Sublay Incisional Hernia Repair with Composite Mesh in Patients with Additional Abdominal Disorders
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The authors present two patients operated on for large incisional hernias with additional abdominal disorders requiring surgical treatment. The first patient was scheduled for cholecystectomy whereas the second one for partial resection of the small bowel. Since those hernias did not qualify for classical operations due to extensive destruction of the muscular and fascial layers of the abdominal wall the patients underwent repair with modern composite meshes. Those meshes can be applied directly on the bowel loops. Of the two patients a polyester mesh coated with polyethylene-glycol-glycerol-oxidized bovine atelocollagen was applied in the former whereas a polypropylene monofilament mesh coated with a layer of silicone in the latter. Those biomaterials coating the visceral surface of the meshes prevent them from adherence to the bowel loops. What is more, inflammatory response to the foreign body with following adhesion formation and as a result either bowel obstruction or enterocutaneous fistulas can be reduced. The postoperative course was uneventful in both patients in spite of the operations being performed in the contaminated field.
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24 - 12 - 2009
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