The Benefit of Open Rives-Stoppa Procedure in Complex Incisional Hernia.

Abstract

Introduction: Ventral hernia is one of the most common general surgical pathologies. An incisional hernia will develop in 10–15% of patients with an abdominal incision, and the risk increases to up to 23% in those who develop surgical site infections. Ventral hernia repairs are mostly elective (90%) procedures, but the repair methods are highly variable. Popularized in Europe by Rives and Stoppa, the retromuscular technique has proven to be very effective, with a 94.2% probability of having the lowest odds for recurrence and a 77.3% probability of having the lowest odds for SSI. The study aimed to evaluate our experience at a secondary care center performing Rives-Stoppa repair for abdominal ventral and incisional hernias. Materials and Methods: Between April 2019 and August 2021, 46 patients in the practice at a secondary regional hospital, Teni Konomi, Korce, Albania, underwent a Rives-Stoppa incisional hernia repair. Results: There were 14 (31%) males and 32(69%) females (age range 31-75). Most incisional hernias were midline xiphoid-pubic incision and supraumbilical, with several subcostals (2 right and 1 left) hernias.At the time of repair, most incisional hernias were symptomatic and evident on physical exam. In four cases, the hernia sac was incarcerated at the presentation time. Conclusion: The Rives-Stoppa technique has excellent long-term results and low morbidity in patients with large primary or recurrent incisional hernias. It is the gold standard for most surgeons. Keywords: Incisional Hernia, mesh, polypropylene, abdominal wall surgery, rectus muscle