We recently repaired a giant lumbar hernia and had a rare postoperative complication of delayed presentation of the loss of domain and ultimately managed it uneventfully.
We have some expeience in this area; we always performed laparoscopic repair. The trick to avoid loss of domain is to suture the 'defect' before meshplasty. Please refer our article:
Palanivelu C, Rangarajan M, John SJ, Madankumar MV, Senthilkumar K. Laparoscopic transperitoneal repair of lumbar incisional hernias: a combined suture and 'double-mesh' technique. Hernia 2008 Feb;12(1):27-31.
http://www.ncbi.nlm.nih.gov/pubmed/17668145
Although Laproscopic Repair is preferred currently, however result of the onlay mesh repair with open surgery are also very excellent. We performed 5 cases during last 7 cases, and to date no recurrence is reported.
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