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Clinical Study and Changing Trends in the Management of Incisional Hernia

S.V. Satyanarayana Rao, Professor & Head, Department of Surgery, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh 532484, India. , Sarangam Venkata Satya Narayana Rao1 , Vinodh Varada2 , Pilli Ashok Teja3 , K. Phani Jotsna4 , Grace Lalitha Priya5 , D. Sai Spandana6

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New Indian Journal of Surgery 9(5):p 625-629, Sep-Oct 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.15

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Abstract

Background: Incisional hernia repair especially large ones still remains a challenge to the surgeons even today. With the advent of minimal invasive surgery, rapid advances had taken place in the working concept of incisional hernia. It is a long-term and common complication following abdominal surgery especially in females and estimated to occur in 03 to 13% following laprotomy incisions. At present, no consensus exist on the ideal placement of mesh in open hernia repair.But for laproscopic repair,mesh is always placed in Underlay position.Repair of incisional hernia with mesh either by open or laproscopic repair is now well accepted as gold-standard treatment worldwide. Here, in open hernia repair,we aim to identify the ideal position for mesh placement to assess complications like recurrence rate and surgical site infections. Materials and Methods: The study was carried out in the department of General surgery, Gems and Hospital, Srikakulam, Andhra pradesh. A total of 60 patients were enrolled for the study from among admitted cases.A thorough clinical assessment, laboratory investigations and radioimaging studies were performed in all cases. Later the patients were categorized for open and laproscopic repair as per suitability. Results: Incisional hernia was found most commonly in the age group of 30-50 years [46.6%]. Females constitute about 61.7%. Middle aged females undergoing laprotomy with midline vertical incision with wound dehiscence are more prone to  develop incisional hernia with in a period of 01-03 years. Conclusion: Sub-lay mesh placement in open hernia repair and Underlay in laproscopic repair were found to be ideal and yielded good results. 

Keywords: Incisional Hernia; Component Separation Technique; Laproscopic Repair; Onlay Repair; Sub-Lay Repair; Surgical Site Infections  

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.15

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