[Parietal prosthetic mesh in the treatment of large incisional hernias]

The repair of abdominal wall deficiencies has been simplified by the introduction of synthetic prostheses. The aim of this work was to describe the treatment of very large incisional abdominal hernias with a technique using a prosthetic mesh anchoring to the fibro-aponeurotic layers without closure the fascia. The procedure described has been used in 32 cases between 1974 and 1991 (15 male, 17 female). The median age was 62 years. All the patients were reexamined (median time: 4 years, range: 6 months-14 years). There was no operative mortality. Six patients had a subcutaneous seroma treated by multiple punctions. Three patients presented in the postoperative time a respiratory failure which necessitated artificial ventilation during 7 to 15 day. Two patients were reoperated, 6 months and 3 years after the first incisional hernia operation (1 cutaneous fistula, 1 hernia recurrence). Extremely large incisional hernias can be closed safely and effectively using this technique, without mortality and with a low morbidity.