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Recurrent Ventral Hernia Repair

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The SAGES Manual of Hernia Surgery

Abstract

Recurrent ventral hernias represent a technical challenge for surgeons as well as a financial burden to the US healthcare system. Although recurrences are somewhat diminished by the use of mesh, the risk for recurrence still remains significant and does not appear to be further decreasing over time. When approaching recurrent hernias, it is of utmost importance to not only optimize any patient comorbidities, but also to try to identify potential causes of failure of the prior repair in order to maximize the chance of success and minimize risk of further recurrence. In this chapter, we present an algorithm for the workup and management of these complicated patients.

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References

  1. Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16:179–83.

    Article  CAS  PubMed  Google Scholar 

  2. Cox TC, Blair LJ, Huntington CR, Colavita PD, Prasad T, Lincourt AE, Heniford TB, Augenstein VA. The cost of preventable comorbidities on wound complication in open ventral hernia repair. J Surg Res. 2016;206:214–22.

    Article  PubMed  Google Scholar 

  3. Lujendijk RW, Hop WCJ, van den Tol MP, et al. A comparison of suture repair with mesh repair of incisional hernia. N Engl J Med. 2000;343:392–8.

    Article  Google Scholar 

  4. Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population based analysis. Ann Surg. 2003;237:129–35.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hawn MT, Snyder CW, Graham LA, et al. Long-term follow-up of technical outcomes for incisional hernia repair. J Am Coll Surg. 2010;210(5):648–55.

    Article  PubMed  Google Scholar 

  6. Krpata DM, Blatnik JA, Novitsky YW, Rosen MJ. Evaluation of high risk, comorbid patients undergoing open ventral hernia repair with synthetic mesh. Surgery. 2013;153:120–5.

    Article  PubMed  Google Scholar 

  7. Gronkjaer M, Eliasen M, Skov-Etrrup LS. Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann Surg. 2014;259:52–71.

    Article  PubMed  Google Scholar 

  8. Liang MK, Holihan JL, Itani K, Alawadi MD, et al. Ventral hernia management: expert consensus guided by systematic review. Ann Surg. 2017;265:80–9.

    Article  PubMed  Google Scholar 

  9. Lindstom D, Sadr Azodi O, Wladis A, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized controlled trial. Ann Surg. 2008;248:739–45.

    Article  Google Scholar 

  10. Dronge AS, Perkal MF, Kancir S, Concato J, Aslan A, Rosenthal RA. Long term glycemic control and postoperative infectious complications. Arch Surg. 2006;141:375–80.

    Article  PubMed  Google Scholar 

  11. Jones CE, Graham LA, Morris MS, et al. Association between preoperative HbA1c levels, postoperative hyperglycemia, and readmissions following gastrointestinal surgery. JAMA Surg. 2017;152(11):1031–8. https://doi.org/10.1001/jamasurg.2017.2350.

    Article  PubMed  PubMed Central  Google Scholar 

  12. NICE-SUGAR Study Investigators, et al. Hypoglycemia and risk of death in critically ill patients. NEJM. 2012;367:1108–18.

    Article  Google Scholar 

  13. Martindale RG, Deveny CW. Preoperative risk reduction: strategies to optimize outcomes. Surg Clin North Am. 2013;93:1041–55.

    Article  PubMed  Google Scholar 

  14. Giordano SA, Garvey PB, Baumann DP, Liu J, Butler CE. The impact of body mass index on abdominal wall reconstruction outcomes: a comparative study. Plast Reconstr Surg. 2017;139:1234–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Kaoutzanis C, Leichtle SW, Mouawa NJ, et al. Risk factors for postoperative wound infections and prolonged hospitalization after ventral/incisional hernia repair. Hernia. 2015;19:113–23.

    Article  CAS  PubMed  Google Scholar 

  16. Fekkes JF, Velanovich V. Amelioration of the effects of obesity on short-term postoperative complications of laparoscopic and open ventral hernia repair. Surg Laparosc Endosc Percutan Tech. 2015;25:151–7.

    Article  PubMed  Google Scholar 

  17. Unick JL, Neiberg RH, Hogan PE, et al. Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later. Obesity. 2015;23:1353–6.

    Article  PubMed  Google Scholar 

  18. Rosen MJ, Aydogdu K, Grafmilller K, Petro CC, Faiman GH, Prabhu A. A multidisciplinary approach to medical weight loss prior to complex abdominal wall reconstruction: is it feasible? J Gastrointest Surg. 2015;19:1399–406.

    Article  PubMed  Google Scholar 

  19. Pernar LIM, Pernar CH, Dieffenbach BV, Brooks DC, et al. What is the BMI threshold for open ventral hernia repair? Surg Endosc. 2017;31:1311–7.

    Article  PubMed  Google Scholar 

  20. Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238:391–9.

    PubMed  PubMed Central  Google Scholar 

  21. Newcomb WL, Polhill JL, Chen AY, Kuwada TS, Gersin KS, Getz SB, et al. Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias. Hernia. 2008;12:465–9.

    Article  CAS  PubMed  Google Scholar 

  22. Khorgami Z, Haskins IN, Aminian A, Andalib A, Rosen MJ, Brethauer SA, Schauer PR. Concurrent ventral hernia repair in patients undergoing bariatric surgery: a case-matched study using the National Surgical Quality Improvement Program Database. Surg Obes Relat Dis. 2017;13:997–1002.

    Article  PubMed  Google Scholar 

  23. Blatnik JA, Krpata DM, Jacobs MR, Gao Y, Novitsky YW, Rosen MJ. In vivo analysis of the morphologic characteristics of synthetic mesh to resist MRSA adherence. J Gastrointest Surg. 2012;16:2139–44.

    Article  PubMed  Google Scholar 

  24. Franklin BR, Patel KM, Nahabedian MY, Baldassari LE, Cohen EI, Bahnot P. Predicting abdominal closure after component separation for complex ventral hernias: maximizing the use of preoperative computed tomography. Ann Plast Surg. 2013;71:261–5.

    Article  CAS  PubMed  Google Scholar 

  25. Picazo-Yeste J, Moreno-Sanz C, Sedano Vizcaino C, Morandeira-Rivas A, Sanchez-De Pedro F. Outcomes after laparoscopic ventral hernia: does the number of previous recurrences matter? A prospective study. Surg Endosc. 2017;17:5510–4.

    Google Scholar 

  26. Hauters P, Desmet J, Gherardi D, Dewaele S, Poilvache H, Malvaux P. Assessment of predictive factors for recurrence in laparoscopic ventral hernia repair using a bridging technique. Surg Endosc. 2017;1:1–8.

    Google Scholar 

  27. Ferrari G, Bertoglio C, Magistro C, Girardi V, Mazzola M, Lernia SD, Pugliese R. Laparoscopic repair for recurrent incisional hernias: a single institute experience of 10 years. Hernia. 2013;17:573–80.

    Article  CAS  PubMed  Google Scholar 

  28. Silecchia G, Campanile FC, Sanchez L, Ceccarelli G, Antinori A, et al. Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference. Surg Endosc. 2015;29:2463–84.

    Article  PubMed  Google Scholar 

  29. Stoikes N, Quasebarth M, Brunt LM. Hybrid ventral hernia repair: technique and results. Hernia. 2013;17:627–32.

    Article  CAS  PubMed  Google Scholar 

  30. Suwa K, Okamoto T, Yanaga K. Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature. Surg Today. 2016;46:764–73.

    Article  PubMed  Google Scholar 

  31. Wennergen JE, Askenasy EP, Greenberg JA, et al. Laparoscopic ventral hernia repair with primary fascial closure versus bridged repair: a risk adjusted comparative study. Surg Endosc. 2016;30:3231–18.

    Article  Google Scholar 

  32. Papageorge CM, Funk LM, Poulose BK, Philips S, Rosen MJ, Greenberg JA. Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications. Surg Endosc. 2017;31(11):4551–7. https://doi.org/10.1007/s00464-017-5515-z.

    Article  PubMed  Google Scholar 

  33. Carbonell AM, Criss CN, Cobbs WS, Novtisky YW, Rosen MJ. Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg. 2013;217:991–8.

    Article  PubMed  Google Scholar 

  34. The Ventral Hernia Working Group. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery. 2010;148:544–8.

    Article  Google Scholar 

  35. Den Hartog D, Dur AHM, Tuinebreijer WE, Kreis RW. Open surgical procedures of incisional hernias (Review). Cochrane Database Syst Rev. 2008;3:1–36.

    Google Scholar 

  36. Holihan JL, Askenasy EP, Greenberg J, et al. Component separation vs. bridged repair for large ventral hernias: a multi-institutional risk-adjusted comparison, systemic review, and meta-analysis. Surg Infect. 2016;17:17–26.

    Article  Google Scholar 

  37. Stoikes N, Webb D, Powell B, Voeller G. Preliminary report of a sutureless onlay technique for incisional hernia repair using fibrin glue alone for mesh fixation. Am Surg. 2013;79:1177–80.

    PubMed  Google Scholar 

  38. Rives J, Lardennois B, Pire JC, Hibon J. Les grandeseventration. Importance du volet abdominal et des troubles respiratoires qui lui sont secondaires. Chirurgie. 1973;99:547–63.

    CAS  PubMed  Google Scholar 

  39. Ramirez OM, Ruas E, Dellon AL. “Components separation” method for closure of abdominal wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990;86:519–26.

    Article  CAS  PubMed  Google Scholar 

  40. Giurgius M, Bendure L, Davenport DL, Roth JS. The endoscopic component separation technique for hernia repair results in reduced morbidity compared to the open component separation technique. Hernia. 2012;16:47–51.

    Article  CAS  PubMed  Google Scholar 

  41. Pauli EM, Rosen MJ. Open ventral hernia repair with component separation. Surg Clin North Am. 2013;93:1111–33.

    Article  PubMed  Google Scholar 

  42. Igbal CW, Pham TH, Joseph A, Mai J, Thompson GB, Sarr MG. Long-term outcome of 254 complex incisional hernia repairs using the modified Rives-Stoppa technique. World J Surg. 2007;31:2398–404.

    Article  Google Scholar 

  43. Novitsky Y, Elliott H, Orenstein S, Rosen M. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204:709–16.

    Article  PubMed  Google Scholar 

  44. Bauer JJ, Harris MT, Gorfine SR, Kreel I. Rives-Stoppa procedure for repair of large incisional hernias: experience with 57 patients. Hernia. 2002;6:120–3.

    Article  CAS  PubMed  Google Scholar 

  45. Holihan JL, Bondre I, Askenasy E, et al. Sublay versus underlay in open ventral hernia repair. J Surg Res. 2016;202:26–32.

    Article  CAS  PubMed  Google Scholar 

  46. Sbitany H, Kwon E, Chern H, Finlayson E, Madhulika V, Hansen S. Outcomes analysis of biologic mesh use for abdominal wall reconstruction in clean-contaminated and contaminated ventral hernia repair. Ann Plast Surg. 2015;75:201–4.

    Article  CAS  PubMed  Google Scholar 

  47. Atema JJ, Furnee EJ, Maeda Y, Warusavitarne J, Tanis PJ, et al. Major complex abdominal wall repair in contaminated fields with use of non-cross-linked biologic mesh: a dual institution experience. World J Surg. 2017;14:1993–9.

    Article  Google Scholar 

  48. Lopez-Cano M, Quiles MT, Pereira JA, Armengol-Carrasco M, Via MAA. Complex abdominal wall hernia repair in contaminated surgical fields: factors affecting the choice of prosthesis. Am Surg. 2017;83:583–9.

    PubMed  Google Scholar 

  49. Rosen MJ, Bauer JJ, Harmaty MD, et al. Multicenter, prospective longitudinal study of the recurrence, surgical site infection and quality of life after contaminated ventral hernia repair using biosynthetic absorbable mesh. The COBRA study. Ann Surg. 2017;265:205–11.

    Article  PubMed  Google Scholar 

  50. Itani KM, Rosen M, Vargo D, et al. RICH Study Group. Prospective study of single-staged repair of contaminated hernias using a biologic porcine tissue matrix: the RICH Study. Surgery. 2012;152:498–505.

    Article  PubMed  Google Scholar 

  51. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2015 May 19. Identifier NCT02451176, A prospective randomized trial of biologic mesh versus synthetic mesh for the repair of complex ventral hernias. https://clinicaltrials.gov/ct2/show/record/NCT02451176?cond=Hernia%2C+Ventral&draw=1&rank=26.

  52. Mancini GJ, Le HN. Loss of abdominal domain. In: Hernia surgery. Switzerland: Springer; 2016. p. 361–70.

    Google Scholar 

  53. Petro CC, Raigani S, Fayezizadeh M, et al. Permissible intraabdominal hypertension following complex abdominal wall reconstruction. Plast Reconstr Surg. 2015;136:868–81.

    Article  CAS  PubMed  Google Scholar 

  54. Mavrodin CI, Pariza G, Ion D, Antoniac VI. Abdominal compartment syndrome—a major complication of large incisional hernia surgery. Chirurgia. 2013;108:414–7.

    CAS  PubMed  Google Scholar 

  55. Alam MN, Narang SK, Pathak S, Daniels IR, Smart NJ. Methods of abdominal wall expansion for repair of incisional herniae: a systematic review. Hernia. 2016;20:191–9.

    Article  CAS  PubMed  Google Scholar 

  56. Fernando EJ, Guerron AD, Rosen MJ. A case of splenic rupture within an umbilical hernia repair with loss of domain. J Gastrointest Surg. 2015;19:789–91.

    Article  PubMed  Google Scholar 

  57. Gurunluoglu R, Ghaznavi A, Krpata D, Zins J, Rosen MJ. Arteriovenous loop graft in abdominal wall reconstruction with free tissue transfer. J Plast Reconstr Aesthet Surg. 2016;69:1513–5.

    Article  PubMed  Google Scholar 

  58. Sue GR, Narayan D. Niche reconstruction techniques for complex abdominal wall reconstruction: a review. Am Surg. 2014;80:327–34.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA

    Charlotte Horne MD & Ajita Prabhu MD

Authors
  1. Charlotte Horne MD
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  2. Ajita Prabhu MD
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Correspondence to Ajita Prabhu MD .

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Editors and Affiliations

  1. Emory University, Atlanta, GA, USA

    S. Scott Davis, Jr.

  2. Weill Med College At Cornell University, New York, NY, USA

    Gregory Dakin

  3. Stony Brook Surgical Associates, Centereach, NY, USA

    Andrew Bates

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© 2019 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

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Horne, C., Prabhu, A. (2019). Recurrent Ventral Hernia Repair. In: Davis, Jr., S., Dakin, G., Bates, A. (eds) The SAGES Manual of Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-78411-3_26

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  • DOI: https://doi.org/10.1007/978-3-319-78411-3_26

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  • Online ISBN: 978-3-319-78411-3

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