Alternative to mesh repair for ventral hernias: Modified rectus muscle repair

doi:10.5412/wjsp.v13.i3.14

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Dec 28, 2023 (publication date) through Feb 24, 2026

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World Journal of Surgical Procedures

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2219-2832

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Control Study

World J Surg Proced. Dec 28, 2023; 13(3): 14-21
Published online Dec 28, 2023. doi: 10.5412/wjsp.v13.i3.14

Alternative to mesh repair for ventral hernias: Modified rectus muscle repair

Vijay Naraynsingh, Shamir O Cawich, Samara Hassranah

Vijay Naraynsingh, Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago

Shamir O Cawich, Department of Surgery, University of the West Indies, St. Augustine, Trinidad and Tobago

Samara Hassranah, Department of Surgery, Medical Associate Hospital, St. Joseph, Trinidad and Tobago

Author contributions: Naraynsingh V conceptualized the manuscript and checked scientific integrity; Cawich SO wrote the manuscript and checked for scientific integrity; Hassranah S prepared images, collected data and checked the manuscript for scientific integrity

Institutional review board statement: This study was approved by the local institutional review board (certificate attached).

Informed consent statement: This is to confirm that I give consent to the use of my operation data for publication purposes. Both the pictures of the surgery as well as the clinical findings may be used on the understanding that these will be anonymous and I will not be personally identifiable. Neither my name nor face will be shown.

Conflict-of-interest statement: All the authors declare that there are no conflicts of interest

Data sharing statement: All data are stored by the corresponding author and will be released upon reasonable request

STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.

Corresponding author: Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago. socawich@hotmail.com

Received: September 23, 2023
Peer-review started: September 23, 2023
First decision: November 1, 2023
Revised: November 18, 2023
Accepted: December 19, 2023
Article in press: December 19, 2023
Published online: December 28, 2023
Processing time: 94 Days and 5.5 Hours

Abstract

BACKGROUND

Mesh utilization for ventral hernia repair is associated with potential complications such as mesh infections, adhesions, seromas, fistula formation and significant postoperative pain. The modified rectus muscle repair (RMR) is as an option to repair midline ventral hernias without mesh.

AIM

To evaluate the short term outcomes when the modified RMR was used to repair ventral hernias.

METHODS

This was a 5-year prospective study that examined the outcome of all consecutive patients with ventral abdominal wall hernias > 5 cm in maximal diameter who underwent repair using the modified RMR technique in a single surgeon unit. Patients were reviewed in an outpatient clinic at 3, 6 and 12 mo and evaluated for hernia recurrence on clinical examination. Each patient’s abdominal wall was also assessed with using ultrasonography at 24 mo to detect recurrences. All data were examined with SPSS ver 18.0.

RESULTS

Over the 5-year study period, there were 52 patients treated for ventral hernias at this institution. Four patients were excluded and there were 48 in the final study sample, at a mean age of 56 years (range 28-80). The mean maximal diameter of the hernia defect was 7 cm (range 5-12 cm). There were 5 (10.4%) seromas and 1 recurrence (2.1%) at a mean of 36 mo follow-up.

CONCLUSION

The authors recommend the modified RMR as an acceptable alternative to mesh repair of ventral hernias. The seroma rate can be further reduced with routine use of drains. The modified RMR also has the benefit of eliminating all mesh-specific complications.

Keywords: Ventral; Hernia; Mesh; Complication; Recurrence

Core Tip: Mesh utilization for ventral hernia repair is associated with potential complications such as mesh infections, adhesions, seromas, fistula formation and significant postoperative pain. Using the modified Rectus Muscle Repair results in 10.4% seromas, which can be further reduced with routine use of drains. Using the modified Rectus Muscle Repair results in 2.1% recurrences at a mean of 36 mo follow up. The modified Rectus Muscle Repair is as an option to repair midline ventral hernias without mesh.