Proposed Technique for Open Repair of a Small Umbilical Hernia and Rectus Divarication With Self-Gripping Mesh

Hernia. 2016 Aug;20(4):527-30. doi: 10.1007/s10029-016-1470-1. Epub 2016 Feb 17.

Abstract

Introduction: There are a group of patients in which umbilical or epigastric hernias co-exist with rectus divarication. These patients have weak abdominal musculature and are likely to pose a higher risk of recurrence following umbilical hernia repair. We would like to describe a technique for open repair of small (<4 cm) midline hernias in patients with co-existing rectus divarication using self-adhesive synthetic mesh. The use of a self-adhesive mesh avoids the need for suture fixation of the mesh in the superior portion of the abdomen, allowing for a smaller skin incision.

Results: In 173 patients, preperitoneal self-fixating mesh has been used for the repair of midline hernias <4 cm in diameter. In 58 of these patients, the mesh was extended superiorly to reinforce a concurrent divarication.

Discussion: The described technique offers a simple option for open repair of small midline hernias in patients with co-existing rectus divarication, to decrease the risk of upper midline recurrence in an at-risk patient group. This initial case series is able to demonstrate a suitably low rate of recurrence and complications.

Keywords: Rectus divarication; Self-gripping mesh; Umbilical hernia.

MeSH terms

  • Hernia, Umbilical / surgery*
  • Hernia, Ventral / surgery
  • Herniorrhaphy / methods*
  • Humans
  • Prune Belly Syndrome / surgery*
  • Rectus Abdominis / surgery
  • Surgical Mesh*

Supplementary concepts

  • Diastasis Recti And Weakness Of The Linea Alba