[Incisional hernias with particular topography--alloplastic procedures]

The aim of the study was to analyse the particular features and treatment difficulties of paramedian incisional hernias.

A retrospective study was performed on a series of 64 patients operated for incisional hernia with particular topography: right subcostal, right iliac and suprapubic area (following a Pfannenstiel incision). These cases represented 17.8% of the 360 patients with incisional hernias operated in our unit in the interval 2003-2007.

The majority of the cases were right hypochondrum (34 cases), followed by suprapubic (16 cases) and right iliac fosse incisional hernias (14 cases). An alloplastic reconstruction procedure with retromuscular polypropylene mesh was carried out in all cases. The follow-up was made at 1, 6 and 12 months. The most frequent local complications were juxtaprosthetic serohematic collections (4 cases - 6.3%), frequently associated with an extensive abdominal lipectomy (3 patients). Reccurence of the hernia was noticed in one case only (1.5%).

Mesh repair is the procedure of choice in incisional hernias, including those with particular locations, as justified by the low reccurence and morbidity rate.