B J Privett1,2, M Ghusn3,4. 1. The Tweed Hospital, Tweed Heads, Australia. ben.j.privett@gmail.com. 2. School of Medicine, Griffith University, Gold Coast, Australia. ben.j.privett@gmail.com. 3. The Tweed Hospital, Tweed Heads, Australia. 4. John Flynn Private Hospital, Tugun, Australia.
Abstract
INTRODUCTION: There are a group of patients in which umbilical or epigastric hernias co-exist with rectus divarication. These patients have weak abdominal musculature and are likely to pose a higher risk of recurrence following umbilical hernia repair. We would like to describe a technique for open repair of small (<4 cm) midline hernias in patients with co-existing rectus divarication using self-adhesive synthetic mesh. The use of a self-adhesive mesh avoids the need for suture fixation of the mesh in the superior portion of the abdomen, allowing for a smaller skin incision. RESULTS: In 173 patients, preperitoneal self-fixating mesh has been used for the repair of midline hernias <4 cm in diameter. In 58 of these patients, the mesh was extended superiorly to reinforce a concurrent divarication. DISCUSSION: The described technique offers a simple option for open repair of small midline hernias in patients with co-existing rectus divarication, to decrease the risk of upper midline recurrence in an at-risk patient group. This initial case series is able to demonstrate a suitably low rate of recurrence and complications.
INTRODUCTION: There are a group of patients in which umbilical or epigastric hernias co-exist with rectus divarication. These patients have weak abdominal musculature and are likely to pose a higher risk of recurrence following umbilical hernia repair. We would like to describe a technique for open repair of small (<4 cm) midline hernias in patients with co-existing rectus divarication using self-adhesive synthetic mesh. The use of a self-adhesive mesh avoids the need for suture fixation of the mesh in the superior portion of the abdomen, allowing for a smaller skin incision. RESULTS: In 173 patients, preperitoneal self-fixating mesh has been used for the repair of midline hernias <4 cm in diameter. In 58 of these patients, the mesh was extended superiorly to reinforce a concurrent divarication. DISCUSSION: The described technique offers a simple option for open repair of small midline hernias in patients with co-existing rectus divarication, to decrease the risk of upper midline recurrence in an at-risk patient group. This initial case series is able to demonstrate a suitably low rate of recurrence and complications.
Authors: F Köckerling; R Lorenz; B Stechemesser; J Conze; A Kuthe; W Reinpold; H Niebuhr; B Lammers; K Zarras; R Fortelny; F Mayer; H Hoffmann; J F Kukleta; D Weyhe Journal: Hernia Date: 2021-07-28 Impact factor: 4.739
Authors: Elwin H H Mommers; Jeroen E H Ponten; Aminah K Al Omar; Tammo S de Vries Reilingh; Nicole D Bouvy; Simon W Nienhuijs Journal: Surg Endosc Date: 2017-06-08 Impact factor: 4.584
Authors: N A Henriksen; R Kaufmann; M P Simons; F Berrevoet; B East; J Fischer; W Hope; D Klassen; R Lorenz; Y Renard; M A Garcia Urena; A Montgomery Journal: BJS Open Date: 2020-01-09