Modified Rives-Stoppa technique for repair of complex incisional hernias in 59 patients

Area of Science:

• Abdominal Surgery
• Hernia Repair
• Surgical Materials

Background:

• Incisional hernias affect 2-11% of laparotomy patients.
• Prosthetic mesh repair offers advantages over primary tissue repair but carries risks like infection.
• The Rives-Stoppa repair minimizes mesh-bowel contact, reducing complications.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified Rives-Stoppa repair for complex incisional hernias.
• To assess recurrence and complication rates in patients undergoing this procedure.
• To explore benefits for patients with inflammatory bowel disease.

Main Methods:

• A review of 89 consecutive patients undergoing a modified Rives-Stoppa repair.
• Exclusion of patients lost to follow-up before 6 months, leaving 59 patients for analysis.
• Analysis of mesh types (ePTFE and polypropylene) and follow-up duration (average 40.0 months).

Main Results:

• Low hernia recurrence rate of 1.7% (1 patient).
• Infection requiring prosthesis removal occurred in 5.1% (3 patients).
• 64.4% of patients had inflammatory bowel disease, potentially benefiting from reduced adhesions.

Conclusions:

• The modified Rives-Stoppa repair is an effective open technique for complex incisional hernias.
• It offers low recurrence and manageable complication rates.
• The technique is advantageous for inflammatory bowel disease patients due to decreased adhesions and easier re-entry for future surgeries.