Incisional Hernia: lisk factors, prevention, and repair

Incisional hernia is a major health care problem. It is one of the most frequent longterm complications of abdominal surgery and it continues to be a significant problem for patients as well as surgeons. As a result of advances in surgical knowledge and increase in the variety and number of abdominal incisions, the incidence of postoperative incisional hernias has increased rapidly. Unfortunately, attempts of repair of these hernias have not been uneventful, with high rates of hernia recurrence, and considerable rates of morbidity and mortality, making many surgeons hesitant to undertake incisional hernia repair. On the other hand, however, delay in repair may have serious clinical consequences. Apart from discomfort and pain, incisional hernias may predispose to incarceration or strangulation of primarily small bowel, which is almost certainly fatal if not promptly reduced. Also, as a consequence of the impact on health, incisional hernias have enormous economic consequences. At this time no consensus has been reached about whether, how, and when to operate on a patient with an incisional hernia. To solve the incisional hernia problem, first of all methods of prevention are needed. Furthermore, once an incisional hernia has developed, ideally, methods of repair that do not lead to recurrence or other complications should be available. In this thesis, several clinical studies have been undertaken in an attempt to determine the most effective way to repair and prevent incisional hernia herniation and recurrence.

• View at Worldcat

Free Full Text ( Final Version , 3mb )