Understanding Hernia's Repair, Techniques, Mesh Options, and Recurrence Rates in Abdominal Wall Surgery

Authors

DOI:

https://doi.org/10.62497/IRABCS.2024.42

Keywords:

hernia repair, surgical techniques, mesh options, recurrence rates, postoperative complications

Abstract

Introduction: Hernia repair surgery is a common procedure with significant variations in techniques, mesh options, and recurrence rates. Understanding these factors is essential for optimizing patient outcomes.

Objective: This study aims to investigate hernia repair techniques, mesh options, and recurrence rates in abdominal wall surgery, providing insights to optimize patient outcomes and inform clinical decision-making.

Methodology: A retrospective cohort study was conducted at two renowned hospitals in Peshawar, Pakistan, with a sample size of 102, from April 2023 to March 2024. Data on surgical techniques, mesh options, postoperative complications, and hernia recurrence rates were collected from medical records. Chi-square tests were used for statistical analysis.

Results: A total of 102 patients were included in the study, with inguinal hernias being the most common (56.9%). Open tension-free repair was the predominant surgical approach (62.7%), and polypropylene mesh was the most commonly used (70.6%). Postoperative complications were observed in 19.6% of patients, with surgical site infection being the most frequent (11.8%). Hernia recurrence occurred in 13.7% of cases, with no significant association found between surgical approach and recurrence rates (p=0.632).

Conclusion: This study provides insights into hernia repair outcomes highlighting the prevalence of inguinal hernias, the predominance of open tension-free repair, and the challenges posed by postoperative complications and hernia recurrence. By addressing these challenges and embracing tailored surgical approaches, we can enhance patient care and improve surgical outcomes.

Downloads

Download data is not yet available.

Author Biographies

  • Muhammad Umair, Northwest School of Medicine, Peshawar, Pakistan

    MBBS, house officer

  • Syeda Farwa Zaidi, Rehman Medical College, Peshawar, Pakistan

    MBBS, house officer

  • Muhammad Usman Khan, Northwest School of Medicine, Peshawar, Pakistan

    MBBS, house officer

  • Mahnoor Naveed , Combined Military Hospital, Peshawar, Pakistan

    Pharm D, Hospital Pharmacist

  • Sumbal Yaseen Wazir, Khyber Medical College, Peshawar, Pakistan

    MBBS, house officer

  • Lal Jawahir, Northwest School of Medicine, Peshawar, Pakistan

    MBBS

References

Rangwani SM, Kraft CT, Schneeberger SJ, Khansa I, Janis JE. Strategies for mesh fixation in abdominal wall reconstruction: concepts and techniques. Plastic and Reconstructive Surgery. 2021 Feb 1;147(2):484-91.

Pereira JA, Bravo-Salva A, Montcusí B, Pérez-Farre S, Fresno de Prado L, López-Cano M. Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters. BMC surgery. 2019 Dec;19:1-6.

Quiroga-Centeno AC, Quiroga-Centeno CA, Guerrero-Macías S, Navas-Quintero O, Gómez-Ochoa SA. Systematic review and meta-analysis of risk factors for Mesh infection following Abdominal Wall Hernia Repair Surgery. The American Journal of Surgery. 2022 Jul 1;224(1):239-46.

Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, De Beaux A, Ferzli G. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))—Part A. Surgical endoscopy. 2019 Oct 15;33:3069-139.

Kokotovic D, Bisgaard T, Helgstrand F. Long-term recurrence and complications associated with elective incisional hernia repair. Jama. 2016 Oct 18;316(15):1575-82.

Birindelli A, Sartelli M, Di Saverio S, Coccolini F, Ansaloni L, Van Ramshorst GH, Campanelli G, Khokha V, Moore EE, Peitzman A, Velmahos G. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias. World journal of emergency surgery. 2017 Dec;12:1-6.

den Hartog FP, Sneiders D, Darwish EF, Yurtkap Y, Menon AG, Muysoms FE, Kleinrensink GJ, Bouvy ND, Jeekel J, Lange JF. Favorable outcomes after retro-rectus (Rives-Stoppa) mesh repair as treatment for noncomplex ventral abdominal wall hernia, a systematic review and meta-analysis. Annals of Surgery. 2022 Jul 1;276(1):55-65.

De Simone B, Birindelli A, Ansaloni L, Sartelli M, Coccolini F, Di Saverio S, Annessi V, Amico F, Catena F. Emergency repair of complicated abdominal wall hernias: WSES guidelines. Hernia. 2020 Apr;24:359-68.

Dietz UA, Menzel S, Lock J, Wiegering A. The treatment of incisional hernia. Deutsches Ärzteblatt International. 2018 Jan;115(3):31.

Köckerling F. Recurrent incisional hernia repair—an overview. Frontiers in Surgery. 2019 May 14;6:26.

O'Brien J, Sinha S, Turner R. Inguinal hernia repair: a global perspective. ANZ journal of surgery. 2021 Nov;91(11):2288-95.

Bernardi K, Adrales GL, Hope WW, Keith J, Kuhlens H, Martindale RG, Melin AA, Orenstein SB, Roth JS, Shah SK, Tsuda S. Abdominal wall reconstruction risk stratification tools: a systematic review of the literature. Plastic and reconstructive surgery. 2018 Sep 1;142(3S):9S-20S.

Parker SG, Halligan S, Liang MK, Muysoms FE, Adrales GL, Boutall A, Beaux AC, Dietz UA, Divino CM, Hawn MT, Heniford TB. International classification of abdominal wall planes (ICAP) to describe mesh insertion for ventral hernia repair. Journal of British Surgery. 2020 Feb;107(3):209-17.

Lockhart K, Dunn D, Teo S, Ng JY, Dhillon M, Teo E, van Driel ML. Mesh versus non‐mesh for inguinal and femoral hernia repair. Cochrane Database of Systematic Reviews. 2018(9).

Podolsky D, Ghanem OM, Tunder K, Iqbal E, Novitsky YW. Current practices in complex abdominal wall reconstruction in the Americas: need for national guidelines?. Surgical Endoscopy. 2022 Jul 1:1-5.

See CW, Kim T, Zhu D. Hernia mesh and hernia repair: a review. Engineered Regeneration. 2020 Jan 1;1:19-33.

Cunningham HB, Weis JJ, Taveras LR, Huerta S. Mesh migration following abdominal hernia repair: a comprehensive review. Hernia. 2019 Apr 1;23:235-43.

Cornish J, Harries RL, Bosanquet D, Rees B, Ansell J, Frewer N, Dhruva Rao PK, Parry C, Ellis-Owen R, Phillips SM, Morris C. Hughes Abdominal Repair Trial (HART)–Abdominal wall closure techniques to reduce the incidence of incisional hernias: study protocol for a randomised controlled trial. Trials. 2016 Dec;17:1-6.

Romain B, Renard Y, Binquet C, Poghosyan T, Moszkowicz D, Gillion JF, Ortega-Deballon P, Gadiri N, Mesli S, Bouillot JL, Mariette C. Recurrence after elective incisional hernia repair is more frequent than you think: an international prospective cohort from the French Society of Surgery. Surgery. 2020 Jul 1;168(1):125-34.

Mitura K. Different approach to laparoscopic IPOM ventral hernia surgery–what has the last decade taught us?. Polish Journal of Surgery. 2016 Jan 8;88(1):54-61.

Tubre DJ, Schroeder AD, Estes J, Eisenga J, Fitzgibbons RJ. Surgical site infection: the “Achilles Heel” of all types of abdominal wall hernia reconstruction. Hernia. 2018 Dec;22:1003-13.

Downloads

Published

07/02/2024

Issue

Section

Research Articles

Categories

How to Cite

1.
Muhammad Umair, Zaidi SF, Muhammad Usman Khan, Mahnoor Naveed, Sumbal Yaseen Wazir, Lal Jawahir. Understanding Hernia’s Repair, Techniques, Mesh Options, and Recurrence Rates in Abdominal Wall Surgery. IRABCS [Internet]. 2024 Jul. 2 [cited 2024 Jul. 20];2(1):27-32. Available from: https://irabcs.com/ojs/article/view/42

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)