Thursday, 22 March 2018

What to do about recurrent abdominal hernias?????? -------Abdominal Wall Reconstruction is the answer


Panchkula: Abdominal wall hernias are very common surgical problem known to mankind. The high prevalence of hernia, for which the lifetime risk is 27 % for men and 3 % for women, has resulted in this condition inheriting one of the longest traditions of surgical management. The Egyptians (1500 BC), the Phoenicians (900 BC), and the Ancient Greeks (Hippocrates, 400 BC) diagnosed hernia. 
The problem of recurrence of disease or defect is high and next after the cancer recurrence rates. This leads to the quest for a better and comprehensive technique so as to achieve long and short term results and lesser recurrence rates.

Type of Repair
Method
Wound Complications
Pain
Recurrence
On The Muscle- Onlay
Open
+++
+++
20-25%
Retro Muscular- Sublay
Open or Lap
+
+
5-7%
Inside abdomen-Inlay
Lap or Open
++
+
10-15%

Retro muscular approach of the abdominal wall repair and component separation (with or without Transverses abdominus separation-TAR) has proved to be best alternative to all repairs. Although infrequently performed due to difficult and demanding skills, it has a long scar too. But the correction of divarication and Abdominoplasty are added advantages of it.
Dr Rajender Kumar Batra has been doing this repair by Retro muscular approach at Alchemist Hospital Sector 21 Panchkula since 3 years now and with less than 3 partial recurrences out of 30 odd cases. This type of mesh repairs have lesser pain, less recurrences and wound problems after surgery.

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