Retrorectus prosthetic mesh repair of midline abdominal hernia

BACKGROUND: Midline abdominal hernia is a common problem seen by the general surgeon, Recurrence rates are as high as 49% when an autogenous repair is performed, and as high as 11% when prosthetic mesh is used as a ''bridge'' or ''onlay.'' METHODS: This study analyzes results of midline abdominal hernia repair in 106 cases using prosthetic mesh, in the retrorectus position, as described by Stoppa and Wantz. Charts were reviewed, patient satisfaction determined by telephone interview, and recurrence rate by physician examination. RESULTS: Major systemic complications occurred in 17%, There were no deaths. Eighteen percent developed a wound complication, requiring a return to the operating room in 5%, There were three recurrences (3.5%). CONCLUSIONS: Retrorectus placement of prosthetic mesh in the repair of midline abdominal hernia is effective and compares favorably with other methods. Significant complications are low, recurrence is rare, and patient satisfaction is high. (C) 1997 by Excerpta Medica, Inc.