Devices and methods for preventing incisional hernias
A reinforcement device comprises a sheet of biocompatible material equipped with a plurality of hooks for reinforcing the closure of a surgical incision, including elongated abdominal incisions. The reinforcement device, when implanted through surgery, reduces the likelihood of and/or prevents incisional hernias. The reinforcement device may be included in a surgical kit.
1. A method of reinforcing a closure of a surgical opening, comprising:
placing a surgical mesh intra-peritoneally or extra-peritoneally such that the center region is generally aligned with an incision, wherein the surgical mesh has a longitudinal axis and a horizontal axis and a plurality of spaced apart columns of hooks on the surgical mesh running substantially parallel to one another and substantially parallel with the longitudinal axis, the hooks in each column having a common longitudinal distance between each adjacent hook; and
a reinforcing column of hooks on the surgical mesh between the spaced apart columns of hooks, wherein the hooks in the reinforcing column have a greater common longitudinal distance between hooks than in the spaced apart columns of hooks;
wherein the plurality of spaced apart columns comprises a first column on a first side of an center region and the second column on a second side of the center region, wherein the center region is an elongated substantially rectangular area that extends from a first edge of the sheet to a second edge of the sheet, the first and second edges being opposite one another and being substantially perpendicular to the longitudinal axis of the sheet;
suturing the surgical mesh to fascia, and looping suture through hooks in the spaced apart columns in a series of shaped formations; and
when a hook in the reinforcing column falls within a single shaped formation, winding suture through such hook in the reinforcing column.
2. The method of claim 1 further comprising, prior to suturing, marking suture points on human tissue through a plurality of the apertures.
3. A method of preventing an abdominal incisional hernia, comprising:
placing surgical mesh intra-peritoneally or extra-peritoneally in an abdomen such that the center region is aligned with an incision; wherein the surgical mesh has a longitudinal axis and a horizontal axis and a plurality of spaced apart columns of hooks on the surgical mesh running substantially parallel to one another and substantially parallel with the longitudinal axis, the hooks in each column having a common longitudinal distance between each adjacent hook; and
a reinforcing column of hooks on the surgical mesh between the spaced apart columns of hooks, wherein the hooks in the reinforcing column have a greater common longitudinal distance between hooks than in the spaced apart columns of hooks;
wherein the plurality of spaced apart columns comprises a first column on a first side of an center region and the second column on a second side of the center region, wherein the center region is an elongated substantially rectangular area that extends from a first edge of the sheet to a second edge of the sheet, the first and second edges being opposite one another and being substantially perpendicular to the longitudinal axis of the sheet;
suturing the surgical mesh to fascia by inserting suture through fascia and through hooks in the spaced apart columns in a series of substantially Z-shaped or X-shaped formations such that a ratio of suture length to incision length is about 4:1; and
when a hook in the reinforcing column falls within a specific Z-shaped or X-shaped formation, looping the suture through such hook in the reinforcing column.