[Incisional hernias after median laparotomy. A concept for anatomic reconstruction of the abdominal wall]

The abdominal wall is a complex system of fibres and has its function in stabilisation of the lower back and pressure build-up for coughing and evacuation of the bowels. In case of incicional hernias after median laparotomy, which occur in 10-20%, reconstruction is a great challange for the surgeon. As methods of repair doubling of fascias, implantation of mesh grafts and muscle transfers have been described. In the following article we present a concept for anatomic and functional restoration of the abdominal wall in a selected patient population. Besides an exact surgical technique, the patient's compliance for weight reduction, special work-out and wearing a bodice pre- and postoperatively is essential for a good result.