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This is a retrospective study on 128 patients who underwent surgery between 1986 and 1996 for incisional hernia repair with placement of an intraperitoneal prosthesis. A polyester mesh (Mersilene®) was used in 95 cases (74.2%) and one of PTFE in 33 cases (25.8%). Mortality was 2.34% (3 patients); 32 patients (25.6%) developed an early postsurgical complication. Overall morbidity was 3.9% (3 cases of postoperative pneumonopathy, one case of decompensated asthma, and one of sural vein phlebitis). Three (2.34%) early intra-abdominal complications occurred, manifest as an intestinal obstruction or postsurgical ileus. Seven patients (5.6%) developed a non-infectious abdominal wall complication, and 17 (13.6%) experienced an infectious abdominal wall complication which in 5 cases (29.4%) required surgery with removal of the prosthesis in 3 cases (60%). One patient (0.78%) developed a late small intestine obstruction, 18 months after the incisional hernia repair. Twenty patients (16%) had a recurrence and 22 (17.6%) complained of abdominal wall pain at an interval after the operation. The investigators concluded that placement of an intraperitoneal prosthesis should be reserved only for those cases in whom placement of an extraperitoneal prosthesis cannot be performed.

Obturator hernias comprise a rare group of abdominal hernias. They are often diagnosed when the small bowel has become obstructed and the patients are operated on without the causes of the obstruction being known. Although many techniques for closure of the defect are available, there is no agreement at the present time as to which is the procedure of choice.

Solitary rectal ulcer syndrome (SRUS) is an infrequent pathology often associated with pelvic floor disorders. The aim of this retrospective study was to review the long-term results of a surgical series of SRUS. Between 1988 and 1998, 13 patients were operated on for SRUS. Seven patients had associated internal rectal prolapse (58%), two had associated total rectal prolapse (15%), and two had associated mucosal prolapse (15%). We performed simple resection of the SRUS in one case (8%), a stoma as primary operation in one (8%), three rectopexies according to Orr-Loygue (23%), and eight Delorme's operations as modified by Berman (62%). Mean follow-up was 57 months (range 15-112). Simple resection of the solitary rectal ulcer syndrome did not improve symptoms. Colostomy permitted relief of symptoms and healing of the SRUS. Two of the three rectopexies achieved good results, and the third patient relapsed at the 6th postoperative month. A secondary modified Delorme's operation permitted relief of symptoms and healing of the SRUS. Five of the eight patients (62.5%) who received modified Delorme's operations had improved at a follow-up of 46 months. We conclude that, considering the high failure rate after surgery, operations should be performed only in patients with total rectal prolapse or intractable symptoms not amenable to behavioral therapy. Delorme's operation and abdominal rectopexy help in about 60% of cases.