scholarly journals A prospective study on incisional hernia, its incidence, etiology and management in a tertiary care hospital of Odisha

2019 ◽  
Vol 6 (4) ◽  
pp. 1280
Author(s):  
S. K. Pattanaik ◽  
Afroza Firodous ◽  
Ajax John ◽  
Harsha Pattnaik ◽  
Biplab Mishra ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Tertiary Care ◽  
Operating Time ◽  
Surgical Techniques ◽  
Wound Management ◽  
Anatomical Reconstruction ◽  
Suture Repair ◽  
Care Hospital ◽  
Open Mesh Repair

Background: Incisional hernia (IH) is defined as the hernia protruding through incompletely healed abdominal surgical wound. Management of IH can be preventive (avoidance of infection and suture line tension, proper abdominal wound closure) or operative (anatomical reconstruction or repair with synthetic non-absorbable mesh either by open or laparoscopy method).Methods: A descriptive prospective observational study on 51 patients with age >15 yrs was conducted in the Department of General Surgery, SCB Medical College and Hospital, Cuttack from August 2015 to August 2017. Diagnosis was made with clinical history, physical examination, X-ray abdomen and USG abdomen. The patients underwent different surgical procedures depending on size of defect, patient’s consent and expertise available. Post-operative complications were noted and patients were followed up to 1 year for any recurrence.Results: 28 males and 23 females were included. The mean age was 42.3 years. Most common cause of IH was post-operative wound infection (47.1%). Maximum cases were following emergency surgery (88.2%). Midline incision contributes maximum number (52.9%) followed by Pfannenstiel incision (25.4%). Open hernioplasty was the most common procedure (58.8%) followed by anatomical repair (19.6%) and laparoscopic hernioplasty (15.6%). Recurrence with suture repair was 10%, open mesh repair 3.3% and no recurrence was observed following laparoscopic repair.Conclusions: Prevention of IH is to be taken care of, by avoiding infection during index operation with thorough peritoneal toileting, proper surgical techniques and appropriate antibiotics. Although laparoscopic mesh repair needs more operating time and skill, it has lesser blood loss, hospital stay and recurrence rate when compared to other procedures.

scholarly journals Long-term results of incisional hernia treatment

Medicina ◽  
2007 ◽  
Vol 43 (11) ◽  
pp. 855 ◽  
Author(s):  
Linas Venclauskas ◽  
Jolita Šilanskaitė ◽  
Jurga Kanišauskaitė ◽  
Mindaugas Kiudelis
Keyword(s):  
Physical Activity ◽  
Incisional Hernia ◽  
Mesh Repair ◽  
Study Groups ◽  
Hernia Recurrence ◽  
Suture Repair ◽  
Open Mesh Repair ◽  
Onlay Technique ◽  
Open Mesh

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.

scholarly journals HERNIOPLASTY

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.

scholarly journals VENTRAL INCISIONAL HERNIAS

2011 ◽  
Vol 18 (02) ◽  
pp. 228-232
Author(s):  
HAROON JAVAID MAJID ◽  
HARUN MAJID DAR ◽  
MUHAMMAD SHAFI ◽  
Muhammad Arif Javed
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Randomized Clinical Trials ◽  
Incisional Hernia Repair ◽  
Suture Repair ◽  
Recurrence Rates ◽  
Incisional Hernias ◽  
Number Of Patients ◽  
Open Mesh Repair ◽  
Ventral Incisional Hernia

Ventral Incisional Hernias are a well known complication after abdominal surgery with a reported incidence of 10% - 20% and a recurrence rate of 30% - 50% after open suture repair and less than 10% after open mesh repair. Objectives: To compare the outcome of two different methods of open repair of VIH (i.e. Mesh versus Non-mesh or Suture Repair in terms of morbidity, complications and recurrence. Period: 11 years period (January 2000 – December 2010). Setting: Shaikh Zayed Hospital, Lahore. Patients & Methods: The total number of patients who underwent surgery for repair of VIH during the study period was 321.There were only 33 patients in Group A (simple suture/Keel repair) while Group B had 288 patients. The most common early postoperative complications seen in both the groups were wound seroma and infection. Post-operative respiratory insufficiency was more common in the obese. Chronic pain and feeling of foreign body was more frequently seen in the mesh group. On the other hand, recurrence rates were far greater in the suture repair group. The overall mortality in the whole series was 3 patients (0.93%). Conclusions: The rates of ventral incisional hernia recurrence and complications are significantly lower after open onlay mesh repair as compared to the open suture repair. However, these results require confirmation by prospective randomized clinical trials which should also include the results of laparoscopic ventral incisional hernia repair which is a new and emerging technique in Pakistan.

scholarly journals Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

2018 ◽  
Vol 5 (3) ◽  
pp. 834
Author(s):  
Yamanur P. Lamani ◽  
Subhash N. Halbhavi ◽  
Bheemangowda V. Goudar ◽  
Eshwar B. Kalaburgi ◽  
Veerabhadra Gowd Y. C.
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Surgical Techniques ◽  
Standard Technique ◽  
Advantages And Disadvantages ◽  
Open Mesh Repair ◽  
Onlay Technique ◽  
Sublay Technique ◽  
Sublay Repair ◽  
Onlay Repair

Background: Incisional hernia (IH) remains a very frequent postoperative complication and common hernias in middle aged population more commonly in females. The two techniques most frequently used are the onlay repair and sublay repair. Various studies have been conducted to compare the advantages and disadvantages of sublay and onlay mesh repair in incisional hernia and the superiority of sublay mesh repair. These studies whether they hold good for the population is a pertinent question. In view of this, author need to study the appropriate surgical techniques sublay versus onlay repair in the set up.Methods: Author conducted randomized comparative study of 100 patients having incisional hernia admitted to various surgical units of SNMC and HSK Hospital, Bagalkot during the period December 2014 to June 2016.Results: In present study of 100 cases, females have more incidence of incisional hernias than males. In onlay technique seroma formation was found in 72% of patients postoperatively and 4% in sublay technique. Surgical site infection (SSIN) was noticed in 8% of sublay technique whereas 12% in onlay technique. There is no recurrence in sublay group whereas onlay had 12% recurrence.Conclusions: Sublay technique is superior to onlay concerning the hospital stay, complications and recurrence.

scholarly journals A comparative study of various techniques of incisional hernia repair in a tertiary care center at Bikaner (North-West Rajasthan)

2019 ◽  
Vol 6 (8) ◽  
pp. 2909
Author(s):  
Bhal Singh ◽  
Mahender Kumar Jalthania ◽  
Santosh Kumari
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Abdominal Wall Defect ◽  
Care Center ◽  
Tertiary Care ◽  
Suture Repair ◽  
Onlay Mesh ◽  
Sublay Mesh ◽  
Repair Group

Background: Incisional hernia can be defined as an internal abdominal wall defect that develops after a previously closed laparotomy. Aim of present study was to compare open suture repair and mesh repair (onlay and sublay), various factors predisposing to incisional hernia and evaluate complications following surgery for incisional hernias.Methods: A prospective study was conducted in 60 cases of incisional hernia admitted in Department of General Surgery, PBM Hospital Bikaner between October 2017 to September 2018. 20 cases were selected in each group (open anatomical repair, onlay mesh repair and sublay mesh repair). All cases were followed up for 6 months postoperatively.Results: Incisional hernia was found to occur more often in 41-60 years age group (61.67%) and in females. Wound infection (46.67%) after index surgery was most important risk factor followed by obesity. LSCS (30%) was found to be most common index surgery followed by hysterectomy (28.33%). Seroma was most common postoperative complication (5% patient in anatomical repair group, 30% patients in onlay group and 10% patients in sublay group).Only one recurrence (5%) was observed in anatomical repair group over a period of 6 months follow up.Conclusions: Sublay mesh repair is superior to onlay mesh repair and Anatomical suture repair regarding recurrence rate. Local postoperative complications like seroma formation or wound infection were more common in mesh repair surgery than anatomical repair. Among mesh repair these complications were higher in onlay group than sublay repair.

scholarly journals A Prospective Study to Evaluate the Effectiveness of Prolene Mesh Repair in Incisional Hernia: A Hospital Based Study

2020 ◽  
Vol 9 (1) ◽  
pp. PT09-PT11
Author(s):  
Vinod Kumar Jeengar ◽  
Rita Verma
Keyword(s):  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Mesh Repair ◽  
Suture Repair ◽  
Outpatient Basis ◽  
Gap Size ◽  
Prolene Mesh ◽  
Open Mesh Repair ◽  
Group A ◽  
Group B

Background: Inguinal hernia is the most common diversity accounting for roughly 75% of all hernia. The etiology of an inguinal hernia is clearly not understood. The technique of hernia repair is usually based on custom rather than evidence.4 According to data there is a good observation that open mesh repair is better than suture repair in terms of recurrences. The aim of this study to evaluated the effectiveness of prolene mesh rapair in incisional hernia.Subjects and Methods:A prospective hospital based study done on 30 cases in department of general surgery at RVRS medical college & associated group of hospitals, Bhilwara, Rajasthan. We randomly assigned 30 patients to suture repair or mesh repair of an incisional hernia. The patients were followed up by local physical examination at 1 month & 3 months were done as per standard protocol. Factors related to the operation including the surgical technique, presence or absence of seroma, hematoma, infection, dehiscence were recorded. Follow-up of cases was done at 1 month & 3 months after surgery on an outpatient basis for recurrence of hernia.Results:Our study showed that the majority of cases (43.33%) were seen in 40-49 years of age group. Small (0-5cm) gap size 90% cases and 10% cases have medium gap size in our study. Pain present in 26.66% patients in group A and 20% in group B at 1 month. The recurrence of hernia was present in 28% cases in group A and 4% in group B. It was statistically significant (P=0.0488*) at 3 months and the mostly were well built and have 27.27% wound infection present in these type of patients. Mostly infection occurred in obese patients (40%).Conclusion: We concluded that restoration with polypropylene mesh is superior to suture repair group with concern to the recurrence of hernia.

scholarly journals Cynoacrylate surgical glue as an alternative to suturing for mesh fixation in lichtenstein hernia repair

2018 ◽  
Vol 5 (5) ◽  
pp. 1882
Author(s):  
Deepak Jaiswal ◽  
TRV Wilkinson ◽  
Murtaza Akhtar
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Tertiary Care ◽  
Operating Time ◽  
Recurrent Hernia ◽  
Care Hospital ◽  
Lichtenstein Hernia Repair ◽  
Average Pain

Background: Tension free repair using mesh in open hernia repair has become more popular in recent years. Chronic pain remains a frequent complication after Lichtenstein inguinal hernia repair. The use of sutures to fix the mesh has been implicated. Fixing the mesh using cynoacrylate glue could avoid this complication. The purpose of the present study is to study the incidence of pain and other complications following inguinal hernia repair performed by the Lichtenstein technique with mesh fixation by cyanoacrylate surgical glue.Methods: T This study was conducted at tertiary care hospital. Inclusion criteria were all patients coming to the hospital with inguinal or inguinoscrotal hernias diagnosed clinically. Exclusion criteria were all complicated inguinal hernia namely obstructed, strangulated, and large hernias with scrotal abdomen, recurrent hernia. Patient not fit for surgery or not consenting to join the study. The patients will be informed about the surgery and thereafter requested to sign an informed consent. Primary outcome was postoperative pain. Secondary endpoints were operating time, surgical site infection and recurrence rate.Results: Total number of 31 cases enrolled in the study of which twenty-two had unilateral and seven had bilateral inguinal hernias. Average pain score on POD 1, 3, 7 was 5.75; 4.53; 3.32 respectively. One patient developed seroma which was managed conservatively. No evidence of recurrence during study period.Conclusions: Cyanoacrylate surgical glue is a reliable method and can be used as an alternative for conventional Lichtenstein hernia repair.

scholarly journals Role of laparoscopy in incisional hernia and relative benefit of the laparoscopic incisional hernia repair to the open incisional hernia repair

2020 ◽  
Vol 7 (7) ◽  
pp. 2165
Author(s):  
Sudhir Singh Pal ◽  
Azad Kumar Mourya
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Mesh Repair ◽  
Laparoscopic Group ◽  
Incisional Hernia Repair ◽  
Visual Analogue Score ◽  
Laparoscopic Incisional Hernia Repair ◽  
Post Operative Pain ◽  
Open Mesh Repair

Background: Incisional hernia is a common complication of abdominal surgery. Historically the open repair with or without mesh was the mainstay of treatment. However, many recently published laparoscopic repair studies have challenged surgeons to re-evaluate which technique provides the best short and long term outcomes.Methods: The study was conducted on 50 patients admitted at GMC Bhopal with approval from college ethical committee.Results: In 50 cases 21 were male and 29 were female. 7 male (14%) and 15 female (30%) patients had undergone laproscopic mesh repair (LMR) and 14 male (28%) and 14 female (28%) patients had undergone open mesh repair (OMR). Total complication in OMR group is 10 (35%) and in LMR group is 2 (9.09%). Mean duration of hospital stay in LMR group was 6.6 days and in OMR group was 15.57 days. Post-operative patients of LMR group returned back to the work early (mean 12 days) compared to OMR group (mean 20.7 days). Mean post-operative day of movement in LMR group was 1 day and in OMR group was 2.03 days. Pain measured using visual analogue score on 3rd post-operative day showed decreased pain score in laparoscopic group (mean 2) compared to open group (mean 5.35).Conclusions: Laparoscopic incisional hernia repair provides lesser post-operative pain, lesser complications, shorter hospital stay and lesser economic impact as they returned to work early. Thus patients have less morbidity and improved quality of life. 

scholarly journals Intraperitoneal Onlay Mesh in Ventral Hernia Repair – Experience in A Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 7 (2) ◽  
pp. 106-109
Author(s):  
Md Ezharul Haque Ratan ◽  
Hasina Alam
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Intraperitoneal Onlay Mesh ◽  
Diabetes Status ◽  
Onlay Mesh

Background: Ventral hernias are common problem in surgical practice. Repair of hernia by a prosthetic mesh is a well recognized procedure. But whether the procedure is to be done by open or laparoscopic technique is still a topic of discussion. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia in our country. We are evaluating the usefulness of this procedure as routine operation for ventral hernias.Methods: All patients attending at Bangladesh Institute of Research & Rehabilitation of Diabetes, Endocrine and Metabolic disorders (BIRDEM) outpatient department (OPD) with ventral hernia were approached and counseled for laparoscopic IPOM, but only those who agreed were included in this study. Fifty consecutive patients underwent IPOM by a single surgeon. Preoperative evaluation was done rationally and surgery performed by standard laparoscopic method. Age, sex, diabetes status and additional procedures done were evaluated. Post- operative follow up period was from 3 months to 75 months and any complication or recurrence were noted.Results: We are reporting 50 cases of laparoscopic IPOM, over a time period of 78 months (April 2010- September 2016). Eleven cases were male, 39 female (M: F=1:3.5). 35 (70%) cases were diabetic, 15 (30%) were non-diabetic. Mean age of the patients were 47.7yrs (male 47.7+9.5 yrs, female 47.7- 2.6 yrs, diabetic patients 47.7+ 2.5yrs, non-diabetic patients 47.7-5.9yrs). Indication for IPOM was paraumbilical hernia 29 cases (58%), incisional hernia 14 cases(28%), multiple incisional hernia 2 cases ( 2 large defect in one case, 5 defects of varying size in another patient), umbilical port hernia 2 cases, paraumbilical along with incisional hernia 1 case, epigastric hernia 1 case, lumber hernia 1 case. In 48 cases (96%) polypropylene mesh and only in 2 cases (4%) dual mesh were used. In addition to IPOM procedure, in same sitting laparoscopic cholecystectomy was done in 8 cases, Dilatation & Curettage in 1 case and adhesiolysis in 7 cases. None of the case required conversion to open, neither was there any intra-operative complication. In one case there was recurrence . In another case there was false recurrence due to development of ascites. Four patients developed seroma which were managed conservatively.Conclusion: Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty has proved to be an effective surgical procedure for ventral hernia repair. It provides much benefits with low complications and conversion in experienced hands.Birdem Med J 2017; 7(2): 106-109

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