Mesh Fixation in Abdominal Wall Reconstruction- A Retrospective Review

Jimmy Mena, Seshu Bylapudi, Barrie Keeler and Adnan Qureshi

Department of General Surgery, Milton Keynes University Hospital NHS Trust, UK Consultant Colorectal Surgeon, Milton Keynes University Hospital NHS Trust, UK Consultant Colorectal & General Surgeon, Milton Keynes University Hospital NHS Trust, UK

^*Correspondance to: Adnan Qureshi 

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Abstract:

Background: Mesh Fixation techniques in abdominal wall reconstruction has always been a topic of debate because of benefits and drawbacks of different fixation techniques. No fixation is advisable by some but this leaves surgeons apprehensive about mesh drifting etc. We aim to compare the outcomes of tissue adhesion (TA) versus tissue suturing (TS) for mesh fixation in patients with major abdominal wall reconstruction (AWR). Methods: A retrospective review of all patients who underwent abdominal wall reconstruction (AWR) from April 2018 to April 2023 was performed. All patients who underwent mesh fixation with TA or TS were included in the study. Outcomes included intraoperative and postoperative outcomes. Results: A total of 51 patients underwent AWR during this time, 28 patients had mesh fixation using TA while 23 patients had TS. The two groups were comparable in terms of hospital stay (p=0.87) and blood loss (p=0.34). Although there was a significantly shorter operating time in the TA group (p<0.05), the overall rate of early postoperative complications was 10% (n=3) in the TA group and 39% (n=9) in the TS group, with a significant difference. On the other hand, the overall rate of late postoperative complications was 14.2% (n=4) in the TA group and 47.8% (n=11) in the TS group. The 24-month recurrence rate was 3.5% in the TA group and 8.6% (1) in the TS group. Conclusion: In open abdominal wall reconstruction, it is safe to utilize tissue adhesives for mesh fixation in the retromuscular space, and this is linked with better postoperative recovery and pain at the 24-month follow-up. There is no association between the method of hernia fixation and the incidence of early recurrence or wound-related complications.

Keywords:

Mesh fixation; Hernia; Tissue adhesion; Suturing; Level of evidence: IV

Cite the Article:

Mena J, Bylapudi S, Keeler B, Qureshi A. Mesh Fixation in Abdominal Wall Reconstruction- A Retrospective Review. World J Surg Surgical Res. 2025; 8: 1596..