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Updated: Apr 16, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Lower recurrence rate with full-thickness mesh fixation in incisional hernia repair
K Gemici1,2, T Acar3, S Barıs4
1Department of General Surgery, Faculty of Medicine, Mevlana University, Konya, Turkey. drkazimgemici@hotmail.com.
Insights
Full-thickness mesh fixation for incisional hernias (IHs) significantly lowers recurrence rates. This technique provides mechanical support and promotes healing, reducing long-term complications.
Area of Science:
- Abdominal Surgery
- Hernia Repair
- Surgical Innovation
Background:
- Incisional hernias (IHs) pose a significant challenge in abdominal surgery.
- Recurrence after surgical repair remains a common complication.
- Optimizing mesh fixation techniques is crucial for improving outcomes.
Purpose of the Study:
- To evaluate the long-term recurrence rate of incisional hernias (IHs) repaired using full-thickness onlay mesh fixation.
- To assess the efficacy of a specific surgical technique in reducing IH recurrence.
Main Methods:
- Retrospective analysis of 154 incisional hernia (IH) cases operated on between 2002 and 2013.
- Detailed intraoperative technique involving full-thickness suspension sutures for onlay mesh fixation.
- Evaluation of patient records for recurrence, pain, and follow-up data.
Main Results:
- A low recurrence rate of 5.2% was observed in 154 analyzed incisional hernia (IH) cases.
- The average follow-up period was 54 months, demonstrating long-term efficacy.
- Persistent pain (>3 months) was reported in 6.5% of patients.
Conclusions:
- Full-thickness mesh fixation offers robust mechanical support to the fascia.
- This technique promotes homogeneous fibrous healing and prevents mesh migration.
- The described method is crucial for significantly reducing incisional hernia (IH) recurrence rates.
Purpose:
To share the lower recurrence rate achieved during long-term follow-up by repairing incisional hernias (IHs) with full-thickness fixation of onlay mesh.
Methods:
We retrospectively analyzed 196 IH cases operated on by the same surgeon between 2002 and 2013. After exclusions (unrelated death, lack of follow-up), 154 cases were included. Abdominal examination findings, recurrence dates (if accessible), and imaging results were obtained from computer records and evaluated. Intraoperatively, all hernial sac adhesions were separated to reveal the anterior abdominal wall, and full-thickness suspension sutures were placed 6-8 cm lateral to the fascial edge at 2-cm intervals, excluding the peritoneum. The primary fasciae were closed, suspension sutures were passed through the mesh holes, and the mesh was fixed as an onlay, leaving no space between the fasciae.
Results:
In total, 154 subjects with IHs were analyzed: 107 (69.5%) females and 47 (30.5%) males. The mean patient age was 52.60 years [standard deviation (SD) 11.24 years], and the mean fascial defect diameter was 77 cm(2). The average operation time was 128 min (SD 42.5 min), and the average patient follow-up time was 54 months (SD 22.8 months). Eight (5.2%) patients developed recurrences after full-thickness mesh fixation, and ten subjects (6.5%) had persistent pain in the operative area for longer than 3 months.
Conclusions:
Full-thickness mesh fixation mechanically supports the fascia, especially in the early postoperative period, and enables homogeneous fibrous healing in a wide area, preventing mesh migration; we believe that these attributes are crucial in reducing the IH recurrence rate.
