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Surgery. 2010 Jul;148(1):140-4. doi: 10.1016/j.surg.2009.12.014. Epub 2010 Feb 6.

Repair of complex incisional hernias using double prosthetic repair: single-surgeon experience with 50 cases.

Author information

1
Abdominal Wall Unit, Department of Surgery, Morales Meseguer University Hospital, Murcia, Spain. moreno-egea@ono.com

Abstract

BACKGROUND:

The treatment of complex incisional hernias is still difficult and controversial. With technologic developments we can modify and update the operative techniques described for treating complex abdominal wall hernias.

METHODS:

This is a prospective study of 50 patients with complex incisional hernias undergoing complex abdominal wall herniorrhaphy at a university hospital. All patients were evaluated in a multidisciplinary clinic dedicated to abdominal wall reconstruction. All patients underwent pre-operative computed tomography. Complex incisional hernias were regarded as those with multiple recurrences (>3 times), a previous mesh complicated by fistula and chronic infection, giant diffuse lumbar hernias, an associated parastomal hernia, or hernias developing after bariatric surgery. The operative technique was a double reconstruction prosthetic mesh. The type of repair as well as clinical, operative, and follow-up data were analyzed.

RESULTS:

Eight patients had considerable loss of tissue, 5 had trophic skin lesions, and 2 had chronic suppurative infection. The mean size of the defects was 18.2 cm. Morbidity included 5 cases of seroma, 2 neuralgias, and 2 cutaneous necroses. The mean duration of hospital stay was 5 days (range, 2-9). Complete follow-up (mean, 48 months; range, 12-108) showed no recurrent hernias.

CONCLUSION:

While awaiting a longer follow-up to confirm the results, we conclude that complex incisional hernias can be repaired safely and with a low morbidity and recurrence rate by means of a double prosthetic repair technique.

PMID:
20138324
DOI:
10.1016/j.surg.2009.12.014
[Indexed for MEDLINE]

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