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Laparoscopic incisional hernia repair after solid-organ transplantation
Peter T Kennealey1, Cynthia S Johnson, A Joseph Tector
1Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Hypothesis:
Laparoscopic incisional hernia repair (LIHR) is efficacious in transplant recipients.
Design:
Retrospective review.
Setting:
University hospital.
Patients:
Thirty-one transplant recipients who underwent LIHR between July 9, 2004, and October 27, 2005.
Main Outcome Measures:
Operative complications and incisional hernia recurrence.
Results:
The mean (SD) mesh size required for LIHR was 611 (307) cm2. Median (range) hospital stay was 4 (1-28) days, with follow-up of 589 (22-953) days. Eighteen patients developed a postoperative complication, most frequently seroma formation, which occurred in 13 patients (72%). The mesh size required for LIHR was significantly larger in patients with a postoperative complication (n = 18; 706 [319] cm2 vs n = 13; 480 [244] cm2; P = .04). Seroma formation was not associated with previous open hernia repair, diabetes mellitus, or corticosteroid use. No statistically significant relationship was noted between the transplanted organ and seroma development. There were no post-LIHR wound infections. In 7 patients (23%), hernia recurred.
Conclusions:
Laparoscopic incisional hernia repair in solid-organ transplant recipients is associated with a high rate of seroma formation but minimal long-term morbidity. The recurrence rate after LIHR is equivalent to that after open hernia repair. These results suggest that LIHR is a safe and effective alternative to open repair in this patient population.
