Incidence of Hernia Development in a Surgical Scar (Poih), in the Presence of Untreated Rectus Muscle Diastasis Treated by Scola Repair

In the last decade, many works have been published demonstrating the recurrence of Umbilical or Epigastric Hernia that are repaired without a combined repair of an existing Rectus Diastasis (RD). Guidelines recently published including the European Hernia Society recommend combined repair and use of the Mesh. These are mostly small Hernias, but we would like to report on the development of Post Operative Incisional Hernias (POIH) sometimes big in the midline, following even small incision of Laparoscopic and Robotic procedures, in the presence of undiagnosed and uncorrected RD. We will bring our experience to the repair of these POIH and RD by Subcutaneous Onlay Laparoendoscopic Approach-SCOLA with the Release of the Anterior Rectus Fascia (RFR). Since 2016, we perform a combined repair of Hernias together with an existing RD using a SCOLA with RFR. All patients are discharged home the day after surgery. We analyzed 123 patients, 34 of whom had POIH combined with RD, while 17 of them had the POIH in a Laparoscopic or Robotic scar. Hernia width was 2–10 cm. The repaired Hernia recurred in only 2 of them, 10 of them developed a Seroma that was treated by aspiration. Any surgical operation performed on the ventral abdominal line should ensure the presence of RD. Also, ventral penetration in Laparoscopic or Robotic approach in the presence of undiagnosed and uncorrected RD, will lead to the development of POIH. Even big POIH combined with present for RD, are successfully repaired with low trauma by SCOLA approach with RFR.