What is Retrorectus mesh?

Background: In abdominal wall reconstruction, the retrorectus plane offers an ideal location for mesh placement. Mesh fixation in this plane is often achieved using transfascial sutures, which risks entrapping intercostal nerves and causing significant pain, and takes time to place.

What material is used for hernia mesh?

The most common material used to make a hernia mesh patch is polypropylene. It is safe, resistant to infection and has been used for more than 50 years. Every several years, technology improves the material characteristics in order to provide stronger, lighter products that are better tolerated by patients.

What is a Retrorectus repair?

Retrorectus ventral hernia repair, as originally described by Rives, Stoppa, and Wantz, allows for creation of a well-vascularized sublay space for mesh placement, although within the confines of the rectus sheath.

What material is surgical mesh?

Surgical mesh is a screen-like material that is used as a reinforcement for tissue or bone. It can be made of synthetic polymers or biopolymers. Materials used for surgical mesh include: Non-absorbable synthetic polymers (polypropylene).

Where is the Retrorectus space?

The retrorectus compartments are separated in the midline by the linea alba. Here, the posterior sheath is divided about 2–3 mm away from the midline, taking care not to breach the layer of pre-peritoneal fat and peritoneum dorsally, on both the sides, to create a single retrorectus compartment.

What is Sublay mesh repair?

The sublay mesh technique is an open surgical procedure for large incisional hernias. With this technique a skin incision is made directly above the protruding hernial sac [Fig. 32] and the scar is cut out.

How big is a piece of retrorectus mesh?

With this, a piece of Prolene mesh measuring 6 x 6 inches in size was placed in the retrorectus fashion and this was sutured in placed using #1 Prolene sutures in a horizontal mattress fashion going through the anterior abdominal wall circumferentially. With this, this retrorectus space was then copiously irrigated with sterile normal saline.

Can a hernia be repaired with retrorectus mesh?

After institutional review board approval, a retrospective review of 26 consecutive patients who underwent elective ventral hernia repair with mesh placement in the retrorectus plane with primary musculofascial reapproximation with at least 12-month follow-up was performed.

How to fix mesh in the retrorectus plane?

Fixation of mesh in the retrorectus plane can be performed using sutures between the mesh and the rectus sheath reflection at the semilunar line.

When to use retrorectus self for abdominal wall reconstruction?

Incisional ventral hernias are a prevalent problem, affecting up to 10% of patients who have undergone a laparotomy. 1 At the time of the initial hernia repair, it is important to achieve the most durable reconstruction as the risk of hernia recurrence increases with every subsequent reconstructive attempt. 2