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Hernia

, Volume 12, Issue 3, pp 251–256 | Cite as

Laparoscopic repair of suprapubic incisional hernias: suturing and intraperitoneal composite mesh onlay. A retrospective study

  • C. PalaniveluEmail author
  • M. Rangarajan
  • R. Parthasarathi
  • M. V. Madankumar
  • K. Senthilkumar
Original Article

Abstract

Background

Suprapubic hernias are those defects located 4 cm from the pubic symphysis. Our aim is to highlight the laparoscopic repair of suprapubic incisional hernias.

Patients and methods

We retrospectively reviewed 17 patients with suprapubic incisional hernias from 1999 to 2007. A modified technique of laparoscopic intraperitoneal composite mesh onlay was performed for these patients.

Results

There were 12 females and 5 males with a mean age of 55.9 years and a mean BMI of 30 kg/m2. The mean hernia size was 87.5 cm2, with an average mesh size of 234 cm2. Mean follow-up was 9 months. Complications were seen in five patients, with an overall recurrence rate of 5.8%.

Discussion

Suprapubic hernias are difficult to manage because of the complexity of dissection and their anatomic proximity to bony, vascular and nerve structures. The lower end of the mesh should be fixed to the Cooper’s ligament and the pubic bone. Laparoscopic repair of these uncommon hernias is safe, effective and provides all the benefits of minimally invasive surgery.

Keywords

Suprapubic hernia Laparoscopic repair Cooper’s ligament Composite mesh 

References

  1. 1.
    Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Johannes 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 583–585PubMedGoogle Scholar
  2. 2.
    LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMedGoogle Scholar
  3. 3.
    el Mairy AB (1974) A new procedure for the repair of suprapubic incisional hernia. J Med Liban 27:713–718PubMedGoogle Scholar
  4. 4.
    Lobel RW, Sand PK (1997) Incisional hernia after suprapubic catheterization. Obstet Gynecol 89:844–846PubMedCrossRefGoogle Scholar
  5. 5.
    Losanoff JE, Richman BW, Jones JW (2002) Parapubic hernia: case report and review of the literature. Hernia 6:82–85PubMedCrossRefGoogle Scholar
  6. 6.
    Pfannenstiel H (1900) Ueber die vortheile des suprasymphysaren fascienquerschnitts fur die gynakologischen koliotomien. Samml Klin Vortr 268:1735–1756Google Scholar
  7. 7.
    Luijendijk RW, Jeekel J, Storm RK, Schutte PJ, Hop WCJ, Drogendijk AC, Huikeshoven FJM (1997) The low transverse pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment. Ann Surg 225:365–369PubMedCrossRefGoogle Scholar
  8. 8.
    Bendavid R (1990) Incisional parapubic hernias. Surgery 108:898–901PubMedGoogle Scholar
  9. 9.
    Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13:545–554PubMedCrossRefGoogle Scholar
  10. 10.
    Hirasa T, Pickleman J, Shayani V (2001) Laparoscopic repair of parapubic hernia. Arch Surg 1136:1314–1317Google Scholar
  11. 11.
    Carbonell AM, Kercher KW, Matthews BD, Sing RF, Cobb WS, Heinford BT (2005) The laparoscopic repair of suprapubic ventral hernias. Surg Endosc 9:174–177CrossRefGoogle Scholar
  12. 12.
    McKay R, Haupt D (2006) Laparoscopic repair of low abdominal wall hernias by tack fixation to the Cooper’s ligament. Surg Laparosc Endosc Percutan Tech 16:86–90PubMedCrossRefGoogle Scholar
  13. 13.
    LeBlanc KA (2001) The critical technical aspects of laparoscopic repair of ventral and incisional hernias. Am Surg 67:809–812PubMedGoogle Scholar
  14. 14.
    Matuszewski M, Stanek A, Maruszak H, Krajka K (1999) Laparoscopic treatment of parapubic postprostatectomy hernia. Eur Urol 36:418–420PubMedCrossRefGoogle Scholar
  15. 15.
    Joels CS, Matthews BD, Kercher KW, Austin C, Norton HJ, Williams TC, Heniford BT (2005) Evaluation of adhesion formation, mesh fixation strength, and hydroxyproline content after intraabdominal placement of polytetrafluoroethylene mesh secured using titanium spiral tacks, nitinol anchors, and polypropylene suture or polyglactin 910 suture. Surg Endosc 19:780–785PubMedCrossRefGoogle Scholar
  16. 16.
    van’t Riet M, de Vos van Steenwijk PJ, Kleinrensink GJ, Steyerberg EW, Bonjer HJ (2002) Tensile strength of mesh fixation methods in laparoscopic incisional hernia repair. Surg Endosc 16:1713–1716PubMedCrossRefGoogle Scholar
  17. 17.
    Koehler RH, Voeller G (1999) Recurrences in laparoscopic incisional hernia repairs: a personal series and review of the literature. JSLS 3:293–304PubMedGoogle Scholar
  18. 18.
    Norris JP, Flanigan RC, Pickleman J (1994) Parapubic hernia following radical retropubic prostatectomy. Urology 44:922–923PubMedCrossRefGoogle Scholar
  19. 19.
    Morales-Conde S (2004) Laparoscopic ventral hernia repair: advances and limitations. Semin Laparosc Surg 11:191–200PubMedGoogle Scholar
  20. 20.
    Palanivelu C, Jani KV, Senthilnathan P, Parthasarathi R, Madhankumar MV, Malladi VK (2007) Laparoscopic sutured closure with mesh reinforcement of incisional hernias. Hernia 11(3):223–228PubMedCrossRefGoogle Scholar
  21. 21.
    Miserez M, Tomczyk K, Penninckx F (2007) Laparoscopical repair: the local patch. In: Schumpelick V, Fitzgibbons RJ (eds) Recurrent hernia: prevention and treatment. Springer, Berlin, pp 223–233Google Scholar
  22. 22.
    Chelala E, Gaede F, Douillez V, Dessily M, Alle L (2003) The suturing concept for laparoscopic mesh fixation in ventral and incisional hernias: preliminary results. Hernia 7(4):191–196PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • C. Palanivelu
    • 1
    Email author
  • M. Rangarajan
    • 1
  • R. Parthasarathi
    • 1
  • M. V. Madankumar
    • 1
  • K. Senthilkumar
    • 1
  1. 1.GEM Hospital and Postgraduate InstituteCoimbatoreIndia

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