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PTH-233 Combined open and laparoscopic technique (COLT) for recurrent complex incisional hernia repairs
  1. L Toquero,
  2. J Ellul
  1. Colorectal Suregry, Kings College University, London, UK


Introduction The aim of this study was to determine the suitability of a novel technique of a combined open and laparoscopic technique (COLT Technique), in the repair of complex recurrent incisional hernias, where laparoscopic or open techniques alone do not achieve optimal results. Immediate and late complication rates, and recurrence rates are compared with that achieved with either laparoscopic or open (component separation) repair alone.

Method 19 consecutive patients with recurrent complex incisional hernia with significant morbidity were enrolled, and all underwent the COLT Technique. Follow-up was at six, twelve and twenty four weeks, along with subsequent telephone follow-up. The method involved an initial open repair of the incisional hernia, oppposing muscle together to give the repair strength. The approach would convert to a laparoscopic repair for ease of mesh insertion and placement using a simple prolene mesh, negating the need for expensive biological meshes.

Results Completion to follow-up was recorded in 100% of patients, with an overall healing rate of one hundred per-cent achieved, pain scores were found to be lower than those of the component separation technique. Infection and seroma rates were relatively low (three per-cent), whilst only one recurrence was recorded (three per-cent). Completion times achieved were within one and a half hours.

Conclusion The COLT technique is an effective and safe treatment option in patients with complex recurrent incisional hernias. Benefits of this procedure include ease of mesh placement, compared with open techniques requiring using the introduction of sutures. Approximation of muscle layers repairing the defect without opening the defect, its cost effectiveness negating the use of expensive biological meshes, early mobilisation and quick recovery.

Disclosure of interest None Declared.

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