Common complications of laparotomy
Annually, over 7 million patients in the US and EU undergo open abdominal surgeries, mainly for intraabdominal cancer, trauma, and emergencies. Wound infection and incisional hernia are common abdominal wall complications that effects up to 30% of these patients. Another particularly critical medical condition is burst abdomen. It affects 4-6% of patients and carries a high mortality risk.
For individuals battling cancer, the aftermath of these complications might result in an inability to endure post-operative chemotherapy, further complicating their recovery. Incisional hernias significantly reduce patients’ quality of life, often requiring additional re-do surgeries.
Deerenberg Eva B. et al., Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet (2015), 386: 1254–60.
HART Collaborative, Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). BJS (2022), 109, 943–950.
Jensen K.K. et al., Abdominal wound dehiscence is dangerous: a nationwide study of 14,169 patients undergoing elective open resection for colonic cancer. Hernia (2022), 26:75–86.
Korgaard Jensen T. et al., Sarcopenia is associated with increased risk of burst abdomen after emergency midline laparotomy: a matched case–control study. European Journal of Trauma and Emergency Surgery (2022), 48:4189–4196.
Malheiro Rui M. et al., Surveillance of surgical site infection after colorectal surgery: comprehensiveness and impact of risk factors. Infection Control & Hospital Epidemiology (2023), 1–6.
Pedroso-Fernandez Y. et al., Prediction of surgical site infection after colorectal surgery. American Journal of Infection Control 44 (2016), 450-4.
Annual open abdominal procedures 1 2
Million in Western Europe / year
Million in the US / year
- 1.Incisional Hernia Prevention | Medtronic (UK)
- 2.Deerenberg EB, Harlaar JJ, Steyerberg EW, Lont HE, van Doorn HC, Heisterkamp J, et al. Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. The Lancet. 2015;386(10000):1254-60.
Common complications
Surgical site infections
Burst abdomen
Insicional hernia
Incisional hernia incidence 3 4 5
15-20%
up to 40% In high risk groups
- 3 Söderbäck H, Gunnarsson U, Hellman P, Sandblom G. Incisional hernia after surgery for colorectal cancer: a
population-based register study. Int J Colorectal Dis. 2018 Oct;33(10):1411-1417 - 4 Sanders DL, Kingsnorth AN. The modern management of IHs. BMJ 2012; 344:e2843.
- 5 Barranquero AG, Molina JM, Gonzalez-Hidalgo C, Porrero B, Blázquez LA, Ocaña J, Gandarias Zúñiga C, Fernández Cebrián JM. Incidence and risk factors for incisional hernia after open abdominal aortic aneurysm repair. Cir Esp (Engl Ed). 2022 Nov;100(11):684-690. doi: 10.1016/j.cireng.2022.08.023. PMID: 36270702.
Patient risk factors 6 7 8
- 6.Bosanquet DC, Ansell J, Abdelrahman T, Cornish J, Harries R, Stimpson A et al. Systematic review and
meta-regression of factors affecting midline incisional hernia rates: analysis of 14 618 patients. PLoS One 2015;10:e0138745 - 7.Hoer J, Lawong G, Klinge U, Schumpelick V. [Factors influencing the development of incisional hernia. A retrospective study of 2983 laparotomy patients over a period of 10 years.] Chirurg 2002;73:474–480
- 8.Itatsu K, Yokoyama Y, Sugawara G et al. Incidence of and risk factors for IH after abdominal surgery. Br J Surg 2014; 101: 1439–1447.
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