Incisional hernia

With a long-term incidence of 10-20%, incisional hernias remain one of the most common surgical complications. Beside technical causes, wound-healing problems are increasingly being discussed. Conventional suture repair shows disappointing results and should be used only in selected cases. By the implantation of mesh prostheses, notable improvement could be achieved, with recurrence rates of <10%. Its main principle is retromuscular mesh reinforcement of the entire scar. Particularly in the neighbourhood of osseous structures, only retromuscular placement allows sufficient subduction of the mesh by healthy tissue of at least 5 cm in all directions. Preparation must take into account the special anatomic features of the abdominal wall, especially in the area of the Linea alba and Linea semilunaris.