Modifications to Rives technique for midline incisional hernia repair

Abstract

Between 1990 and 1997, 284 patients were treated in our hospital for abdominal hernias. In the original group, 239 patients (84.15%) had midline hernia, and 45 (15.8%) had lateral hernia. A total of 152 midline hernia patients (63.5%) were treated using our variant of Rives technique. In all these cases, preperitoneal and retromuscular polypropylene mesh was used as a reinforcement and was subsequently attached by means of absorbable sutures to the external border of the rectus muscles. There were no deaths. A total of 42 of all patients operated on (27.6%) suffered from long-term postoperative pain. In seven cases (4.6%) it was necessary to remove the prosthesis because of chronic infection, and there were two recurrences in patients in whom the prosthesis had to be removed. In our experience, the Rives technique is a suitable and safe treatment for the repair of midline incisional hernias. The use of absorbable sutures and fixation of the mesh to the external oblique aponeurosis can reduce the original problems of abdominal pain and unaesthetic skin scars.

Favorable Outcomes After Retro-Rectus (Rives-Stoppa) Mesh Repair as Treatment for Noncomplex Ventral Abdominal Wall Hernia, a Systematic Review and Meta-analysis

“…Median or mean follow-up duration (as reported) ranged from 1 to 112 months (aggregated median 17 months). Surgery for recurrent incisional hernia occurred in 1807 patients (9.7%) across 44 studies 19–62 . Results after minimally invasive (laparoscopic, robotic, or hybrid) retro-rectus repair were reported by 17 studies (n = 1516) 22,24,28,40,47,53,54,58,63–71 and results after open retro-rectus repair were reported by 78 studies (n = 10,924) 19–21,23,25–27,29–39,41–46,48–52,54–62,71–110 .…”

Utility of drainage in incisional hernia repair with mesh

“…En la mayoría de los casos reportados, se han utilizado drenajes de succión en un intento de prevenir la formación de seroma y hematoma, aunque un grupo enfatizó que el drenaje aspirativo se eliminó lo más pronto posible para reducir el riesgo de infección 16 .…”

Three stitch hernioplasty: A novel technique for beginners

“…The high level of postoperative pain at the wound and also at the edges of the prosthesis due to tissue damage and tension prolongs patient recovery. [ 5 ] As per Lichtenstein et al .,[ 10 ] in a study performed in 1988, the incidence of chronic groin pain is 1–2%. In another study conducted in 104 patients treated by laparoscopic hernia repair by Panton and Panton in 1994, the incidence of the chronic groin pain is only 1%.…”

“…[ 4 ] In addition, these sutures cause extensive tissue tension, predisposition to infection, and nerve entrapment, causing prolonged postoperative pain. [ 5 6 7 ] Even the application of absorbable sutures instead of the nonabsorbable ones does not solve the problem. [ 5 ] In order to avoid the above disadvantages, it was proposed that polypropylene mesh be applied with less or without suture fixation to the surrounding tissue.…”

“…[ 5 6 7 ] Even the application of absorbable sutures instead of the nonabsorbable ones does not solve the problem. [ 5 ] In order to avoid the above disadvantages, it was proposed that polypropylene mesh be applied with less or without suture fixation to the surrounding tissue. [ 8 ] The aim of the study is to analyze mess fixation with minimum sutures and on its recurrence.…”