The "Inside-out" Technique for Hernia Repair with Mesh Underlay

Area of Science:

• Surgical Innovation
• Hernia Repair Techniques
• Abdominal Wall Reconstruction

Background:

• Component separation is a key step in complex ventral hernia repair.
• Traditional mesh placement can be challenging, impacting visualization and control.
• The Carter-Thomason suture passer offers a novel solution for mesh fixation.

Purpose of the Study:

• To present and evaluate an improved
• inside-out
• mesh repair technique for ventral hernias.
• To assess the safety, ease of use, and efficacy of this novel approach.
• To determine the recurrence rates associated with this technique.

Main Methods:

• The
• inside-out
• technique was employed in 23 patients undergoing ventral hernia repair.
• Mesh was secured using preplaced sutures passed from within the abdominal cavity through the anterior rectus sheath.
• Patients were followed for a median of 24.5 months to evaluate outcomes.

Main Results:

• An overall hernia recurrence rate of 8.7% (2 of 23 patients) was observed.
• One recurrence occurred in a patient with a prior recurrent hernia repair.
• The other recurrence was in a patient with significant loss of domain requiring inlay mesh.

Conclusions:

• The
• inside-out
• technique is a safe, easy, and reliable method for ventral hernia repair.
• This technique facilitates mesh underlay placement after component separation.
• No hernia recurrences were noted in patients with primary ventral hernias repaired using this underlay technique.