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Langenbecks Arch Surg. 2004 Oct;389(5):366-70. Epub 2003 Nov 18.

Long-term pain and recurrence after repair of ventral incisional hernias by open mesh: clinical and MRI study.

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  • 1Department of Surgery and Radiology, Central Hospital of Mikkeli, 50100 Mikkeli, Finland. hannu.paajanen@esshp.fi

Abstract

BACKGROUND AND AIMS:

Polypropylene mesh repair of large incisional ventral hernias has become increasingly popular. Long-term effects of the mesh on pain and abdominal muscles are not known.

PATIENTS/METHODS:

Retromuscular pre-peritoneal polypropylene mesh was placed by open technique in 84 consecutive patients with large ventral hernias (mean defect size 130 cm(2)). We re-examined the patients after a mean follow-up time of 3 years to find out the frequency of recurrence and chronic pain. We measured the thickness of abdominal muscles of eight patients preoperatively, and postoperatively after 1 year, using magnetic resonance imaging (MRI).

RESULTS:

Recurrent hernias had appeared in four patients (5%) at follow-up. Nine patients (13%) needed occasional pain-relieving drugs, but only three (4%) suffered persistent, severe, pain from the mesh. Some limitation during leisure-time physical activities was found in 10% of patients. Only ten patients (12%) were re-operated on because of wound complications or recurrence. MRI study indicated that abdominal muscles were postoperatively well preserved. Although wound infections (6%) and seroma (9%) were frequent complications, there was no need for meshes to be removed in the follow-up.

CONCLUSION:

Open ventral herniorrhaphy with mesh is safe, effective and inexpensive. Small, recurrent hernias were infrequent and easy to re-operated on. Severe pain from the mesh was not common. Postoperative MRI study indicated no obvious damage of abdominal muscles after mesh placement.

PMID:
15605167
DOI:
10.1007/s00423-003-0440-0
[PubMed - indexed for MEDLINE]
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