Management of giant ventral hernia by polypropylene mesh and host tissue barrier: trial of simplification.

BACKGROUND: Surgical management of giant ventral hernias is a surgical challenge due to limited abdominal cavity. This study evaluates management of giant ventral hernias using polypropylene mesh and host tissue barrier after suitable preoperative preparation.

METHODS: In the period from January 2005 and January 2007, 35 patients with giant ventral hernias underwent hernia repair. After careful preoperative preparation, repair was done using polypropylene mesh. The mesh was separated from the viscera by a small part of the hernia sac and the greater omentum.

RESULTS: The average age of the patients was 52. Twenty patients had post-operative incisional and 15 had para-umbilical hernias. The mean hernia defect size was 16.8 cm. Mean body mass index was 33. Follow up ranged from 18-36 months. No patient required ventilation after operation. Recurrent seroma, which responded to repeated aspiration, was experienced in 4 patients. Minor wound infection was observed in 5 patients. Small hernia recurrence occurred in one patient.

CONCLUSION: The use of polypropylene and host tissue barrier after suitable preoperative preparation is relatively simple, safe, and reliable surgical solution to the problem of giant ventral hernia.

KEYWORDS: Hernia repair; Giant ventral hernia; Polypropylene mesh.