Department of General Surgery, Tel Aviv Sourasky Medical Center, Ichilov Hospital, Tel Aviv, Israel.
Department of General Surgery, Wolfson Medical Center, Holon, Israel.
Langenbecks Arch Surg. 2021 Sep;406(6):2117-2123. doi: 10.1007/s00423-021-02087-y. Epub 2021 Feb 15.
To describe the abdominal wall reconstruction technique with an Ultrapro mesh and outcome for the repair of postoperative ventral hernias after the use of a Mercedes incision during the initial abdominal operation.
A retrospective review of all the patients undergoing elective postoperative ventral hernia repair between 2013 and 2019. The cohort of these patients that had an initial Mercedes incision was used for this study.
Fourteen patients met the criteria for this study. Thirteen of the patients were transplant patients (10 liver transplant and 3 combined pancreas and kidney transplant), and one patient was after a hepatectomy. Fifty-seven percent of these hernias were multiple defects. All the patients underwent the same repair of a modified Rives-Stoppa, transversus abdominis release, and a bilateral transverse plication. A partially absorbable Ultrapro mesh was used for all the patients, with two of the patients needing an additional Symbotex mesh in order to bridge a portion of the posterior fascia. There were 6 minor early postoperative complications (hematoma, superficial wound infection, and seroma) that did not require reoperation. Two patients were readmitted for observation of a wound hematoma, and two patients (14.2%) had recurrence during the follow-up period. The average length of hospitalization was 5.6 days.
This technique, with the use of an Ultrapro mesh, was found to be safe and effective for the repair of a postoperative ventral hernia due to an initial Mercedes incision.
描述一种使用 Ultrapro 网片进行腹壁重建的技术，并报告在初次腹部手术中使用奔驰切口（Mercedes incision）后修复术后腹疝的结果。
回顾性分析 2013 年至 2019 年间所有择期行术后腹疝修补术的患者。本研究使用了最初采用奔驰切口的患者队列。
14 名患者符合本研究标准。13 名患者为移植患者（10 例肝移植，3 例胰肾联合移植），1 例为肝切除术后患者。这些疝中有 57%为多发缺损。所有患者均行改良 Rives-Stoppa 修复、腹横肌松解和双侧横形折叠术。所有患者均使用部分可吸收的 Ultrapro 网片，其中 2 例患者需要额外的 Symbotex 网片以桥接部分后筋膜。有 6 例轻微的早期术后并发症（血肿、浅表伤口感染和血清肿）无需再次手术。2 例患者因伤口血肿再次入院观察，2 例患者（14.2%）在随访期间复发。平均住院时间为 5.6 天。
对于因初次奔驰切口导致的术后腹疝，使用 Ultrapro 网片的这种技术被发现是安全有效的。
