[Repair of midline incisional hernias using the Lazaro da Silva aponeuroplasty technique].
OBJECTIVE
The aim of this retrospective study was to assess Lazaro da Silva's rectus sheath aponeuroplasty technique for repair of midline incisional hernias situated above the arcuate line.


METHODS
Twenty-six patients underwent surgical repair of a supraumbilical (n = 19) or periumbilical (n = 7) incisional hernia. Six patients had had repeated laparotomies and two of them had recurrent incisional hernia. There were 11 obese patients (42%). Muscle diastasis ranged from 4 to 20 centimeters (mean: 9.7 cm). Three overlapping aponeurotic and peritoneal layers were used. The peritoneal sac was partially or totally incorporated in the repair.


RESULTS
There was one postoperative death at day 5 from acute pancreatitis in a patient with associated cholecystectomy. Postoperative complications occurred in six patients. There were 3 abdominal wall infections. Obesity was the main factor associated with operative complications (p = 0.03). Mean follow-up was 19.1 months. There were 2 recurrences, one of them related to an abdominal wall infection.


CONCLUSIONS
The Lazaro da Silva aponeuroplasty technique compares favourably with alternative techniques using mesh implants. It is indicated for incisional hernias less than 20 centimeters wide, situated above the arcuate line.
Service de chirurgie viscérale et urgence, hôpital général, CHU Dijon, 3, rue du Faubourg-Raines, BP 1519, 21033, Dijon, France.
L
L
Benoit
E
E
Arnal
P
P
Goudet
P
P
Cougard
D005260:Female; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012008:Recurrence; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects; D013710:Tendons; D016896:Treatment Outcome