Abstract

BackgroundDebate persists on the optimal management of incisional hernias due to paucity of accurate recurrence rates. Reoperation rates implicate a severe underestimation of the risk of a recurrence. Therefore, long-term postoperative clinic visits allowing physical examination of the abdomen are deemed necessary. However, these are time and costs consuming. Aim of this study was to develop and evaluate a new screenings method for recurrent hernias, the ‘PINCH-Phone’ (Post-INCisional-Hernia repair-Phone).MethodsThe PINCH-Phone is a telephone questionnaire. In this multicenter prospective study, the PINCH-Phone was answered by patients after incisional hernia repair. Afterwards the patients were seen at the clinic and physical examination was done to detect any recurrences.ResultsThe PINCH-Phone questions were answered by 210 patients with a median postoperative follow-up of 36 months. Fifty-six patients were seen after multiple incisional hernia repairs. In 137 patients who had replied positively to one or more questions, 28 recurrent incisional hernias were detected at physical examination. Six recurrences were noted in 73 patients who had replied negatively to all questions. The overall sensitivity and specificity of the PINCH-Phone were 82% and 38%, respectively.ConclusionThe PINCH-Phone appears a simple and valuable screenings method for recurrences after incisional hernia repair and, hence, is recommended for implementation.

Highlights

  • Debate persists on the optimal management of incisional hernias due to paucity of accurate recurrence rates

  • In search of a simple and reliable method of follow-up after incisional hernia repair, we developed a telephone questionnaire to screen for asymptomatic and symptomatic recurrences

  • The questions of the PINCH-Phone were the following: (1) Do you have any symptoms related to your incisional hernia repair? (2) Have you noticed anything related to your incisional hernia repair? (3) Have you noticed anything related to your incisional hernia repair when coughing, sneezing, or squeezing? (4) Could you please stand up and put one hand flat at the site of your incisional hernia repair? Could you cover your mouth with the other hand and blow? Do you notice anything at the site of your incisional hernia repair?

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Summary

Introduction

Debate persists on the optimal management of incisional hernias due to paucity of accurate recurrence rates. Long-term postoperative clinic visits allowing physical examination of the abdomen are deemed necessary. Methods The PINCH-Phone is a telephone questionnaire. In this multicenter prospective study, the PINCH-Phone was answered by patients after incisional hernia repair. Results The PINCH-Phone questions were answered by 210 patients with a median postoperative follow-up of 36 months. In 137 patients who had replied positively to one or more questions, 28 recurrent incisional hernias were detected at physical examination. Conclusion The PINCH-Phone appears a simple and valuable screenings method for recurrences after incisional hernia repair and, is recommended for implementation

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