Three-dimensional mesh for ventral hernias: a new technique for an old problem.

The morbidity/mortality associated with ventral hernias continues to be a serious medical problem due to high rates of recurrence. Meshes offer a simple and effective solution and, bearing this in mind, we describe a new protocol developed in our department, which consists of dissecting the hernia to free the peritoneal space, in which the three-dimensional mesh (PHS) is lodged. From July 1999-November 2002, this technique was used in 32 adult and elderly patients: four eventrations caused by trocars, seven eventrations from laparotomy, 14 umbilical hernias, five epigastric hernias, and two spigelian hernias. The size of the hernial ring was 10 cm or less in all cases. All patients underwent surgery under spinal anaesthesia and with antibiotic prophylaxis. No patient required readmission, experienced infection of the mesh or recurrence, or required more oral analgesia than prescribed on discharge. The mean hospital stay was 30+/-15 h, and only five of 32 patients required more than 1 day of stay. No deaths occurred. Therefore, we think that the use of the PHS mesh in ventral hernia is a safe, effective, and simple technique.