On lay mesh repair technique is a safe tension free repair for large incisional hernia (Prospective study)

Incisional hernia remains a frequent complication of abdominal surgeries with a reported incidence of (10-15)% Repair of large incisional hernia is a difficult surgical problem with short and long term complications , severity of these complications are related in part to the type of operative technique adopted. Aim of this study: to evaluate the outcome of repair of large incisional hernia with the (on lay tension free) mesh technique. Patients and Method: A prospective study that includes a 70 patients who underwent mesh repair for large incisional hernia on lay tension free polypropylene mesh with two points fixation during the period from January2007 to December 2011 in Al-Diwanyh Teaching Hospital. Complications like; hematoma, seroma, Wound infection, intestinal obstruction and enterocutaneous fistula Were recorded, the Follow up period Range from 4 to 21 month. Recurrence rate with the period of fellow up was recorded. Results: Patients were included in the study 40 Females median age of 49.5 and 30 Males with median age of 51.5 year, 31 patients were overweight and had body mass index "BMI" equal to more than 30, twenty six patients made regular visits that extended up to 12 month, 22 patients made regular visits up to 6 months, 3 made regular visits up to 18 month , 3 patient was followed-up to 17 month ,while 8 patients made irregular visits up to 21 month due to causes other than the hernia , 8 patients lost from follow-up after 4 months. The main postoperative complications were seroma formation 8 patients(11.7 %), wound haematoma 4 patient (5.7 %), wound infection3 patients (4.2 %),chronic wound sinuses one patient(1.4%) ,partial intestinal obstruction one patient(1.4%) No recurrence of hernia and no enterocutaneous fistula were reported during our follow-up period. Conclusion: Tension free onlay mesh repair is a feasible operative procedure for repair of large incisional hernia with no significant major morbidity.