Incisional Hernia Repair with Polypropylene Mesh: Where should

Incisional Hernia Repair with
Polypropylene Mesh:
Where should the mesh be placed?
HOSPITAL UNIVERSITARIO
AUSTRAL
Department of general surgery
Authors: Iudica Fernando MD, Cingolani Pablo,MD
INTRODUCTION
The technical aspects of incisional hernia repair are
particularly important because this repair is associated
with one of the highest failures rates of any operations
performed by the general surgeon . Risk factors included
,previous respiratory disease,obesity,wound infection The
recurrence rate after simple closure of the defect is near
than 40%
40%. Polypropylene is the most comon material used
for
repair this disease.
METHODS
62 years old patient with history of
epigastric hernia surgery six months ago
with subsequent wound infection, leaving
in its wake a median incisional hernia.
Surgery 30/12/08: Close the defect and
placement of polypropylene mesh in
retrorectal space by reinforcement the
closer and use Albanese relaxation
incisions.
RESULTS
La eventración es una entidad común. Incidencia 10%.
Es mas frecuente en varones, edad avanzada, obesos y en aquellos cuya incisión abdominal es mayor a 18 cm.
Los factores más importantes en la génesis de la eventración postoperatoria: son problemas respiratorios, y la
i f ió de
infección
d la
l herida.
h id
El porcentaje de recidiva tras cierre simple de una eventración es alto, para algunos autores el 30%, cifra que
aumenta con los intentos de reparación.
En la reparación con malla el material mas empleado es el polipropileno
Patient with good postoperative
evolution, without pain, early
deambulation, and control at 3 , 6
months, and 2 year without
recurrence and total recovery of the
the abdominal wall physiology.
Summary
Incisional hernias repair with mesh reduces recurrence.
Procedures/techniques for successful mesh placement:
· Avoid contact with viscera.
· Mesh size should exceed by far defect size.
necessary
· Free tension with relaxation incision if necessary.
· Retrieve wall functionality.
References:
1- Conze J, Binnebosel, M, Junge K, Schumpelick V “Incisional hernia : How do I do it- Standard surgical approach” Chirurg 2010 81: 192
2-Barroetaveña J, Herszage, “Hernias de la ingle” 5° edition, 2009
3- Mayagoitía González JC, “Hernias de la pared abdominal. Tratamiento actual” Second edition 2009