[Reconstruction of incisional median hernia with retromuscular mesh and hernial sac]

Abstract

Introduction: one of the most frequent complications of a laparotomy is the development of an incisional hernia. Proper surgical technique can somewhat reduce the incidence, but it still remains a common sequel. Application of prolene mesh for the reconstruction of the abdominal wall with tension-free methods has excellent results.

Patients and methods: between 2001-2005, 50 abdominal wall reconstructions were performed using prolene mesh in sublay position including the peritoneal sac of the incisional hernia.

Results: postoperative complication was found in one case only, namely a haematoma was formed in the rectus sheat possibly due to an injury of a branch of the inferior epigastric artery. The haematoma was managed non-operatively by suction drainage. No postoperative respiratory problems were detected; all we noticed was minimal abdominal pain. Patients were mobilized shortly after the surgery.

Conclusions: application of prolene mesh in sublay position including the hernia sac is an effective alternative procedure for preventing postoperative complications, when large incisional hernias are repaired in median laparotomy scars.