Modified Peritoneal Flap Hernioplasty Versus Retromuscular Technique for Incisional Hernia Repair: a Retrospective Cohort Study

Abstract

Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective single-center cohort study. Outcomes were evaluated from the Swedish Ventral Hernia Registry, by chart review, physical examination, and an abdominal wall complaints questionnaire. Results: The modified peritoneal flap hernioplasty group ( n = 78) had larger hernias (mean width 10.4 vs 8.5 cm, p = 0.005), more advanced Centers for Disease Control classification ( p = 0.009), and more simultaneous gastrointestinal-tract surgery (23.1% vs 11.5%, p = 0.041) than the retromuscular group ( n = 96). No difference in short-term complications was seen. Incisional hernia recurrence was lower in the modified peritoneal flap hernioplasty group (1.4% vs 10.3%, p = 0.023), and patients were more satisfied (93.8% vs 81.7%, p = 0.032). Follow-up time was shorter in the modified peritoneal flap hernioplasty group (614 vs 1171 days, p < 0.001). Conclusion: This retrospective study showed similar rates of short-term complications, despite more complex hernias in the modified peritoneal flap hernioplasty group. Furthermore, a lower incisional hernia recurrence rate for the modified peritoneal flap hernioplasty technique compared with the retromuscular technique used in our department was found. If this holds true with equally long follow-up remains to be proven.

Comparative Study between H Shape Mesh Repair and Standard Tummy Tuck Procedure in Small Paraumblical Hernia with Diastasis of the Rectus Muscles

“…Among gender of (group A) was 20 (66.7%) female and (group B) was 22 (73.3%) female as high female percentage agree with 7 studies (Cheesborough, et al [11] study, Sallam et al [7] study, Arunagiri, et al [9] study, Elgohary, et al [8] study, Baig, et al [12] study, Novitsky, et al [10] study and Petersson et al [15] study). Disagree with 3 studies (Nockolds, et al [13], Wiessner, et al [16] study and Ko¨hler, et al [14] study).…”

“…Main age of (group A) was 50.77 years and (group B) was 48.23 years agree with 5 studies (Sallam, et al [7] study, Elgohary, et al [8] study, Arunagiri, et al [9] study, Novitsky, et al [10] study and Cheesborough, et al [11] study). Disagree with 5 studies (Baig, et al [12] study, Nockolds, et al [13] study, Ko¨hler, et al [14] study, Petersson et al [15] study and Wiessner, et al [16] study).…”

“…SC drain insertion reported with (group B) was 100% and removed mainly 14.93 days. Agree with Nockolds, et al [13] study, Disagree with Petersson et al [15] study.…”

“…Agree with Arunagiri, et al [9] study. Disagree with 4 studies (Sallam, et al [7] study, Elgohary et al [125] study, Petersson et al [15] study and Baig SJ, et al [12] study).…”

Peritoneal flap mesh hernioplasty: A reliable option for difficulty in closure of complex ventral hernia: A case report

“…In 2014, Malik et al 5 described the peritoneal flap hernioplasty technique, in which flaps of the hernia sac are created by entering the hernia sac in the midline and retro muscular space through the posterior rectus fascia on one side and the anterior fascia on the other side. This technique increases abdominal domain by expanding the abdominal wall at the site of herniation without inducing weakness laterally.…”