to have more frequent rate of success in creation of an intact pre peritoneal space. The overall post operative wound infection rate was 3.8%. Significant correlation was found between the approach to the pre peritoneal space and the prolonged post-operative ileusand recurrence rate.
Conclusion: The type of repair should be tailored to the individual type of hernia, the size of hernia defect appeared to be a major predictor. The double layered bridged mesh repair is good alternative for large hernias and associated with low infectious complications.
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| Keyword:
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Incisional hernia, Defect size, Different approaches
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.01.303
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| Download:
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