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Abdominal Wall Reconstruction

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Coloproctology

Part of the book series: European Manual of Medicine ((EUROMANUAL))

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Abstract

Incisional hernia following abdominal surgery is a common complication with a multifactorial etiology and has been defined as “any abdominal wall gap with or without bulge in the area of a postoperative scar perceptible or palpable by clinical examination or imaging.” This broad definition encompasses a range of hernia defect sizes, patients, and clinical situations. Consequently, the differentiation between incisional hernia repair and abdominal wall reconstruction is vague. This chapter covers the perioperative management of patients with incisional herniae, operative strategies for hernia repair, and choice of mesh. Adjuncts for tissue expansion and the management of excess adipose tissue in the most complex cases are also reviewed. No single hernia repair technique is suitable for all patients, and tailored approaches are advocated. Preoperative patient optimization in terms of diabetic control, smoking cessation, and obesity management are associated with significant improvements in recurrence and complication rates and should be considered the most important determinants of a good outcome.

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Authors and Affiliations

  1. Exeter Surgical Health Service Research Unit (HeSRU), Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon, UK, EX2 5DW

    Neil J. Smart MBBS(Hons) PhD FRCSEd(Gen Surg) & Ian R. Daniels BSc, MB BCh, FRCS

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  1. Neil J. Smart MBBS(Hons) PhD FRCSEd(Gen Surg)
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  2. Ian R. Daniels BSc, MB BCh, FRCS
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Correspondence to Ian R. Daniels BSc, MB BCh, FRCS .

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Editors and Affiliations

  1. End- und Dickdarm-Zentrum Mannheim, Mannheim, Germany

    Alexander Herold

  2. Clinique de chirurgie digestive et endocrinienne, Institut des maladies de l’appareil digestif, Hotel Dieu, Nantes, France

    Paul-Antoine Lehur

  3. Chirurgische Klinik mit Poliklinik, Universitaet Erlangen, Erlangen, Germany

    Klaus E. Matzel

  4. UCD School of Medicine, St Vincent’s University Hospital, Dublin, Ireland

    P. Ronan O'Connell

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Smart, N.J., Daniels, I.R. (2017). Abdominal Wall Reconstruction. In: Herold, A., Lehur, PA., Matzel, K., O'Connell, P. (eds) Coloproctology. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53210-2_38

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