[The repair of recurrent postoperative incisional hernias. Objectives and therapeutic indications (68 cases)].

Among 327 surgical repairs of incisional hernias done between 1974 and 1989, 68 repairs (21%) were performed because of a primary treatment failure. Failed primary attempts of cure had been unique in 71%, and multiple in 29% of cases; their procedure had been essentially suture or herniorrhaphy. Site of recurrent incisional hernia (R.I.H.), was midline or lateral incision in respectively 84% and 16% of cases. Size of R.I.H. was considered as large in two third of cases. Operation was performed electively in majority of cases (93%). More than half of the patients were "prepared" by preoperative pneumoperitoneum and/or weight reducing regimen. Mersilene* mesh was used in 81% of cases. Results of treatment of R.I.H. are reported, depending on procedure. Among 55 cures by use of Mersilene* mesh, 1 patient died (from myocardial infarction), and 5 recurrences occurred, 4 of which from sepsis. Study of complications and failures suggests: 1) careful attention to indications, 2) advantages of a large size Mersilene* mesh, 3) attention to preoperative treatment, especially weight loss regimen and progressive pneumoperitoneum.