[Ventral hernia surgery].

BACKGROUND

A personal technique for polypropilene mesh implantation in the treatment of massive, boundary and recurrent incisional hernias is described. METHODS.

METHODS

retrospective evaluation of cases observed over the last 3 years.

METHODS

division of General, Oncological and Thoracic Surgery, Department of Surgical and Anatomical Sciences, University of Palermo.

METHODS

twenty-four patients with massive, boundary and recurrent ventral hernia were selected and treated with this technique.

METHODS

the patients were submitted to implantation of a polypropilene prosthesis by using a part of the well vascularised hernial sac in order to close completely the peritoneal layer under the prosthesis (so as to avoid the contact between prosthesis and viscera) and to close the layer over the prosthesis (avoiding a contact between prosthesis and subcutis).

METHODS

morbidity and mortality have been evaluated.

RESULTS

Patients were discharged from the 7th and 15th postoperative day. No mortality was recorded. In four out of 24 patients the following complications were observed: 1 case of high postoperative fever; 2 cases of superficial infection of the surgical wound; 1 case of wide cutaneous suppuration without prosthesis involvement. No recurrences were observed during the follow-up (6 months-3 year).

CONCLUSIONS

Even if a scientific evaluation of the results is not possible due to the poor number of cases, short-term follow-up and unavailable randomized studies, this technique may be useful since it permits to avoid the contact between prosthesis and viscera, with lower postoperative adherences and the isolation of prosthesis from the subcutaneous tissue, sometimes involved in suppuration.