Chronic Pain After Open Mesh Repair of Incisional Hernia

Ventral hernia is a common problem in general surgery practice. Incisional hernia can develop in 15–25% of patients after abdominal surgery. The aim of this study was to compare two different methods of incisional hernia surgery. Materials and methods. A retrospective analysis of database of surgery department from 1997 to 2000 was performed. All patients were divided into two groups. The first group patients were operated using open suture repair (keel technique); the second group patients – using open mesh repair (onlay technique). Long-term follow-up was done by a mail questionnaire. A special questionnaire was sent to all patients. Postoperative evaluation included pain and discomfort in the abdomen, physical activity, and recurrence rate after operation. Statistical evaluation was conduced using descriptive analysis: the unpaired Student t test to compare parametric criterions between two study groups, Mann-Whitney U test to compare the unpaired nonparametric criterions between two study groups, and X2 test to investigate nonparametric criterions between these groups. Results. A total of 202 patients (51 males, 151 females) with incisional hernia were operated during 1997–2000. One hundred seventy-one patients were in the keel technique group, and 31 patients in the onlay technique group. There were no significantly differences in age and sex between these groups. The hospitalization time was significantly longer in the open mesh repair group. The postoperative complication (wound seroma and suppuration) rate was significantly higher in the onlay technique group. One hundred sixty-one patients (79.7%) answered the questionnaire (133 in the keel technique group, 28 the in onlay technique group). The patients’ return to physical activity after surgery was significantly longer in the keel technique group. Forty-one patients (31%) had hernia recurrence in the keel technique group and 3 patients (11%) in the onlay technique group (P<0.05). There were no postoperative deaths in both groups. Conclusions. The rates of postoperative therapeutic complications and hernia recurrence are significantly lower after open mesh repair surgery. Return to normal physical activity after surgery is significantly longer after open suture repair surgery.

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Open Mesh Repair of Incisional Hernia Using a Sublay Technique: Long-Term Follow-up

World Journal of Surgery ◽

10.1007/s00268-007-9118-z ◽

2007 ◽

Vol 32 (1) ◽

pp. 31-36 ◽

Cited By ~ 31

Author(s):

Martin Kurzer ◽

Allan Kark ◽

Simon Selouk ◽

Philip Belsham

Keyword(s):

Incisional Hernia ◽

Mesh Repair ◽

Open Mesh Repair ◽

Sublay Technique ◽

Long Term Follow Up ◽

Open Mesh

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Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia

Hernia ◽

10.1007/s10029-015-1351-z ◽

2015 ◽

Vol 19 (3) ◽

pp. 449-463 ◽

Cited By ~ 82

Author(s):

A. Awaiz ◽

F. Rahman ◽

M. B. Hossain ◽

R. M. Yunus ◽

S. Khan ◽

...

Keyword(s):

Systematic Review ◽

Incisional Hernia ◽

Mesh Repair ◽

Meta Analysis ◽

Open Mesh Repair ◽

Open Mesh

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Incisional hernia: conventional open mesh versus laparoscopic repair; a randomized controlled study

International Surgery Journal ◽

10.18203/2349-2902.isj20204115 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3211

Author(s):

Ibrahim F. Alsubaiee

Keyword(s):

Incisional Hernia ◽

Laparoscopic Repair ◽

Mesh Repair ◽

Randomized Controlled Study ◽

Controlled Study ◽

Patient’S Satisfaction ◽

Randomized Controlled ◽

Open Mesh Repair ◽

Repair Group ◽

Open Mesh

Background: Incisional hernia is a common complication after laparotomy. Up to now, there is no consensus on the ideal surgical approach of such hernia. The aim of the present study was to compare the surgical outcomes, feasibility and cost effectiveness of the open mesh repair and laparoscopic repair of incisional hernia.Methods: A randomized controlled study conducted between August 2015 and September 2019 in which 64 patients with incisional hernias were randomly selected for either open mesh repair (36 patients) or laparoscopic repair (28 patients).Results: Patients in both groups were similar in their characteristics. The mean operative time was significantly longer in laparoscopic repair than in open mesh repair (128.6±15 minutes versus 89.8±82 minutes, p<0.05). The peri-operative complications and intra-operative blood loss were comparable in the two groups. The use of the drain was significantly higher in open group than in laparoscopic repair group (44.4% versus 10.7%). The overall rate of postoperative complications was similar in both groups, (25% for each group). The rate of wound infection and the length of hospitalization were significantly less in laparoscopic repair group. The results of postoperative pain score, cosmetic outcomes and recurrence rate showed no significant differences between the two groups but patient's satisfaction was significantly higher in laparoscopic repair. p>0.05.Conclusion: Both laparoscopic and conventional open mesh repair of incisional hernia are equivalent and feasible and safe technique. Laparoscopic repair was superior to open mesh repair in term of surgical site infection, hospital stay and patient’s satisfaction only.

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HERNIOPLASTY

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.02.2907 ◽

2009 ◽

Vol 16 (02) ◽

pp. 224-227

Author(s):

MUHAMMAD FAISAL BILALL ◽

MUHAMMAD AKRAM ◽

SUMERA KANWAL ◽

Jawaid Iqbal

Keyword(s):

Incisional Hernia ◽

Wound Infection ◽

Mesh Repair ◽

Enterocutaneous Fistula ◽

Tertiary Care ◽

Rectus Sheath ◽

Fistula Formation ◽

Open Mesh Repair ◽

Sublay Technique ◽

Open Mesh

Incisional hernia is a common complication of abdominal surgery and an important source of morbidity. It may be repairedusing open suture, open mesh or laparoscopic mesh techniques. O b j e c t i v e s : To examine the results of open mesh repair using "sublaytechnique" of hernioplasty. Setting: Surgical Unit-I, Department of Surgery at Allied Hospital, a tertiary care teaching hospital affiliated withPunjab Medical College, Faisalabad. Patient & M e t h o d s : Sixty patients (male:16, female:44) were operated for incisional hernia. Openmesh repair was done. Polypropylene mesh was placed over closed posterior rectus sheath layer and over the rectus abdominis, wereavailable. Anterior rectus sheath was closed in front of the implanted mesh. All the patients received injectable third generation cephalosporinfor 48hrs postoperatively. Postoperative recovery in terms of seroma formation, wound infection, intraabdominal adhesions leading tointestinal obstruction, enterocutaneous fistula formation and recurrence were the main factors noted and analyzed statistically. Results:Mean postoperative hospital stay was 03 days. Only one patient developed wound infection. None of the patients developed seromaformation, intestinal obstruction or enterocutaneous fistula. Maximum follow up till this study is 14 months. No recurrence has been reportedso far. C o n c l u s i o n s : Open mesh repair using "sublay technique" does not carry risk of enterocutaneous fistula, carries low risk of seromaformation and wound infection. Proper technique is not associated with recurrence.

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Chronic pain after laparoscopic and open mesh repair of groin hernia

British Journal of Surgery ◽

10.1046/j.1365-2168.2002.02260.x ◽

2002 ◽

Vol 89 (11) ◽

pp. 1476-1479 ◽

Cited By ~ 177

Author(s):

S. Kumar ◽

R. G. Wilson ◽

S. J. Nixon ◽

I. M. C. Macintyre

Keyword(s):

Chronic Pain ◽

Mesh Repair ◽

Groin Hernia ◽

Open Mesh Repair ◽

Open Mesh

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Chronic pain after laparoscopic and open mesh repair of groin hernia

Annales de Chirurgie ◽

10.1016/s0003-3944(02)00048-2 ◽

2003 ◽

Vol 128 (2) ◽

pp. 131

Keyword(s):

Chronic Pain ◽

Mesh Repair ◽

Groin Hernia ◽

Open Mesh Repair ◽

Open Mesh

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Incisional Hernia After Liver Transplantation: Analysis of Tailored Open Mesh Repair

International Surgery ◽

10.9738/intsurg-d-17-00046.1 ◽

2019 ◽

Vol 104 (5-6) ◽

pp. 226-231

Author(s):

Daniel Heise ◽

Andreas Kroh ◽

Roman Eickhoff ◽

Andreas Lambertz ◽

Marcel Binnebösel ◽

...

Keyword(s):

Liver Transplantation ◽

Incisional Hernia ◽

Abdominal Wall ◽

Mesh Repair ◽

Abdominal Wall Defect ◽

Wall Defect ◽

Abdominal Wall Repair ◽

Open Mesh Repair ◽

The Mean ◽

Open Mesh

Objective Incisional hernia is a frequent complication post liver transplantation (LT). The aim of this study was to compare divergent approaches to open abdominal wall repair post-LT. Summary of background data After liver transplantation (LT) via Mercedes incision (MSI) we observed an incidence of incisional hernia between 5% and 34%. Conventional repair consists of reopening the whole incision and reinforcement of the whole fascia using a mesh plastic in sublay position. This retrospective analysis compares open mesh repair with complete reinforcement of the Mercedes incision and open mesh repair of solely the abdominal wall defect. Methods Between 2010 and 2015, 218 orthotopic liver transplantations (LT) were performed at our institution, and 25 (11.5%) of those patients required an incisional hernia repair post-LT. One group received a local hernia repair (n = 15) while the other group obtained a reconstruction of the whole MSI (n = 10). We analyzed the preoperative status, causative factors for incisional hernia, operative details, and long-term outcome of these patients. Results Analyzing preoperative details no significant differences were found between the 2 groups. The mean time post-LT at which the abdominal wall defect appeared was 18 ± 12 months. The mean follow-up time after abdominal wall repair was 15 (11–19) months. Additionally, 1 (4%) patient developed a hernia recurrence without statistic significant difference between the 2 groups (P = 0.400). Conclusion Local mesh reinforcement seems to be feasible and safe in incisional hernia patients after Mercedes incision due to liver transplantation.

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