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Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Mesh-reinforced ventral hernia repair: preference for 2 techniques.
1Surgical Service, Birmingham Veterans Affairs Medical Center, Room 4343, 700 S 19th St, Birmingham, AL 35233, USA. jgleyst@bellsouth.net
Archives of Surgery (Chicago, Ill. : 1960)
|August 19, 2009
Summary
Retrorectus mesh repair for ventral hernias shows lower recurrence rates than onlay mesh repair. This open surgical technique avoids mesh complications and is preferred for incisional hernia treatment.
Area of Science:
- General Surgery
- Abdominal Wall Reconstruction
Background:
- Ventral hernia repair often involves prosthetic mesh reinforcement.
- Comparing different mesh placement techniques is crucial for optimizing outcomes.
- Long-term recurrence and complication rates vary based on surgical approach.
Purpose of the Study:
- To compare long-term recurrence rates between onlay (OR) and retrorectus (RR) mesh reinforcement for ventral hernia repair.
- To evaluate complications associated with each mesh placement technique.
Main Methods:
- Retrospective study of prospective data from university and Veterans Affairs hospitals.
- Included 125 patients (75 OR, 50 RR) undergoing open surgical extraperitoneal prosthetic mesh reinforcement.
- Primary outcomes included recurrent hernia, wound infection, and intestinal fistulas.
Main Results:
- Wound infections occurred in 8.8% of patients, with no significant difference between groups; no fistulas were reported.
- Median recurrence rates were 20.0% at 15 months for OR and 4.0% at 9 months for RR (P < .02).
- Recurrences primarily occurred at the mesh edges, with later recurrences observed in the OR group.
Conclusions:
- Retrorectus mesh reinforcement is associated with lower recurrence rates and avoids mesh-related complications compared to onlay repair.
- Onlay mesh reinforcement leads to more frequent recurrences, typically at the mesh edges within two years.
- Retrorectus repair is the preferred open surgical method for incisional hernias, though not universally applicable.
