Peritoneal flap repair for large (>8 cm width) recurrent incisional ventral hernia

Area of Science:

• Abdominal Wall Surgery
• Hernia Repair Techniques
• Surgical Case Reports

Background:

• Large incisional hernias, particularly recurrent ones, pose significant surgical challenges.
• Previous repair attempts and large defect size complicate management.
• Standard component separation techniques can compromise abdominal wall integrity.

Purpose of the Study:

• To present a case of large recurrent incisional hernia repair.
• To demonstrate a novel technique utilizing the hernia sac as a peritoneal flap.
• To highlight an alternative to traditional component separation for complex ventral hernias.

Main Methods:

• Case report of a patient with a large recurrent incisional hernia after multiple prior surgeries.
• Tension-free hernia repair using the patient's own hernia sac to create peritoneal flaps.
• Dissection and mobilization of the hernia sac for anterior and posterior mesh coverage.
• Intraoperative video documentation of the surgical procedure and anatomical layer handling.

Main Results:

• Successful repair of a large recurrent incisional hernia.
• Preservation of abdominal musculature integrity by avoiding component separation.
• Demonstration of the hernia sac's utility in creating peritoneal flaps for mesh coverage.

Conclusions:

• Peritoneal flap repair using the hernia sac is an effective strategy for large recurrent incisional hernias.
• This technique offers a viable alternative to component separation, maintaining abdominal wall function.
• The presented case underscores the efficacy of this innovative approach in complex hernia management.