Open incisional hernia repair with retromuscular mesh augmentation

  1. Exzision der Hautnarbe

    Exzision der Hautnarbe

    The present skin scar is excised completely

  2. Exposing the fascial defect

    Exposing the fascial defect

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

  3. Opening the abdominal cavity

    Opening the abdominal cavity

    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.

  4. Local adhesiolysis

    Local adhesiolysis

    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

  5. Dissecting the anterior fascia

    Dissecting the anterior fascia

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

Incising the rectus sheath

Starting at the margin of the fascia, incise the rectus sheath on both sides of the linea alba, the

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