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A hybrid technique for recurrent incisional hernia repair.

Title: A hybrid technique for recurrent incisional hernia repair.
Authors: Griniatsos J; First Department of Surgery, University of Athens, Medical School, LAIKO Hospital, Athens, Greece. johngriniatsos@yahoo.com; Yiannakopoulou E; Tsechpenakis A; Tsigris C; Diamantis T
Source: Surgical laparoscopy, endoscopy & percutaneous techniques [Surg Laparosc Endosc Percutan Tech] 2009 Oct; Vol. 19 (5), pp. e177-80.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100888751 Publication Model: Print Cited Medium: Internet ISSN: 1534-4908 (Electronic) Linking ISSN: 15304515 NLM ISO Abbreviation: Surg Laparosc Endosc Percutan Tech Subsets: MEDLINE
Imprint Name(s): Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c1999-
MeSH Terms: Hernia, Ventral/*surgery ; Laparoscopy/*methods; Hernia, Ventral/prevention & control ; Laparoscopy/adverse effects ; Aged ; Feasibility Studies ; Female ; Humans ; Male ; Prospective Studies ; Safety ; Secondary Prevention ; Surgical Mesh ; Suture Techniques
Abstract: Purpose: The aim of this technical report is to investigate the safety and effectiveness of a hybrid technique for recurrent incisional hernia repair, which combines the conventional and laparoscopic approaches.; Methods: Six patients suffering from recurrent and complicated incisional hernias underwent a hybrid technique for their repair. The open part of the operation ensured extensive and safe adhesiolysis, reduction of the hernia content into the peritoneal cavity, and proper placement of the bowel loops into the peritoneal cavity, minimizing the risk of bowel perforation. For the laparoscopic part of the procedure, intraperitoneal (underlay) e-PTFE mesh placement, of the appropriate size covering the actual hernia size and the scar edges for at least 3 cm, was laparoscopically fixated by transfascial stay stitches, allowing stretch of the mesh on the anterior abdominal wall, probably avoiding the mesh deformation in the future.; Results: The overall size of the fascial defect was calculated between 116 and 187 cm, the size of the mesh used ranged from 308 to 468 cm, the total operative time ranged from 128 to 207 minutes and within a maximum follow-up period of 12 months, all patients are asymptomatic without any evidence of hernia recurrence.; Conclusions: The hybrid technique is safe in cases of recurrent or complicated or difficult incisional hernias. A longer follow-up period is required to estimating the effectiveness and the cost-effectiveness of the method.
Comments: Erratum in: Surg Laparosc Endosc Percutan Tech. 2010 Feb;20(1):64. Eugenia, Yiannakopoulou [corrected to Yiannakopoulou, Eugenia]; Anastasios, Tsechpenakis [corrected to Tsechpenakis, Anastasios]; Christos, Tsigris [corrected to Tsigris, Christos]; Theodoros, Diamantis [corrected to Diamantis, Theodoros].
Entry Date(s): Date Created: 20091024 Date Completed: 20110113 Latest Revision: 20141120
Update Code: 20260130
DOI: 10.1097/SLE.0b013e3181bb859c
PMID: 19851247
Database: MEDLINE

Journal Article