Direct mesh repair of lateral abdominal wall hernia

"Direct mesh repair" or "direct supported repair" involves the use of an underlay sheet of mesh that extends 3 to 5 cm beyond the edges of the defect and is sutured to robust-appearing muscle tissue surrounding the hernia. It is a load-sharing approach in which both the mesh and the adjacent abdominal wall share stresses to avoid recurrence. The rationale behind this technique is that coaptation of the mesh to the dynamic adjacent musculature maintains the abdominal wall compliance such that the forces at the mesh-muscle interfaces are lower.