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Incisional Hernia Repair with Polypropylene Mesh: Where should the mesh be placed? HOSPITAL UNIVERSITARIO AUSTRAL Department of general surgery Authors: Iudica Fernando MD, Cingolani Pablo,MD INTRODUCTION The technical aspects of incisional hernia repair are particularly important because this repair is associated with one of the highest failures rates of any operations performed by the general surgeon . Risk factors included ,previous respiratory disease,obesity,wound infection The recurrence rate after simple closure of the defect is near than 40% 40%. Polypropylene is the most comon material used for repair this disease. METHODS 62 years old patient with history of epigastric hernia surgery six months ago with subsequent wound infection, leaving in its wake a median incisional hernia. Surgery 30/12/08: Close the defect and placement of polypropylene mesh in retrorectal space by reinforcement the closer and use Albanese relaxation incisions. RESULTS La eventración es una entidad común. Incidencia 10%. Es mas frecuente en varones, edad avanzada, obesos y en aquellos cuya incisión abdominal es mayor a 18 cm. Los factores más importantes en la génesis de la eventración postoperatoria: son problemas respiratorios, y la i f ió de infección d la l herida. h id El porcentaje de recidiva tras cierre simple de una eventración es alto, para algunos autores el 30%, cifra que aumenta con los intentos de reparación. En la reparación con malla el material mas empleado es el polipropileno Patient with good postoperative evolution, without pain, early deambulation, and control at 3 , 6 months, and 2 year without recurrence and total recovery of the the abdominal wall physiology. Summary Incisional hernias repair with mesh reduces recurrence. Procedures/techniques for successful mesh placement: · Avoid contact with viscera. · Mesh size should exceed by far defect size. necessary · Free tension with relaxation incision if necessary. · Retrieve wall functionality. References: 1- Conze J, Binnebosel, M, Junge K, Schumpelick V “Incisional hernia : How do I do it- Standard surgical approach” Chirurg 2010 81: 192 2-Barroetaveña J, Herszage, “Hernias de la ingle” 5° edition, 2009 3- Mayagoitía González JC, “Hernias de la pared abdominal. Tratamiento actual” Second edition 2009