Rectusbanding: a method for the repair of incisional hernias.

BACKGROUND: We report on a new method of incisional hernia repair applicable to any size of hernia and the long-term results of this method. Musculus rectus abdominis is bandaged or partially bandaged in a loose way with a 2-cm-wide band of polypropylene (Prolene) on both sides at a distance of 2 cm, depending on the size of the hernial opening. The aims of this technique, which were defined in 1999 when we started using the method, were to find a simple method for surgeons, a safe mesh fixation and the prevention of a postoperative stiff abdomen. Another aim was to find a method for optimal patient care at reasonable costs.
METHODS: Two hundred and seventeen patients underwent an operation according to this method in our department from June 1999 until December 2007. The first 75 patients of this cohort were treated using a technique in which the musculus rectus abdominis was bandaged in a loose way. One hundred and forty-two patients (since October 2001) were treated using a technique in which the muscle was not entirely bandaged. Instead, the polypropylene bands, which had been placed in sublay position, were penetrating the lateral rim through incisions and were fastened there. We included 124 patients (October 2001 to December 2006) in our further examination with a follow-up of 17-79 months.
RESULTS: We found a recurrence rate of 6%, 80.1% of the patients had no trouble, 18.1% of the patients had very rarely any complaint, 0.9% of the patients had problems after exercise and 0.9% had permanent problems. All patients had excellent mobility of the abdomen.
CONCLUSION: This method was proven to give good results in the long run and can be easily learned by any surgeon. This method is a true alternative to all methods which have been published so far.