Operations for Large Ventral Hernia

Abstract

Incisional hernia may follow 5-20% of all laparotomies. Repair of any large ventral hernia (≥10 cm2) requires considerable amount of resources, can be technically challenging, and is fraught with high recurrence rate. As such, the first repair of a large ventral hernia is the most important repair since it has the highest likelihood of success; utmost diligence and technical attention must be given to achieve optimal outcome. Prevention is the most important strategy to treat large ventral hernia. This can be achieved by preventing surgical site infection, improving technical closure, and perhaps using prophylactic mesh on patients with increased risk of developing hernia. This chapter covers factors that lead to incisional hernia formation. It describes several common kinds of mesh repairs including repair with autologous tissue using component separation. Laparoscopic ventral hernia repair is described in a separate chapter.