Incisional hernia repair by preperitoneal [sublay] mesh implantation

ABSTRACT

Incisional Hernia is a common surgical condition with a reported incidence of 2-11% following all laparatomies. Results of tissue repair have been disappointing. The optimal approach for abdominal incisional hernias is still under discussion. To evaluate the technique of preperitoneal [sublay] mesh repair of incisional hernias. This retrospective study of consecutive 50 cases was done from January .2004 to January 2006 using a computerized database. Preperitoneal [sublay] mesh implantation was done in all the 50 cases. Follow up of 12-24 months was carried in the OPD and on telephone with regards to postoperative complications, hospital stay and recurrences if any. In our study of fifty patients, eighty percent of females [n= 40] outnumbered twenty percent males [n=10]. The female to male ratio was 4 1 and the highest incidence was in the 5th decade of life. The main presenting feature was swelling of the abdomen in all the fifty patients [100%] in the vicinity of the previous operative scar. In sixty percent of patients [n=30], the most common incision leading to incisional hernia was the midline incision of abdomen followed by Pfannensteil's incision in fourteen percent [n=7] and paramedian incision in twelve [n=6]. Major wound infection occurred in two patients [4%] only but without the removal of mesh. Forty patients [80%] attended for follow up ranging from 12 months to 24 months. Twenty seven patients [67.5%] attended OPD for follow up and thirteen patients [32.5%] replied the questions on phone. No recurrence was noted in follow up group. Based on this study, we conclude that preperitoneal [sublay] mesh repair is the ideal technique for incisional hernia. Though still there are few publications regarding this technique of repair