Single-access laparoscopic primary and incisional prosthetic hernia repair: first 50 patients
- First Online:
- 225 Downloads
Primary and incisional hernia can be repaired by multitrocar laparoscopy. Single-access laparoscopy (SAL) recently gained interest to decrease the invasiveness and to reduce the abdominal trauma, besides improved cosmetic results. The authors report first 50 patients who consulted for primary and incisional hernia and treated by SAL prosthetic repair.
Patients and methods
Between December 2009 and March 2012, 50 patients (24 females, 26 males) were submitted to SAL for primary (23) and incisional hernia (27). Mean age was 49.1 ± 15.1 years (17–75), and mean body mass index 29.7 ± 5.7 kg/m2 (19–44.1). A total of 26 primary and 30 incisional hernias were treated. The technique consisted in implied the use of an 11-mm trocar for 10-mm scope, curved reusable instruments without trocars, and dualface prosthesis fixed by tacks without transfascial closures.
No conversion to open surgery nor addition of one or more trocars was necessary. Mean perioperative hernia sizes were 7.0 ± 5.0 cm (2–24) in length and 6.0 ± 3.4 cm (1–16) in width, for a surface of 55.0 ± 64.6 cm2 (2.8–268.2). Mean prosthesis size used was 188.1 ± 113.4 cm2 (56.2–505.6). Mean laparoscopic time was 60.2 ± 32.8 min (26–153), and mean final scar length was 21.2 ± 4.5 mm (13–35). Mean hospital stay was 2.2 ± 1.2 days (1–8). Perioperative complications were registered in 4 patients and minor early complications in 13 patients of each group. After a mean follow-up of 16.1 ± 8.8 months (4–34), 2 late complications were observed in one patient of each group.
Primary and incisional hernia can safely be treated by SAL prosthetic repair, but a learning curve is unavoidable. Thanks to this approach, in patients with primary hernia, only a small scar is finally visible, and in patients who proved to be prone to develop incisional hernia, the number of fascial incisions can be reduced.
KeywordsSingle-access Single-incision Single-port Single-site Umbilical hernia Ventral hernia Incisional hernia Laparoscopy
- 6.Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev Mar 16(3):CD007781Google Scholar
- 11.Gonzales R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic verus open umbilical hernia repair. JSLS 7(4):323–328Google Scholar
- 30.Barbaros U, Demirel T, Sumer A, Deveci U, Tukenmez M, Cansumar MI, Kalayci M, Dinccag A, Seven R, Mercan S (2011) SILS Incisional hernia repair: is it feasible in giant hernias? A report of three cases. Diagn Ther Endosc 2011:387040Google Scholar
- 31.Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13(4):407–414PubMedCrossRefGoogle Scholar
- 41.Gurusamy KS, Allen VB, Samraj K (2012) Wound drains after incisional hernia repair. Cochrane Database Syst Rev Feb 15(2):CD005570Google Scholar