Repair of complex giant ventral hernias with polypropylene and omentoplasty

The Authors in this report describe their experience with complex giant ventral hernias repaired by omentoplasty and polypropylene meshes. They explain their own technique of using the omentum when there is a lack of tissue and the need of an autologous tissue to place between the viscera and the above-lying polypropylene mesh. Among the 5 patients repaired, 4 had a giant sub-umbilical midline ventral hernia and one had a giant border ventral hernia. In all patients, the omentum was placed between the viscera and the mesh, which was fixed by interrupted sutures to the above-lying musculoaponeurotic plane. No complications, signs of bowel obstruction, or recurrences occurred. The Authors stress the omentum as an ideal tissue because of its biocompatibility and prevention of adhesions and fistulas allowing the use of a rigid and efficient prosthesis such as polypropylene. Thus, on the basis of their own short- and long-term good results, they suggest, whenever possible and necessary, the use of omentoplasty to repair complex giant ventral hernias.