Preperitoneal mesh repair of incisional hernias: A seven-year retrospective study

Background : Incisional hernia is a common surgical condition with a reported incidence of 2-11% following all laparotomies. Results of repair have been disappointing.
Aim : To evaluate our technique of preperitoneal mesh repair of incisional hernias.
Materials and Methods : A seven-year retrospective study was done from January 1994 to December 2000 using a computerized database. Follow-up was initiated by a postal questionnaire on a response card. Our repair was evaluated by clinical examination, response card and telephone. Results were documented and statistically analyzed.
Results : In our series of 105 patients, clinical details of 95 (90.5%) patients were available. Females (90.5%, n = 90) outnumbered males (9.5%, n = 10) and the highest incidence was in the 5^th decade of life in females and the 6^th decade of life in males ( P = 0.028). Gynecological operations accounted for 68.4% ( n = 65) of the index operations, with lower midline incisions resulting in 63% ( n = 60) of the incisional hernias. The polypropylene mesh placed preperitoneally varied from 15 ´ 7.5 cm to 30 ´ 20 cm. Sixty-five patients (62%) attended our follow-up, ranging from 14 months to eight years. Method of follow-up in outpatients department (OPD): 44.6% ( n = 29), postal: 40% ( n = 26), telephone: 15.3% ( n = 10). No recurrence was noted in the follow-up group.
Conclusions : Based on our analyses, we believe that preperitoneal mesh repair is the ideal operation for incisional hernias. There are however, very few publications covering this technique of repair.