Skip to main content
SpringerLink
Log in

Dynamic patchplasty—a tension-free reconstruction of incisional hernias

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background and aims

An anatomical and physiological reconstruction of the abdominal wall after incisional hernia must include reconstruction of the linea alba to restore the physiological function of the vertebral column and respiration. Against this background, a special reconstruction method employing a mesh, which is performed in our department, is presented.

Materials and methods

In the period between 1 January 2000 and 1 June 2004, a total of 106 patients with incisional hernias after median laparotomy of the upper and lower abdomen were operated on in our department using this tension-free technique with one or two meshes. We have now evaluated the outcomes after a median follow-up of 25.8 months (6.5–53.3).

Results

In one patient (0.9%), the peritoneal sac was inadvertently opened, resulting in injury to the small bowel serosa. Surgical complications were observed in 14 patients (13.2%) after dynamic patchplasty. In seven cases (6.6%), wound healing disorders were seen. Overall, 6 out of 106 (5.5%) patients needed revision surgery. In the follow-up period, 92 patients (follow-up 86.8%) could be contacted and re-examined. Four patients (3.8%) had died. There were four recurrences (4.3%), which had already been repaired, and one chronic seroma, which caused no symptoms and which was detected in ultrasound and computed tomography.

Conclusion

In view of the possibility of achieving physiological reconstruction and in the light of a tolerable morbidity rate, dynamic patchplasty is a suitable method for incisional hernias. Long-term results hold out promise of an acceptable low recurrence rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Koebke J (1997) Anatomy of the abdominal wall—an area at risk for hernias. Zentralbl Chir 122:852–854

    PubMed  CAS  Google Scholar 

  2. Stelzner F (1991) The musculo-fascial skeleton—hernias and anorectal incontinence. Langenbecks Arch Surg 376:108–120

    CAS  Google Scholar 

  3. Chevrel JP (1979) The treatment of large midline incisional hernias by “overcoat” plasty and prosthesis. Nouv Presse Med 8:695–696

    PubMed  CAS  Google Scholar 

  4. Abrahamson J (2001) The shoelace repair. In: Bendavid R, Abrahamson J, Arregui ME, Flament JB, Phillips EH (eds) Abdominal wall hernias, 1st edn. Springer, Berlin Heidelberg New York, pp 483–486

    Google Scholar 

  5. Chevrel JP (2001) Treatment of incisional hernias by overlapping herniorrhaphy and onlay prosthetic implant. In: Bendavid R, Abrahamson J, Arregui ME, Flament JB, Phillips EH (eds) Abdominal wall hernias, 1st edn. Springer, Berlin Heidelberg New York, pp 500–503

    Google Scholar 

  6. Rehn E (1957) Surgery in hernias of the lower abdominal wall. In: Fischer AW, Gohrbrandt E, Sauerbruch F (eds) Chirurgische Operationslehre Band V, 7th edn. JA Barth Verlag, Leipzig, pp 92–93

    Google Scholar 

  7. Korenkov M, Eypasch E, Paul A, Köhler L, Troidl H (1997) The autodermal hernioplasty—a rare and unknown technique. Zentralbl Chir 122:871–878

    PubMed  CAS  Google Scholar 

  8. Abrahamson J, Eldar S (1988) “Shoelace” repair of large postoperative abdominal hernias: a simple extraperitoneal technique. Contemp Surg 32:24–34

    Google Scholar 

  9. Cassar K, Munro A (2002) Surgical treatment of incisional hernia. Br J Surg 89:534–545

    Article  PubMed  CAS  Google Scholar 

  10. Millikan KW (2003) Incisional hernia repair. Surg Clin N Am 83:1223–1234

    Article  PubMed  Google Scholar 

  11. Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, Ijzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398

    Article  PubMed  CAS  Google Scholar 

  12. Burger JWA, Luijendijk RW, Hop WCJ, Halm JA, Verdaasdonk EGG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585

    PubMed  Google Scholar 

  13. Korenkov M, Sauerland S, Arndt M, Bograd L, Neugebauer EA, Troidl H (2002) Randomized clinical trial of suture repair, polypropylene mesh and autodermal hernioplasty for incisional hernia. Br J Surg 89:50–56

    Article  PubMed  CAS  Google Scholar 

  14. Schumpelick V, Klinge U, Junge K, Stumpf M (2004) Incisional abdominal hernia: the open mesh repair. Langenbecks Arch Surg 389:1–5

    Article  PubMed  CAS  Google Scholar 

  15. Paajanen H, Hermunen H (2004) Long-term pain and recurrence after repair of ventral incisional hernias by open mesh: clinical and MRI study. Langenbecks Arch Surg 389:366–370

    Article  PubMed  Google Scholar 

  16. Schumpelick V, Klinge U, Welty G, Klosterhalfen B (1999) Meshes within the abdominal wall. Chirurg 70:876–887

    Article  PubMed  CAS  Google Scholar 

  17. Korenkov M, Paul A, Sauerland S, Neugebauer E, Arndt M, Chevrel JP, Corcione F, Fingerhut A, Flament JB, Kux M, Matzinger A, Myrvold HE, Rath AM, Simmermacher RKJ (2001) Classification and surgical treatment of incisional hernia. Langenbecks Arch Surg 386:65–73

    Article  PubMed  CAS  Google Scholar 

  18. Kingsnorth A, LeBlanc K (2003) Hernias: inguinal and incisional. Lancet 362:1561–1571

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre for Minimally Invasive Surgery, Department of Surgery, Hanover Hospital, Roesebeckstrasse 15 (Siloah), 30449, Hanover, Germany

    Christine Schug-Paß, Yvonne Trommer, Carsten Tamme & Ferdinand Köckerling

  2. Department of Surgery, Otto von Guericke University Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany

    Hans Lippert

Authors
  1. Christine Schug-Paß
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yvonne Trommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carsten Tamme
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans Lippert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ferdinand Köckerling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christine Schug-Paß.

Additional information

A commentary on this paper is available at http://dx.doi.org/10.1007/s00423-006-0053-5.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schug-Paß, C., Trommer, Y., Tamme, C. et al. Dynamic patchplasty—a tension-free reconstruction of incisional hernias. Langenbecks Arch Surg 391, 403–408 (2006). https://doi.org/10.1007/s00423-006-0053-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-006-0053-5

Keywords

Search

Navigation