The Use of Polypropylene-mesh, Pre-peritoneally for Incisional Hernia Repair in Northern Ghana

The use of alloplastic-mesh is now a common practice in hernia repair around the world especially in the developed and industrialized countries [4].However in developing countries like Ghana, this methodology is either unknown by many local surgeons and general practitioners, or for fear of the unknown,it is not practiced. This study aimed to assess the appropriateness, outcomes and suitability of polypropylene-mesh (Prolene, Ethicon, Belgium) for large incisional hernia and recurrent incisional hernia repair in Northern Ghana as a “Tension-free” operation procedure. All patients undergoing incisional hernia repair of the anterior abdominal wall defects measuring greater than or equal to 5cm in diameter or any recurrent incisional hernia case from January 2010 to December 2013 were eligible for the study.The “Sublay-technique” was adopted for the use of polypropylene-mesh implantation procedure. A total of 270 patients underwent the polypropylene-mesh, “Tension-free”, abdominal wall hernia repair in Tania specialist hospital. The two main indications for the previous laparotomies, prior to the incisional hernia repair in Tania specialist hospital, were median incision for caesarean sections and laparotomy for typhoid intestinal perforations. Patients’ age ranged from 14 to 70 years. All cases were done under spinal anaesthesia. Postoperatively, one patient (0,37%) had superficial wound infection, six patients (2,22%) had seroma formation and three patients (1,11%) had haematoma formation. No patient developed fistula, net dislocation, strangulation, or recurrent hernia in the immediate postoperative six months period. The study recorded no death. Conclusion: Polypropylene-mesh for large incisional hernia and recurrent incisional hernia repair, is effective, safe and suitable in Ghana, just as it is good for the developed countries.