Recurrent Incisional Repair Research Articles

Prosthetic incisional hernioplasty

I read the recent publication on prosthetic incisional hernioplasty by Abdollahi et al. [1]. The authors concluded that ‘‘the prosthetic incisional hernioplasty approaches, especially the Rives–Stoppa method, yielded excellent long-term results, with minimal morbidity in patients and large primary or recurrent incisional repair.’’ Indeed, there are some current reports on prosthetic incisional hernioplasty. Mehrabi et al. [2] reported a cross-publication in World J Surg that ‘‘The Rives–Stoppa repair of complex ventral incisional hernia using a Mersilene prosthesis is a safe and durable technique with excellent long-term results and minimal serious morbidity, with an overall recurrence rate in the present series of 1.1%.’’ The recurrence rate at present is higher compared to that reported by the crossauthors in that paper [2]. Hence, this might imply that the actual recurrence rate might be higher than that which is presented if larger surgeries are performed. In addition, some serious complications such as seroma and wound infections should still be kept in mind [3].

Prosthetic incisional hernioplasty: clinical experience with 354 cases

The use of prosthetic materials has become the standard of care in the management of incisional hernias because of its association with a low rate of recurrence. In this paper, the results of the treatment of incisional hernias is reported. Over a 15-year period, 354 open abdominal wall incisional hernia repairs were performed using the Rives-Stoppa, onlay and inlay techniques. The prosthetic materials used were polypropylene and Mersilene mesh. Using a questionnaire, the individual characteristics, type of operation (technique), type of prosthesis, complications and surgical outcome were recorded and analysed by SPSS software. A total of 354 patients underwent prosthetic incisional hernioplasty, comprising 265 women and 89 men, with a mean age of 52.1 years, using three techniques that included Rives-Stoppa (312), onlay (33) and underlay (9). The majority of complications included seroma (10), infection (8), intestinal fistula (2), mesh removal (2) and respiratory complication (4). Eighty percent of the patients used abdominal belts after the surgical procedure. Recurrent hernias were observed in four patients with a mean of 98 months follow up. All patients received pre-operative intravenous antibiotics and were discharged with oral antibiotics. In this series, the prosthetic incisional hernioplasty approaches, especially the Rives-Stoppa method, yielded excellent long-term results, with minimal morbidity in patients and large primary or recurrent incisional repair.