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Laparoscopically assisted approach for postoperative ventral hernia repair.
1Department of Surgery, Western Galilee Hospital, Nahariya, affiliated with the Faculty of Medicine, the Technion Israel Institute of Technology, Haifa, Israel.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|December 10, 2002
Summary
The laparoscopically assisted approach is a safe and feasible method for complex incisional hernia repair when open surgery is considered. This technique preserves laparoscopic benefits for challenging postoperative ventral hernia cases.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Abdominal Wall Reconstruction
Background:
- Laparoscopic incisional hernia repair is established due to its benefits.
- Conversion to open repair is sometimes necessary due to technical challenges.
Purpose of the Study:
- To evaluate the feasibility and safety of a laparoscopically assisted approach for difficult incisional hernia repairs.
- To determine if this approach can preserve the advantages of laparoscopy.
Main Methods:
- A laparoscopically assisted repair was performed on seven patients undergoing laparoscopic repair for postoperative ventral hernia (POVH).
- Reasons for conversion included technical difficulties in adhesiolysis, hernia reduction, and potential intestinal injury.
- The assisted approach involved a small incision for exploration and completion of laparoscopic repair.
Main Results:
- Two iatrogenic intestinal perforations and one serosal injury were identified and repaired.
- Adhesiolysis completion was the primary intervention in four cases.
- All patients experienced uneventful postoperative recovery with no recurrence to date.
Conclusions:
- The laparoscopically assisted approach is a feasible and safe option for complex POVH repair.
- This technique allows for the preservation of laparoscopic surgery advantages.
- It is recommended when conversion to open repair is contemplated during laparoscopic incisional hernia repair.