Surgical Treatment of Postoperative Giant Median Incisional Hernia, Combining Retromuscular Prolene Mesh and Hernial Sac

Written by Fülöp Zsolt Zoltán, Drágus Emőke, Bara Tivadar, ifj. Bara Tivadar

Background: Postoperative incisional hernias are the most frequent complications of laparotomies. In the treatment of giant incisional hernia several surgical techniques are being used, but even so the recurrence rate is high. The appearance of Prolene mesh brought significant changes in the postoperative results. Material and methods: We conducted a retrospective study, during 2010 and 2016 at the 2nd Department of Surgery, about the reconstruction methods in cases of incisional hernias treatment with polypropylene mesh. The purpose of the study was to analyze reconstructive methods, using Prolene mesh in retromuscular position and hernial sac, in cases of giant, median incisional hernias treatment. The cases were classified in function of sex, age, length of hospital stay, appearance of complications or recurrences. Results: In the studied period 833 patients were operated due to postoperative incisional hernias, from which in 536 cases the reconstruction of the parietal defect was carried out using polypropylene mesh. The reconstruction of the giant, median incisional hernias was performed in 70 cases, using Prolene mesh in retromuscular position and hernial sac. Regarding to all the cases the recurrence rate was 6.6%, while in case of the method used at big parietal defects it was 4.28%. Conclusions: The use of the biocompatible meshes brought changes in the reconstruction of the large incisional hernias. Tension-free techniques provide better results. The Prolene mesh placed in retromuscular position and covered with the hernial sac is an alternative procedure in the reconstruction of giant, median incisional hernias and in the prevention of postoperative complications.


Keywords: incisional hernia, giant, Prolene mesh, hernia sac

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