Open incisional hernia repair with retromuscular mesh augmentation

The present skin scar is excised completely

Dissect down to the fascia and fully expose the entire fascial scar.

When opening the abdominal cavity, the fascial scar is transected completely.

It is not enough to repair the fascial defect because frequently there are small multiple incisional hernia orifices.

Local adhesiolysis of abdominal organs in the hernia sac allows better overview and helps avoid iatrogenic bowel lesions when dissecting the tissue for the mesh bed.

Follow this by covering the abdominal cavity with a warm wet laparotomy pad.

Note: Interenteric adhesiolysis should only be performed in case of pertinent complaints

Dissect the anterior fascia epifascially and sparingly. This facilitates the subsequent dissection of the tissue for the mesh bed and later fascial closure.