How is incisional hernia treatment chosen?

  The incidence of incisional hernia is reported to be about 10% abroad. Postoperative incisional infection is the main cause of incisional hernia, and other factors such as postoperative abdominal distension, abdominal closure technique, anesthesia effect, and malnutrition, excessive obesity, diabetes mellitus, and chronic obstructive pulmonary disease are also related to the occurrence of postoperative incisional hernia. Incisional hernia is also a common postoperative complication in China, but there is a lack of detailed reports in China, because most patients who develop incisional hernia after surgery in China first seek solutions from surgeons, so the treatment of incisional hernia is relatively scattered, and most doctors are not specialized in the treatment of incisional hernia, and most of them adopt simple methods of simple suturing, and the recurrence rate of such surgery is as high as 20%~40%, and when the incisional hernia When the incisional hernia repair surgery fails, the patient is likely to seek treatment from a hernia surgeon who specializes in hernia surgery, and most of my contacts are with patients who have relapsed after incisional hernia repair. Although expert suturing techniques in the field of hernia may pay more attention to the management of some key aspects of the closed abdomen than the general surgeon, this simple suturing method is only suitable for small incisional hernias.  The application of modern hernia patches has led to a significant reduction in the recurrence rate of incisional hernia repair, and the patch is sutured to the defect so that the abdominal wall at the defect is effectively strengthened, reducing the recurrence rate of incisional hernia to less than 10%. onlay repair, inlay repair, and sublay repair are constantly being introduced, leading to an improvement in the effectiveness of incisional hernia repair, and open incisional hernia repair for most The results of open incisional hernia repair can be satisfactory for most incisional hernia of the abdominal wall.  The application of laparoscopic technology provides more therapeutic means for incisional hernia treatment. Laparoscopic repair of incisional hernia (IPOM) has more advantages than open incisional hernia repair, such as less trauma, more reasonable repair from inside the defect, lower recurrence rate, and lower infection rate, etc. However, it is more expensive and requires higher surgical technique, which is not familiar to general surgeons and requires some experience.  Comparison of the three commonly used surgical methods for incisional hernia repair is superior as follows: simple suture: low cost; general surgeon; high recurrence rate; slow recovery; high infection rate.  Open repair: cheaper patch; experienced surgeon; lower recurrence rate; slower recovery; high infection rate.  Lumpectomy repair: more expensive patch; hernia specialist; low recurrence rate; fast recovery; low infection rate.  In conclusion, incisional hernia is an embarrassing complication for surgeons, and the seemingly simple surgery is often ineffective, and the recurrence rate is higher after failed incisional hernia repair surgery. It is especially important to repair the incisional hernia for the first time, so choose carefully the method, materials and surgeons with extensive experience in hernia repair.