Abstract
Sublay mesh repair seems to be the most effective method for treating incisional hernias (IHs). The aim of this study was to report our experience with retromuscular repair and self-gripping mesh for the treatment of midline IHs. In addition, we provided a systematic review of the literature regarding the use of this novel combination. All patients undergoing elective IH repair from June 2016 to November 2018 were included. The self-gripping mesh was placed in the sublay position. Demographic data, defect sizes, postoperative complications and follow-up durations were collected. A systematic review of the available literature was conducted in January 2020 using main databases. A total of 37 patients (20/17M/F) were included in this study, and the mean age and body mass index (BMI) were 58 years and 27 kg/m2, respectively. Minor complications occurred in six patients. Long-term follow-up demonstrated recurrence in three patients. Regarding the review, five publications were considered relevant. The highest complication rate was 28.6%, and the recurrence rate varied from 0 to 5.1%. This is the first review of the literature regarding sublay IH repair using a self-gripping mesh. The low rates of postoperative complications and recurrence in our experience and those reported by most of the reviewed articles demonstrate that this is a safe and effective method for repairing IHs.
Highlights
Incisional hernia (IH) is a common late complication of laparotomy, with an estimated occurrence rate of 12.8% after approximately 2 years [1]
Mesh repair seems to be more effective than suture repair in the treatment of IHs because the former leads to a lower recurrence rate [2]
Categorical data were analysed as frequencies and percentages. This retrospective analysis enrolled all 37 patients (17 females and 20 males) with IHs who were treated with this technique at our department from June 2016 to November 2018
Summary
Incisional hernia (IH) is a common late complication of laparotomy, with an estimated occurrence rate of 12.8% after approximately 2 years [1]. Sublay mesh placement seems to have the lowest recurrence rate [5, 6]. This is probably due to the position of the mesh between the posterior rectus sheath and the anterior myofascial complex, which provides the tissues that are necessary for mesh integration [5, 7]. Several studies have suggested the safety and efficacy of self-gripping mesh inguinal hernia repair [9, 10]. The aim of this study was to analyse data derived from our experience and the literature to demonstrate the safety and efficacy of the sublay self-gripping mesh technique as a sutureless and tension-free treatment option for the open repair of midline IHs. In addition, we conducted a systematic review of the literature to support our experience
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