Naraynsingh V, Cawich SO, Hassranah S. Alternative to mesh repair for ventral hernias: Modified rectus muscle repair. World J Surg Proced 2023; 13(3): 14-21 [DOI: 10.5412/wjsp.v13.i3.14]
Corresponding Author of This Article
Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago. socawich@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Surg Proced. Dec 28, 2023; 13(3): 14-21 Published online Dec 28, 2023. doi: 10.5412/wjsp.v13.i3.14
Alternative to mesh repair for ventral hernias: Modified rectus muscle repair
Vijay Naraynsingh, Shamir O Cawich, Samara Hassranah
Vijay Naraynsingh, Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
Shamir O Cawich, Department of Surgery, University of the West Indies, St. Augustine, Trinidad and Tobago
Samara Hassranah, Department of Surgery, Medical Associate Hospital, St. Joseph, Trinidad and Tobago
Author contributions: Naraynsingh V conceptualized the manuscript and checked scientific integrity; Cawich SO wrote the manuscript and checked for scientific integrity; Hassranah S prepared images, collected data and checked the manuscript for scientific integrity
Institutional review board statement: This study was approved by the local institutional review board (certificate attached).
Informed consent statement: This is to confirm that I give consent to the use of my operation data for publication purposes. Both the pictures of the surgery as well as the clinical findings may be used on the understanding that these will be anonymous and I will not be personally identifiable. Neither my name nor face will be shown.
Conflict-of-interest statement: All the authors declare that there are no conflicts of interest
Data sharing statement: All data are stored by the corresponding author and will be released upon reasonable request
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago. socawich@hotmail.com
Received: September 23, 2023 Peer-review started: September 23, 2023 First decision: November 1, 2023 Revised: November 18, 2023 Accepted: December 19, 2023 Article in press: December 19, 2023 Published online: December 28, 2023
Abstract
BACKGROUND
Mesh utilization for ventral hernia repair is associated with potential complications such as mesh infections, adhesions, seromas, fistula formation and significant postoperative pain. The modified rectus muscle repair (RMR) is as an option to repair midline ventral hernias without mesh.
AIM
To evaluate the short term outcomes when the modified RMR was used to repair ventral hernias.
METHODS
This was a 5-year prospective study that examined the outcome of all consecutive patients with ventral abdominal wall hernias > 5 cm in maximal diameter who underwent repair using the modified RMR technique in a single surgeon unit. Patients were reviewed in an outpatient clinic at 3, 6 and 12 mo and evaluated for hernia recurrence on clinical examination. Each patient’s abdominal wall was also assessed with using ultrasonography at 24 mo to detect recurrences. All data were examined with SPSS ver 18.0.
RESULTS
Over the 5-year study period, there were 52 patients treated for ventral hernias at this institution. Four patients were excluded and there were 48 in the final study sample, at a mean age of 56 years (range 28-80). The mean maximal diameter of the hernia defect was 7 cm (range 5-12 cm). There were 5 (10.4%) seromas and 1 recurrence (2.1%) at a mean of 36 mo follow-up.
CONCLUSION
The authors recommend the modified RMR as an acceptable alternative to mesh repair of ventral hernias. The seroma rate can be further reduced with routine use of drains. The modified RMR also has the benefit of eliminating all mesh-specific complications.
Core Tip: Mesh utilization for ventral hernia repair is associated with potential complications such as mesh infections, adhesions, seromas, fistula formation and significant postoperative pain. Using the modified Rectus Muscle Repair results in 10.4% seromas, which can be further reduced with routine use of drains. Using the modified Rectus Muscle Repair results in 2.1% recurrences at a mean of 36 mo follow up. The modified Rectus Muscle Repair is as an option to repair midline ventral hernias without mesh.
