A Novel Approach to Recurrent Incisional Hernia. Combined Open and Laparoscopic Technique (COLT)

Lawrence Toquero, MD, Sabina Patel, Miss, Joseph Ellul, Mr. Kings College Hospital NHS Trust

Objective:

The aim of this study was to determine the suitability of a novel technique of a combined open and laparoscopic technique (COLT Technique), in the repair of complex recurrent incisional hernias.

Materials and Methods:

10 consecutive patients with recurrent or complex incisional hernia with significant comorbidities underwent the COLT Technique. Follow-up was up to twenty four weeks, along with subsequent telephone follow-up.

Results:

5F:5M with a median age of 72 years. ASA grade >3 in each patient.

Complete follow-up was recorded in all patients, with a minimum of 2-30 months (median follow-up 8 months). Overall healing rate of 100% achieved. Operative times ranged between 75 – 145mins with a median time of 90 minutes.

Each patient underwent ERAS. Median time to discharge was 2 days, whilst pain post operatively were found to be lower.

Discussion:

The COLT technique is an effective and safe treatment option. Benefits of this procedure include: (I) Ease of mesh placement (II) Economic benefits negating the use of expensive biological meshes, (III) Approximation of the muscle layers adding strength to the repair, (IV) Reduction in incidence of wound infections and (V) Low recurrence rates following the procedure all benefitting both the patient and the surgical department. 

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