[Rectusbanding variation II - a method for the repair of incisional hernias - further developments].

We report on further developments of the rectusbanding variation II method which is used for the repair of large incisional hernias in 70 patients. Using this method the musculus rectus abdominis is not entirely looped. Instead, the polypropylene bands, which have been placed in sublay position, are penetrating the lateral rim through incisions and are fastened there. Important to note that the polypropylene bands are not used to ligate the abdominal wall. The bands must be placed loosely. This allowed us to reduce the applied material by almost 50 per cent. Although a high number (n = 70) of large incisional hernias (about 150 cm (2), variation I n = 16/20,3%, variation II n = 29/41,4%) were operated upon with this method (rectusbanding variation II) previous excellent results could be further improved (wound infectionrate 2,8%, recurrence rate after 18 months 0%, patients had no complaints and their mobility was excellent). Only the seroma formation rate was slightly increased due to the large size of the hernias. These excellent results are mainly based on the absolutely reliable fixing of the polypropylene bands and the complete mesh coverage by soft tissue. This method can be easily learned by any surgeon and is a true alternative to all conventional methods which have been published so far. In particular laparoscopic methods for incisional hernia repair can be replaced by this technique.