Mesh expansion and fixation at the recto-rectus plane through multiple stabs by using two tip hole needles in midline hernias repair. A prospective study.

OBJECTIVE: Midline hernias are a common surgical problem and numerous procedures of repair have been described, but there is no consensus about which type of these procedures are the best. Stabbing technique for midline hernias repair is a procedure collecting the advantages of laparoscopic and traditional open techniques, and avoids the complications of both of them.

METHODS: In the present study, 60 patients with midline hernias were subjected to retro-rectus prosthetic mesh repair using stabbing method and by helping special fork which has two tip hole needles, from February 2004 through March 2006 at General Surgery Department, Faculty of Medicine, Zagazig University, Egypt. Small laparotomy incision was done over hernial sac, the contents were then released and reduced into the peritoneal cavity without much subcutaneous dissection. The suitable sheet of polypropylene mesh to cover the hernial defect and any weak area of the anterior abdominal sheath all around by about 5 cm was prepared and fixed at retro-rectus plane through multiple small stabs incisions in skin of the abdominal wall by using a special fork. The mean period of follow up was 36 months.

RESULTS: The postoperative convalescence was uneventful, and no recurrence has been recorded.

CONCLUSION: The stabbing technique for mesh fixation at retro-rectus plane offers a viable option for midline hernias repair without special complications.