Advertisement

Surgical Endoscopy

, Volume 26, Issue 5, pp 1264–1268 | Cite as

Laparoscopic ventral hernia repair: Does primary repair in addition to placement of mesh decrease recurrence?

  • Ambar Banerjee
  • Catherine Beck
  • Vimal K. Narula
  • John Linn
  • Sabrena Noria
  • Bradley Zagol
  • Dean J. Mikami
Article

Abstract

Background

The advent of laparoscopic ventral hernia repair (LVHR) not only reduced the morbidity associated with open repair but also led to a decrease in the hernia recurrence rate. However, the rate continues to remain significant.

Methods

A retrospective observational study was conducted on 193 patients who were treated with LVHR by two minimally invasive surgeons in a 24-month period. The patient population was broadly divided into two groups based on the laparoscopic repair of the fascial defect with mesh underlay, or with primary suture repair and mesh underlay (PSR + MU). Patient demographics, rates of hernia recurrence, and other associated complications were compared between the two groups. Patient variables and the clinical outcomes were analyzed with descriptive statistics and chi-square test.

Results

One hundred ninety-three consecutive patients underwent LVHR for incisional (n = 136), umbilical (n = 44), epigastric (n = 9), and parastomal (n = 4) hernia. Hernia recurrence was documented in eight patients (4.1%). The mean follow-up period was 10.5 months (range 1–36 months). Incisional hernias accounted for all eight recurrences. The rate of recurrence in those treated with PSR + MU was 3% (two of 67 cases) in comparison with 4.8% (six of 126 patients) associated with mesh alone. The rate of recurrence in the recurrent hernia group, treated with mesh only, was 10.5% (four of 38 patients) compared with 4.8% (one of 21 patients) in the PSR + MU group.

Conclusions

Primary laparoscopic repair along with mesh placement for the management of ventral hernia was found to be effective in selected cases as evidenced by the low rate of recurrence when compared with conventional laparoscopic repair with mesh alone. Further retrospective and prospective studies, with larger patient enrollment, are warranted to confirm the benefit of this technique over traditional repair.

Keywords

Laparoscopic ventral hernia repair Primary repair with mesh Recurrence 

Notes

Disclosures

Ambar Banerjee, Catherine Beck, Vimal K. Narula, John Linn, Sabrena Noria, Bradley Zagol, and Dean J. Mikami have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Seymour Neal EBRL (2010) Chapter 35. Abdominal wall, omentum, mesentery, and retroperitoneum, 9th edn. Schwartz’s Principles of Surgery, McGraw-HillGoogle Scholar
  2. 2.
    Lomanto D, Iyer SG, Shabbir A, Cheah WK (2006) Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc 20:1030–1035PubMedCrossRefGoogle Scholar
  3. 3.
    Hoer J, Lawong G, Klinge U, Schumpelick V (2002) Factors influencing the development of incisional hernia. A retrospective study of 2, 983 laparotomy patients over a period of 10 years. Chirurg 73:474–480PubMedCrossRefGoogle Scholar
  4. 4.
    Santora TA, Roslyn JJ (1993) Incisional hernia. Surg Clin North Am 73:557–570PubMedGoogle Scholar
  5. 5.
    LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMedGoogle Scholar
  6. 6.
    Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13:545–554PubMedCrossRefGoogle Scholar
  7. 7.
    Rives J, Pire JC, Flament JB, Palot JP, Body C (1985) Treatment of large eventrations. New therapeutic indications apropos of 322 cases. Chirurgie 111:215–225PubMedGoogle Scholar
  8. 8.
    Martorana G, Carlucci M, Alia C, Barrianco G, Iacopinelli SM, Labruzzo C, Noto N, Restivo FP, Viola M, Mastrandrea G (2007) Laparoscopic incisional hernia repair: our experience and review of the literature. Chir Ital 59:671–677PubMedGoogle Scholar
  9. 9.
    Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583 (discussion 583–575)Google Scholar
  10. 10.
    Bower CE, Reade CC, Kirby LW, Roth JS (2004) Complications of laparoscopic incisional-ventral hernia repair: the experience of a single institution. Surg Endosc 18:672–675PubMedCrossRefGoogle Scholar
  11. 11.
    Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238:391–399 (discussion 399–400)Google Scholar
  12. 12.
    Franklin ME Jr, Gonzalez JJ Jr, Glass JL, Manjarrez A (2004) Laparoscopic ventral and incisional hernia repair: an 11-year experience. Hernia 8:23–27PubMedCrossRefGoogle Scholar
  13. 13.
    LeBlanc KA, Whitaker JM, Bellanger DE, Rhynes VK (2003) Laparoscopic incisional and ventral hernioplasty: lessons learned from 200 patients. Hernia 7:118–124PubMedCrossRefGoogle Scholar
  14. 14.
    Yavuz N, Ipek T, As A, Kapan M, Eyuboglu E, Erguney S (2005) Laparoscopic repair of ventral and incisional hernias: our experience in 150 patients. J Laparoendosc Adv Surg Tech A 15:601–605PubMedCrossRefGoogle Scholar
  15. 15.
    Rosen M, Brody F, Ponsky J, Walsh RM, Rosenblatt S, Duperier F, Fanning A, Siperstein A (2003) Recurrence after laparoscopic ventral hernia repair. Surg Endosc 17:123–128PubMedCrossRefGoogle Scholar
  16. 16.
    Iqbal CW, Pham TH, Joseph A, Mai J, Thompson GB, Sarr MG (2007) Long-term outcome of 254 complex incisional hernia repairs using the modified Rives-Stoppa technique. World J Surg 31:2398–2404PubMedCrossRefGoogle Scholar
  17. 17.
    Leber GE, Garb JL, Alexander AI, Reed WP (1998) Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382PubMedCrossRefGoogle Scholar
  18. 18.
    Temudom T, Siadati M, Sarr MG (1996) Repair of complex giant or recurrent ventral hernias by using tension-free intraparietal prosthetic mesh (Stoppa technique): lessons learned from our initial experience (fifty patients). Surgery 120:738–743 (discussion 743–734)Google Scholar
  19. 19.
    Jonas J (2009) The problem of mesh shrinkage in laparoscopic incisional hernia repair. Zentralbl Chir 134:209–213PubMedCrossRefGoogle Scholar
  20. 20.
    Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D (2011) Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25(3):749–55Google Scholar
  21. 21.
    Gonzalez R, Fugate K, McClusky D 3rd, Ritter EM, Lederman A, Dillehay D, Smith CD, Ramshaw BJ (2005) Relationship between tissue ingrowth and mesh contraction. World J Surg 29:1038–1043PubMedCrossRefGoogle Scholar
  22. 22.
    Torres-Villalobos G, Sorcic L, Ruth GR, Andrade R, Martin-del-Campo LA, Anderson JK (2010) Evaluation of the Rebound Hernia Repair device for laparoscopic hernia repair JSLS 14:95–102Google Scholar
  23. 23.
    Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D (2011) Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25:749–755Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Ambar Banerjee
    • 1
  • Catherine Beck
    • 1
  • Vimal K. Narula
    • 1
  • John Linn
    • 1
  • Sabrena Noria
    • 1
  • Bradley Zagol
    • 1
  • Dean J. Mikami
    • 1
  1. 1.Center for Minimally Invasive SurgeryThe Ohio State University Medical CenterColumbusUSA

Personalised recommendations