The Efficacy of Different Modalities Used In the Repair Of Incisional Hernias

Abstract

Introduction: Incisional hernia is a serious surgical problem and has been reported to occur in 2 to 11 per cent of laparatomy incisions and remain a frequent and serious complication of abdominal surgery. Repair of large abdominal incisional hernias is a difficult surgical problem with recurrence being a common outcome. Major complications which can occur in repair of large incisional hernias include mesh infection and enterocutaneous fistula. The Aim Of The Study: is to evaluate and compare the efficacy of using Primary suture repair and On-lay mesh implantation in the repair of midline incisional hernias. Patient And Methods: A prospective study done during the period from January 2010 to January 2012 at AlKadhmyia Teaching Hospital in Baghdad. The patients’ full data regarding history of risk factors and abdominal surgical history were recorded. Among 76 patients with midline incisional hernia enrolled in this study, 41 patients of them were assigned to On-lay mesh repair and 35 patients to Primary suture repair. These patients were evaluated for 12 months after surgery either by outpatients’ clinic visits or phone. Results: The overall recurrence rate was seen in 12 patients (15.8%). It was seen in 9 patients (25.7%) of those who underwent Primary suture repair, while in 3 patients (7.3%) of those with On-lay mesh repair. In 75% of patients who developed recurrence, the recurrence occurred after 6 months of Incisional hernia repair. Conclusion: Prosthetic hernia repair gives acceptable recurrence rates and have a good results in comparison to suture repair. The use of prosthetic mesh should be considered for repair of large or recurrent incisional hernias, especially in high risk patients.