Tension-free open mesh repair of ventral hernias--Stoppa's technique

Tension-free prosthetic mesh repair of giant, complex, or recurrent ventral hernias in the form of a modified Stoppa technique has been used in 60 cases. Complication rate has been comparable with other such studies. In obese patients with a pendulous anterior abdominal wall, limited panniculectomy was carried out while repairing the hernia through a low transverse abdominal incision. None of the patients required a progressive preoperative pneumoperitoneum. The incidence of wound infection was 5%. One patient had a wound hematoma that required evacuation; minor wound complications occurred in 11% cases. The hospital stay ranged from 1 to 6 weeks (mean, 10.3 days). One case required readmission for resuturing of the wound. None of the cases required removal of the mesh. There was no recurrence at follow-up (mean, 26 months) in 80% of the cases. This technique is an excellent but somewhat tedious procedure.