[Surgical treatment of supraumbilical eventrations]

Among postoperative incisional hernias, mid-epigastric eventrations have peculiar features for physiopathological reasons that are summed up in general and specifically in the first paragraph of this paper; they are characterized by the quick retraction of the lateral belt, with the chondrocostal margin of the thorax participating as the upper limit of the cleft, and by the rapidly irreducible diastasis--hence the importance of an early decision to operate. The authors propose three regular procedures with which they are experienced: repair with a large retromuscular nonabsorbable synthetic tulle prosthesis for extensive epigastric eventrations, fillup aponeuroplasty using the sheath of the rectus abdominis associated with a premuscular patch in case of diastasis or of multiple superimposed orifices and suture associated with a small retromuscular auxiliary patch to treat small incisional hernias. The article, mainly dealing with the technical details of the three procedures and of their variants, is concluded by a brief report of the personal results obtained with a series of 616 postoperative eventrations, including 91 mid-epigastric ones, controlled after an average time lapse of 5.5 years.