The use of self-gripping mesh with anterior component separation technique in incisional hernia repair: A case series. (2019)

• Record Type: Journal Article
• Authors: Fukuda, Rintaro; Tsujinaka, Shingo; Maemoto, Ryo; Takenami, Tsutomu; Toyama, Nobuyuki; Rikiyama, Toshiki
• Is Part Of: International journal of surgery case reports. Volume 60(2019)
• Page Start: 148
• Page End: 151
• Publication Date: 2019
• Subjects: Incisional hernia -- Component separation technique -- Self-gripping mesh; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2019.06.005
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: We present three cases of incisional hernia repair using onlay self-gripping mesh. The mesh was placed following the anterior component separation technique. Self-gripping mesh enhances tissue adhesion and requires minimal suture fixation. The advantages are more sufficient reinforcement and technical simplicity. The disadvantages are risk of decreased blood flow, infection, fistula, and pain. Abstract: Introduction: Incisional hernia (IH) is a common postoperative complication that affects 10% of the patients who undergo abdominal surgery. The component separation (CS) technique is suitable for large and/or complex hernias; however, CS alone may not eliminate recurrence and is associated with an increased incidence of wound complications. Self-gripping mesh enhances tissue adhesion and contributes to a reduced risk of migration, chronic pain, and other complications. Here, we present three cases of IH that were successfully repaired by anterior CS (ACS) using onlay self-gripping meshes. Case presentation: All three patients underwent surgery using the following technique: Briefly, a skin flap was created with release of the external oblique muscle and preservation of the perforating vessels. The linea alba was closed with absorbable interrupted sutures. A self-gripping mesh was trimmed and placed with a 4–5 cm overlap bilaterally from the closed linea alba using an onlay technique. For all patients, the postoperative courses were uneventful and there were no complications at the 3-month follow-up. Discussion: The advantages of our technique include more sufficient abdominal reinforcement, technical simplicity, and minimal time required for mesh placement. The disadvantages are the potential risk of decreased blood flow of the skin flaps, wound infection, intestinal fistula, persisting or chronic pain, and difficulty with subsequent abdominal surgery. Conclusion: The use of self-gripping mesh with ACS can be performed without increasing the operative time or causing short-term surgical complications. This technique may be recommended for large IH because of its simplicity and secure abdominal reinforcement provided.