Modified retrorectus ventral hernia repair

BackgroundTraditional retrorectus techniques for ventral hernia repair often produce abdominal wall pain related to transfascial suture placement. This report details results of a retrorectus mesh herniorrhaphy technique avoiding transfascial suture fixation.MethodsA retrospective review of 90 patients who underwent retrorectus ventral hernia repair between 2009 and 2015 was performed. All were treated with primary posterior rectus fascial closure and retrorectus mesh placement. Standard weight polypropylene mesh was used with polypropylene tacking sutures to the posterior rectus sheath with medialization of the rectus muscles and primary closure of the anterior rectus sheath over the mesh repair.ResultsThe overall complication rate was 19.6%. Hernia recurrence occurred in 2 patients (2.2%) with mean follow-up of 3.0 years. There were 4 cases of superficial infection (4.3%). Two patients (2.2%) developed hematomas and 2 patients developed seromas (2.2%). Late abdominal pain occurred in 6 (6.5%) patients, eventually resolving in all but 2.ConclusionsRetrorectus ventral hernia repair avoiding transfascial suture placement produces a functional repair with minimal chronic pain and a low rate of complications.