Advertisement

Parietal Disaster

  • Chowbey Pradeep
Chapter

Abstract

Incisional hernia (IH) is defined by the European Hernia Society (EHS) as “any abdominal wall gap with or without bulge in the area of postoperative scar perceptible or palpable by clinical examination or imaging” [1]. The incidence of incisional hernia is around 20% after abdominal wall surgeries [2]. The risk factors associated with development of IH include patient-related factors, nature of primary surgery, and biological factors. Patient-related factors include age >60 years, male gender, [3–6] obesity with increased BMI > 25 kg/m2 [5], and patient comorbidities (diabetes, chronic lung disease, immunosuppression in organ transplant patient, chemotherapy, and steroid therapy) [7–10]. Surgery related risk factors for incisional hernia include emergency operations [9], bowel surgery, re-laparotomy, burst abdomen with evisceration [11–14], wound infection, wound dehiscence, midline abdominal incision has higher risk for developing IH compared to transverse and oblique incisions, respectively [4, 11]. Biological factors include enzyme defects, smoking, and nutritional deficiencies [15]. The occurrence of IH is multifactorial in nature. Laparoscopic approaches have also contributed to the development of incisional hernia. Laparoscopy-related factors are diameter of the port size >10 mm, multiple insertions, long duration of surgery, inadequate evacuation of pneumoperitoneum, unrelaxed abdominal wall at the end of the procedure, and increased abdominal pressure at the end of surgery [16].

References

  1. 1.
    Muysoms FE, Miserz M, Benevoet F, Campanelli G, Champault GG, Chelala E, et al. Classification of primary and incisional abdominal wall hernias. Hernia. 2009;13(4):407–14.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Alaedeen DI, Lipman J, Medalie D, Rosen MJ. The single-staged approach to the surgical management of abdominal wall hernias in contaminated fields. Hernia. 2007;11:41–5.  https://doi.org/10.1007/s10029-006-0164-5.CrossRefPubMedGoogle Scholar
  3. 3.
    Le Huu Nho R, Mege D, Ouaïssi M, Sielezneff I, Sastre B. Incidence and prevention of ventral incisional hernia. J Visc Surg. 2012;149(5 suppl):e3–e14.CrossRefPubMedGoogle Scholar
  4. 4.
    Sørensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jørgensen LN. Smoking is a risk factor for incisional hernia. Arch Surg. 2005;140(2):119–23.CrossRefPubMedGoogle Scholar
  5. 5.
    Llaguna OH, Avgerinos DV, Lugo JZ, Matatov T, Abbadessa B, Martz JE, et al. Incidence and risk factors for the development of incisional hernia following elective laparoscopic versus open colon resection. Am J Surg. 2010;200(2):265–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Mannien MJ, Lavonius M, Perhoniemi VJ. Results of incisional hernia repair. A retrospective study of 172 unselected herneoplasties. Eur J Surg. 1991;157(1):129–31.Google Scholar
  7. 7.
    Jargon D, Friebe V, Hopt UT, Obermaier R. Risk factors and prevention of incisional hernia—what is evidence based. Zentralbl Chir. 2008;133(5):453–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Koivukangas V, Oikarinen A, Risteli J, Haukipuro K. Effect of jaundice and its resolution on wound re epithelization, skin collagen synthesis and serum collagen peptide levels in patients with neoplastic pancreatico biliary obstruction. J Surg Res. 2005;124(2):237–43.CrossRefPubMedGoogle Scholar
  9. 9.
    Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel J. An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet. 1993;176(3):228–34.PubMedGoogle Scholar
  10. 10.
    Aboian E, Winter DC, Metcalf DR, Wolff BG. Perineal hernia after proctectomy: prevalence, risks and management. Dis Colon Rectum. 2006;49(10):1564–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Beltran MA, Cruces KS. Incisional after Mc Burney’s incision. Retrospective case control study of risk factors and surgical treatment. World J Surg. 2008;32(4):596–601.CrossRefPubMedGoogle Scholar
  12. 12.
    Song IH, Ha HK, Choi SG, Jeon BG, Kim MJ, Park KJ. Analysis of risk factors for the development of incisional hernia and parastomal hernias in patients after colorectal surgery. J Korean Coloproctol. 2012;28(6):299–303.CrossRefGoogle Scholar
  13. 13.
    Müller-Riemenschneider F, Roll S, Friedrich M, Zieren J, Reinhold T, von der Schulenburg JM, et al. Medical effectiveness and safety of conventional compared to laparoscopic incisional hernia repair: a systematic review. Surg Endosc. 2007;21(12):2127–36.CrossRefPubMedGoogle Scholar
  14. 14.
    Gislasson H, Viste A. Closure of burst abdomen after major gastro intestinal operation—comparison of deferent surgical technique and later development of incisional hernia. Eur J Surg. 1999;165(10):958–61.CrossRefGoogle Scholar
  15. 15.
    Bellon JM, Duran HJ. Biological factors involved in the genesis of incisional hernia. Cir Esp. 2008;83(1):3–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Scheuerlein H, Setmacher U, Lenshow M, Rauchfuss F. Complex incisional hernias. Arch. Clin Gastroenterol. 2016;2(1):017–26.Google Scholar
  17. 17.
    Ezer A, Calışkan K, Colakoğlu T, Parlakgümüş A, Belli S, Tarım A. Factors affecting morbidity in urgent repair of abdominal wall hernia with intestinal incarceration in adults. Ulus Travma Acil Cerrahi Derg. 2011;17:344–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Kurt N, Oncel M, Ozkan Z, Bingul S. Risk and outcome of bowel resection in patients with incarcerated groin hernias: retrospective study. World J Surg. 2003;27:741–3.CrossRefPubMedGoogle Scholar
  19. 19.
    Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM, et al. Presentation and outcome of incarcerated external hernias in adults. Am J Surg. 2001;181:101–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Alvarez JA, Baldonedo RF, Bear IG, Solís JA, Alvarez P, Jorge JI. Incarcerated groin hernias in adults: presentation and outcome. Hernia. 2004;8:121–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Martínez-Serrano MA, Pereira JA, Sancho JJ, López-Cano M, Bombuy E, Hidalgo J, Study Group of Abdominal Hernia Surgery of the Catalan Society of Surgery. Risk of death after emergency repair of abdominal wall hernias. Still waiting for improvement. Langenbeck’s Arch Surg. 2010;395:551–6.CrossRefGoogle Scholar
  22. 22.
    Kelly ME, Behrman SW. The safety and efficacy of prosthetic hernia repair in clean-contaminated and contaminated wounds. Am Surg. 2002;68:524–8. discussion 528–9PubMedGoogle Scholar
  23. 23.
    Vix J, Meyer C, Rohr S, Bourtoul C. The treatment of incisional and abdominal hernia with a prosthesis in potentially infected tissues—a series of 47 cases. Hernia. 1997;1:157–61.  https://doi.org/10.1007/BF01234750.CrossRefGoogle Scholar
  24. 24.
    Morris-Stiff GJ, Hughes LE. The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience. J Am Coll Surg. 1998;186:352–67.  https://doi.org/10.1016/S1072-7515(98)00002-7.CrossRefPubMedGoogle Scholar
  25. 25.
    Temudom T, Siadati M, Sarr MG. Repair of complex giant or recurrent ventral hernias by using tension-free intraparietal prosthetic mesh (Stoppa technique): lessons learned from our initial experience (fifty patients). Surgery. 1996;120:738–43.  https://doi.org/10.1016/S0039-6060(96)80025-0. discussion 743–4CrossRefPubMedGoogle Scholar
  26. 26.
    Campanelli G, Nicolosi FM, Pettinari D, Avesani EC. Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible? Hernia. 2004;8:190–2.CrossRefPubMedGoogle Scholar
  27. 27.
    McLanahan D, King LT, Weems C, Novotney M, Gibson K. Retrorectus prosthetic mesh repair of midline abdominal hernia. Am J Surg. 1997;173:445–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Coccolini F, Agresta F, Bassi A, Catena F, Crovella F, Ferrara R, Gossetti F, et al. Italian Biological Prosthesis Work-Group (IBPWG): proposal for a decisional model in using biological prosthesis. World J Emerg Surg. 2012;7(1):34.  https://doi.org/10.1186/1749-7922-7-34.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Jafari MD, Wexner SD, Martz JE, McLemore EC, Margolin DA, Sherwinter DA. Perfusion assessment in laparoscopic left sided/anterior resection (PILLAR) II: a multi-institutional study. J Am Coll Surg. 2015;220:82–92.CrossRefPubMedGoogle Scholar
  30. 30.
    Leblanc KA, Elieson MJ. Enterotomy and mortality rates of laparoscopic incisional and ventral hernia repair: a review of the literature. JSLS. 2007;11:408–14.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Bringman S, Conze J, Cuccurullo D, Deprest J, Junge K, Klosterhalfen B, et al. Hernia repair: the search for ideal meshes. Hernia. 2010;14:81–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Brown CN, Finch JG. Which mesh for hernia repair? Ann R Coll Surg Engl. 2010;92:272–8.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Jenkins ED, Yom V, Melman L, et al. Prospective evaluation of adhesion characteristics to intraperitoneal mesh and adhesiolysis-related complications during laparoscopic reexploration after prior ventral hernia repair. Surg Endosc. 2010;24(12):3002–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Forbes S, Eskicioglu C, McLeod R, Okrainec A. Metaanalysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009;96(8):851–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, Köckerling F, Kukleta J, LeBlanc K. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])—part 2. Surg Endosc. 2014;28:353–79.  https://doi.org/10.1007/s00464-013-3171-5.CrossRefPubMedGoogle Scholar
  36. 36.
    Sharma A, Khullar R, Soni V, Baijal M, et al. Iatrogenic enterotomy in laparoscopic ventral/incisional hernia repair: A single centre experience of 2,346 patients over 17 yrs: the world journal of hernia and abdominal wall. Surgery. 2013;17(5):581–7.  https://doi.org/10.1007/s10029-013-1122-7.CrossRefGoogle Scholar
  37. 37.
    Szczerba SR, Dumanian GA. Definitive surgical treatment of infected or exposed ventral hernia mesh. Ann Surg. 2003;237:437–41.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Voyles CR, Richardson JD, Bland KI, Tobin GR, Flint LM, Polk HC. Emergency abdominal wall reconstruction with polypropylene mesh: short-term benefits versus long-term complications. Ann Surg. 1981;194(2):219–23.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Gray SH, Vick CC, Graham LA. Risk of complications from enterotomy or unplanned bowel resection during elective hernia repair. Arch Surg. 2008;143(6):582–6.CrossRefPubMedGoogle Scholar
  40. 40.
    Houck JP, Rypins EB, Sarfeh IJ, Juler GL, Shimoda KY. Repair of incisional hernia. Surg Gynecol Obstet. 1989;169:397–400.PubMedGoogle Scholar
  41. 41.
    Read RC, Yoder G. Recent trends in the management of incisional herniation. Arch Surg. 1989;124:485–8.CrossRefPubMedGoogle Scholar
  42. 42.
    Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg. 1989;13:545–54.CrossRefPubMedGoogle Scholar
  43. 43.
    Zhang V, Zhou H, Chai Y, Cao C, Jin K, Hu Z. Laparoscopic versus open incisional and ventral hernia repair: a systematic review and meta-analysis. World J Surg. 2014;38:2233–40.CrossRefPubMedGoogle Scholar
  44. 44.
    Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M, Chowbey PK. Laparoscopic ventral/incisional hernia repair: a single centre experience of 1,242 patients over a period of 13 years. Hernia. 2011;15:131–9.CrossRefPubMedGoogle Scholar
  45. 45.
    Barzana D, Johnson K, Clancy TV, Hope WW. Hernia recurrence through a composite mesh secondary to transfascial suture holes. Hernia. 2012;16(2):219–21. Epub 2010 Sep 12CrossRefPubMedGoogle Scholar
  46. 46.
    Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238(3):391–9. discussion 399–400PubMedPubMedCentralGoogle Scholar
  47. 47.
    Kurmann A, Visth E, Candinas D, Beldi G. Long-term follow-up of open and laparoscopic repair of large incisional hernias. World J Surg. 2011;35(2):297–301.CrossRefPubMedGoogle Scholar
  48. 48.
    Bencini L, Sanchez LJ, Bernini M, Miranda E, Farsi M, Boffi B, et al. Predictors of recurrence after laparoscopic ventral hernia repair. Surg Laparosc Endosc Percutan Tech. 2009;19(2):128–32.CrossRefPubMedGoogle Scholar
  49. 49.
    Biondi A, Tropea A, Monaco G, Musmeci N, Zanghi G, Basile F. Complications in the laparoscopic treatment of primary and secondary hernias of the abdominal wall. Ann Ital Chir. 2010;81(3):193–8.PubMedGoogle Scholar
  50. 50.
    Chowbey PK, et al. Max institute of MAMBS. India Symp. 2006;2(3):192–8.Google Scholar
  51. 51.
    Klinge U, Binnebösel M, Rosch R, Mertens P. Hernia recurrence as a problem of biology and collagen. J Minim Access Surg. 2006;2(3):151–4.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Varela JE, Wilson SE, Nguyen NT. Laparoscopic surgery significantly reduces surgical-site infections compared with open surgery. Surg Endosc. 2010;24:270–6.CrossRefPubMedGoogle Scholar
  53. 53.
    Sturt NJ, Liao CC, Engledow AH, Menzies D, Motson RW. Results of laparoscopic repair of primary and recurrent incisional hernias at a single UK institution. Surg Laparosc Endosc Percutan Tech. 2011;21(2):86–9.CrossRefPubMedGoogle Scholar
  54. 54.
    Moreno- Egea A, Castillo Bustos JA, Girela E, Aguayo-Albasini JL. Long-term results of laparoscopic repair of incisional hernias using an intraperitoneal composite mesh. Surg Endosc. 2010;24:359–65.CrossRefPubMedGoogle Scholar
  55. 55.
    Griniatsos J, Yiannakopoulou E, Tsechpenakis A, Tsigris C, et al. A hybrid technique for recurrent incisional hernia repair. Surg Laparosc Endosc Percutan Tech. 2009;19(5):e177–80.  https://doi.org/10.1097/SLE.0b013e3181bb859c.CrossRefPubMedGoogle Scholar
  56. 56.
    Stoikes N, Quasebarth M, Brunt LM. Hybrid ventral hernia repair: technique and results. Hernia. 2013;17(5):627–32.CrossRefPubMedGoogle Scholar
  57. 57.
    Vrijland WW, Van Den Tol MP, Luijendijk RW, et al. Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia. Br J Surg. 2002;89:293–7.CrossRefPubMedGoogle Scholar
  58. 58.
    Cobb WS, Harris JB, Lokey JS, McGill ES, Klove KL. Incisional herniorrhaphy with intraperitoneal composite mesh: a report of 95 cases. Am Surg. 2003;69:784–7.PubMedGoogle Scholar
  59. 59.
    Chowbey P. Endoscopic repair of abdominal wall hernias. India: Byword Books Private Limited; 2012.Google Scholar
  60. 60.
    White TJ, Santos MC, Thompson JS. Factors affecting wound complications in repair of ventral hernias. Am Surg. 1998;64:276–80.PubMedGoogle Scholar
  61. 61.
    Leber GE, Garb JL, Alexander AI, Reed WP. Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg. 1998;133:378–82.  https://doi.org/10.1001/archsurg.133.4.378.CrossRefPubMedGoogle Scholar
  62. 62.
    Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect. 2005;11(1):3–8.CrossRefPubMedGoogle Scholar
  63. 63.
    Troy MG, Dong QS, Dobrin PB, Hecht D. Do topical antibiotics provide improved prophylaxis against bacterial growth in the presence of polypropylene mesh? Am J Surg. 1996;171:391–3.  https://doi.org/10.1016/S0002-9610(97)89616-X.CrossRefPubMedGoogle Scholar
  64. 64.
    Aguilar B, Chapital AB, Madura JA 2nd, Harold KL. Conservative management of mesh-site infection in hernia repair. J Laparoendosc Adv Surg Tech A. 2010;20(3):249–52.  https://doi.org/10.1089/lap.2009.0274.CrossRefPubMedGoogle Scholar
  65. 65.
    Trunzo JA, Ponsky JL, Jin J, Williams CP, Rosen MJ. A novel approach for salvaging infected prosthetic mesh after ventral hernia repair. Hernia. 2009;13(5):545–9.CrossRefPubMedGoogle Scholar
  66. 66.
    Petersen S, Henke G, Freitag M, Faulhaber A, Ludwig K. Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome. Eur J Surg. 2001;167:453–7.CrossRefPubMedGoogle Scholar
  67. 67.
    Kingsnorth AN, Sivarajasingham N, Wong S, Butler M. Open mesh repair of incisional hernias with signifiant loss of domain. Ann R Coll Surg Engl. 2004;86:363–6.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Carbonell AM. Massive ventral hernia with loss of domain. In: Jones DB, editor. Hernia. Philadelphia: Lippincott Williams&Wilkins; 2013. p. 263–79.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Chowbey Pradeep
    • 1
    • 2
    • 3
  1. 1.Max Institute of Minimal Access, Metabolic and Bariatric SurgeryMax Hospital, SaketNew DelhiIndia
  2. 2.Surgery and Allied Surgical SpecialtiesMax Hospital, SaketNew DelhiIndia
  3. 3.Max Super Specialty Hospital, SaketNew DelhiIndia

Personalised recommendations