A Donati

G Brancato

JJ Diaz Jr

JM Bellon

M Donati

S Puglia

English

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The extraperitoneal prosthetic repair of abdominal wall defects in the elderly

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MEETING ABSTRACT Open Access
The extraperitoneal prosthetic repair of
abdominal wall defects in the elderly
M Donati*, G Brancato, S Puglia, A Donati
From de Senectute: Age and Health Forum
Catanzaro, Italy. 5-7 December 2009
Background
One of the most debated topics in the surgery of the
abdominal wall hernias is the type and location of the
prosthesis and even the employment of prosthetic mate-
rials for some authors is an object of discussion [1,2].
The aim of this work is to present the experience of a
specialized center in abdominal wall surgery, showing
the results of open extraperitoneal prosthetic repair of
the abdominal wall defects in the elderly.
Matherials and methods
We retrospectively analyzed the 75 patients >65 years
old admitted to our Center with a diagnosis of Inci-
sional, Epigastric, Umbilical, Lumbar, and Spigelian
hernia between January 1994 and January 2009. They
were 38 males and 37 females. The diagnosis was:
umbilical hernias in 6 patients, epigastric hernias in 9
patients, Spigelian hernias in 4 patients and incisional
hernias in 57 patients. The comorbidities and the
dimension of the defects are summarised in Figure 1
Table 1. In 42 patients we used a double-layered poli-
propilene mesh, in 27 a simple plug and in 4 cases a
mono-layered polipropilene mesh and in 2 cases a
dual-mesh. In 37 cases the mesh was placed in pre-
peritoneal position, in 37 in premuscolar and in 2 cases
in intraperitoneal. In 53 cases the surgical procedure
was completed under local anaesthesia, in 22 (all inci-
sional hernias) under general anaesthesia, no patients
under spinal anaesthesia.
Results
We observed in group 6 under local anaesthesia intrao-
perative minor complications. Four patients referred little
intraoperative pain and one medium pain. In 33 cases the
patient was discharged within 24 hours (Day Surgery).
We observed no postoperative complications. In our
follow-up (12-180 months) we found 3 recurrences
among the incisional hernias (5,2%), Figure 2 and 3.
Conclusions
The open extraperitoneal approach by using a polipropi-
lene double layer mesh is in our experience the pre-
ferred technique; it almost always permits surgical repair
to be carried out under local anaesthesia very often in
Day Surgery [3], giving excellent long-term results and
minor complications.
Surgical Sciences, Organ Transplantations and New Technologies
Department. O.U. General and Week Surgery. University Hospital of Catania.
Via S. Sofia 78. 95123.Catania, Italy
Figure 1 Distribution of main co-morbidities in the patients >65
years (75 Patients).
Table 1 Distribution of patients in relation to hernia’s
defect (size in cm.)
Size of hernias defect < 5 cm 5-10 cm >10 cm
N of Patients 40 25 10
Donati et al. BMC Geriatrics 2010, 10(Suppl 1):A6
http://www.biomedcentral.com/1471-2318/10/S1/A6
© 2010 Donati et al; licensee BioMed Central Ltd.
Published: 19 May 2010
References
1. Diaz JJ Jr, Gray BW, Dobson JM, Grogan EL, May AK, Miller R, Guy J,
O’Neill P, Morris JA Jr: Repair of giant abdominal hernias: does the type
of prosthesis matter? Am. Surg. 2004, 70(5):396-401.
2. Bellon JM, Rodriguez M, Garcia-Honduvilla N, Gomez-Gil V, Pascual G,
Bujan J: Comparing the behaviour of different polypropylene meshes
(heavy and lightweight) in an experimental model of ventral hernia
repair. J.Biomed.Mater.Res.B.Appl.Biomater 2009, 89B(2):448-55.
3. Donati M, Gandolfo L, Privitera A, Brancato G, Donati A: Day hospital for
incisional hernia repair: selection criteria. Acta Chir Belg. 2008,
108(2):198-202.
doi:10.1186/1471-2318-10-S1-A6
Cite this article as: Donati et al.: The extraperitoneal prosthetic repair of
abdominal wall defects in the elderly. BMC Geriatrics 2010 10(Suppl 1):A6.
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Figure 2 Epigastric Incisional hernias
Figure 3 Extraperitoneal repair with double-layered Polipropilene
mesh
Donati et al. BMC Geriatrics 2010, 10(Suppl 1):A6
http://www.biomedcentral.com/1471-2318/10/S1/A6
Page 2 of 2


Donati A

Puglia S

Brancato G

Donati M

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BMC Geriatrics

A: Day hospital for incisional hernia repair: selection criteria. Acta Chir Belg.

Comparing the behaviour of different polypropylene meshes (heavy and lightweight) in an experimental model of ventral hernia repair. J.Biomed.Mater.Res.B.Appl.Biomater

Jr: Repair of giant abdominal hernias: does the type of prosthesis matter?

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3290204

The extraperitoneal prosthetic repair of abdominal wall defects in the elderly

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