Laparoscopic repair of incisional hernias located on the abdominal borders: a retrospective critical review

Surg Laparosc Endosc Percutan Tech. 2009 Aug;19(4):348-52. doi: 10.1097/SLE.0b013e3181aa869f.

Abstract

Background: The aim of this study was to assess feasibility and results of laparoscopic approach to repair incisional hernias of the abdominal borders, the weakest points of abdominal wall.

Methods: Since 2002 through 2008 a total of 39 patients with fascial defects of the abdominal borders underwent laparoscopic repair. The defects were suprapubic (n=18), subxiphoidal (n=15), and lateral sided (n=6). The body mass index was >oe=30 Kg/m2 in 19 patients. The parietal defects was measured both externally and from within the peritoneal cavity and 56% of meshes were fixed only by tacks, especially in suprapubic site.

Results: The mean operating time was 161.8+/-25 minutes. There was 1 intraoperative complication, an intestinal injury repaired laparoscopically. Conversion was needed in 1 patient for massive adhesions. Postoperative early surgical complications were 7 (1 seroma). Morbidity in obese and nonobese patients showed no statistically relevant difference (P>0.05). There was no postoperative death. Mean hospital stay was 5.1+/-3 days. The mean follow-up was 37 months and recurrence was observed in 3 cases.

Conclusions: The onlay laparoscopic approach for repair of incisional hernias of the abdominal borders can warrant good results. Obesity is not a contraindication to laparoscopic repair. Anyway, further experiences are necessary to confirm these results.

MeSH terms

  • Abdominal Wall / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Hernia, Ventral / surgery*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Retrospective Studies