Abstract
The laparoscopic ventral hernia repair with preperitoneal placement of mesh minimizes the complications related to the intraperitoneal position of mesh and fixating devices. It allows safe use of conventional and less expensive polypropylene mesh. The prospectively collected data of 68 patients who underwent laparoscopic transabdominal preperitoneal mesh hernioplasty, for different types of ventral hernias between January 2005 and December 2009 was retrospectively reviewed. The study included 68 patients, 16 males and 52 females with a mean age 51.1 ± 11.1 years (range 23–74 years). Most of the hernias (67.6%) were in the midline position. The mean size of the defect was 30.8 ± 24.4 cm2 (range, 4–144 cm2) and the mean mesh size was 237.8 ± 66.8 cm2 (range, 144–484 cm2). The mean operating time was 96.7 ± 16.7 min (range 70–150 min). All repairs were done with polypropylene mesh. The mean postoperative hospital stay was 1.5 ± 0.6 days (range, 1–4 days). Nineteen patients (27.9%) suffered from postoperative complications. Four patients (5.8%) were detected to have seroma formation. There were two recurrences (2.9%). The mean follow up was 22.7 ± 13.4 months (range, 6–48 months). The laparoscopic preperitoneal ventral hernia repair with polypropylene mesh is cheaper and has acceptable postoperative outcomes. Peritoneal coverage of the mesh not only acts as a barrier between mesh and bowel and thereby prevents adhesions, it also provides an additional security of fixation. This is a safe and feasible option of ventral hernia repair in expert hands. However, for proper validation of these conclusions a long term prospective clinical trial is required.
Similar content being viewed by others
References
Read RC, Yoder G (1989) Recent trends in the management of incisional herniation. Arch Surg 124:485–458
Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24:95–101
Luijendijk RW, Hop WC, Van den Tol MP, de Lange DCD, Braaksma MM, Ijzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398
Coob WS, Kercher KW, Heniford BT (2005) Laparoscopic repair of incisional hernias. Surg Clin N Am 85:91–103
Leber GE, Garb JL, Alexander AI, Reed WP (1998) Long term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382
Stoppa RE (1989) The treatment of complicated groin and incisional hernia. World J Surg 13(5):545–554
Rives J, Pire JC, Flament JB, Palot JP (1985) Treatment of large eventration. New therapeutic indications apropos of 322 cases. Chirurgie 111:215–225
LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41
Foda M, Carlson MA (2009) Enterocutaneous fistula associated with ePTFE mesh: case report and review of literature. Hernia 13:323–326
Jenkins ED, Yom V, Melman L, Brunt LM, Eagon JC, Frisella MM, Matthews BD (2010) Prospective evaluation of adhesive characteristics to intraperitoneal mesh and adhesiolysis-related complication during laparoscopic re-exploration after prior ventral hernia repair. Surg Endosc 13(1):10–13
Farmer L, Ayoub M, Werejcka D, Southerland S, Freeman A, Solis M (1998) Adhesion formation after intraperitoneal and extraperitoneal implantation of polypropylene mesh. Am Surg 64(2):144–146
Sharma A, Panse R, Khullar R, Soni V, Baijal M, Chowbey PK (2005) Laparoscopic transabdominal extraperitoneal repair of lumbar hernia. J Min Access Surg 1(2):70–73
Stoppa R, Henry X, Odimba E, Verhaeghe P, Largueche S, Myon Y (1980) Traitement chirurgical des eventrations post-operatoires. Utilisation des protheses en tulle de Dacron et de la colle biologique. Nouv Presse Med 9:3541–3545
Miserez M, Penninckx F (2002) Endoscopic totally preperitoneal ventral hernia repair. Surg Endosc 16:1207–1213
Israelsson LA, Jonsson T (1996) Incisional hernia after midline laparotomy: a prospective study. Eur J Surg 162(2):125–129
Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72(1):70–71
Cobb WS, Kercher KW, Matthews BD, Burns JM, Tinkham NH, Singh RF, Heniford BT (2006) Laparoscopic ventral hernia repair: a single centre experience. Hernia 10(3):236–242
Luijendijk RW, de Lange DC, Wauters CC, Hop WC, Duron JJ, Pailler JL, Camprodon BR, Holmdahl L, van Geldrop HJ, Jeekel J (1996) Foreign material in postoperative adhesions. Ann Surg 223:242–248
de Vries Reilingh TS, van Geldere D, Langenhorst B, Jong D, Wilt GJ, Goor H, Bleichrodt RP (2004) Repair of large midline incisional hernias with polypropylene mesh: comparison of three operative techniques. Hernia 8(1):56–59
Ellis H (1997) The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg Suppl 577:5–9
diZerega GS (1997) Biochemical events in peritoneal tissue repair. Eur J Surg Suppl 557:10–16
Suslavich FJ, Turner NA, King PS, Brown HK (1989) Intra-abdominal adhesions: intraoperative US. Radiology 172(2):387–388
Vrijland WW, Jeekel J, Steyerberg EW, Den Hoed PT, Bonjer HJ (2000) Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula. Br J Surg 87(3):348–352
Halm JA, de Wall LL, Steyerberg EW, Jeekel J, Lange JF (2007) Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg 31:423–429
Utreragonzalez A, de la Portilla de Juan F, Carranza Albarran G (1999) Large incisional hernia repair using intraperitoneal placement of expanded polytetrafluoroethylene. Am J Surg 177:291–293
Arnaud JP, Hennekinne-Mucci S, Pesssaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88
Balique JG, Benchetrit S, Bouillot JL, Flament JB, Gouillat C, Jarsaillon P, Lepère M, Mantion G, Arnaud JP, Magne E, Brunetti F (2005) Intraperitoneal treatment of incisional and umbilical hernias using an innovative composite mesh; four-year results of a prospective multicenter clinical trial. Hernia 9:68–74
Diaz-Pizarro Graf JI, Moreno Portillo M, Cardenas Lailson LE, Ramirez Solis ME, Palacios Ruiz JA, Parraguirre Martínez S (2005) Laparoscopic transabdominal preperitoneal approach to place a polypropylene mesh on the abdominal wall: an experimental swine model of a technique that can be used for incisional hernia repair. Surg Endosc 19:990–995
Chowbey PK, Sharma A, Khullar R, Soni V, Baijal M (2003) Laparoscopic ventral hernia repair with extraperitoneal mesh: surgical technique and early results. Surg Laparosc Endosc Techn 13(2):101–105
Tayfun K, Ender O, Bilgi B, Ismail H, Salih P, Deniz EB et al (2004) Spiral tacks may contribute to intra-abdominal adhesion formation. Surg Today 34:860–864
DeMaria EJ, Moss JM, Surgerman HJ (2000) Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia: prospective comparison to open prefascial polypropylene mesh repair. Surg Endosc 326–329
Koehler RH, Voeller G (1999) Recurrences in laparoscopic incisional hernia repairs: a personal series and review of literature. JSLS 3:293–304
Carbajo MA, Martin del Olmo JC, Blanco JI, Toledano M, de la Cuesta C, Ferraras C et al (2003) Laparoscopic approach to incisional hernia. Surg Endosc 17:118–122
Heniford BT, Park A, Ramshaw BJ, Voeller G (2000) Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 190:645–650
LeBlank KA, Whitaker JM, Bellanger DE, Rhynes VK (2003) Laparoscopic incisional and ventral hernioplasty; lessons learned from 200 patients. Hernia 7:118–124
Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years experiences with 850 consecutive hernia. Ann Surg 238:391–400
Authors Disclosure Statement
Drs. Parmanand Prasad, Om Tantia, Nirmal M Patle, Shashi Khanna and Bimalendu Sen have no conflicts of interest or financial ties to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Prasad, P., Tantia, O., Patle, N.M. et al. Laparoscopic Transabdominal Preperitoneal Repair of Ventral Hernia: A Step Towards Physiological Repair. Indian J Surg 73, 403–408 (2011). https://doi.org/10.1007/s12262-011-0366-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-011-0366-7