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Hernia

, Volume 22, Issue 2, pp 285–291 | Cite as

Persistent posterior seroma after laparoscopic repair of ventral abdominal wall hernias with expanded polytetrafluoroethylene mesh: prevalence, independent predictors and detached tacks

Retrospective review
  • V. M. A. Stirler
  • R. J. de Haas
  • J. T. F. J. Raymakers
  • S. Rakic
Original Article
  • 193 Downloads

Abstract

Purpose

A persistent seroma located posterior to a mesh (PPS) remains a little known complication after laparoscopic ventral hernia repair (LVHR). The aim of this large case series was to analyse the prevalence and clinical course as well as identify related factors and independent predictors of PPS.

Methods

All 1288 adult patients who underwent a LVHR with an expanded polytetrafluoroethylene mesh (ePTFE) between January 2003 and July 2014 were reviewed. Those who underwent an abdominal computed tomography (CT) scan more than 3 months afterwards (n = 166) were included and their scans were analysed. The primary outcome measure was the prevalence of a PPS and its characteristics. The secondary outcome measures were identification of significantly related factors and independent predictors of PPS.

Results

A PPS was observed in 14 of 166 analysed CT scans (8.4%). Eleven patients were symptomatic; conservative treatment (wait-and-see policy) was successful in eight. Three underwent relaparoscopy with removal of a thick neoperitoneum. Several instances of tack and/or mesh detachment were identified on CT scans and during relaparoscopy. Independent predictors were: > 3 trocars (RR 5.0, 95% CI 1.6–15.8) and use of a mesh larger than > 300 cm2 (RR 9.9, 95% CI 1.9–51.2).

Conclusions

A PPS is a relatively common complication after LVHR with an ePTFE mesh of usually larger hernias. A “wait-and-see” approach seems justified in most cases. Some require laparoscopic excision of the thick neoperitoneum. A PPS can cause tack and mesh detachment but the clinical consequences are unclear. Recurrences have not been observed in this series.

Keywords

Posterior seroma Ventral hernia Laparoscopic repair Tack detachment 

Notes

Funding

No financial support has been accepted for this research and/or publication.

Compliance with ethical standards

Conflict of interest

VS declares no conflict of interest. RH declares no conflict of interest. JR declares no conflict of interest. SR declares no conflict of interest.

Ethical approval

Approval from the institutional review board was not required for this study.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryZGT HospitalsAlmeloThe Netherlands

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