Suture repair and mesh repair in Incisional Hernia

Dr. Chandrkant Paliwal; Dr. Kannomal Garg; Dr. Surendra Kumar Jain

Volume : VIII, Issue : IV, April - 2019

Suture repair and mesh repair in Incisional Hernia

Dr. Chandrkant Paliwal, Dr. Kannomal Garg, Dr. Surendra Kumar Jain

Abstract :

Incisional hernia is an important complication of abdominal surgery. Procedures for the repair of these hernias with sutures and with mesh have been reported, but there is no consensus about which type of procedure is best. Studies around the globe were analyzed to compare suture repair and mesh repair techniques in incisional hernia. Results recommended attachment of the prosthesis to the dorsal side of the defect with an overlap as large as possible, and we recommend that the mesh be sutured to the surrounding fascia with intervals of no more than 1 to 2 cm between stitches. Bulging must be prevented, but the mesh should not be implanted under tension. Contact between the polypropylene mesh and the viscera must be avoided because of the risk of adhesions, intestinal obstruction, and fistulas. When the peritoneum cannot be closed or when omentum cannot be interposed, polyglactin 910 (Vicryl) mesh may be interposed to protect the viscera, but experimental and clinical studies are not conclusive with respect to the efficacy of the interposition of the polyglactin mesh in preventing these complications. It was concluded that in patients with incisional hernias, retrofascial preperitoneal repair with polypropylene mesh is superior to suture repair with regard to the recurrence of hernia, even in patients with small defects