[Use of prostheses in the treatment of laparocele]

Effective solutions to the problem of surgery for bulk laparoceles began to emerge with the introduction of synthesis materials that can be used to reinforce or replace the abdominal wall. The ideal prosthesis has yet to be found, though today a large number of laparoceles are treated with the use of polypropylene (Marlex) and PTFE (Goretex), which are considered the best materials for alloplasty with only a very limited number of recurrences and complications. The authors describe their experience over two distinct periods: in the first of these, from 1985 to 1994, 49 of 126 patients were treated with prostheses (39 using the Rives technique and 10 simple alloplasty); in the second period, from 1995 to 2000, 39 of 79 patients were treated with prostheses (12 using the Rives technique and 27 simple alloplasty). This prosthesis was used only to reinforce the abdominal wall with a modified technique. The mortality rate was nil. In the first period the complications presented by the 49 patients were 6 seromas and 3 infections; in the second period (39 patients) the complications observed were 3 seromas, resolved with conservative therapy, and one relapse due to the use of a Vycril prosthesis. One case of haematoma and one of subcuticular infection occurred, but neither of these required removal of the prosthesis.