Lateral incisional hernia: Surgical challenge

Abstract

Introduction: Incisional lateral hernia has not been studied properly, the surgical management is a challenge, because bone and neurovascular structures difficult the mesh fixation. Objective: The first objective of this study is to describe the cases of lateral incisional hernia, to show the experience in terms of type of mesh, surgical approach, recurrence, and expand the knowledge of this pathology that every day becomes more important. Methods: A case series of patients with lateral incisional hernia, which undergo surgical repair, between February 2015, and November 2018, in a 4th level hospital in Bogotá, Colombia. Results: Between 2015 and 2018, 27 patients, with a mean age of 70 years (IQR: 12 years), and a mean of body mass index of 27-9 kg/m2 (IQR: 5.46 kg/m2), that undergo surgical repair of lateral hernia. We follow patients with a mean of 14 months (IQR: 4.2), with an evidence of recurrence of 3 patients. The majority of the hernias were in flank (L2) (48.2 %) localization. Appendectomy with 29.6 %, were the surgical procedure with most of the cases. Surgical technique more commonly used was on lay mesh fixation, with a polypropylene mesh material in most of the cases (81.4 %). Conclusion: Actually we do not have a standardized technique for these defects, for that reason more randomized controlled studies are required comparing the techniques to define a secure approach, with a less rate of recurrence.