Treatment of Incisional Ventral Hernias : Mesh Repair Method

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  • メッシュを用いた腹壁瘢痕ヘルニアの治療

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We introduced the mesh repair method in incisional ventral hernias back in 1996 and this method is now being performed in almost all cases. Before 1996, the simple repair method (29 cases) was mainly used, however, since then we gradually started using Marlex mesh. In cases where the peritoneum reconstruction is difficult, the Composix mesh, which has an expanded polytetrafluoroethylene face (ePTFE) and is resistant to the formation of adhesion, is utilized. Since the year 2000, in cases of small hernia, we have been conducting mesh repair by the Prolene hernia system (PHS) which has been used in inguinal hernias. However, in 2 PHS cases where the diameter was 4 cm or more, the mesh transformed into a mass, 6 months to 1 year after the operation. However, since no abnormalities were found in cases where the iameter was 3 cm or less (4 cases), it could be determined that the use of PHS was inappropriate in cases where the diameter of the hernia was 3 cm or more. At present, there have been no reports of complications from infections or ecurrence in mesh repair cases (26 cases). If we are able to establish an accurate method using mesh in the future, we believe that mesh repair in incisional ventral hernia could become the procedure of choice.

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