Surgical treatment of subcostal incisional hernia with polypropylene mesh - analysis of late results

Abstract

OBJECTIVE: To evaluate the results of subcostal incisional hernia repair using polypropylene mesh, the technical aspects of musculo-aponeurotic reconstruction, routine fixation of supra-aponeurotic mesh and follow-up for five years.METHODS: We conducted a retrospective study that assessed 24 patients undergoing subcostal incisional hernia repair with use of polypropylene mesh; 15 patients (62.5%) were female; ages ranged from 33 to 82, and 79.1% had comorbidities.RESULTS: Early complications: three cases (12.5%) of wound infection, three cases (12.5%) of seroma, one case (4.1%) of hematoma; and one case (4.1%) of wound dehiscence. Late complications occurred in one case (4.1%) of hernia recurrence attributed to technical failure in the fixation of the mesh and in one case (4.1%) of chronic pain. There were no cases of exposure or rejection of the mesh.CONCLUSION: The subcostal incisional hernia, though not very relevant, requires adequate surgical treatment. Its surgical correction involves rebuilding the muscle-aponeurotic defect, supra-aponeurotic fixation of polypropylene mesh, with less complexity and lower rates of complications and recurrences.

Comparative Analysis of Tissular Response After Abdominal Wall Repair Using Polypropylene Mesh and Bovine Pericardium Mesh

“…The first reported use of tissue for hernioplasty is dated 1958 by Usher et al 16 , who used a polypropylene mesh. This remains the most used material 18 because it is safe and offers several advantages in its use, including its availability, easy handling, low cost and good tolerance 9 .…”

Complex subcostal eventration: use of sac and prosthesis in resolution

“…Las eventraciones pueden surgir a partir de las incisiones subcostales derechas descritas por Kocher (de quien recibieron su nombre), en la sigue un margen costal, lo que proporciona una buena presentación de la vía biliar 4 .…”