Long-term outcome of Rives-Stoppa technique in complex ventral incisional hernia repair

Use of the Rives-Stoppa procedure for ventral incisional hernia repair (RS-VIHR), in which the prosthesis is placed between the rectus abdominis muscle and the posterior sheath, has diminished reherniation markedly and is the most promising open technique.

Over a 5-year period 176 open abdominal wall incisional hernia repairs were performed in our department by the Rives-Stoppa technique. The prosthetic material used was Mersilene and the mean follow-up time was 96 months (range: 62-121 months).

During the 5-year period, 123 women and 53 men with mean age of 50.8 +/- 13.3 years (range: 24-79 years) underwent RS-VIHR. Of these patients, 80 (45.4%) had had a prior VIHR and 18 had undergone multiple previous attempts at repair. Overall postoperative mortality and morbidity were 0 and 10.2%, respectively. The total recurrence rate was 1.1%, which occurred in patients with late prosthetic infection requiring mesh explantation. Except for prosthetic infection there was no correlation between hernia recurrence and age, gender, defect size, position of incision, seroma formation, respiratory complication, or superficial wound infection (p > 0.05).

The Rives-Stoppa repair of complex ventral incisional hernia using a Mersilene prosthesis is a safe and durable technique with excellent long-term results and minimal serious morbidity, with an overall recurrence rate in the present series of 1.1%. Prosthesis infection requiring mesh explantation might be a risk factor for hernia recurrence.