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A D V E R T I S E M E N T
A D V E R T I S E M E N T
This is an example of a 1-cm suprapubic hernia in a Pfannensteil incision done for C-section. The subcutaneous hernia sac measured 2x6 cm and contained omentum. The sac was resected to reduce the chance of seroma formation. The defect was small enough to close primarily, with the least tension being in a side-to-side direction. Primary closure of incisional hernia defects often fails because of tension and the brittle nature of scar tissue at the edges of such defects. For that reason, a patch of polypropylene mesh was placed anterior to the closed defect. If there is a small sac that can be inverted, it may be possible to place the mesh below the fascia. With an open defect, it is not advisable to place mesh where it will be in direct contact with abdominal viscera because of the risk of adhesions and fistula formation. There are now dual-sided meshes that may obviate this problem. Such meshes are being used for both open and laparoscopic ventral/incisional hernia repairs.
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This page was last modified on 3/20/2000.
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