Open Rives-Stoppa ventral hernia repair made simple and successful but not for everyone

Area of Science:

• Abdominal Surgery
• Hernia Repair
• Surgical Innovation

Background:

• The Rives-Stoppa (RS) repair for ventral incisional hernias (VIHR) is a complex procedure.
• Traditional RS repair involves retromuscular mesh placement and primary anterior fascia closure, with recurrence rates between 0-8%.

Purpose of the Study:

• To evaluate the success of an open RS-VIHR using intraperitoneal mesh placement.
• To identify factors associated with hernia recurrence after this modified RS repair.

Main Methods:

• An open Rives-Stoppa ventral incisional hernia repair (RS-VIHR) with intraperitoneal mesh was performed on 81 patients.
• Patients were evaluated for hernia recurrence and potential contributing factors.

Main Results:

• The overall recurrence rate was 15% (12/81), with 10% recurrence excluding cases related to mesh infection or laparotomy.
• No correlation was found between recurrence and patient demographics, hernia characteristics, or surgical factors (p>0.05).
• Wound infection/abscess formation (60% vs. 8%) and pulmonary disease (50% vs. 12%) were significantly associated with higher recurrence rates (p<0.001 and p=0.01, respectively).

Conclusions:

• RS-VIHR with intraperitoneal mesh offers a successful and less technically demanding alternative to traditional methods.
• Prompt identification and treatment of infections are crucial to prevent abscesses and recurrence.
• Elective RS-VIHR is not recommended for patients with chronic pulmonary disease due to high recurrence rates.