Volume : 5, Issue : 4, April - 2016

SANDWICH REPAIR OF INCISIONAL HERNIAS

Dr. Lakshmana Murthy, Dr. K. Raghu, Dr. P. Rambabu

Abstract :

<p>&lt;p&gt;&amp;lt;p&amp;gt;&amp;amp;nbsp;Repair of incisional hernias is done by placing mesh in the preperitoneal space ( stoppas technique ) and infront of anterior rectus sheath (onlay technique) Incisional Hernia is common surgical condition with a reported incidence of 2-11% following all laparatomies. Results of tissue repair have been disappointing. The optimal approach for abdominal incisional hernias is still under discussion. Aims: To evaluate the sandwich technique(onlay plus sublay) mesh repair of incisional hernias. Material and Methods: This retrospective study of consecutive 50 cases was done from January .2012 to January 2014 using a computerized database. Onlay plus Preperitoneal (sublay) mesh implantation was done in all the 50 cases. Follow up of 12-24 months was carried in the OPD and on telephone with regards to postoperative complications, hospital stay and recurrences if any. Results: In our study of fifty patients, eighty percent of females (n= 40) outnumbered twenty percent males (n=10). The female to male ratio was 4: 1 and the highest incidence was in the 5th decade Of Life. The main presenting feature was swelling of the abdomen in all the fifty patients (100%) in the vicinity of the previous operative scar. In sixty percent of patients (n=30), the most common incision leading to incisional hernia was the midline incision of abdomen followed by Pfannensteil&amp;amp;rsquo;s incision in fourteen percent ( n=7) and paramedian incision in twelve ( n=6). We repaired all hernias by sandwich technique. Major wound infection occurred in two patients (4%) only but without the removal of mesh. Forty patients (80%) attended for follow up ranging from 12 months to 24 months. Twenty seven patients (67.5%) attended OPD for follow up and thirteen patients (32.5%) replied the questions on phone. No recurrence was noted in follow up group. Conclusion: Based on this study, we conclude that Sandwich repair is the ideal technique for incisional hernia. Though still there need few publications regarding this technique of repair.&amp;lt;/p&amp;gt;&lt;/p&gt;</p>