[Full-thickness replacement using intraperitoneal mesh in large incisional hernia].
Parieto-suture (simple closure or Judd-Mayo technique) is appropriate for most incisional hernias, but not in case of large or complex parietal defect. In these peculiar cases, prosthesis mesh is recommended, biased by two factors: biodisponibility of the material related to the choice of parietal insertion. In practice, fascial onlay is abandoned in favour of extra/retro-muscular onlay, which offers a better vascular support for mesh implantation and is ideal if anatomic closure is feasible. Occasionally, full-thickness replacement is a must in large incisional hernia, in order to restore parietal competence. Technically, substitution is easy to perform, followed by a low rate of in-hospital complications; the same is true if recurrence occurs. In exchange, the hazard of enterocutaneous fistula requires appropriate measures for visceral protection. Our commentary regarding the advantages and disadvantages of intraperitoneal (pro-epiploic) mesh placement, as well as technical details, are based on 10 years of surgical practice.
Mateş
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Clinica de Chirurgie Generală si Esofagiană, Spital Clinic "Sfânta Maria", UMF "Carol Davila", Bucureşti. ioan.mates@gmail.com
D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010537:Peritoneum / Q000601:surgery*; D011138:Polytetrafluoroethylene; D013526:Surgical Mesh; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene