Evaluation of the double mesh and intraperitoneal onlay mesh techniques in giant incisional hernias

Gülten Çiçek Okuyan 1 * , Mehmet Talu 1
More Detail
1 Department of General Surgery, Haydarpaşa Numune Education and Training Hospital, İstanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 4, pp. 17-21. https://doi.org/10.23950/jcmk/13488
OPEN ACCESS 858 Views 655 Downloads
Download Full Text (PDF)

ABSTRACT

Background: Giant incisional hernias are difficult to manage. The present study aims to comparatively evaluate the intraperitoneal onlay mesh (IPOM) technique to double-mesh repair techniques in patients with a midline abdominal wall incisional hernia larger than 15 cm (transvers width) that cannot be closed primarily.
Material and methods: Patients who underwent repair surgery with the diagnosis of incisional hernia in our hospital between January 2017 and December 2019 were retrospectively evaluated. The repair was performed with open surgery using the IPOM technique in 19 patients and the double-mesh technique in 13 patients for 2 years to evaluate for postoperative complications, pain, and recurrence.
Results: The mean age, gender distribution, body mass index, defect size, and American Society of Anesthesiologists scores were similar between the groups. The total rate of postoperative complications was 42.1% in Group A and 30.8% in Group B, with no significant difference between the groups (p > 0.05). Recurrence occurred in three patients (15.8%) in Group A, but it did not in Group B. Although the absence of recurrence in Group B was a remarkable finding, the difference was not statistically significant (p>0.05).
Discussion: The IPOM and double-mesh techniques can be used safely to perform tension-free abdominal wall reconstruction in patients with complex and giant incisional hernias. However, the double-mesh technique may be preferred owing to its lower recurrence rate.
Keywords: giant incisional hernia, double mesh, IPOM

CITATION

Çiçek Okuyan G, Talu M. Evaluation of the double mesh and intraperitoneal onlay mesh techniques in giant incisional hernias. J CLIN MED KAZ. 2023;20(4):17-21. https://doi.org/10.23950/jcmk/13488

REFERENCES

  • Le Huu Nho R, Mege D, Ouaïssi M, Sielezneff I, Sastre B. incidence and prevention of ventral incisional hernia. J Visc Surg. 2012;149 Supplement:e3-14. https://doi.org/10.1016/j.jviscsurg.2012.05.004
  • Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, et al. Classification of primary and incisional abdominal wall hernias. Hernia. 2009;13:407-14. https://doi.org/10.1007/s10029-009-0518-x
  • Flament JB, Palet JP. Nyhus and Condon’s Hernia 5th edition. Philadelphia, USA: Lippincott W&W; 2002. Prosthetic repair of massive abdominal ventral hernias; pp. 341-66.
  • Muysoms FE, Antoniou SA, Bury K, Campanelli G, Conze J, Cuccurullo D, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015;19:1-24. https://doi.org/10.1007/s10029-014-1342-5
  • Lasses Martínez B, Peña Soria MJ, Cabeza Gómez JJ, Jiménez Valladolid D, Flores Gamarra M, Fernández Pérez C, et al. Surgical treatment of large incisional hernias with intraperitoneal composite mesh: a cohort study. Hernia. 2017;21:253-60. https://doi.org/10.1007/s10029-016-1557-8
  • Holmdahl V, Stark B, Clay L, Gunnarsson U, Strigård K. One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial. Hernia. 2019;23:355-61. https://doi.org/10.1007/s10029-019-01900-4
  • O’halloran EB, Barwegen CJ, Dombrowski JM, Vandevender DK, Luchette FA. Can’t have one without the other: component separation plus mesh for repairing difficult incisional hernias. Surgery. 2014;156:894-9. https://doi.org/10.1016/j.surg.2014.06.021
  • Parker SG, Mallett S, Quinn L, Wood CPJ, Boulton RW, Jamshaid S, et al. Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis. BJS Open. 2021;5:071. https://doi.org/10.1093/bjsopen/zraa071
  • Silecchia G, Campanile FC, Sanchez L, Ceccarelli G, Antinori A, Ansaloni L, et al. Laparoscopic ventral/incisional hernia repair: updated Consensus Development Conference based guidelines [corrected]. Surg Endosc. 2015;29:2463-84. https://doi.org/10.1007/s00464-015-4293-8
  • Ali F, Sandblom G, Wikner A, Wallin G. Laparoscopic ventral and incisional hernia repair using intraperitoneal onlay mesh with peritoneal bridging. Hernia. 2022;26:635-46. https://doi.org/10.1007/s10029-021-02502-9
  • López-Cano M, Martin-Dominguez LA, Pereira JA, Armengol-Carrasco M, García-Alamino JM. Balancing mesh-related complications and benefits in primary ventral and incisional hernia surgery. A meta-analysis and trial sequential analysis. PLOS ONE. 2018;13:e0197813. https://doi.org/10.1371/journal.pone.0197813
  • Köckerling F. What do we know about the Chevrel technique in ventral incisional hernia repair? Front Surg. 2019;6:15. https://doi.org/10.3389/fsurg.2019.00015
  • Liang MK, Holihan JL, Itani K, Alawadi ZM, Gonzalez JR, Askenasy EP, et al. Ventral hernia management: expert consensus guided by systematic review. Ann Surg. 2017;265:80-9. https://doi.org/10.1097/SLA.0000000000001701
  • Bröker M, Verdaasdonk E, Karsten T. Components separation technique combined with a double-mesh repair for large midline incisional hernia repair. World J Surg. 2011;35:2399-402. https://doi.org/10.1007/s00268-011-1249-6
  • Ayik N, Klein P, Grützmann R, Demir R. Long-term outcome of ıncisional hernia repairs using the erlangen ınlay onlay mesh (EIOM) technique. J Surg Res. 2019;243:14-22. https://doi.org/10.1016/j.jss.2019.04.045
  • Moreno-Egea A, Mengual-Ballester M, Cases-Baldó MJ, Aguayo-Albasini JL. Repair of complex incisional hernias using double prosthetic repair: single-surgeon experience with 50 cases. Surgery. 2010;148:140-4. https://doi.org/10.1016/j.surg.2009.12.014
  • Bernard C, Polliand C, Mutelica L, Champault G. Repair of giant incisional abdominal wall hernias using open intraperitoneal mesh. Hernia. 2007;11:315-20. https://doi.org/10.1007/s10029-007-0222-7
  • Oussoultzoglou E, Baulieux J, De la Roche E, Peyregne V, Adham M, Berthoux N,Ducerf C. Long-term results of 186 patients with large incisional abdominal wall hernia treated by intraperitoneal mesh. Ann Chir. 1999;53:33-40.
  • Al Taha MA. Outcome of open intraperitoneal dual mesh versus on–lay mesh for incisional hernia repair. Medico-Legal Update. 2020;20:1253-8. https://doi.org/10.37506/mlu.v20i1.546
  • Afifi RY. A prospective study between two different techniques for the repair of a Large recurrent ventral hernia: a double mesh intraperitoneal repair versus onlay mesh repair. Hernia. 2005;9:310-5. https://doi.org/10.1007/s10029-005-0017-7
  • Farid M, Fiad A, Nour H, Mohamed H. Management of large midline incisional hernia, double mesh modification of Chevrel’s technique versus on lay mesh hernioplasty, A comparative study. RJPBCS. 2020;11:60-8. https://doi.org/10.33887/rjpbcs/2020.11.5.7
  • Godara R, Garg P, Raj H, Singla SL. Comparative evaluation of sublay versus onlay meshplasty in ventral hernia. Indian J Gastroenterol. 2006;25:2223.
  • Afifi RY, Hamood M, Hassan M. The outcome of A. Double mesh intraperitoneal repair for complex ventral hernia: a retrospective cohort study. Int J Surg. 2018;53:129-36. https://doi.org/10.1016/j.ijsu.2018.03.036
  • Köckerling F, Scheuerlein H, Schug-Pass C. Treatment of large ıncisional hernias in sandwich technique - a review of the literature. Front Surg. 2018;5:37. https://doi.org/10.3389/fsurg.2018.00037