Novel Surgical Paradigm and Technique: Applying Physics to Incisional/Ventral Hernia Repairs

Francis Baccay, MD, Hanna Alemayehu, MD, Jai P Singh, MD, Irene J Lo, Arpit Amin, MD, Alexander Harrington, MBA, Hunter Benvenuti, MD, David Y Cho, Finny George, Sarah P Cate, MD. Westchester Medical Center

INTRODUCTION

Outcomes from a patient series based on the laws of physics are presented to support a novel incisional/ventral hernia reconstruction. The technique incorporates multiple symmetric suture lines for dispersement of incurred forces. Multiple symmetric suture lines are the prominent distinction of this original repair.

METHODS AND PROCEDURES

A total of 88 consecutive patients with incisional/ventral hernias were repaired. All hernias were repaired using open bilateral components separation. Biologic grafts were placed either in the retro-rectus pre-peritoneal or retro-rectus intra-peritoneal position.

RESULTS

There are no recurrences or re-admissions. Mean age is 62.2yr (16-84yr), mean body mass index of 37.2 kg/m2 (19.5-56.8 kg/m2), mean follow-up is 27.6 months (4-88mo), mean hernia size 492 cm2 (48-1200cm2) and mean length of stay is 4.6 days (2-10 days). Wound infection rate is 3.4% (3/88).

CONCLUSION

The novel paradigm and technique emphasizes the manner in which the reinforcing material is sutured to the abdominal wall, rather than the material itself. This innovative technique utilizes multiple symmetric suture lines for dissipation of horizontal and vertical eccentric forces. The increased surface approximation decreases dead space and movement between the biologic graft and patient tissues allowing for optimal incorporation.