A new diverting ileostomy is described which avoids the attendant problems associated with the previously described "loop ileostomy," and other described-ileostomies used in conjunction with ileoanal pull-through procedures. The ileostomy result is a functionally superior stoma, similar to that of the standard Brooke ileostomy, and requires only a local exploration for takedown. Initial experience with the procedure has been uniformly excellent and would support wider use of the "close loop" double barreled ileostomy.
We report the results of a new method of primary repair of massive ventral hernia in 409 patients using internal retention sutures. Notably, 40 per cent of these patients had failed Marlex mesh repairs. The mean transverse diameter of their hernial defects was 10.4 +/- 0.7 cm (range, 4-18 cm). The overall recurrence rate was 2.5 per cent, superior to other methods of primary repair, and equal or superior to Marlex mesh repair. Wound infection occurred in 5 per cent. The risk of wound infection was significantly increased (P less than 0.05) in patients with a history of prior wound infection. We conclude that the internal retention method of primary repair of ventral hernia for defects less than 18 cm in diameter is equal to Marlex in the repair of previously infected recurrent hernias of this size.
