Recurrent Incisional Hernia Repair-An Overview.

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Abdominal Wall Reconstruction

Background:

• Recurrent incisional hernias represent a significant challenge, accounting for approximately 20% of all incisional hernias.
• Limited studies hinder the establishment of definitive treatment recommendations for recurrent incisional hernias.

Purpose of the Study:

• To systematically review and collate existing data on the treatment of recurrent incisional hernias.
• To identify optimal surgical approaches for managing incisional hernia recurrence.

Main Methods:

• A comprehensive systematic literature search was conducted in January 2019 across major medical databases (Medline, PubMed, Scopus, Embase, Springer Link, Cochrane Library).
• Analysis included 47 identified publications, focusing on case series and prospective comparative studies.
• Data extraction centered on treatment outcomes for recurrent incisional hernias, particularly defect size and surgical technique.

Main Results:

• The majority of available data consists of case series, with limited prospective comparative studies.
• Laparoscopic repair is feasible for recurrent incisional hernias following primary open repair, especially for defects < 8-10 cm, provided the surgeon possesses adequate experience.
• Data on repeat laparoscopic surgery after primary minimally invasive repair is scarce, necessitating extreme caution and experienced surgeons.

Conclusions:

• There is a critical need for more research into the optimal treatment of recurrent incisional hernias.
• A tailored approach, utilizing laparoscopic techniques by experienced surgeons, is a viable option for recurrent hernias post-open repair with defects up to 8-10 cm.