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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 2/2008

01-03-2008 | Original Article

Nuttall technique: A method for subumbilical incisional hernia repair revised

Authors: Antonios-Apostolos K. Tentes, Athanasios I. Xanthoulis, Charalambos G. Mirelis, Ioannis G. Bougioukas, Evanthia G. Tsalkidou, Konstantina A. Bekiaridou, Odysseas S. Korakianitis

Published in: Langenbeck's Archives of Surgery | Issue 2/2008

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Abstract

Background

Large ventral incisional hernias are frequently repaired either by open or by laparoscopic mesh technique. The technique recommended by Nuttall has been used for the repair of large subumbilical incisional hernias but has not been popularized.

Materials and methods

From 1991 to 2005, 21 patients, mean age 64.6 ± 13 (44–86) years, underwent repair of large subumbilical incisional hernia with the Nuttall technique by which the rectus muscles are detached from the symphysis pubis and transposed to the opposite side. The exerted tension is minimal to the underlying tissues, and no prosthetic material is required to reinforce the abdominal wall.

Results

Morbidity was recorded in five patients (23.8%). The median follow-up time was 84 months, and the recurrence rate was 4.8% (one patient).

Conclusions

Although a small number of patients have undergone repair with the Nuttall technique, the long-term results of the method seem to be encouraging for the repair of large subumbulical incisional hernias.
Literature
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Sauerland S, Schmedt CG, Lein S, Leibl BJ, Bittner R (2005) Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up. Langenbecks Arch Surg 390:408–412PubMedCrossRef
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Perrone JM, Soper NJ, Eagon JC et al (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surg 138:708–715CrossRef
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Mc Greevy JM, Goodney PP, Birkmeyer CM et al (2003) A prospective study comparing the complication rates between laparoscopic and open ventral hernia repairs. Surg Endosc 17:1778–1780CrossRef
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Goodney PP, Birkmeyer CM, Birkmeyer JD (2002) Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 137:1161–1165PubMedCrossRef
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Chrysos E, Athanasakis E, Saridaki Z et al (2000) Surgical repair of incisional ventral hernias: tension-free technique using prosthetic materials (expanded polytetrafluoroethylene Gore-Tex Dual Mesh). Am Surg 66:679–682PubMed
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Luijendijk R, Lemmen M, Hop W, Wereldsma J (1997) Incisional hernia recurrence following “vest-over-pants” or vertical Mayo repair of primary hernias of the midline. World J Surg 21:62–66PubMedCrossRef
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Hesselink VJ, Luijendijk RW, de Wilt JH, Neide R, Jeckel J (1993) An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 176:228–234PubMed
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Buker R (1989) Incisional hernia. In: Nyhus LM, Condon RE (eds) Hernia, 3rd edn. Philadelphia, Lippincott, pp 321–329
Metadata
Title
Nuttall technique: A method for subumbilical incisional hernia repair revised
Authors
Antonios-Apostolos K. Tentes
Athanasios I. Xanthoulis
Charalambos G. Mirelis
Ioannis G. Bougioukas
Evanthia G. Tsalkidou
Konstantina A. Bekiaridou
Odysseas S. Korakianitis
Publication date
01-03-2008
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 2/2008
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-007-0226-x

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