Incisional and Abdominal Wall Hernia Repair with Minimally Invasive Extraperitoneal Synthetic Mesh Implantation Using MILOS Technique (Mini and Less Open Sublay Surgery)

  • Wolfgang ReinpoldEmail author


Incisional hernia is the most common complication after abdominal surgeries at 10–30% worldwide. Abdominal wall hernias never heal spontaneously. The risk of incarceration and strangulation is 1–2% per year. The main cause seems to be genetically determined insufficient cross-links between the collagen molecules.


  1. 1.
    Seiler CM, Deckert A, Diener MK, Knaebel HP, Weigand MA, Victor N, et al. Midline versus transverse incision in major abdominal surgery: a randomized, double-blind equivalence trial (POVATI: ISRCTN60734227). Ann Surg. 2009;249(6):913–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Seiler CM, Bruckner T, Diener MK, Papyan A, Golcher H, Seidlmayer C, et al. Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg. 2009;249(4):576–82.CrossRefPubMedGoogle Scholar
  3. 3.
    Usher FC, Ochsner J, Tuttle LL Jr. Use of marlex mesh in the repair of incisional hernias. Am Surg. 1958;24(12):969–74.PubMedGoogle Scholar
  4. 4.
    Rives J, Pire JC, Flament JB, Convers G. Treatment of large eventrations (apropos of 133 cases). Minerva Chir. 1977;32(11):749–56.PubMedGoogle Scholar
  5. 5.
    Stoppa R, Warlaumont C, Chantriaux JF. Prosthetic surgical treatment of inguinal hernias. Parietalization of the spermatic cord. Presse Med. 1984;13(38):2317–8.PubMedGoogle Scholar
  6. 6.
    Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF. The use of Dacron in the repair of hernias of the groin. Surg Clin North Am. 1984;64(2):269–85.CrossRefPubMedGoogle Scholar
  7. 7.
    Conze J, Binnebösel M, Junge K, Schumpelick V. Narbenhernie – Wie ist zu verfahren? Chirurgische Standardversorgung. Chirurg. 2010;81(3):192–200.CrossRefPubMedGoogle Scholar
  8. 8.
    Forbes SS, Eskicioglu C, McLeod RS, Okrainec A. Meta-analysis 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
  9. 9.
    Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg. 2009;197(1):64–72. Epub 2008 Jul 9. ReviewCrossRefPubMedGoogle Scholar
  10. 10.
    Kapischke M, Schulz T, Schipper T, Tensfeldt J, Caliebe A. Open versus laparoscopic incisional hernia repair: something different from a meta-analysis. Surg Endosc. 2008;22(10):2251–60. Epub 2008 Mar 5. ReviewCrossRefPubMedGoogle Scholar
  11. 11.
    Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, et al. Classification of primary and incisional abdominal wall hernias. Hernia. 2009;13(4):407–14. Epub 2009 Jun 3CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Amid PK, Lichtenstein IL. Retromuscular alloplasty of large scar hernias: a simple staple attachment technique. Chirurg. 1996;67(6):648–52.PubMedGoogle Scholar
  13. 13.
    Rosen MJ, Jin J, McGee MF, Williams C, Marks J, Ponsky JL. Laparoscopic component separation in the single-stage treatment of infected abdominal wall prosthetic removal. Hernia. 2007;11(5):435–40. Epub 2007 Jul 24.CrossRefPubMedGoogle Scholar
  14. 14.
    den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev. 2008;(3):CD006438. Review.Google Scholar
  15. 15.
    Schroeder AD, Debus ES, Schroeder M, Reinpold WM. Laparoscopic transperitoneal sublay mesh repair: a new technique for the cure of ventral and incisional hernias. Surg Endosc. 2013;27(2):648–54.CrossRefPubMedGoogle Scholar
  16. 16.
    Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, Köckerling F, Kukleta J, Leblanc K, Lomanto D, Misra MC, Bansal VK, Morales-Conde S, Ramshaw B, Reinpold W, Rim S, Rohr M, Schrittwieser R, Simon T, Smietanski M, Stechemesser B, Timoney M, Chowbey P, International Endohernia Society (IEHS). Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)-part 1). Surg Endosc. 2014;28(1):2–29. Epub 2013 Oct 11.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Reinpold W. Endoskopisch totalextraperitonealer transhernialer Sublay –Bauchwand-Hernienverschluss in Single-Port-Technik. In: Schumpelick V, Arlt G, Conze J, Junge K, editors. Hernien. 5th ed. Stuttgart: Thieme; 2015. p. 301–4.Google Scholar
  18. 18.
    Schwarz J, Reinpold W, Bittner R. Endoscopic mini/less open sublay technique (EMILOS)—a newtechniquefor ventral hernia repair. Langenbeck’s Arch Surg. 2017;402(1):173–180. doi:  10.1007/s00423-016-1522-0. Epub 2016.CrossRefPubMedGoogle Scholar

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© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery and Hernia CenterGross Sand Hospital, Teaching Hospital of the University of HamburgHamburgGermany

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