Surgeons should focus on techniques that lead to the lowest abdominal surgery recurrence rates instead of being overly concerned with the type and position of the mesh they use when fixing incisional hernias, says Mary T. Hawn, MD, MPH, associate professor and chief of gastrointestinal surgery at the University of Alabama at Birmingham.
Dr. Hawn led a team of researchers that reviewed the records of 1,444 patients who underwent elective incisional hernia repair at 16 Veteran Affairs medical centers over a 4-year span. They discovered that 25% of the patients required follow-up abdominal surgery within 80 months of the initial procedure, a little more than half of which were elective procedures to repair the original incisional hernia, according to a report in General Surgery News
"Incisional hernia repairs have a high recurrence," explains Dr. Hawn. "Mesh reduces recurrence without significant increase in complications." Her investigation found no link between the type or location of permanent mesh used and the risks for urgent surgery, intestine perforation or bowel resection during subsequent procedures, according to the report.
In a study published in the Journal of the American College of Surgeons, Dr. Hawn and colleagues say the underlay technique for mesh implantation performed either laparoscopically or open during elective incisional hernia repair substantially reduces the risk of recurrence, without increasing the risk of serious mesh infection or enterocutaneous fistulas.
Daniel Cook
