Dumanian Technique for Repair of Complex Incisional Hernias

Abstract

Incisional hernia is protrusion of tissue at or near the site of an incision from a previous surgery. It is a challenging procedure to repair complex incisional hernias. Most of the numerous reconstructive techniques are unable to achieve goals of hernioplasty owing to various factors being planar mesh impose the risk of pain and infection whereas conventional suture repairs can fail due to suture pull through, rupture or slipping of knot. The open components separation technique (CST) creates large undermining skin flaps especially useful in patients with complex hernias who require judicial approximation of the midline fascia. Another novel technique for repair of such hernias is the Dumanian Technique : using mesh as a suture material and has been shown to improve the ultimate tensile strength (UTS) and thus prevent surgical failure. Both the techniques are implemented in our case to achieve successful abdominal closure.