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Related Experiment Videos

Mesh herniorrhaphy during elective colorectal surgery.

R A Stringer1, J R Salameh

  • 1Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|September 15, 2004
PubMed
Summary

Ventral hernia repair with mesh during colorectal surgery is feasible but carries a high risk of wound complications. Despite complications, mesh removal is typically unnecessary, avoiding repeat surgeries.

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Area of Science:

  • Abdominal Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Management of large ventral hernias during elective colorectal surgery is challenging due to concerns about mesh use in clean-contaminated fields.
  • Mesh repair is often avoided to prevent surgical site infections in these cases.

Purpose of the Study:

  • To evaluate the safety and outcomes of concomitant ventral hernia repair with mesh during elective colorectal surgery.
  • To assess the incidence of complications and the need for mesh removal in such combined procedures.

Main Methods:

  • Retrospective review of patients undergoing colorectal surgery and ventral hernia repair with mesh (1997-2003).
  • Analysis of hernia size, mesh type (polypropylene, onlay), operative time, and postoperative complications.

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  • Inclusion of three patients with large ventral hernias (330-1,243 cm²) undergoing procedures like hemicolectomy and colostomy closure.

    • Main Results:

    • Concomitant mesh herniorrhaphy was performed in three patients with large ventral hernias.
    • Average operative time was 199 minutes.
    • High incidence of wound complications: two superficial wound infections (one requiring drainage) and one skin necrosis, all healing by secondary intention with exposed mesh.

    Conclusions:

    • Prosthetic ventral hernia repair with polypropylene mesh can be safely performed concurrently with elective colorectal operations.
    • While wound complication rates are elevated, mesh excision is generally not required.
    • This approach avoids the need for a separate laparotomy for hernia repair.