The musculo-aponeurotic repair for midline ventral abdominal wall herniae - abstract

ABSTRACT

Recurrence-free repair of midline ventral abdominal wall herniae continues to challenge surgeons despite the abundance of described techniques. Based on the observation that spontaneous herniation through the rectus abdominis muscles is unknown, a new technique of repair was devised. The recti and their sheath on either side of the hernial defect are directly brought together to obliterate the hernia, while the intervening linea alba and intact hernia sac are "keeled" into the abdominal cavity. Using this technique, 85 consecutive midline abdominal herniae were repaired over an 11 year period. The follow-up period was between 18 months and 12 years, and there was one recurrence (1.2 percent). On re-operation, technical error was judged the cause of recurrence and the patient remains well 18 months following the second operation. The rectus repair is recommended as a highly effective method of dealing with ventral midline wall herniae (AU)