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Laparoscopic Subxiphoid Hernia Repair with Intracorporeal Suturing of Mesh to the Diaphragm as a Means to Decrease
Omar M Ghanem1, Hamid R Zahiri2, Stephen Devlin2
11 Department of General Surgery, Union Memorial Hospital , Baltimore, Maryland.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|February 11, 2016
Summary
This study introduces a new laparoscopic technique for subxiphoid hernia repair, enhancing mesh fixation to the diaphragm. This novel approach aims to significantly reduce recurrence rates in patients undergoing this challenging surgical procedure.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Subxiphoid hernias are a rare but challenging complication post-median sternotomy.
- Current repair methods, both open and laparoscopic, have high recurrence rates (42% and 30%).
Purpose of the Study:
- To present a novel laparoscopic technique for subxiphoid hernia repair.
- To improve mesh overlap and fixation to reduce hernia recurrence.
Main Methods:
- A new laparoscopic technique involving falciform ligament dissection for optimal mesh positioning.
- Secure mesh fixation using nonabsorbable sutures to the diaphragm and anterior abdominal wall.
Main Results:
- The technique was successfully applied in 4 patients with no postoperative complications.
- A 1-year follow-up showed no evidence of hernia recurrence.
- Average operative time was 93 minutes for an average defect size of 20.5 cm².
Conclusions:
- Laparoscopic subxiphoid hernia repair is feasible and safe with this enhanced technique.
- Suturing mesh to the diaphragm improves fixation and overlap, potentially lowering recurrence rates.
