UNACCEPTABLE RESULTS OF THE MAYO PROCEDURE FOR REPAIR OF ABDOMINAL INCISIONAL HERNIAS

Objective: To evaluate the current practice of incisional hernia repai r in Germany and analysis of the results of the Mayo duplication techn ique done in our hospital over a 10-year period. Design: Nationwide su rvey, retrospective analysis. Setting: University department, Germany. Subjects: Survey of most surgical departments and of 114 patients wit h 135 incisional hernias in our unit. Intervention: Mayo duplication r epair incisional hernias. Main outcome measures: Common practice, recu rrence rates, quality of Life. Results: The Mayo overlap is the prefer red technique in most surgical departments. The estimated failure rate s (12% or less) in general practice are grossly underestimated. In our hospital the recurrence rate after Mayo duplication repair was 61/114 (54%) during a follow up time of 5.7 years with a follow-up-rate of 8 4%. Univariate and multivariate analyses failed to identify any predis posing factors. All patients with incisional hernias had limitations t heir physical function. Conclusions: The widely used Mayo procedure le ads to unacceptable results for repair of incisional hernias and other techniques should be evaluated and used more often. Repair of an inci sional hernia does not improve overall quality of life.