RESUMEN
Background and objectives: Incisional hernia is the one true iatrogenic hernia. The Incisional hernia occurs in less than 5-11% of patients subjected to abdominal operation. Incisional hernia usually starts within few months after surgery, as a result of failure of the lines of closure of the abdominal wall following laparotomy. If left unattended they tend to attain large size and cause discomfort to the patient. This study has been undertaken to assess the magnitude of this problem, various factors leading to development of this condition and the different modalities of treatment practiced in our set up. Methodology: The present study was conducted at the Department of General Surgery; AMC MET Medical college and Seth L. G. Hospital Ahmedabad, in which 60 patients of incisional hernia were treated during June 2018 to April 2020. Interpretation and Conclusion: Successful repair relies on knowledge of the dynamics of the abdominal wall, thorough technical execution, appropriate selection of synthetic or bioprosthetic material, and constitution of surgical team. Though laparoscopic repair has been demonstrated to be safe and a more resilient repair than open repair, open mesh repair remains a suitable alternative.
RESUMEN
Lumbar hernias occur infrequently and can be congenital, primary (inferior or Petit type, and superior or Grynfeltt type), post-traumatic, or incisional. They are bounded by the 12th rib, the iliac crest, the erector spinae, and the external oblique muscle. Most postoperative incisional hernias occur in nephrectomy or aortic aneurysm repair incisions for which various surgical method in context of meshplasty are available. In this case 60 yr. male hypertensive patient presented to the outpatient clinic of institute with recurrent left side lumbar incisional hernia, patient was previously operated for left side nephrolithiasis 15 years back and onlay meshplasty 2 years back for incisional hernia. The patient was operated under high risk for recurrent incisional hernia repair by triple layered meshplasties in the same sitting. Lumbar incisional hernias are often diffuse with fascial defects that are usually hard to appreciate. Computed tomography scan is the diagnostic modality of choice with adjuvant clinical findings, which allows differentiating them from abdominal wall musculature denervation atrophy complicating flank incisions. Repairing these hernias is difficult due to the surrounding structures for which our surgical approach included a triple mesh repair consisting of underlay, inlay and onlay meshplasty thereby anticipating further such incidences of incisional hernia.
RESUMEN
Background: Incisional hernia is still relatively common in our practice. The aim of the study was to identify risk factors associated with incisional hernia in females in our region. Methods: All the women who presented with incisional hernia between 2010 and 2012 were retrospectively studied using records and preparing a standard form to obtain information on pre-hernia (index) operations and possible predisposing factors. They all had open surgical repair and were followed up for 12-36 months. Results: Fifty two women were treated during study period. The index surgeries leading to the hernias were emergency caesarian section 26/52 (50%), emergency exploratory laparotomy 6/52 (11.6%), and elective surgeries 20/52 (38.5%). Major associated risk factors were the use of wrong suture materials for fascia repair, midline incisions, wound sepsis, and overweight. Conclusions: For elective surgeries, reduction of weight should be encouraged when appropriate, and transverse incisions are preferred. Absorbable sutures should be avoided in fascia closure. Antibiotics should be used for complicated cases.
RESUMEN
In this article we report a case of inferior lumbar hernia. The patient underwent preperitoneal meshplasty. The patient is well on follow up with no recurrence. The relevant literature has been reviewed and management discussed in brief.