A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects
Summary:. The primary goal of abdominal wall reconstruction is to prevent hernia recurrence through robust and durable repair. Synthetic mesh utilization can provide sound strength but is susceptible to extrusion, infection, and intestinal fistulization. The use of autologous fasciae latae to reinfo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-04-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003558 |
| _version_ | 1818827691236786176 |
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| author | Takashi Kurabayashi, MD Hirotaka Asato, MD Yasutoshi Suzuki, MD Goro Takada, MD Noriyuki Ishizuka, MD Shoichi Sasaki, MD Michihiko Moteki, MD |
| author_facet | Takashi Kurabayashi, MD Hirotaka Asato, MD Yasutoshi Suzuki, MD Goro Takada, MD Noriyuki Ishizuka, MD Shoichi Sasaki, MD Michihiko Moteki, MD |
| author_sort | Takashi Kurabayashi, MD |
| collection | DOAJ |
| description | Summary:. The primary goal of abdominal wall reconstruction is to prevent hernia recurrence through robust and durable repair. Synthetic mesh utilization can provide sound strength but is susceptible to extrusion, infection, and intestinal fistulization. The use of autologous fasciae latae to reinforce the primary fascial reapproximation has mostly been abandoned, presumably because synthetic patches are readily available. There is a specific demand for a sustainable, less-invasive, and ready-to-use repair method without mesh. The authors devised a herniorrhaphy lamination technique using local musculofascial flaps inspired by composite laminates. In this procedure, the primary fascial reapproximation is reinforced with 3 additional laminated musculofascial layers: (1) turnover hinge flaps of the anterior sheath of the rectus abdominis, (2) bilateral rectus abdominis, and (3) advancement flaps of newly generated edges of the fascia of the rectus sheath. Our technique’s stability is essentially due to the mechanical superiority of the centralized pipe-like structure of musculofascia. Between February 2009 and November 2019, we used the lamination technique to repair midline incisional hernias in 10 patients. The operative procedure was successful in all patients, and there has been no evidence of recurrence. The follow-up period ranged from 12 to 69 months, with a mean follow-up of 35 months. The herniorrhaphy lamination technique to reinforce the primary repair can help prevent hernia recurrence. Although our technique is suitable for a small-sized defect, it is less invasive, and can be readily applied. Because it does not include any mesh, it is suitable for the contaminated abdominal wall reconstruction. |
| first_indexed | 2024-12-19T00:47:35Z |
| format | Article |
| id | doaj.art-b6d7c615478649269413c1becc944a55 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-19T00:47:35Z |
| publishDate | 2021-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-b6d7c615478649269413c1becc944a552022-12-21T20:44:14ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742021-04-0194e355810.1097/GOX.0000000000003558202104000-00036A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall DefectsTakashi Kurabayashi, MD0Hirotaka Asato, MD1Yasutoshi Suzuki, MD2Goro Takada, MD3Noriyuki Ishizuka, MD4Shoichi Sasaki, MD5Michihiko Moteki, MD6From the * Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan† Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan.From the * Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan† Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan.From the * Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan† Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan.From the * Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, JapanSummary:. The primary goal of abdominal wall reconstruction is to prevent hernia recurrence through robust and durable repair. Synthetic mesh utilization can provide sound strength but is susceptible to extrusion, infection, and intestinal fistulization. The use of autologous fasciae latae to reinforce the primary fascial reapproximation has mostly been abandoned, presumably because synthetic patches are readily available. There is a specific demand for a sustainable, less-invasive, and ready-to-use repair method without mesh. The authors devised a herniorrhaphy lamination technique using local musculofascial flaps inspired by composite laminates. In this procedure, the primary fascial reapproximation is reinforced with 3 additional laminated musculofascial layers: (1) turnover hinge flaps of the anterior sheath of the rectus abdominis, (2) bilateral rectus abdominis, and (3) advancement flaps of newly generated edges of the fascia of the rectus sheath. Our technique’s stability is essentially due to the mechanical superiority of the centralized pipe-like structure of musculofascia. Between February 2009 and November 2019, we used the lamination technique to repair midline incisional hernias in 10 patients. The operative procedure was successful in all patients, and there has been no evidence of recurrence. The follow-up period ranged from 12 to 69 months, with a mean follow-up of 35 months. The herniorrhaphy lamination technique to reinforce the primary repair can help prevent hernia recurrence. Although our technique is suitable for a small-sized defect, it is less invasive, and can be readily applied. Because it does not include any mesh, it is suitable for the contaminated abdominal wall reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003558 |
| spellingShingle | Takashi Kurabayashi, MD Hirotaka Asato, MD Yasutoshi Suzuki, MD Goro Takada, MD Noriyuki Ishizuka, MD Shoichi Sasaki, MD Michihiko Moteki, MD A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects Plastic and Reconstructive Surgery, Global Open |
| title | A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects |
| title_full | A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects |
| title_fullStr | A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects |
| title_full_unstemmed | A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects |
| title_short | A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects |
| title_sort | herniorrhaphy lamination technique for the reconstruction of midline abdominal wall defects |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003558 |
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