Modified Chevrel Technique: A Lifesaver for Surgeons

<i>Background and Objectives:</i> Ventral hernias (VH) pose significant challenges for surgeons due to the risk of recurrence, complexities in aligning abdominal muscles, and selecting the most suitable layer for mesh augmentation. This study aims to evaluate the effectiveness of utilizing the anterior rectus fascia as a turnover flap in conjunction with onlay mesh reinforcement, a procedure known as the modified Chevrel technique (MCT). <i>Materials and Methods</i>: We conducted a retrospective analysis of patients who were operated on using MCT for abdominal hernias between January 2013 and December 2019. Data were extracted from our hospital's electronic database. Recurrence rates, as well as the rates of surgical site occurrences (SSO), surgical site infections (SSI), and surgical site occurrences requiring procedural intervention (SSOPI), were analyzed based on patients' comorbidities and demographic characteristics. <i>Results</i>: The median follow-up period was 42.9 months (range: 14-96), and the recurrence rate was 4% (n = 3). Among the recurrent cases, three patients had chronic obstructive pulmonary disease, representing a statistically significant association (<i>p</i> = 0.02). Although all patients with recurrence were obese, this association did not reach statistical significance (<i>p</i> > 0.05). The mean hospitalization duration was 17.6 days (range: 6-29). SSO, SSI, and SSOPI rates were 39 (52%), 12 (16%), and 32 (42%), respectively. <i>Conclusions</i>: Managing VH remains a surgical challenge, emphasizing the importance of achieving effective abdominal closure for both functional and cosmetic outcomes. MCT presents a relatively simple approach compared to techniques like transversus abdominis release (TAR) and anterior component separation (ACS), with acceptable rates of SSO, SSOPI, SSI, and recurrence.

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Publication Details

Journal
Medicina
Published
2024-08-16
DOI
https://doi.org/10.3390/medicina60081328
Citations
1
Primary Topic
Hernia repair and management
Type
article
Field-Weighted Citation Impact
0.57
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article

Modified Chevrel Technique: A Lifesaver for Surgeons

Özcan Dere, Cenk Yazkan, Önder Özcan, Okay Nazlı et al.
1 citations
Medicina
Hernia repair and management
0.57
article

Modified Chevrel Technique: A Lifesaver for Surgeons

Özcan Dere, Cenk Yazkan, Önder Özcan, Okay Nazlı, Samet Şahin
article en
1 citations

Abstract

<i>Background and Objectives:</i> Ventral hernias (VH) pose significant challenges for surgeons due to the risk of recurrence, complexities in aligning abdominal muscles, and selecting the most suitable layer for mesh augmentation. This study aims to evaluate the effectiveness of utilizing the anterior rectus fascia as a turnover flap in conjunction with onlay mesh reinforcement, a procedure known as the modified Chevrel technique (MCT). <i>Materials and Methods</i>: We conducted a retrospective analysis of patients who were operated on using MCT for abdominal hernias between January 2013 and December 2019. Data were extracted from our hospital's electronic database. Recurrence rates, as well as the rates of surgical site occurrences (SSO), surgical site infections (SSI), and surgical site occurrences requiring procedural intervention (SSOPI), were analyzed based on patients' comorbidities and demographic characteristics. <i>Results</i>: The median follow-up period was 42.9 months (range: 14-96), and the recurrence rate was 4% (n = 3). Among the recurrent cases, three patients had chronic obstructive pulmonary disease, representing a statistically significant association (<i>p</i> = 0.02). Although all patients with recurrence were obese, this association did not reach statistical significance (<i>p</i> > 0.05). The mean hospitalization duration was 17.6 days (range: 6-29). SSO, SSI, and SSOPI rates were 39 (52%), 12 (16%), and 32 (42%), respectively. <i>Conclusions</i>: Managing VH remains a surgical challenge, emphasizing the importance of achieving effective abdominal closure for both functional and cosmetic outcomes. MCT presents a relatively simple approach compared to techniques like transversus abdominis release (TAR) and anterior component separation (ACS), with acceptable rates of SSO, SSOPI, SSI, and recurrence.

MedicinaVol. 60(8)
Muğla University (TR)
Openalex Percentile: Top 31%
Hernia repair and management
0.57
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