LAPAROSCOPIC INTRAPERITONEAL PROSTHETIC MESH PLACEMENT IN VENTRAL-INCISIONAL HERNIAS

Abstract

After the first repair of ventral-incisional hernias with conventional technique, recurrence rate has changed between 25 % and 49 %. The aim of this study is to review the results of patients with laparoscopically repaired ventral-incisional hernias and compare these results with the literature findings of conventional technique.

Between September 1997 and July 2001, we reviewed the results of our cases with ventral-incisional hernias treated with laparoscopically intraperitonal prosthetic mesh placement.

We performed laparoscopic intraperitoneal graft placement in 33 patients with ventral-incisional hernias. Of these patients, four were male and 29 were female. We converted laparoscopic surgery to open method in 1 patient (3,1 %). The median defect size was 1 9 cm² (range from 4 to 1 00 cm²). The median operation time and hospitalization period were 125 minutes (range 45-160) and 1.5 days (range, 0-3 days) respectively. As complications, 3 patients had seromas lasted over four weeks, 2 patients had long lasting incisional pain, 1 had port site serous discharge, 1 had posoperative ileus, 1 had urinary retention and 1 had acute respiratory dystress. In the median 30,5 months (range, 5-34 months) of follow-up, late mesh reaction occured in 1 patient and mesh was removed. Recurrent hernia was seen in 3 patients (9,4%).

Laparoscopic treatment of ventral-incisional hernias has advantages such as short hospitalization, less postoperative pain and low complication rate. This method should be considered as an alternative to the conventional technique.