Abdominal wall reconstruction in combined midline and lateral hernias.

Abstract

<h4>Purpose</h4>Abdominal wall reconstruction in the presence of midline hernia (MH) and lateral hernia (LH) is a challenging procedure. The purpose of this study was to introduce surgical method combining the retromuscular sublay technique and component separation technique with mesh augmentation for the simultaneous repair of midline and lateral hernias.<h4>Methods</h4>Between January 2006 and January 2025, 67 consecutive patients who underwent abdominal wall reconstruction for combined MH and LH or parastomal hernia (PH) were retrospectively analysed. The abdominal wall was reconstructed using a combination of the retromuscular sublay technique and the component separation technique, followed by mesh reinforcement.<h4>Results</h4>Of 67 patients, 53 underwent reconstruction surgery for simultaneous MH and LH, and 14 patients underwent surgery for MH and PH. LH was incisional (after previous pararectal, oblique, subcostal, or "J" incisions) in 58.5%, at the site of stoma closure in 37.7%, and as a consequence of blunt trauma in 3.8%. The median total defect width was 15 cm (range, 11-18) for the entire cohort. The median operative time was 150 min. Overall morbidity was 17.9%. After a median follow-up period of 24 months (range, 1-58), recurrence developed in 2 (3%) patients and abdominal wall bulging in 1 (1.5%).<h4>Conclusion</h4>The combination of the retromuscular sublay technique, the component separation technique and mesh reinforcement is a safe and effective method for the simultaneous repair of MH and LH or PH.