Retrospective Descriptive Study of Abdominal Wall Hernias and Their Management

Abstract

BACKGROUND This is a retrospective descriptive study of 422 cases of abdominal wall hernias done by single surgeon and their follow-up upto 12 years. Abdominal wall hernias are a group of conditions, which occur mainly through the natural openings and weak areas of abdominal wall-1. Groin, 2. Ventral part of the anterior abdominal wall, 3. Previous operative sites and 4. Through natural openings and weak areas of abdominal wall. MATERIALS AND METHODS 422 cases of abdominal wall hernias treated in the last 12 years along with their management were studied. They were followed upto 12 yrs. The differences in the selection of cases and surgical skill are excluded in the study by including cases done by single surgeon (1 st Author) only. Only open surgeries are included in the study to avoid learning curve mistakes. Mode of Presentation-Elective and emergency surgery and their management is discussed. Anatomical tissue repair, monofilament polypropylene mesh repair in primary and recurrent hernias of various varieties and their results were studied. Bowel resections, omental excisions and separation of bowel adhesions (Adhesiolysis) in sliding and irreducible hernias are analysed. Various complications including mortality are discussed. RESULTS No recurrences were observed in mesh hernioplasty patients. 6 cases of recurrences were observed in anatomical repair patients-1.4%. Monofilament polypropylene mesh was used and fixed to the tissues with 2.0 prolene. 3 patients expired in our series in complicated and strangulated cases-0.7%. CONCLUSION Prolene mesh repair is definitely superior to anatomical tissue repairs in all cases of abdominal wall hernias. Anatomical tissue repair in young good musculature and small defects gives equally good results in experienced hands.