Giant incisional hernia in the ederly patient. A Rapid and simple surgical technique

Abstract

Objectives The aim is to obtain a) a safe procedure to repair the large abdominal defect and reinforce the fragile zones around; b) a simple and rapid technique to reduce the operation time. Materials And Methods Retrospective review of medical records of 72 elderly patients in whom intraperitoneal mesh placement was used between January 1988 and June 2005. Results No intraoperative complication occurred. In the postoperative stage 7 seromas, 4 haematomas, 2 infections occurred, all solved with conservative treatment. Conclusion The incidence of incisional hernia (IH) vary between 1% and 15 %, with increasing risk of recurrence in relation to the age of patients, wound infection, obesity and to the closure technique. Primary closure is preferred even if it is impossible to apply it in all patients because of an important relapse rate, from 30% to 50% as reported by several studies, for IH repaired without prothesis. Various techniques have been proposed to repair IH, using a prosthetic material. Here we describe a rapid and simple method of intraperitoneal mesh placement in elderly with large IH. This surgical procedure allows to obtain several advantages over other technique, including minimal dissection of subcutaneous tissues from fascial and muscular structures.