Classification and surgical treatment of incisional hernia - Results of anexperts' meeting

Background: The treatment of incisional hernia (IH) is a current problem in modern surgery. Many important aspects of incisional hernia surgery are ye t to be answered, especially the choice of surgical technique and its adapt ation to the individual patient. The aim of this experts' meeting was to re solve some current questions in incisional hernia surgery and to organise a n international hernia register. Methods: An international panel of ten experts met under the auspices of th e European Hernia Society (GREPA) to investigate the classification and the rapeutic alternatives for incisional hernia. Prior to the conference, all e xperts were asked to submit their arguments in the form of published result s. All papers received were weighted according to their scientific quality and relevance. The information from this correspondence was used as a basis for panel discussion. The personal experiences of the participants and oth er aspects of individualised therapy were also considered. Results. The exp ert panel suggested a new classification of incisional hernia based on loca lisation, size, recurrences and symptoms. All experts agreed that the fasci a duplication and the fascia adaptation should only be used for small incis ional hernias. Fascia duplication is of value only in the horizontal direct ion. The technical details and the pros and cons of each procedure were dis cussed for prosthetic implantation using onlay and sublay techniques and th e technique of autodermal hernioplasty. Conclusions: The management of incisional hernia is currently not standardi sed. In order to answer relevant questions of incisional hernia surgery, an international hernia register should be established.