Combined Rives–Albanese technique in the management of a complex incisional hernia: a case report
DOI:
https://doi.org/10.18203/2349-2902.isj20261581Keywords:
Incisional hernia, Abdominal wall reconstruction, Rives technique, Albanese technique, Prosthetic meshAbstract
Incisional hernias of the abdominal wall affect up to 20% of patients undergoing laparotomy and may evolve into a complex condition associated with significant physical and psychological morbidity. Several surgical techniques have been developed for their repair. The Rives technique enables midline reconstruction through retromuscular dissection and medial advancement, achieving low recurrence rates. In contrast, the Albanese technique employs lateral releasing incisions in the abdominal wall musculature to facilitate tension-free closure. We report the case of a 58-year-old female with a complex incisional hernia following a prior midline laparotomy for appendicular peritonitis. The patient presented with progressive abdominal bulging and pain. Preoperative evaluation revealed a 12 cm defect without loss of domain. Surgical repair was performed using a combined Rives–Albanese technique, including retromuscular mesh placement and lateral releasing incisions to facilitate tension-free closure. Repair of complex incisional hernias using this combined approach is feasible in experienced hands. Postoperative outcomes were favorable, with no significant complications observed, demonstrating the functional effectiveness of the technique. Management of complex abdominal wall defects with muscle retraction remains challenging and requires advanced surgical expertise. The combination of retromuscular repair (Rives) and lateral releasing incisions (Albanese) represents a valuable option for achieving primary closure with acceptable morbidity. Long-term success depends on comprehensive multidisciplinary management beyond the surgical procedure.
References
Ramírez O, Palomino M. Reconstrucción de las hernias complejas de pared abdominal anterior: un problema de enfoque multidisciplinario. Rev Hispanoam Hernia. 2015;3(2):47-8.
Hernández López A. Escenarios catastróficos en el manejo de las hernias ventrales e incisionales. En: Mayagoitia JC, editor. Hernias de la pared abdominal. México: Alfil. 2009. Available at: https://dokumen.pub/hernias-de-la-pared-abdominal.html. Accessed on 12 February 2026.
Utrera González A, Escoresca Suárez I, Bejarano de La Serna D, Perea Sánchez MJ. Eventraciones de línea media: generalidades. En: Utrera González A, Utrera-Sánchez C, de Oca Gómez J, Targarona Soler JA, Bellido-Luque JA, editores. Libro de eventraciones de la pared abdominal. Sociedad Hispanoamericana de la Hernia. 2017;363-75.
Moreno Egea A, Mancebo G, Moreno B, Villarejo G, Giraldo A. Técnicas de reparación anatómica: autoplastias. En: Utrera González A, Utrera-Sánchez C, de Oca Gómez J, Targarona Soler JA, Bellido-Luque JA, editores. Libro de eventraciones de la pared abdominal. Sociedad Hispanoamericana de la Hernia. 2017;429-41.
Albanese AR. Remodelación por movilización músculo-aponeurótica en el tratamiento quirúrgico de las grandes eventraciones del abdomen. Día Méd. 1976;53:418-25.
Carbonell F. Nuevo método de operar en la eventración compleja: separación anatómica de componentes modificada. En: VIII Reunión de la Sección de Pared Abdominal y Suturas de la AEC. 2009;86(2):61-125.
Mehrabi M, Jangjoo A, Tavoosi H, Kahrom M, Kahrom H. Long-term outcome of Rives-Stoppa technique in complex ventral incisional hernia repair. World J Surg. 2010;34(7):1696-701.
Comin R, Pesenti D, Manna R, Juri Nam H. Las incisiones de descarga como tratamiento para el cierre de las laparotomías reiteradas. Rev Argent Cirug. 1993;65:82-3.
Ramírez O, Ruas E, Dellon AL. Components separation method for closure of abdominal wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990;86:519-26.
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