Reoperation of Recurrent Incisional Hernia after Mesh Repair with Prosthetic Patch_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Feide , WANG Shibin , ZHU Yingmei , YAO Sheng , PEI Lijuan , LI Jiye

Department of General Surgery, The First Affiliated Hospital,General Hospital of PLA, Beijing 100048, China;

Corresponding author：

Keywords：

Incisional hernia; Recurrent hernia; Hernia repair; Prosthetic patch; Surgical procedure

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Objective To summarize the experiences and methods on reoperation of recurrent incisional hernia after mesh repair with prosthetic patch.
Methods 　Sixteen patients who got reoperation from January 2007 to December 2010 because of recurrent incisional hernia after mesh repair were analyzed retrospectively.
Results 　All patients received prosthetic patch repair for reoperation. Thirteen patients received new mesh repair accompanied with old mesh removal, repair conducted by suturing new mesh with old mesh together in two patients, and repair performed by new mesh overlapping the old mesh in one patient. All patients recovered with primary wound healing. Fluid upon the mesh occurred in 3 patients and cured by percutaneous puncture and pressure dressing. Postoperative hospital stay was 7 to 16 days and the average 9 days. The drainage was removed 2 to 7 days after operation and the average was 4 days. All the 16 patients were followed up. And during a follow-up range of 5 to 36 months and the average 20 months, there was slight foreign body sensation in one patient, no chronic pain in wound area occurred. And no abdominal wall hernia recurrence occurred.
Conclusions 　Reoperation of recurrent incisional hernia after mesh repair need to consider the recurrent position, material of the previous mesh, and the previous surgical methods, and should select appropriate prosthetic patch and surgical procedure, then could gain satisfied results.

Citation： LIU Feide,WANG Shibin,ZHU Yingmei,YAO Sheng,PEI Lijuan,LI Jiye,.. Reoperation of Recurrent Incisional Hernia after Mesh Repair with Prosthetic Patch. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(3): 300-304. doi: Copy

1.	Langer C， Neufang T， Kley C， et al. Central mesh recurrence after incisional hernia repair with Marlex—— are the meshes strong enough? [J]. Hernia， 2001， 5(3)： 164-167.
2.	Jansen PL， Mertens PR， Klinge U, et al. The biology of hernia formation [J]. Surgery， 2004， 136(1)： 1-4.
3.	Abdollahi A， Maddah GH， Mehrabi BM， et al. Prosthetic incisional hernioplasty： clinical experience with 354 cases [J].Hernia， 2010， 14(6)： 569-573.
4.	Sanchez VM， Abi-Haidar YE， Itani KM. Mesh infection in ventral incisional hernia repair： incidence, contributing factors,and treatment [J]. Surg Infect (Larchmt)， 2011， 12(3)： 205-210.
5.	Liu F， Li J. Repair of large abdominal wall defects using the Proceed? surgical mesh with open intra-peritonium onlay method [J]. Saudi Med J， 2011， 32(5)： 504-509.
6.	Tong WM， Hope W， Overby DW， et al. Comparison of outcome after mesh-only repair, laparoscopic component separation, and open component separation [J]. Ann Plast Surg， 2011， 66(5)：551-556.
7.	Martin DF， Williams RF， Mulrooney T， et al. Ventralex mesh in umbilical/epigastric hernia repairs： clinical outcomes and complications [J]. Hernia， 2008， 12(4)： 379-383.
8.	Steinhagen E， Khaitov S， Steinhagen RM. Intraluminal 中国普外基础与临床杂志2012 年3 月第19 ? 304 ? 卷第3 期 Chin J Bases Clin General Surg, Vol. 19, No. 3, Mar. 2012migration of mesh following incisional hernia repair [J]. Hernia，2010， 14(6)： 659-662.
9.	Stremitzer S， Bachleitner-Hofmann T， Gradl B， et al. Mesh graft infection following abdominal hernia repair： risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations [J]. World J Surg， 2010， 34(7)： 1702-1709.
10.	Tolino MJ， Tripoloni DE， Ratto R， et al. Infections associated with prosthetic repairs of abdominal wall hernias： pathology，management and results [J]. Hernia， 2009， 13(6)： 631-637.
11.	Andersen LP， Klein M， Gögenur I， et al. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique [J]. BMC Surg， 2009， 9(1)： 6.
12.	Falagas ME， Kasiakou SK. Mesh-related infections after hernia repair surgery [J]. Clin Microbiol Infect， 2005， 11(1)： 3-8.
13.	Burger JW， Halm JA， Wijsmuller AR， et al. Evaluation of new prosthetic meshes for ventral hernia repair [J]. Surg Endosc，2006， 20(8)： 1320-1325.
14.	Adotey JM. Incisional hernia： a review[J]. Niger J Med，2006，15(1)： 34-43.
15.	Stoppa R. About prosthetic repair and contaminated areas [J].Hernia， 2005， 9(1)： 107-108.
16.	Höer J， Lawong G， Klinge U， et al. Factors influencing the development of incisional hernia. A retrospective study of 2 983 laparotomy patients over a period of 10 years [J]. Chirurg，2002， 73(5)： 474-480.
17.	Schumpelick V， Conze J， Klinge U. Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias [J]. Chirurg， 1996， 67(10)： 1028-1035.
18.	Amid PK， Shulman AG， Lichtenstein IL， et al. Biomaterials for abdominal wall hernia surgery and principles of their applications [J]. Langenbecks Arch Chir， 1994， 379(3)： 168-171.
19.	Gray SH， Vick CC， Graham LA， et al. Variation in mesh placement for ventral hernia repair： an opportunity for process improvement? [J]. Am J Surg， 2008， 196(2)： 201-206.
20.	Schumpelick V， Klinge U， Junge K， et al. Incisional abdominal hernia： the open mesh repair [J]. Langenbecks Arch Surg，2004， 389(1)： 1-5.
21.	Flum DR， Horvath K， Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis [J]. Ann Surg， 2003， 237(1)： 129-135.
22.	Bower CE， Reade CC， Kirby LW， et al. Complications of laparoscopic incisional-ventral hernia repair： the experience of a single institution [J]. Surg Endosc， 2004， 18(4)： 672-675.
23.	Uranues S， Salehi B， Bergamaschi R. Adverse events， quality of life， and recurrence rates after laparoscopic adhesiolysis and recurrent incisional hernia mesh repair in patients with previous failed repairs [J]. J Am Coll Surg， 2008， 207(5)： 663-669.
24.	Tsimoyiannis EC， Siakas P， Glantzounis G， et al. Seroma in laparoscopic ventral hernioplasty [J]. Surg Laparosc Endosc Percutan Tech， 2001， 11(5)： 317-321.
25.	Malik AM， Jawaid A， Talpur AH， et al. Mesh versus nonmesh repair of ventral abdominal hernias [J]. J Ayub Med Coll Abbottabad， 2008， 20(3)： 54-56.

1. Langer C， Neufang T， Kley C， et al. Central mesh recurrence after incisional hernia repair with Marlex—— are the meshes strong enough? [J]. Hernia， 2001， 5(3)： 164-167.
2. Jansen PL， Mertens PR， Klinge U, et al. The biology of hernia formation [J]. Surgery， 2004， 136(1)： 1-4.
3. Abdollahi A， Maddah GH， Mehrabi BM， et al. Prosthetic incisional hernioplasty： clinical experience with 354 cases [J].Hernia， 2010， 14(6)： 569-573.
4. Sanchez VM， Abi-Haidar YE， Itani KM. Mesh infection in ventral incisional hernia repair： incidence, contributing factors,and treatment [J]. Surg Infect (Larchmt)， 2011， 12(3)： 205-210.
5. Liu F， Li J. Repair of large abdominal wall defects using the Proceed? surgical mesh with open intra-peritonium onlay method [J]. Saudi Med J， 2011， 32(5)： 504-509.
6. Tong WM， Hope W， Overby DW， et al. Comparison of outcome after mesh-only repair, laparoscopic component separation, and open component separation [J]. Ann Plast Surg， 2011， 66(5)：551-556.
7. Martin DF， Williams RF， Mulrooney T， et al. Ventralex mesh in umbilical/epigastric hernia repairs： clinical outcomes and complications [J]. Hernia， 2008， 12(4)： 379-383.
8. Steinhagen E， Khaitov S， Steinhagen RM. Intraluminal 中国普外基础与临床杂志2012 年3 月第19 ? 304 ? 卷第3 期 Chin J Bases Clin General Surg, Vol. 19, No. 3, Mar. 2012migration of mesh following incisional hernia repair [J]. Hernia，2010， 14(6)： 659-662.
9. Stremitzer S， Bachleitner-Hofmann T， Gradl B， et al. Mesh graft infection following abdominal hernia repair： risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations [J]. World J Surg， 2010， 34(7)： 1702-1709.
10. Tolino MJ， Tripoloni DE， Ratto R， et al. Infections associated with prosthetic repairs of abdominal wall hernias： pathology，management and results [J]. Hernia， 2009， 13(6)： 631-637.
11. Andersen LP， Klein M， Gögenur I， et al. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique [J]. BMC Surg， 2009， 9(1)： 6.
12. Falagas ME， Kasiakou SK. Mesh-related infections after hernia repair surgery [J]. Clin Microbiol Infect， 2005， 11(1)： 3-8.
13. Burger JW， Halm JA， Wijsmuller AR， et al. Evaluation of new prosthetic meshes for ventral hernia repair [J]. Surg Endosc，2006， 20(8)： 1320-1325.
14. Adotey JM. Incisional hernia： a review[J]. Niger J Med，2006，15(1)： 34-43.
15. Stoppa R. About prosthetic repair and contaminated areas [J].Hernia， 2005， 9(1)： 107-108.
16. Höer J， Lawong G， Klinge U， et al. Factors influencing the development of incisional hernia. A retrospective study of 2 983 laparotomy patients over a period of 10 years [J]. Chirurg，2002， 73(5)： 474-480.
17. Schumpelick V， Conze J， Klinge U. Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias [J]. Chirurg， 1996， 67(10)： 1028-1035.
18. Amid PK， Shulman AG， Lichtenstein IL， et al. Biomaterials for abdominal wall hernia surgery and principles of their applications [J]. Langenbecks Arch Chir， 1994， 379(3)： 168-171.
19. Gray SH， Vick CC， Graham LA， et al. Variation in mesh placement for ventral hernia repair： an opportunity for process improvement? [J]. Am J Surg， 2008， 196(2)： 201-206.
20. Schumpelick V， Klinge U， Junge K， et al. Incisional abdominal hernia： the open mesh repair [J]. Langenbecks Arch Surg，2004， 389(1)： 1-5.
21. Flum DR， Horvath K， Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis [J]. Ann Surg， 2003， 237(1)： 129-135.
22. Bower CE， Reade CC， Kirby LW， et al. Complications of laparoscopic incisional-ventral hernia repair： the experience of a single institution [J]. Surg Endosc， 2004， 18(4)： 672-675.
23. Uranues S， Salehi B， Bergamaschi R. Adverse events， quality of life， and recurrence rates after laparoscopic adhesiolysis and recurrent incisional hernia mesh repair in patients with previous failed repairs [J]. J Am Coll Surg， 2008， 207(5)： 663-669.
24. Tsimoyiannis EC， Siakas P， Glantzounis G， et al. Seroma in laparoscopic ventral hernioplasty [J]. Surg Laparosc Endosc Percutan Tech， 2001， 11(5)： 317-321.
25. Malik AM， Jawaid A， Talpur AH， et al. Mesh versus nonmesh repair of ventral abdominal hernias [J]. J Ayub Med Coll Abbottabad， 2008， 20(3)： 54-56.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Reoperation of Recurrent Incisional Hernia after Mesh Repair with Prosthetic Patch

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