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Laparoscopic Abdominal Wall Hernia Repair.

Stefano Olmi1, Matteo Uccelli1, Giovanni Carlo Cesana1

  • 1Surgeon of General and Oncologic Surgery Department, Centre of Advanced Laparoscopic Surgery, Centre of Bariatric Surgery, San Marco Hospital GSD, Zingonia, Italy.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|April 9, 2020
PubMed
Summary

Laparoscopic ventral hernia repair is safe and effective. Key factors to prevent recurrence include ensuring adequate mesh overlap (≥4 cm) and avoiding resorbable fixation devices.

Keywords:
incisional herniaintraperitoneal onlay meshlaparoscopic repairventral hernia

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Area of Science:

  • Minimally Invasive Surgery
  • Abdominal Wall Reconstruction
  • Surgical Outcomes Research

Background:

  • Laparoscopic ventral/incisional hernia repair is a common surgical procedure.
  • Evaluating long-term outcomes and recurrence rates is crucial for optimizing surgical techniques.

Purpose of the Study:

  • To assess the efficacy and recurrence rates of laparoscopic incisional/ventral hernia repair.
  • To identify risk factors associated with hernia recurrence and mesh complications.

Main Methods:

  • Retrospective, single-center observational study of 1,029 patients.
  • Utilized the open intraperitoneal onlay mesh technique for hernia repair.
  • Data collected on surgical time, hospital stay, complications, and long-term follow-up.

Main Results:

  • Low complication rates: 0.19% intraoperative, 4.86% early postoperative.
  • Hernia recurrence observed in 3.9% of patients; mesh bulging in 5.6%.
  • Mesh overlap ≥4 cm (P < .001) was protective against recurrence; overlap ≥5 cm (P < .001) protected against bulging. Resorbable fixation significantly increased recurrence risk (OR 111.53, P < .001).

Conclusions:

  • Laparoscopic ventral/incisional hernia repair is a safe, effective, and reproducible procedure.
  • Adequate mesh overlap (≥4 cm) and avoiding resorbable fixation are critical for reducing hernia recurrence.