Abstract:

Suprapubic incisional hernia (SIH) is a special type of abdominal wall incision hernia, which specifically refers to incision hernia that occurs within 4 cm from the midline to the pubic arch. The hernia ring is adjacent to the bone, blood vessels, nerves and bladder and other structures. Because the posterior sheath of the rectus abdominis muscle is missing, surgical treatment is very challenging, and the selection of appropriate surgical methods has been controversial. The purpose of this article is to discuss the selection of surgical options for SIH, including indications for surgery, surgical methods, and prevention and treatment of complications. Traditional open surgery is still widely used, and laparoscopic surgery has been rapidly developing, with a variety of novel surgical procedures emerging. The differences between the various surgical procedures lie in the different surgical accesses and the different levels of placement of the repair material; the combination of open and laparoscopic procedures is a flexible option. In the process of abdominal wall reconstruction, the surgeons not only need to fully understand the complex anatomical structure and spatial anatomical relationship of the abdominal wall, but also have the ability to suture in the narrow space. The choice of surgical procedures should be based on an individualized plan, thorough evaluation of the patients’ general condition, combination of experiences, technical feasibility, economic accessibility of materials, and the overall financial burden.

Key words: Suprapubic incisional hernia, Mesh repair surgery, Hybrid surgery, 3D printing technology, Complications