Results from a consecutive series of laparoscopic incisional and ventral hernia repairs

Incisional hernia is a problematic complication of abdominal surgery and both late and early outcomes can be unsatisfactory. Laparoscopic repair has been gaining popularity for both incisional and ventral herniae. However, the perceived benefits have not been convincingly demonstrated by randomized-controlled studies or meta-analyses.

Case notes from 54 patients undergoing consecutive laparoscopic repairs of the abdominal wall hernia at a single center were reviewed. Demographic data, postoperative complications, length of stay, and recurrence rates were all recorded.

The majority of the patients had incisional hernia, with de novo ventral hernia comprising 7.4% of the total. Forty percent of patients had undergone at least 1 previous repair of their incisional hernia. The median recorded diameter of the hernia defect was 5 cm. No recurrences were recorded over a median follow-up of 26 months. Complications were all minor and included seroma formation, hematoma, and wound infection (n=5 patients). Median operative duration was 45 minutes and median length of stay postoperatively was 1 day.

The results compare well with those in the published literature and would support the continued use of laparoscopic incisional/ventral hernia repair. Any benefits from this approach, however, are likely to be operator dependent. As a result, all units undertaking such repairs should regularly review their results and compare them with the reported standard.