A modified open intraperitoneal mesh (Garestin) technique for incisional ventral hernia repair

Abstract

Background/objective: Incisional hernias (IHs) are a major problem following abdominal surgery. In an effort to resolve large IHs adequately, we herein present our own modified “open intraperitoneal mesh” technique, termed the Garestin technique. Methods: We analyzed early postoperative complications (EPCs; wound infection, hematoma, and seroma) and late postoperative complications (recurrence) in 124 patients operated for IHs and recurrent IHs (RIHs) using our new technique. Our technique involved repairing hernias by preserving the hernia sac, which was later used to conceal the mesh that replaced the abdominal wall defect, thus dividing the mesh from subcutaneous tissue. Results: We operated 66 patients with IH and 58 patients with RIH. In the 4-week postoperative follow-up, 29 patients had EPC; 9 of them had wound infections that healed upon antibiotic therapy, without the need for any surgical procedure. Of the 10 patients with recurrent herniation in the long-term follow-up, 6 previously had EPC. Recurrences occurred 4–25 months after the operation. Conclusion: Our method is reliable and safe for large ventral hernia disposal, but the final conclusion requires a larger number of patients and a longer follow-up period.

Keywords

• hernia
• hernioplasty
• incisional
• mesh
• PROCEED
• recurrent