Comparative study between different methods of mesh hernioplasty in midline abdominal hernias

Abstract

Midline hernia is a common surgical condition well known to be associated with occurrence of serious complications. Surgery remains the only modality of treatment.

Different techniques have been described to deal with these hernias, however there is no final good method. Surgical mesh was later used to repair these hernias with dramatic improvement in the recurrence rates. This study included three groups of patients with large hernial defect admitted to kasr el aini university hospital from 2000 to2002

The first group of patients had repair by preperitoneal approach in which the mesh was fixed in the preperitoneal plane after reduction of the sac.

The second group of patients had reinforcement of the repair either anatomical or keel's method by the conventional onlay method of repair.

The third group of patients had repair by the two point fixation type,where a new linea alba is reconstructed and a surgical prolene mesh fixed beneath the lateral flap of the rectus sheath.

In all patients surgical polypropylene mesh was used, suction drains were used at the level of insertion of the mesh and removed when the effluent ranges from 20-30 cc per day. All groups were followed up for three weeks postoperatively for evaluation of the three different techniques through: