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Medtronic / Clinical Solutions / Incisional Hernia Prevention / Guideline Summaries

Surgical Endoscopy (2019)
Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))([FOOTNOTE=Bittner R, Bain K, Bansal VK, et al. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)) - Part A. Surg End (2019) 33:3069-3139],[ANCHOR=],[LINK=])

RECOMMENDATIONS

Grade A:
A prophylactic mesh should be placed at the primary stoma operation 

Grade B:
Prophylactic onlay mesh reinforcement has the potential to become the standard treatment for high-risk patients undergoing midline laparotomy

CONCLUDE:
“..prophylactic mesh placement reduces the rate of incisional hernia in high-risk groups with morbid obesity or aortic aneurysm, or colorectal surgery"

European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Managment of Abdominal Aorto-iliac Artery Aneurysms([FOOTNOTE=Wanhainen A, Verzini F, Van Herzeele I, et al. European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg (2018) 1-97],[ANCHOR=],[LINK=])

 

“A recent meta-analysis based on several RCTs showed that prophylactic use of mesh reinforcement of midline laparotomies significantly reduces the risk of incisional hernia after open AAA repair.”

RECOMMENDATION

In Patients treated for abdominal aortic aneurysm by open repair, prophylactic use of mesh reinforcement of midline laparotomies may be considered for patients at high risk of incisional hernia.

 

AWMF online 
S3-Leitlinie zu Screening, Diagnostik, Therapie und Nachsorge des Bauchaortenaneurysmas (2018)([FOOTNOTE=Debus ES, Heidemann F, Gross-Fengels W, et al. S3-Leitlinie zu Screening, Diagnostik, Therapie und Nachsorge des Baucharotenaneurysmas. AWMF-online. 2018. Reg.Nr. 004-14],[ANCHOR=],[LINK=])

S3-Guidelines for screening, diagnosis, therapy and follow-up care of abdominal aortic aneurysms (2018)3

 
RECOMMENDATIONS:

Prophylactic mesh in midline laparotomy in sublay technique after open AAA-Surgery is safe and effective in preventing the high prevalence of incisional hernias occurring after the surgery. This should be implemented.

 

 

Hernia 2015
European Hernia Society guidelines on the closure of abdominal wall incisions([FOOTNOTE=Muysoms FE, Antoniou SA, Bury K, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia 2015;19:1–24. DOI 10.1007/s10029-014-1342],[ANCHOR=],[LINK=])

“Prophylactic mesh augmentation appears effective and safe and can be suggested in high-risk patients, like aortic aneurysm surgery and obese patients.” 

RECOMMENDATIONS:

Prophylactic mesh augmentation for an elective midline laparotomy in a high-risk patient in order to reduce the risk of incisional hernia is suggested.

 

 

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