Modified peritoneal flap hernioplasty and abdominoplasty in large incisional hernia after cesarean section with midline vertical incision: a case report

Abstract

An incisional hernia (IH) is a common complication after a cesarean section (CS). Large IH mesh repair is problematic when initial fascial closure cannot be accomplished. We report the case of a large IH for 20 months after a CS with a midline vertical incision that was treated with a combination of modified peritoneal flap hernioplasty and abdominoplasty. There was a large fascia defect (15 × 21 cm) and adhesions of the omentum and the ileum to the anterior abdominal wall. CS with midline vertical incision, history of surgical site infections and obesity are risk factors that increase IH. In conclusion, this combination successfully repairs a large IH, reduces obesity, prevents recurrence and complications after hernia repair, improves the abdominal shape and patient quality of life. Abdominoplasty is also performed to create new umbilical and vascular preservation.