TY - JOUR
T1 - Retromuscular Preperitoneal Repair of Flank Hernias
AU - Phillips, Melissa S.
AU - Krpata, David M.
AU - Blatnik, Jeffrey A.
AU - Rosen, Michael J.
PY - 2012/8/1
Y1 - 2012/8/1
N2 - Introduction: Flank hernias represent a challenging problem to reconstructive surgeons. Their anatomic proximity to the bony prominence and major neurovascular structures limits fixation options and restricts mesh overlap. We present our technique and outcomes of a preperitoneal repair with wide mesh overlap. Methods: This study is a retrospective analysis of patients undergoing open flank hernia repair with a retromuscular preperitoneal approach. Results: Between September 2007 and April 2011, 16 patients, mean age 55 years (range 34-80) and BMI 33 kg/m2 (range 26-46), underwent open flank hernia repair. Eight were recurrent hernias; six previously had mesh placed; nine were incarcerated. Mean hernia defect size was 232 cm2 (range 25-800). Mean operative time was 178 min (range 105-245). One intraoperative complication, ureteral injury in a transplant recipient, occurred and was primarily repaired without sequela. Two patients developed wound complications, one requiring superficial debridement and another requiring partial excision (<5 %) of the mesh with secondary healing. With a mean follow-up of 16.8 months (range 2-49), no recurrent hernias were noted. Conclusion: Open retromuscular preperitoneal repair of flank hernias with iliac bone fixation is technically feasible, allowing wide mesh overlap for a durable repair. This approach may offer advantages of treating abdominal wall laxity and repair of larger defects when compared to laparoscopic approaches.
AB - Introduction: Flank hernias represent a challenging problem to reconstructive surgeons. Their anatomic proximity to the bony prominence and major neurovascular structures limits fixation options and restricts mesh overlap. We present our technique and outcomes of a preperitoneal repair with wide mesh overlap. Methods: This study is a retrospective analysis of patients undergoing open flank hernia repair with a retromuscular preperitoneal approach. Results: Between September 2007 and April 2011, 16 patients, mean age 55 years (range 34-80) and BMI 33 kg/m2 (range 26-46), underwent open flank hernia repair. Eight were recurrent hernias; six previously had mesh placed; nine were incarcerated. Mean hernia defect size was 232 cm2 (range 25-800). Mean operative time was 178 min (range 105-245). One intraoperative complication, ureteral injury in a transplant recipient, occurred and was primarily repaired without sequela. Two patients developed wound complications, one requiring superficial debridement and another requiring partial excision (<5 %) of the mesh with secondary healing. With a mean follow-up of 16.8 months (range 2-49), no recurrent hernias were noted. Conclusion: Open retromuscular preperitoneal repair of flank hernias with iliac bone fixation is technically feasible, allowing wide mesh overlap for a durable repair. This approach may offer advantages of treating abdominal wall laxity and repair of larger defects when compared to laparoscopic approaches.
KW - Bone fixation
KW - Flank hernia
KW - Hernia repair
KW - Lumbar hernia
KW - Retromuscular repair
UR - http://www.scopus.com/inward/record.url?scp=84864107976&partnerID=8YFLogxK
U2 - 10.1007/s11605-012-1890-x
DO - 10.1007/s11605-012-1890-x
M3 - Article
C2 - 22528575
AN - SCOPUS:84864107976
SN - 1091-255X
VL - 16
SP - 1548
EP - 1553
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 8
ER -