Unacceptable results of the Mayo procedure for repair of abdominal incisional hernias

Abstract

Objective: To evaluate the current practice of incisional hernia repair in Germany and analysis of the results of the Mayo duplication technique done in our hospital over a 10-year period.

Design: Nationwide survey, retrospective analysis.

Setting: University department, Germany.

Subjects: Survey of most surgical departments and of 114 patients with 135 incisional hernias in our unit.

Intervention: Mayo duplication repair incisional hernias.

Main outcome measures: Common practice, recurrence rates, quality of life.

Results: The Mayo overlap is the preferred technique in most surgical departments. The estimated failure rates (12% or less) in general practice are grossly underestimated. In our hospital the recurrence rate after Mayo duplication repair was 61/114 (54%) during a follow up time of 5.7 years with a follow-up-rate of 84%. Univariate and multivariate analyses failed to identify any predisposing factors. All patients with incisional hernias had limitations their physical function.

Conclusions: The widely used Mayo procedure leads to unacceptable results for repair of incisional hernias and other techniques should be evaluated and used more often. Repair of an incisional hernia does not improve overall quality of life.