A study of intraabdominal pressure modification in "component separation" technique for repair of incisional hernia

INTRODUCTION: Incisional hernias can be treated with laparoscopic and laparotomic surgery. Laparoscopic surgery can be made without the use of mesh when performing component separation technique. This technique allows to limit the adverse effects to foreign body and promotes a tension-free closure. We studied intravescical pressure changes during intervention in order to quantify intrabdominal pressure. MATERIAL AND METHODS: A prospective, non-controlled study (cohort study), was made on thirty patients, treated to repair incisional hernia. Standard panniculectomies and component separation technique were performed in all patients. A standard Foley catheter was inserted in to the bladder in order to measure pressure modification in the peri-/post-operative phases. Statistical significance of modifications of pressure values was evaluated with the Wilcoxon's sum rank test. RESULTS: Bladder pressure increased after hernia repair and skin closure and decreased in the first day after surgery, but without returning to the original values, and these modifications were statistically significant. DISCUSSION: We study intravescical pressure changes as an indirect measurement of intrabdominal pressure. Intrabdominal pressure cut-off for the arise of complications is 20 mmHg. This technique allows to maintain pressure under dangerous limits and to limits complications.