ABSTRACT
Ventral hernias are a long-standing surgical disease and have been described as far back as ancient Egypt. These are weaknesses in the midline abdominal fascia that increase in size over time. Similarly, incisional hernias develop as a failure of the midline fascia to heal after an abdominal surgery and have been prevalent ever since surgeons have been cutting on the abdomen. Subsequent increases in intra-abdominal pressures then lead to outpouchings, and abdominal contents begin to fill the empty space. Unchecked, these hernias grow in diameter as continued pressure stretches the fascial defect. Complicated hernias occur with recurrent operations, infected fields, the classic swiss-cheese defects, and those with previous open abdomens. Closure of incisional hernias requires thoughtful and deliberate selection of technique. The open repair has been well established, and techniques like the Rive-Stoppa and component separation have proven very effective in closing large complex defects.
