[Incisional hernia - how do I do it? Standard surgical approach]

Area of Science:

• Surgical techniques
• Hernia repair
• Biomaterials

Background:

• Conventional suture techniques for incisional hernia repair have high recurrence rates.
• Patients with incisional hernias may have underlying collagen metabolism disturbances affecting wound healing.
• Abdominal wall reinforcement with mesh prostheses is necessary for long-term cure.

Purpose of the Study:

• To evaluate the efficacy of retromuscular mesh placement in incisional hernia repair.
• To compare retromuscular mesh augmentation with conventional suture techniques.
• To discuss open versus laparoscopic approaches and mesh bridging versus augmentation.

Main Methods:

• Retromuscular placement of non-resorbable alloplastic mesh prostheses.
• Techniques include open and laparoscopic approaches.
• Differentiating between retromuscular augmentation and mesh bridging.

Main Results:

• Retromuscular mesh augmentation shows promisingly decreased recurrence rates compared to simple suture techniques.
• Recurrence rates for retromuscular mesh placement range from 2-12%.
• Optimal placement involves retromuscular augmentation with extra-peritoneal prosthesis placement and good tissue integration.

Conclusions:

• Retromuscular mesh augmentation is superior to simple suture techniques for incisional hernia repair.
• Further advancements in mesh materials and surgical techniques are expected to further reduce recurrence rates.
• Improved surgical techniques and mesh materials will enhance patient satisfaction.