Percutaneous Mesh Expansion and Fixation at the Retro-Rectus Plane without Stabs by Using Redirecting Suture Hook in Midline Hernias Repair
Ahmed E Lasheen, Alaa N. El Sadek, Adel M Tolba, Emad Salah, Ayman F Mehanna
DOI: 10.4236/ss.2011.24039   PDF    HTML     5,830 Downloads   9,587 Views  


Background: Mesh expansion and fixation at retro-rectus plane through multiples stabs produces good results. But these stabs cause cosmetic disorders for the patients and doctors. So, we find some modification to do this procedure without these stabbing wounds in midline hernial repair. Patients and methods: This technique was used to fix the mesh at retro-rectus plane in 50 patients suffering from midline hernias, from January 2008 through January 2010 at Zagazig university Hospital, Egypt. Laparotomy incision was done over the hernial sac or at old incision; the contents were then released and reduced into peritoneal cavity without much subcutaneous dissection. The suitable sheet of polypropylene mesh to cover the hernial defect and any weak area was prepared and fixed at retro-rectus plane percutaneously without stabbing wounds by using redirecting suture hook. The mean period of follow up was 26 months. Results: There was no recurrence during the period of follow up. Five patients developed subcutaneous bluish discoloration at the site of some stitches, which disappear within two weeks with conservative treatment. Conclusion: Percutaneous mesh expansion and fixation at retro-rectus plane by using redirecting suture hook procedure has good results in recurrence rate and cosmetic appearance.

Share and Cite:

A. Lasheen, A. Sadek, A. Tolba, E. Salah and A. Mehanna, "Percutaneous Mesh Expansion and Fixation at the Retro-Rectus Plane without Stabs by Using Redirecting Suture Hook in Midline Hernias Repair," Surgical Science, Vol. 2 No. 4, 2011, pp. 177-182. doi: 10.4236/ss.2011.24039.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg. 2000; 190(6): 645-50.
[2] Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel J. An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet. 1993; 176(3): 228-34.
[3] LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc. 1993; 3(1):39-41.
[4] Leber GE, Garb JL, Alexander AI, Reed WP. Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg. 1998; 133(4): 378-82.
[5] White TJ, Santos MC, Thompson JS. Factors affecting wound complications in repair of ventral hernias. Am Surg. 1998; 64(3): 276-80.
[6] Lasheen AE. Mesh expansion and fixation at the retro-rectus plane through multiple stabs by using two tip hole needles in midline hernias repair. A prospective study. Int J Surg. 2008; 6(5): 367-70.
[7] Lasheen AE, Elzeftawy A, Ahmed AH, Lotfy WE. Anatomical closure of trocar site by using tip hole needle and redirecting suture hook. Surg Endosc. 2010; 26
[8] Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg. 1985; 72(1): 70-1.
[9] Bauer JJ, Harris MT, Kreel I, Gelernt IM. Twelve-year experience with expanded polytetrafluoroethylene in the repair of abdominal wall defects. Mt Sinai J Med. 1999; 66(1): 20-5.
[10] Lomanto D, Iyer SG, Shabbir A, Cheah WK. Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc. 2006; 20(7): 1030-5.
[11] Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg. 1989; 13(5): 545-54.
[12] Wantz GE. Incisional hernioplasty with Mersilene. Surg Gynecol Obstet. 1991; 172(2): 129-37.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.