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Fixation-free incisional hernia repair in the elderly: our experience with a tentacle-shaped implant.

Abstract：

BACKGROUND:Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair. AIMS:In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias. The results of a fixation-free incisional hernia repair carried out in elderly patients using a tentacle-shaped implant are reported herewith. METHODS:A tentacle-shaped flat mesh with a large central body and integrated arms was used to repair incisional hernia in 23 elderly patients. The mesh was placed fixation-free and secured in place through the friction exerted by the tentacles. All tentacle straps were positioned with a special passer needle. Implant placement was preperitoneal in 18 patients and retromuscular sublay in five. RESULTS:In a follow-up of 18 to 59 months (mean 36 months), four seromas occurred. Postoperative fast track helped avoid the typical complications affecting this patient subset. No infection, hematoma, chronic pain, mesh dislocation or recurrence have been reported to date. DISCUSSION:The tentacle strap system allowed for reduced skin incision thus minimizing surgical trauma and ensuring easier and faster implant placement. CONCLUSION:The tentacle arms of the implant ensured mesh stability and broad defect overlap. Besides a very low complication rate, none of the typical postoperative complications of aged patients occurred.

journal_name

Aging Clin Exp Res

journal_title

Aging clinical and experimental research

authors

Romano G,Calò PG,Erdas E,Medas F,Gordini L,Podda F,Amato G

doi

10.1007/s40520-016-0651-1

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

173-177

issue

Suppl 1

eissn

1594-0667

issn

1720-8319

pii

10.1007/s40520-016-0651-1

journal_volume

29

pub_type

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