Research Analysis and Comparison of Various Surgical Techniques of Incisional Hernia Repair

RESEARCH PAPER: RESEARCH ANALYSIS AND COMPARISION OF VARIOUS SURGICAL TECHNIQUES OF INCISIONAL HERNIA REPAIR DR. PRAKASH V. CHAUHAN (M. S. GENERAL SURGERY) ASSISTANT PROFESSOR OF SURGERY, GENERAL SURGERY DEPARTMENT, GOVERNMENT MEDICAL COLLEGE, BHAVNAGAR, GUJARAT. DR. HITENDRA K. DESAI (M. S. , FIAGES) ASSISTANT PROFESSOR OF SURGERY, B. J. MEDICAL COLLEGE, GENERAL SURGERY DEPARTMENT, CIVIL HOSPITAL, AHMEDABAD, GUJARAT. KEY WORDS: INCISIONAL HERNIA OBJECTIVE: Cases of Incisional hernia are seen in increasing frequency now a days. This research was done to identify the best method for incisional hernia repair with least recurrence rate and to give best results by providing most suitable surgical environment. METHODS: The research study was conducted in 50 patients of incisional hernia admitted in surgical wards of general hospital. After admission all patients were studied according to proforma. Proforma was designed to record the history, chief complain, past history, family history, personal history, obstetric and menstrual history (in case of female patient), physical examination, nutritional assesment, local examination, past surgical history, investigations and management. RESULTS: In my study total 50 cases of incisional hernia were taken and studied for various methods of repair and followed for 1 year after hernia repair surgery. ( 5 shoelace repair, 22 onlay meshplasty, 18 preperitoneal meshplasty and 5 laparoscopic intraperitoneal meshplasty done. ) Most of the patients between 40yrs to 60 yrs age group. Mean age of study group is 56.5 yrs. In our study one patient who undergone onlay meshplasty developed mesh infection making removal of mesh mandatory. mesh infection rate is 4.55 % in this study. In our study wound infection rate is 24 %. Wound infection is more after onlay meshplasty (40.91 %), as compared to laparoscopic (0 %) and preperitoneal (11.11 %) which is low. Overall recurrence rate is 4 % in our study. CONCLUSION: All incisional hernias should be repaired surgically. Most common presenting complaint was swelling followed by pain over the scar site. Commonest predisposing factors for incisional hernia were wound infection in previous operation and obesity. Wound Infection is also more common in onlay meshplasty and shoelace method. If meticulous and good aseptic precaution taken, chances of complication of surgery like wound infection is minimized in recent era of highly effective antibiotics. Mesh infection is most important complication of incisional hernia repair as it can lead to surgical failure and recurrence. Recurrence was more in our study with on-lay repair and laparoscopic method. due to local complications and mesh migration respectively.