![]() | Only 14 pages are availabe for public view |
Abstract Incision hernia is defined as a defect occurring through the operative scar.it is the only hernia considered to be iatrogenic.it occure due to failure of the line of closure of abdominal wall following laparotomy. It is one of the most common conditions requiring major surgery despite advances in surgical techniques and suture materials. The incidence of incisional hernia is 2-11% following laparotomies and it is a source of morbidity and requires high health care coast. As a result of high recurrence rate in the repair of incisional hernia, various type of repair has been used both anatomical and prosthetic. But the results have been disappointing with a high incidence of recurrence about 30-50% after primary repair and 1.5-10% following prosthetic mesh repair. The introduction of prosthetics has revolutionized hernia surgery with concept of tension free repair. Although a wide variety of surgical procedures have been adopted for the repair of incisional hernia, but the implantation of a prosthetic mesh remain the most efficient method of dealing with incisional hernia. The prosthetic mesh can be placed over the anterior rectus sheath (onlay mesh repair) as well as in the preperitoneal plane (retromuscular or sublay mesh repair). The later technique has several advantages , one of being not transmitting infection from subcutaneous tissues down to the mesh as it lies quiet deep in the preperitoneal plane. Moreover the mesh implanted in the preperitoneal space unites and consolidates the anterior abdominal wall. The mesh also adheres to the posterior rectus sheath and renders it inextesible allowing no further herniation. |