Lumbar Incisional Hernia Repair: Complete Reconstruction of the Deficient Myofascial Component Using Christmas Tree Bone Anchors

Eleni, B.Sc. Hons; Ackermann, Travis; Lim, James

doi:10.1177/000313481908500332

Cited by 4 publications

(8 citation statements)

References 11 publications

(18 reference statements)

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“…Literature on this technique is scant. There are anecdotal reports describing fixation of the muscle by bone anchors ( 5 , 6 ). In the case presented, bone anchors were fixed to the iliac bone at an interval of one and a quarter inch starting from the anterior end of iliac crest to the posterior end.…”

Section: Discussionmentioning

confidence: 99%

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Novel Technique for Mesh Fixation to the Bone in Recurrent Post Traumatic Lumbar Hernia

Vagholkar¹

2022

Med Arch

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Background: Traumatic lumbar hernia is due to shearing of bony insertions of the muscle in the lumbar region. In recurrent cases, there is more attenuation of muscles. This makes fixation of the mesh extremely difficult. Hence, the need to develop a new technique. Case report: A 27-year-old male presented with a recurrent post-traumatic right- sided lumbar hernia. He had a severe two wheeler accident. Following the accident he had undergone various surgical interventions for a fractured pelvis with a deglowing injury involving the right gluteal region and upper thigh. He had also developed a post-traumatic lumbar hernia for which he had undergone open mesh repair. Subsequently he developed recurrence of the post traumatic right-sided lumbar hernia. After complete investigation he underwent open mesh repair for the recurrent post traumatic lumbar hernia. The defect was wide and was devoid of healthy surrounding muscles. The mesh was fixed to the ileal bone with bone anchors and to the twelfth rib with trans-osseous fiber sutures passed through holes drilled in the twelfth rib. Flaps were created from the remnant surrounding attenuated muscles. They were double-breasted to cover the mesh. Postoperative outcome was excellent with no recurrence for the last six months. Discussion: The various anatomical and technical considerations of bone fixation of the mesh for hernia repair are discussed. Conclusion: Bone fixation of the mesh with bone anchors is a viable option especially in cases where there is severe attenuation of adjacent muscles for mesh fixation.

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Section: Discussionmentioning

confidence: 99%

“…Review of literature reveals hardly any reports of this technique being used for fixation of the mesh. There are anecdotal reports of bone anchors being used for fixing the muscles over the mesh ( 5 - 8 ). But this holds true only if there is adequate length of healthy muscles.…”

Section: Discussionmentioning

confidence: 99%

Novel Technique for Mesh Fixation to the Bone in Recurrent Post Traumatic Lumbar Hernia

Vagholkar¹

2022

Med Arch

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“…Moreno-Egea et al published another study, also non-randomized, in which they made the same comparison and concluded that the laparoscopic approach was possible 12 . Baird-Gunning et al highlighted that fact that the minimally invasive option was not always the most adequate option for surgery, especially for major defects and those in which muscular atrophy was present 13 .…”

Section: Discussionmentioning

confidence: 99%

Lumbar and para-iliac hernias: an alternative technique

Simões

Mansur²,

Pimentel

2021

Rev. Col. Bras. Cir.

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Lumbar and para-iliac hernias are rare and occur after removal of an iliac bone graft, nephrectomies, retroperitoneal aortic surgery, or after blunt trauma to the abdomen. The incidence of hernia after the removal of these grafts ranges from 0.5 to 10%. These hernias are a problem that surgeons will face, since bone grafts from the iliac crest are being used more routinely. The goal of this article was to report the technique to correct these complex hernias, using the technique of fixing the propylene mesh to the iliac bone and the result of this approach. In the period of 5 years, 165 patients were treated at the complex hernia service, 10 (6%) with hernia in the supra-iliac and lumbar region, managed with the technique of fixing the mesh to the iliac bone with correction of the failure. During the mean follow-up of 33 months (minimum of 2 and maximum of 48 months), there was no recurrence of the hernias.

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“…The most commonly described alternative is the use of suture anchors. 43 , 44 , 48 , 49 One series of 8 patients, one of the largest series of this type, who received suture anchor fixation for flank hernias reported a recurrence rate of 20%. 49 Although our series is limited, our results compare favorably to this.…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps the most technically difficult aspect of these hernia repairs is fixating the abdominal wall to the iliac crest when the blunt trauma “rips” the lateral 3 muscles off their origin. Methods described for this study include the use of bone anchors 43 , 44 , 48 , 49 and direct suture fixation. 50 The senior author has developed a method of hernia repair using 2-cm strips of macroporous polypropylene mesh 51 , 52 that are used as sutures.…”

Section: Introductionmentioning

confidence: 99%

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

Kearney

Dumanian

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique. Methods: We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications. Results: The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4–48.7 months). Conclusions: Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.

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Lumbar Incisional Hernia Repair: Complete Reconstruction of the Deficient Myofascial Component Using Christmas Tree Bone Anchors

Cited by 4 publications

References 11 publications

Novel Technique for Mesh Fixation to the Bone in Recurrent Post Traumatic Lumbar Hernia

Novel Technique for Mesh Fixation to the Bone in Recurrent Post Traumatic Lumbar Hernia

Lumbar and para-iliac hernias: an alternative technique

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

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