Page 170 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 8
Postoperative mortality was 0.5%. Seroma or hematoma formation was reported in 5% and wound infection in 4%. In 1.3% of patients the mesh infected, requiring removal of the mesh. The recurrence rate of LIH repair with IPOM and aponeuroplasty was 3.2% after 3-8 years follow-up.
c) Open repair with intraperitoneal mesh by bridging (IPOM)
In cases were the hernia defect is too large or more complicated, IPOM as bridging technique can be used ( gure 5). In 10 studies, a total of 514 LIH were repaired using the IPOM technique(11, 15, 46, 51-57). In one study a biological porcine mesh was used(57). Approximately 15% of patients had a complex LIH, but not all studies reported separately on the outcomes of simple and complex LIH repairs.
Postoperative one death was reported (mortality 0.2%). Wound infection and skin necrosis were reported in 9% of patients and seroma or hematoma formation in 10%. In 3.5% of cases, mesh removal was necessary due to infection. In the RCT of de Vries Reiling 39% (7 out of 18) of intraperitoneal ePTFE meshes became infected and required removal of the mesh(11). The recurrence rate of LIH repair with biological mesh in intraperitoneal position was 15.8% (3 out of 19 patients) after a follow-up of 18 months(57). The overall recurrence rate of LIH repair with IPOM was 8.3% after 1 to 6 years follow-up.
Figure 5. Intraperitoneal onlay mesh technique (IPOM); position of the mesh in relation to the abdominal wall.
d) CST with mesh (modi ed CST)
It can be opted to use an additional mesh during CST procedures. In the studies that investigated the modi ed CST (MCST), three variations on the classic CST were used for component separation, represented by the minimally
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