INCISIONAL HERNIA THROUGH NONVERTICAL INCISIONS

Although uncommon, incisional hernia may occur after operations where vertical or paramedian incision is not used. Fifteen patients of incisional hernia through nonvertical incisions in the age group of 22 to 65 years were studied. This included hernia through subcostal incision commonly used for cholecystectomy, gridiron incision, pfannensteil incision and lumbar incisions. Majority of these hernias were due to wound complications and factors which give rise to an increased strain on suture lines. Although the technique for anatomical repair of incisional hernia seems safe and dependable in patients with small defects, but in patients with large musculoaponeurotic defect, prolene mesh hernioplasty has proved successful. In one patient with giant incisional hernia through rooftop incision, large defect was covered with merselene mesh by inlay and onlay technique. After a median follow up of 18 months only one patient (6.6%) developed a recurrence. Merselene mesh has proved to be an excellent material for bridging of wide tissue gaps.