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American Journal of Applied Science and Technology

Peer Reviewed | Open Access | E-ISSN: 2771-2745
Published Article

Incisional Hernia Repair: A Retrospective Observational Study of Surgical Techniques, Patient Characteristics, and Postoperative Outcomes

Incisional Hernia Repair: A Retrospective Observational Study of Surgical Techniques, Patient Characteristics, and Postoperative Outcomes

Authors

  • Hayder Mohammed Ali Zainy
    M.B.Ch.B./F.I.C.M.S. (General surgery) Safeer Al-Imam Al-Hussain Surgical Hospital/ Karbalaa/ Iraq

DOI:

https://doi.org/10.37547/ajast/Volume05Issue08-03

Keywords:

Incisional hernia Mesh repair Sublay technique Abdominoplasty

Abstract

Background: Incisional hernia is a common complication following abdominal surgery, often linked to patient- and technique-related factors. Despite surgical advancements, it remains a significant clinical challenge due to its high recurrence and complication rates.

Objective: To evaluate the clinical characteristics, surgical techniques, and short-term postoperative outcomes in patients undergoing elective incisional hernia repair at a single center.

Methods: A retrospective observational study was conducted at Safeer Al-Imam Al-Hussain Surgical Hospital in Karbalaa, Iraq, from May 2022 to February 2025. Forty adult patients who underwent elective mesh-based incisional hernia repair were included.

Results: The mean age of patients was 44.5 ± 11.9 years, with 77.5% being female and a mean BMI of 35.5 ± 5.6 kg/m². Diabetes mellitus (17.5%) and hypertension (35%) were the most frequent comorbidities. CT imaging was used in 40% of cases to assess large defects or bowel involvement. The most common surgical technique was sublay + window (37.5%), followed by sublay + window + onlay (25%). Postoperative complications occurred in 22.5% of patients, with seroma (15%) and wound infection (7.5%) being the most common. Significant associations with complications were found for diabetes (p = 0.018), large hernia defect (p = 0.031), use of omentoplasty (p = 0.014), midline incision (p = 0.035), and concurrent abdominoplasty (p = 0.017).

Conclusion: Incisional hernia repair remains complex, a tailored surgical approach and appropriate preoperative imaging are essential to optimize outcomes. Despite these challenges, the overall complication rate were minor and acceptable.

References

Sanders DL, Pawlak MM, Simons MP, Aufenacker T, Balla A, Berger C, Berrevoet F, de Beaux AC, East B, Henriksen NA, Klugar M. Midline incisional hernia guidelines: the European Hernia Society. British Journal of Surgery. 2023 Dec;110(12):1732-68.

Skandalakis LJ. Abdominal wall and hernias. InSurgical Anatomy and Technique: A Pocket Manual 2021 Apr 13 (pp. 115-222). Cham: Springer International Publishing.

Arshava EV. Abdominal Hernias. InHamilton Bailey’s Demonstrations of Physical Signs in Clinical Surgery 2016 Jan 7 (pp. 531-546). CRC Press.

Henriksen NA, Jensen KK, Jorgensen LN. The biology of hernia formation. InTextbook of hernia 2017 Apr 12 (pp. 1-5). Cham: Springer International Publishing.

Haskins IN. Hernia formation: risk factors and biology. Surgical Clinics. 2023 Oct 1;103(5):835-46.

Muysoms FE, Antoniou SA, Bury K, Campanelli G, Conze J, Cuccurullo D, De Beaux AC, Deerenberg EB, East B, Fortelny RH, Gillion JF. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015 Feb;19(1):1-24.

Köckerling F, Hoffmann H, Mayer F, Zarras K, Reinpold W, Fortelny R, Weyhe D, Lammers B, Adolf D, Schug-Pass C. What are the trends in incisional hernia repair? Real-world data over 10 years from the Herniamed registry. Hernia. 2021 Apr;25(2):255-65.

Holihan JL, Nguyen DH, Nguyen MT, Mo J, Kao LS, Liang MK. Mesh location in open ventral hernia repair: a systematic review and network meta‐analysis. World journal of surgery. 2016 Jan;40(1):89-99.

Bittner R, Schwarz J. Inguinal hernia repair: current surgical techniques. Langenbeck's archives of surgery. 2012 Feb;397(2):271-82.

Kokotovic D, Bisgaard T, Helgstrand F. Long-term recurrence and complications associated with elective incisional hernia repair. Jama. 2016 Oct 18;316(15):1575-82.

Tigora A, Radu PA, Garofil DN, Bratucu MN, Zurzu M, Paic V, Ioan RG, Surlin V, Margaritescu D, Badoiu SC, Popa F. Modern Perspectives on Inguinal Hernia Repair: A Narrative Review on Surgical Techniques, Mesh Selection and Fixation Strategies. Journal of Clinical Medicine. 2025 Jul 9;14(14):4875.

Mohammed MA, Ahmed ST, Kafala AR. Risk Factors of Incisional Hernia. Journal Of Medical Sciences. 2023 Oct 17;2(10):6-14.

Gignoux B, Bayon Y, Martin D, Phan R, Augusto V, Darnis B, Sarazin M. Incidence and risk factors for incisional hernia and recurrence: retrospective analysis of the French national database. Colorectal Disease. 2021 Jun;23(6):1515-23.

Yamamoto M, Takakura Y, Ikeda S, Itamoto T, Urushihara T, Egi H. Visceral obesity is a significant risk factor for incisional hernia after laparoscopic colorectal surgery: A single‐center review. Asian Journal of Endoscopic Surgery. 2018 Nov;11(4):373-7.

Huntington C, Gamble J, Blair L, Cox T, Prasad T, Lincourt A, Augenstein V, Heniford BT. Quantification of the effect of diabetes mellitus on ventral hernia repair: results from two national registries. The American Surgeon. 2016 Aug;82(8):661-71.

Jensen KK, Arnesen RB, Christensen JK, Bisgaard T, Jørgensen LN. Large incisional hernias increase in size. Journal of Surgical Research. 2019 Dec 1;244:160-5.

Israelsson LA, Millbourn D. Prevention of incisional hernias: how to close a midline incision. Surgical Clinics. 2013 Oct 1;93(5):1027-40.

Iljin A, Antoszewski B, Zieliński T, Skulimowski A, Szymański D, Strzelczyk J. Sublay or onlay incisional hernia repair along with abdominoplasty: which is better? Long-term results. Hernia. 2019 Aug 1;23(4):757-65.

Moreno-Egea A, Campillo-Soto Á, Morales-Cuenca G. Does abdominoplasty add morbidity to incisional hernia repair? A randomized controlled trial. Surgical innovation. 2016 Oct;23(5):474-80.