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Published on: September 11, 2021
Interparietal hernias after open retromuscular hernia repair
1Division of Minimal Access and Bariatric Surgery, Department of Academic Surgery, Greenville Hospital System University Medical Center, 890 W. Faris Rd., Suite 310, Greenville, SC 29605, USA. acarbonell@ghs.org
Summary
Retromuscular hernia repair can lead to interparietal incarceration, causing bowel obstruction. Surgeons should suspect this complication if patients develop obstruction after ventral hernia surgery.
Area of Science:
- Abdominal wall reconstruction
- Surgical complications
- Hernia repair
Background:
- Retromuscular (sublay) ventral hernia repair, popularized by Rives and Stoppa, involves placing prosthetic mesh dorsal to the rectus muscle.
- This technique requires reapproximating tissue dorsal to the mesh to create a barrier between the bowel and the prosthesis.
Observation:
- Two patients developed bowel obstruction following open retromuscular hernia repair.
- Obstruction resulted from interparietal incarceration of the small bowel between the posterior rectus sheath and the prosthetic mesh through a defect in the dorsal tissue layer.
Findings:
- Computed tomography confirmed small bowel herniation into the space between the prosthesis and the posterior rectus sheath in both patients.
- One patient underwent successful laparoscopic repair, while the other required open surgery for bowel decompression and defect repair.
Implications:
- A high index of suspicion for interparietal hernia is warranted in patients presenting with bowel obstruction post-retromuscular hernia repair.
- Early diagnosis and intervention are crucial to manage this rare but serious complication of ventral hernia surgery.
