Page 167 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Figure 2. Components Separation Technique; relaxing incisions external oblique fascia(1), separating the external oblique from the internal oblique(2), elevating overlying rectus fascia from posterior rectus sheath(3) and bringing fascia from both sides together in midline for closure(4).
b) Aponeuroplasty
In 1941 Welti and Eudel introduced a technique which consists of incising both anterior rectus sheaths and suturing them overlapping together covering the hernia defect(83) ( gure 3). In 3 studies a total of 195 LIH were repaired using aponeuroplasty(10, 36, 37). In 55% of cases, patients had a complex LIH (36, 37). In simple LIH cases postoperative seroma or hematoma formation developed in 6%. Recurrence occurred after aponeuroplasty in 2.2% of patients after a mean follow-up of over 4.5 year. In complex LIH patients the postoperative mortality after aponeuroplasty was 10.4% and 18.9% of patients developed postoperative wound infections. The recurrence rate after aponeuroplasty with complex LIH’s was 21% after 10 years follow-up. The overall recurrence rate of LIH’s repaired with aponeuroplasty was 12% after mean 4-10 years follow-up.
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Review treatment large IH
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