"Open" abdominal surgery for large incisional hernias. Proposal of a personal technique.
Incisional hernia is still a serious complication of abdominal surgery because of its substantial incidence. We have to reduce the rate of complications and, if possible, correct the aesthetic defect due to the pathology itself. The complications are directly related to different factors (surgeon, technique, type of mesh used, patients with associated pathologies etc.). We propose an "open" technique to repair incisional hernias using a polypropylene mesh, sutured in a space created between two peritoneal sheaths, located in an intraparietal site (retromuscular and extraperitoneal), with suturing of the subcutaneous tissue, and without a subcutaneous drainage. We studied 26 patients, including obese subjects, from 2003 to 2006. The follow-up was 24 months. Good short- and long-term results were observed. We had two cases of seroma, treated conservatively. No prosthetic infections were reported, no recurrences were observed and a good final aesthetic result was achieved. In view of the fact that incisional hernia admittedly presents different problems from case to case, surgical experience and an imaginative surgical approach will always be useful in relation to the rigid technical times involved.
Bracci
Francesco
F
General Surgery Unit, San Giovanni Calibita Fatebenefratelli Hospital of Rome.
Pollicita
Stefano
S
Carnuccio
Pasquale
P
D006555:Hernia, Ventral / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D013514:Surgical Procedures, Operative / Q000379:methods