A comparative study of various techniques of incisional hernia repair in a tertiary care center at Bikaner (North-West Rajasthan)

Abstract

Incisional hernia can be defined as an internal abdominal wall defect that develops after a previously closed laparotomy. It commonly develops as a result of disruption of tissue adjacent to the area of abdominal wall incision closure and also due to tension placed on the tissue as a result of suturing. In prospective studies with sufficient follow-up, up to 20% incidences of incisional hernia have been reported after laparotomy. Risk lies between 0.2-2% after laparoscopy. Recent studies have shown about two third of incisional hernia appear within first five years and at least another third appear 5-10 years after operation. Repair of large abdominal incisional hernias has a recurrence rate of up to 33% after first repair and 44% after second repair – mostly within 3 years of the repair. Anemia, diabetes mellitus, alcoholism, obesity have been associated with a high percentage of post-operative hernias. Other patient related risk factors include female gender, older age, abdominal aortic aneurysm, abdominal distension, chronic respiratory disease and jaundice. Index operation related risk factors are type of incision, closure technique, suture material used, emergency surgery, wound failure ABSTRACT