Recurrent Incisional Hernia Cases Operated with The Use of The Existing Integrated Prosthesis

Background: Incisional hernias have a particular dynamic related both to the repair method and to the absence or presence of a prosthetic material. The incidence of incisional hernias is estimated at 9.8% after 21 months and increases to 18.7% after ten years. This study presents a surgical method for the repair of recurrent incisional hernias through open surgery and the use of existing mesh. The selection criteria for this method include: the prosthesis is well integrated, without granulomas, suppurations, or defects appearing on the same prosthetic abdominal area. The analyzed factors were the location of the incisional hernias, the duration of the operation, the duration of hospitalization, identified complications, and the size of the parietal defect. Material and Method: The retrospective study focused on recurrences of incisional hernias from a group of 631 patients operated on for incisional hernias in a general surgery department of Dr. Constantin Andreoiu County Emergency Hospital, Ploiești, Romania, during January 2018 - December 2022. Of the total 18.22% recurrences, 13.6% were relapsed eventrations after prosthetic procedures. Following the application of the selection criteria, 8 patients with recurrent eventrations were operated on using the open method with the existing mesh. Results: In the case of recurrent incisional hernias, the average operation duration was 63.8 minutes, while the average hospitalization duration was 9.22 days, which is related to the fact that the activity is carried out mainly in acute medical emergencies. The monitoring of the group of patients operated on using the open method with the existing mesh was conducted over a period of up to one year, with no recurrences observed, and the disappearance of pain and swelling was noted. Conclusions: In the case of recurrences after prosthetic procedures for incisional hernias, the recurrence can be resolved by open surgery using the existing well-integrated prosthesis, without tension, and with the absence of suppuration in the wound and the peritoneal cavity. For the presented case, the return to daily activities occurred after 22 hours of hospitalization.