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Updated: Aug 14, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
[Laparoscopic incisional hernia repair: prospective non randomized trial in 51 cases]
H Levard1, F Curt, T Perniceni
1Département Médicochirurgical de Pathologie Digestive, Institut Mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France. hugues.levard@imm.fr
Aim Of The Study:
Insertion of a mesh in treatment of incisional hernias reduces the risk of recurrence. A single prospective randomized trial have compared laparoscopic and open approach: there were less postoperative complications and fewer recurrences in the laparoscopic group. Aim of this prospective trial was to control these results.
Patients And Methods:
From January 2000 to May 2005, 51 consecutive incisional hernias were operated on by a laparoscopic approach. Incisional hernia was single in 41 and double in 5. It was median in 41 and lateral in 10. Previous hernia repair was noticed in 33.3%. Main criteria was recurrence. We have considered whether one of the following criteria was associated with the risk of recurrence: sex, obesity, previous repair, pre and preoperative sizes of the hernia, uni or multi orificial aspect of the hernia, median or lateral location, mesh size, ratio mesh surface/hernia surface. Others were postoperative mortality and morbidity, duration of hospitalisation and occurrence of late events.
Results:
At 2 years all patients were followed. Follow up achieved 3 years in 23 cases and 4 years in 9. Recurrence was observed in 7 (13.7%). None predictive factor was disclosed. No death occurred. Median postoperative pain score at D1, D2 and D3 was respectively 3.1+/-1.9, 2.9+/-2.3 and 2.3+/-2.1. Mean postoperative stay was 4.1+/-1.9 days. Seven postoperative complications occurred, al benign. During follow-up 18 events were noticed and of these 8 were chronic abdominal pain.
Conclusion:
This technique could be employed for every type of incisional hernia but peristomial hernias (not assessed in this study) and every patient. Technical improvements ought to be find to reduce recurrence rate.
Insights
Laparoscopic incisional hernia repair using mesh shows a 13.7% recurrence rate. This prospective study aimed to validate previous findings on laparoscopic versus open approaches for incisional hernias.
Area of Science:
- Surgical Innovation
- Gastroenterology
- Hernia Repair
Background:
- Mesh insertion in incisional hernia treatment significantly lowers recurrence risk.
- A prior randomized trial indicated fewer complications and recurrences with laparoscopic repair compared to open surgery.
Purpose of the Study:
- To validate and control findings from a previous prospective randomized trial comparing laparoscopic and open incisional hernia repair.
- To assess the efficacy and safety of laparoscopic incisional hernia repair.
Main Methods:
- A prospective trial involving 51 consecutive patients undergoing laparoscopic incisional hernia repair.
- Data collected included hernia characteristics, patient factors (sex, obesity, prior repair), hernia/mesh size ratios, and postoperative outcomes (mortality, morbidity, pain, hospital stay, late events).
- Recurrence was the primary endpoint, with follow-up extending up to 4 years.
Main Results:
- A recurrence rate of 13.7% was observed over a median follow-up of 2 years.
- No predictive factors for recurrence were identified.
- No deaths occurred; postoperative complications were benign. Mean hospital stay was 4.1 days, with manageable pain scores.
Conclusions:
- Laparoscopic incisional hernia repair is a viable technique for most incisional hernias, excluding peristomial types.
- Further technical advancements are needed to further reduce the recurrence rate in laparoscopic incisional hernia repair.