Recurrent incisional hernia remains a major problem for the general surgeon. The rate of recurrence of hernia repaired by primary closure using nylon sutures or with knitted monofilament polypropylene (Marlex) mesh was studied. A total of 102 repairs were performed over a 19-year period. Marlex mesh was used in 49 cases and primary closure in 53. All except two patients were followed from 1 to 15 (mean 7.6) years or to death. The incidence of recurrence was 8 per cent when Marlex was used and 25 per cent after primary closure. In both groups the majority of the recurrences were in the first 16 months after repair. The use of Marlex mesh should be considered in the management of recurrent incisional hernia.

LMW heparin plus low-dose aspirin resulted in a higher live birth rate than IVIG in the treatment of antiphospholipid antibody syndrome in women with recurrent abortion.

Objective To report our experience with a new laparoscopic technique to treat genital prolapse. Subjects Prospective longitudinal case study of 35 women with genital prolapse treated between June 1997 and January 1999. Intervention The technique involves the use of two composite meshes, one of which is applied to the upper portion of the anterior wall of the vagina and the other to the upper portion of the posterior vaginal wall and posterior aspect of the cervix if present. The lateral ends of the two meshes are pulled trough a retroperitoneal tunnel and fixed to the aponeurosis of the external oblique muscle above the iliac crest. Depending on the patient's symptoms and clinical findings, ancillary procedures (i.e. urethropexy, repair of the pouch of Douglas) may be necessary. Results The average operating time was 254 ± 45 min (range 180–360). The total rate of complications was 20% (seven cases). The mean duration of hospital stay was 4.8 ± 1.2 days (range 3–8). With regard to the anatomical results: the mean postoperative follow up was 5 ± 4.6 months; results were excellent in 80% of cases. The remaining 20% had moderate posterior vaginal wall defect. With regard to the functional results: the mean follow‐up was 10.5 ± 4.6 months; 90.9% of the patients were satisfied; the functional defects were persistent urinary stress incontinence in 6.6% cases, urgency in 6.6% cases, frequency in 6.6% cases, constipation in 9.1% cases; the rate of dyspareunia in patients who were sexually active was 10.3%. Conclusion This technique presents the advantage of providing complete treatment for prolapse using laparoscopic surgery without having to approach the promontory or having to carry out extensive reperitonealization.