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Pitfalls and complications with laparoscopic intraperitoneal expanded polytetrafluoroethylene patch repair of postoperative ventral hernia

Lessons from the first 100 consecutive cases
  • M. Ben-Haim
  • J. Kuriansky
  • R. Tal
  • O. Zmora
  • Y. Mintz
  • D. Rosin
  • A. Ayalon
  • M. Shabtai
Original Articles

Abstract

Background

This study reviewed our experience with laparoscopic ventral postoperative (incisional) hernia repair.

Methods

Clinical data from the first 100 cases were analyzed retrospectively.

Results

Between 1997 and 2000, 64 women and 36 men (mean age, 58.4 ± 13.6 years; range, 27–87 years) underwent laparoscopic hernioplasty. Hernias (mean diameter, 6.2 ± 3.7 cm) were in a midline (74%), subcostal (10%), or other incision location, and were recurrent in 25%, of the patients. The mean operative time was 119 ± 77 min. Extensive adhesiolysis was necessary in 37 cases. There was no mortality. The recorded complications included inadvertent enterotomies (n=6), seromas (n=11), prolonged ileus (n=4), and prolonged fever (n=3). Seven cases were converted; to repair accidental enterotomies (n=4) due to difficult adhesiolysis (n=2), or to control bleeding (n=1). Six patients underwent reoperation because of enetric leak (n=3) or bowel obstruction (n=3). There were two documented recurrences (2%). The mean follow-up period was 19 months (range, 12–54 months).

Conclusions

Laparoscopic intraperitoneal approach to postoperative ventral (incisional) hernia repair may be associated with significant complications and morbidity, which can be prevented in part by meticulous technique and liberal conversions. The justification of this procedure is the low recurrence rate, according to preliminary results.

Key words

Laparoscopy Ventral hernia Patch repair Complications 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • M. Ben-Haim
    • 1
  • J. Kuriansky
    • 1
  • R. Tal
    • 1
  • O. Zmora
    • 1
  • Y. Mintz
    • 1
  • D. Rosin
    • 1
  • A. Ayalon
    • 1
  • M. Shabtai
    • 1
  1. 1.Department of Surgery and Transplantation, Chaim Sheba Medical Center, Sackler School of MedicineTel Aviv UniversityIsrael

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