Hernia (2999) 3:141-147 Hernia 9 Springer-Veflag 1999 Treatment of incisional hernias by placement of an intraperitoneal prosthesis: a series of 128 patients F. Marchal, L. Brunaud, H. Sebbag, L. Bresler, J.M. Tortuyaux and P. Boissel Dept. of Surgery" C ", H6pital de Brabois, rue du Morvan, F-5451zVandoeuvre-les-Nancy, France Summary: This is a retrospective study on 128 patients who underwent surge- -! ry between 1986 and 1996 for incisional hernia repair with placement of an intraperitoneal prosthesis. A polyester mesh (Mersilene| was used in 95 cases (74.2%) and one of PTFE in 33 cases (25.8%). Mortality was 2.34% (3 patients) ; 32 patients (25.6%) developed an early postsurgical complica- tion. Overall morbidity was 3.9% (3 cases of postoperative pneumonopathy, one case of decompensated asthma, and one of sural vein phlebitis). Three (2.34%) early intra-abdominal complications occurred, manifest as an intesti- nal obstruction or postsurgical ileus. Seven patients (5.6%) developed a non- infectious abdominal wall complication, and 17 (13.6%) experienced an infec- tious abdominal wall complication which in 5 cases (29.4%) required surgery with removal of the prosthesis in 3 cases (6o%). One patient (o.78%) develo- ped a late small intestine obstruction, 18 months after the incisional hernia repair. Twenty patients (16%) had a recurrence and 22 (17.6%) complained of abdominal wall pain at an interval after the operation. The investigators concluded that placement of an intraperitoneal prosthesis should be reserved only for those cases in whom placement of an extraperitoneal prosthesis can- not be performed. Key words: Incisional hernia -- Intraperitoneal prosthesis -- Postoperative complications -- Recurrence Correspondence to: F. MarchaI Received December 1G 1998 Accepted in final form May 7, 1999 Incisional hernia is a complication of laparotomy in 5 to 11% of cases [Louis 1985, MacLanahan 1997]. Its natural history involves progressive worsening with development of respiratory and skin disorders [/VlacLanahan 1997]. Incisional hernia carries the risk of strangulation. For this reason, surgery is almost always indicated. The recur- rence rate after simple suture, ranging from 31 to 5o% [Hesselink 1993, Louis 1985], has led to the use of synthetic materials for surgical repair of the abdominal wall since the 196os. Such prosthetic materials maintain and faci- litate the reinsertion of the large abdo- minal muscles at the midline. A poly- ester mesh prosthesis (Dacron, Mersi-