A Prospective Study of complications, risks and causes while repairing the Incisional Hernia by Preperitoneal Meshplasty

Abstract

Background: An abdominal wall hernia is defined as an intermittent or continuous protrusion of abdominal organs through a defect in the abdominal wall. In case of an incisional hernia an abdominal wall defect develops in the scar of a wound in the abdominal wall, which was inflicted during previous surgery. Incisional hernia is a frequent complication of abdominal surgery the exact incidence has not been well defined, although a number of reports in the literature suggest that the incidence is probably between 2% and 11%. Another study shows Incisional hernia occurs in 10- 20 % of patients subjected to abdominal operations. Aim & Objective: To study the causes, complications, operating time, while dealing to Incisional hernia cases. Materials and Methods: This is a prospective study, our sample size was of 30 patients, data collection from Jan 2018 to September 2020 of the admitted patients in the department of surgery, R.D.J.M. medical college & hospital.Patients fulfilling the selection criteria were offered Preperitoneal mesh repair. Results: A total of 30 patients were included in the present study. In which 11 (37%) were male and 19 (63%) were female. All patients were in ranged of 16years to 64 years of age. Maximum number of patients were between to the age group of 36-45 years followed by 46-55 years and 10-20 years. And 14 patients (46.7%) with abdominal swelling and 16 Patients (53.3%) presented with swelling and pain both in abdomen. Out of total of 30 patients, (12) of patients had history of Exploratory Laparotomy followed by Hysterctomy (7), LSCS (6), Herniorraphy and Laproscopy 2 each and Tubal Ligation and open Appendectomy one each, 7 patient ( 23.3%) presented with incisional hernia within 3 months of the previous surgeries. 9(30%) patients noticed swelling at the operation site within 3 months to one year of surgery, 5 patients (16.7%) within 1-3 years of surgery and Remaining 9(30%) patients developed hernia after 3years. Conclusion: The preperitoneal mesh repair an excellent method called as Rive’s stoppa technique where mesh was placed between peritoneum and abdominal wall or rectus muscle and posterior rectus sheath. The main advantage of pre peritoneal mesh repair are - Less chance of mesh infection and erosion through skin because the graft lies in preperitoneal plane between posterior rectus sheath and peritoneum, avoids adhesions, bowel obstruction, enterocutaneous fistula and erosion of mesh, minimal morbidity and duration of hospital stay is less compared to other techniques.