Repair of large, multiple, and recurrent ventral hernias: an analysis of 124 cases.

[OBJECTIVE] To present our technique for repairing large, multiple, and recurrent ventral hernias, and describe our experience.

[DESIGN] Retrospective study.

[SETTING] Teaching hospital, Kuwait.

[SUBJECTS] 124 patients (4 men and 120 women, age range 25-60) who presented with recurrent (n = 34), multiple (n = 27), or large (n = 63) ventral hernias.

[INTERVENTION] Abdominoplasty through a bikini crease incision together with a diamond shaped incision to preserve the umbilicus on its vascular pedicle. After wide dissection the hernia was repaired by two layer, tension-free plication using the available lax tissues. Redundant tissue was excised.

[MAIN OUTCOME MEASURES] Duration of healing, depth of stay in hospital, complications, and recurrence.

[RESULTS] Most of the hernias (113, 91%) had healed within 12 days, and over the three quarters of patients had left hospital within 10 days (median duration of stay 8 days). There was one severe wound infection, 10 patients developed minimal necrosis of fat or skin (4 of which developed secondary infection), and there were 3 seromas. 3 Hernias (2%).

[CONCLUSION] We recommend this technique of abdominoplasty for large, multiple, or recurrent hernias, particularly in those patients who have pronounced prolapse of the abdominal wall.