Lateral Incisional Hernia Repair by the Retromuscular Approach with Polyester Standard Mesh: Topographic Considerations and Long-term Follow-up of 61 Consecutive Patients

Background Because of the lack of published data and the relative rarity of lateral incisional hernia (LIH), their repair remains a major challenge for surgeons. The aim of the present study was to evaluate the outcome of LIH treated by the retromuscular approach (RMA) with a polyester standard mesh. Methods Sixty-one patients were treated between June 2000 and November 2007 in an academic tertiary referral center using one standardized surgical technique and one type of mesh. Lumbar incisional hernia was excluded. All data were prospectively culled. The early complications and recurrence rates were evaluated. Results There were 14 (23 %) subcostal, 12 (19.6 %) flank, and 35 (57.4 %) iliac fossa LIH. The mean patient age was 57 years, and 60 % were male. The average width of the defect was 7.6 cm and the overall defect size averaged 56 cm(2). Seventeen patients (28 %) had had previous LIH repair. Ten patients had double hernia locations (midline and lateral) repaired simultaneously. The average operative time and hospital stay were 136 min and 7 days, respectively. The early complications rate was 18 %. Four patients required reoperation. There were no mesh infections. The median follow-up was 47 months (range: 1-125 months). Recurrence was observed in three patients (4.9 %). Conclusions LIH repair by RMA with a polyester heavyweight mesh proves to be a safe treatment with a moderate complication rate and a low infection rate, even in the treatment of large or multifocal parietal defects.