RETROMUSCULAR PROSTHETIC REPAIR OF MASSIV E INCISIONAL HERNIAS - A SIMPLE STAPLING TECHNIQUE

This article introduces a stapling technique which is a simpler, faste r and safer method of performing the Stoppa procedure. It also encoura ges use of preperitoneal repair instead of the often unsuccessful onla y mesh repair. The latter repair involves placing the mesh over the ab dominal aponeurotic layer and can result in a high incidence of infect ion, seroma accumulation, and chronic fibrous cyst formation. In the p reperitoneal repair technique, the same force that created the hernia - the intra-abdominal hydrostatic pressure - keeps the mesh tightly in place and prevents recurrence of the hernia. In 29 of the 75 patients , the mesh was fixed in place with hand suturing. In the other 46, sta plers attached the mesh. The authors have found the stapling technique to be both simpler to accomplish and safer for the patient.