Intraperitoneal modification of the Rives-Stoppa repair for large incisional hernias

Regan Williams, D. F. Martin, M. T. Mulrooney, G. R. Voeller

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Introduction: Recurrence rates for open repair of ventral/incisonal hernias historically range from 6% for the classic Rives-Stoppa repair to 35-45% for some of the techniques more commonly used in the United States. We report a modification to the classic Rives-Stoppa repair that allows intraperitoneal placement of the prosthetic, secured with a running suture. The abdominal muscles are closed over the mesh to protect it from any superficial wound problems that might develop and to restore normal architecture of the abdominal wall. Method: A chart review was undertaken on all patients undergoing open ventral incisional hernia repair by a single surgeon from 2000 to 2006. All hernias were repaired with the intraperitoneal modification mimicking the principles of the Rives-Stoppa repair. Method: Patient characteristics and operative and postoperative data were collected. Primary outcome was recurrence of hernia. Secondary outcomes were complications and rate of mesh infection. Results: One hundred and fifteen patients were evaluated. Thirty-four patients had repair of recurrent ventral hernias. The average patient was obese, female, and 59 years old. Twenty-five patients used tobacco, eleven were diabetic, and seven used chronic corticosteroids. Meshes utilized included ePTFE, coated polyester, coated polypropylene, and biologic mesh. Average size of mesh was 465.4 cm2. There were four recurrences (3.4%), three of which were due to mesh infection requiring mesh removal. Recurrence rate not secondary to mesh removal was 0.9%. Complications occurred in 26% with seroma formation being the most frequent (16%). Conclusion: The intraperitoneal modification to the original Rives-Stoppa repair leads to a very low recurrence rate for large ventral hernia repairs with minimal complications and low rate of mesh infection.

Original languageEnglish (US)
Pages (from-to)141-145
Number of pages5
JournalHernia
Volume12
Issue number2
DOIs
StatePublished - Apr 1 2008

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Ventral Hernia
Recurrence
Herniorrhaphy
Hernia
Infection
Seroma
Abdominal Muscles
Polyesters
Polypropylenes
Abdominal Wall
Sutures
Tobacco
Incisional Hernia
Adrenal Cortex Hormones
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery

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Intraperitoneal modification of the Rives-Stoppa repair for large incisional hernias. / Williams, Regan; Martin, D. F.; Mulrooney, M. T.; Voeller, G. R.

In: Hernia, Vol. 12, No. 2, 01.04.2008, p. 141-145.

Research output: Contribution to journalArticle

Williams, Regan ; Martin, D. F. ; Mulrooney, M. T. ; Voeller, G. R. / Intraperitoneal modification of the Rives-Stoppa repair for large incisional hernias. In: Hernia. 2008 ; Vol. 12, No. 2. pp. 141-145.
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