Incisional Hernias

Chapter

Abstract

The incisional hernia is an ever more frequent complication of laparotomy which frequently occurs in elderly people. The main problems in the management of incisional hernia are discussed.

Special attention is paid to the surgical approach. The classic Rives–Stoppa technique is described as well as modern laparoscopic methods. The feasibility of these in the elderly is demonstrated.

The use of prosthetic meshes is the gold standard for the repair of incisional hernias. The main materials are described with their advantages and problems.

The therapeutic and physiopathological problems are emphasized, especially with respect to the large incisional hernias and their clinical implications in the elderly.

The importance of systemic impairments such as hypertension, diabetes, respiratory disease, and obesity, which are both etiologic and risk-increasing factors, is underlined.

The advances in the knowledge of both loco-regional abdominal wall impairment and distant troubles (initially respiratory) are emphasized.

Finally, the care in preoperative preparation and postoperative observation is pointed out together with the closing of the wall defect with restoration of a correct abdominal pressure.

Keywords

Hernia Incisional hernia Prosthetic mesh Elder Elderly Large incisional hernia Open incisional hernia repair Laparoscopic incisional hernia repair Incisional hernia physiopathology 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Geriatric Surgery UnitUniversity of PaduaPaduaItaly
  2. 2.General SurgeryTreviso HospitalTrevisoItaly

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