A novel approach for anatomical repair of ventral hernia with modified smead jones technique

Sudipta Chatterjee; Shobhik Chakraborty; Shivani Meena

doi:10.18203/2320-6012.ijrms20241898

Authors

Sudipta Chatterjee Department of General Surgery, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India
Shobhik Chakraborty Department of General Surgery, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India
Shivani Meena Department of General Surgery, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241898

Keywords:

Modified smead jones technique, Primary ventral hernia, Prolene

Abstract

Background: Ventral hernia repair is the most popular procedures done worldwide. Despite of enough literature, evidence for optimal repair is lacking. We introduced a novel surgical technique for open primary ventral hernia repair, using modified smead jones technique.

Methods: This prospective interventional study conducted at the department of general surgery in Midnapore Medical College and Hospital from October 2022 to February 2023 aimed to assess the efficacy of the modified smead jones technique in open primary ventral hernia repair.

Results: Thirty cases were enrolled, predominantly featuring umbilical hernias in females aged 51-60 years. All cases presented with swelling, pain, and irreducibility. The Modified smead jones technique, employing Prolene no. 1, was utilized, with post-operative complications primarily comprising superficial wound infections managed by IV antibiotics and post-operative pain addressed with adequate analgesia. Recurrence was not observed during follow-ups at 15 days, 1 month, 6 months, and 12 months.

Conclusions: The study concludes that this modified technique offers a straightforward approach with low rates of early and potential reduction in late complications, serving as a viable alternative in both elective and emergency settings for primary ventral hernia repair.

Metrics

Metrics Loading ...

References

Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, et al. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16(2):179-83.

Ramshaw BJ, Esartia P, Schwab J, Mason EW, Wilson RA, Duncan TD, et al. Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg. 1999;65(9):827-32.

Colavita PD, Tsirline VB, Belyansky I, Walters A, Lincourt AE, Sing RF, et al. Prospective, long-term comparison of quality of life in laparoscopic versus open ventral hernia repair. Ann Surg. 2012;256(5):714-23.

Holihan JL, Li LT, Askenasy EP, Greenberg JA, Keith JN, Martindale RG, et al. Analysis of model development strategies: predicting ventral hernia recurrence. J Surg Res. 2016;206(1):159-67.

Holihan JL, Alawadi Z, Martindale RG, et al. Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications. J Am Coll Surg. 2015;221(2):478-85.

Lindmark M, Löwenmark T, Strigård K, Gunnarsson U. Major complications and mortality after ventral hernia repair: an eleven-year Swedish nationwide cohort study. BMC Surg. 2022;22(1):426.

Helgstrand F. National results after ventral hernia repair. Dan Med J. 2016;63(7):B5258.

Helgstrand F, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T. Reoperation versus clinical recurrence rate after ventral hernia repair. Ann Surg. 2012;256(6):955-8.

Lindmark M, Strigård K, Löwenmark T, Dahlstrand U, Gunnarsson U. Risk Factors for Surgical Complications in Ventral Hernia Repair. World J Surg. 2018;42(11):3528-36.

Ross SW, Oommen B, Huntington C, Walters A, Lincourt A, Kercher K, et al. National Outcomes for Open Ventral Hernia Repair Techniques in Complex Abdominal Wall Reconstruction. Am Surg. 2015;81(8):778-85.

Sokolova S, Sherbatykh A, Tolkachev K, Beloborodov V, Dulskiy V, Kozlova N, et al. Efficacy Evaluation of a Case-Specific Approach for Surgical Treatment of Inicisional Ventral Hernia. Int J Surg Protoc. 2021;25(1):114-22.

Wolf LL, Ejiofor JI, Wang Y, Huinik MG, Losina E, Haider HA, et al. Management of Reducible Ventral Hernias: Clinical Outcomes and Cost-effectiveness of Repair at Diagnosis Versus Watchful Waiting. Ann Surg. 2019;269(2):358-66.

Halligan S, Parker SG, Plumb AA, Windsor ACJ. Imaging complex ventral hernias, their surgical repair, and their complications. Eur Radiol. 2018;28(8):3560-9.

Agarwal BB, Agarwal S, Mahajan KC. Laparoscopic ventral hernia repair: innovative anatomical closure, mesh insertion without 10-mm transmyofascial port, and atraumatic mesh fixation: a preliminary experience of a new technique. Surg Endosc. 2009;23(4):900-5.

Plymale MA, Davenport DL, Walsh-Blackmore S, et al. Costs and Complications Associated with Infected Mesh for Ventral Hernia Repair. Surg Infect (Larchmt). 2020;21(4):344-9.

Paul A, Korenkov M, Peters S, Köhler L, Fischer S, Troidl H. Unacceptable results of the Mayo procedure for repair of abdominal incisional hernias. Eur J Surg. 1998;164(5):361-7.

Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J. Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg. 2002;89(11):1350-6.

Gislason H, Viste A. Closure of burst abdomen after major gastrointestinal operations--comparison of different surgical techniques and later development of incisional hernia. Eur J Surg. 1999;165(10):958-61.

Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg. 2005;62(2):220-5.

Cursos. Principals of abdominal wall closure, 2011. Available at: http:// cursoenarm.net/Up to Date. Accessed on 12 July 2023.

Idris SA, Ali AQ, Shalayel MH, Idris TA. Design of multicentre study to evaluate frequency and risk factors for wound dehiscence/ burst abdomen: a study of 1683 major midline laparotomies. Sudan Med Monitor. 2010; 5(4):185- 91.

Richards PC, Balch CM, Aldrete JS. Abdominal wound closure. A randomized prospective study of 571 patients comparing continuous vs. interrupted suture techniques. Ann Surg. 1983;197(2):238-43.

Elkheir IS, Idris SA. Evaluation of abdominal wall closure techniques in emergency laparotomies at a peripheral hospital. Sch J App Med Sci. 2014; 2(5):1591-5.

Os JM, Lange JF, Goossens RH, et al. Artificial midline-fascia of the human abdominal wall for testing suture strength. J Mater Sci Mater Med. 2006;17(8):759-65.

Wissing J, Vroonhoven TJ, Schattenkerk ME, Veen HF, Ponsen RJ, Jeekel J. Fascia closure after midline laparotomy: results of a randomized trial. Br J Surg. 1987;74(8):738-41.

Bande A, Saxena D, Nichkaode PB, Akhtar M. A comparative study of single layer closure versus conventional layered closure of laparotomy wounds Int Surg J. 2018;5(4):1459-63.

Bhavikatti GS, Gupta GHVR. Comparative study of mass closure and layered closure techniques in midline and paramedian laparotomies Acad J Surg. 2019;2(1):42-6.

Nitin KB, Vasudevaiah DT, Nayak DRM, Naik DD. Comparative study of efficacy of modified Smead-Jones technique versus conventional closure of midline laparotomy wound Int J Surg Sci. 2020;4(1):134-7.