Publication:

Combined Rives–Albanese technique in the management of a complex incisional hernia: a case report

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.