Repair of large complex recurrent incisional hernias with retromuscular mesh and panniculectomy

Am J Surg. 2007 Aug;194(2):199-204. doi: 10.1016/j.amjsurg.2006.10.031.

Abstract

Background: Recurrent incisional hernia repair is associated with high recurrence and wound complication rates.

Methods: The clinical courses of patients who underwent recurrent incisional hernia repair via retromuscular mesh placement with concomitant panniculectomy at a university teaching hospital from 1999 to 2004 were reviewed retrospectively. Postoperative evaluation included a quality of life survey.

Results: Forty-seven patients (13 male, 34 female) with an average body mass index of 34.4 kg/m2, an average midline hernia defect of 31.4 cm, and at least 1 and on average 2.5 previous repair attempts underwent hernia repair. Wound infections occurred in 4 patients (8%) and seromas requiring aspiration occurred in 1 patient (2%). Four patients (8%) had re-recurrences of their hernias. All patients rated the postoperative appearance of their abdomen as at least satisfactory.

Conclusions: Recurrent incisional hernia repair with a retromuscular mesh and panniculectomy has low recurrence and wound complication rates and excellent patient satisfaction.

MeSH terms

  • Abdominal Fat / surgery*
  • Abdominal Wall / surgery*
  • Adult
  • Aged
  • Female
  • Hernia, Ventral / surgery*
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Quality of Life
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh*
  • Surgical Wound Dehiscence / epidemiology
  • Surgical Wound Infection / epidemiology
  • Suture Techniques
  • Treatment Outcome