Suture Hernia after Transfascial Mesh Fixation
| Discussion in 'All Categories' started by Aravind Menon - Dec 19th, 2016 9:56 am. | |
Aravind Menon
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Sir, I came across few case reports about entity called 'Suture hernia' which were termed so because they were the consequence of transfascial fixation on IPOM technique of ventral hernia repair. It was described that the two limbs of the stitch taken at the corner of mesh make the rectus in between the limbs weak in the long term and this results in suture hernia. One report was from Apollo, Chennai. So does this implicate that tackers are safer than transfascial fixation? Or does it mean that should we stick to absorbable sutures like vicryl for transfascial fixation and not use non absorbable sutures at all to avoid the pressure necrosis of rectus sheath at the corner stitch site?? What is your opinion sir? |
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re: Suture Hernia after Transfascial Mesh Fixation
by Dr R K Mishra -
Dec 24th, 2016
7:43 am
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Dr R K Mishra
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Dear Dr Menon Transfascial suture fixation is used worldwide in addition to tackers (either absorbable or non absorbable) is an established method to prevent recurrence due to mesh migration. There are rare cases reported as recurrent ventral hernia with multiple defects at transfascial suture sites. To minimize it non absorbale suture and tension free application of suture is recommended. Using non absorbable suture has this problem sometime and these are occasionally cause of pain also. In my opinion only corners should be fixed by absorbable suture and rest of the place absorbable tacker can be safely used. Large bites of mesh with non absorbable suture can cause excessive tension and ultimately a hole in the mesh and subsequently hernia. With regard Dr R K Mishra |
