Pure tissue repair? Prosthetic repair? Modern specific device like Ventralex and PVP devices?
Small defects, 1-2 cm, reach good results with primary closure. For defects bigger than 4 cm, the prosthetic laparoscopic way seems to be the best choice. The real question is in defects from two to 4 cm what is the best surgical way?
In my experience in these cases an anterior prosthetic preperitoneal marlex repair is the best choice. Very effective, less discomfort and less expensive
I go by the strength of the abdominal muscles. Mesh for more than 4cms and tissue repair with defects lessthan that. obesity control is a must for preventing chronic increase in Intra abdominal pressure.Recently ,saw a case where a 2cm defect was previously treated by mesh repair. Now the diameter was around 8cms with the mesh being felt as a postage stamp!
Small defects, primary closure. Larger than 3cms I would probably consider mesh repair. Open repair preferable to laparoscopic for most cases
I Have always used a mesh despite size in adults. usually light weight mesh and placed between the anterior and posterior sheet ideally. the reults have been very good with no removal of meshes in the last 24 months and the infection rate less that 5%.
- Badges
- Science topic
- Similar topics
- Social Psychology
- Attitude