Adverse Events After Ventral Hernia Repair

Chapter

Abstract

Ventral hernia repairs are among the most common operations performed by general surgeons worldwide. In the United States, approximately 105,000 ventral abdominal hernias are repaired each year. Incisional hernias, most commonly resulting from a laparotomy, occur after 3–20% of operations. Predisposing factors for ventral hernia include smoking, obesity, advanced age, diabetes, steroid use, pulmonary disease, and infectious wound complications. Surgical approaches to ventral hernia repair have been a subject of much research and debate for many years. Recurrence rates below 10% are usual with both the retrorectus and onlay methods of prosthetic repair of ventral hernias. The Achilles heel of these approaches is the possibility of mesh infection and the frequent wound complications, ranging from 12–20%. Since the first reports of a laparoscopic ventral hernia repair more than 15 years ago, laparoscopic repair has now become established and been used most frequently for smaller fascial defects. This chapter provides a guide to some of the adverse events that can occur in both open and laparoscopic ventral hernia repair.

Notes

Acknowledgement

This is an updated version of the chapter authored by V. B. Tsirline, I. Belyansky, and B. Todd Heniford. None of these authors have participated in the revision of this chapter for the 5th edition.

References

  1. 1.
    Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011;3:CD007781.Google Scholar
  2. 2.
    Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238:391–9. discussion 9–400.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Forbes SS, Eskicioglu C, McLeod RS, Okrainec A. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009;96:851–8.CrossRefGoogle Scholar
  4. 4.
    Swenson BR, Camp TR, Mulloy DP, Sawyer RG. Antimicrobial-impregnated surgical incise drapes in the prevention of mesh infection after ventral hernia repair. Surg Infect. 2008;9:23–32.CrossRefGoogle Scholar
  5. 5.
    Mahmoud Uslu HY, Erkek AB, Cakmak A, et al. Incisional hernia treatment with polypropylene graft: results of 10 years. Hernia. 2006;10:380–4.CrossRefGoogle Scholar
  6. 6.
    Brown CN, Finch JG. Which mesh for hernia repair? Ann R Coll Surg Engl. 2010;92:272–8.CrossRefGoogle Scholar
  7. 7.
    Paton BL, Novitsky YW, Zerey M, Sing RF, Kercher KW, Heniford BT. Management of infections of polytetrafluoroethylene-based mesh. Surg Infect. 2007;8:337–41.CrossRefGoogle Scholar
  8. 8.
    van Kasteren ME, Mannien J, Ott A, Kullberg BJ, de Boer AS, Gyssens IC. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor. Clin Infect Dis. 2007;44:921–7.CrossRefGoogle Scholar
  9. 9.
    Wong A, Lee S, Nathan NS, et al. Postoperative prophylactic antibiotic use following ventral hernia repair with placement of surgical drains reduces the postoperative surgical-site infection rate. Plast Reconstr Surg. 2016;137:285–94.CrossRefGoogle Scholar
  10. 10.
    Finan KR, Vick CC, Kiefe CI, Neumayer L, Hawn MT. Predictors of wound infection in ventral hernia repair. Am J Surg. 2005;190:676–81.CrossRefGoogle Scholar
  11. 11.
    Darehzereshki A, Goldfarb M, Zehetner J, et al. Biologic versus nonbiologic mesh in ventral hernia repair: a systematic review and meta-analysis. World J Surg. 2014;38:40–50.CrossRefGoogle Scholar
  12. 12.
    Park A, Birch DW, Lovrics P. Laparoscopic and open incisional hernia repair: a comparison study. Surgery. 1998;124:816–21. discussion 21–2.CrossRefGoogle Scholar
  13. 13.
    Ogunbiyi SO, Morris-Stiff G, Sheridan WG. Giant mature cyst formation following mesh repair of hernias: an underreported complication? Hernia. 2004;8:166–8.CrossRefGoogle Scholar
  14. 14.
    Ielpo B, Cabeza J, Jimenez D, Delgado I, Torres AJ. Abdominal pseudocyst complicating incisional hernia repair: our experience and literature review. Hernia. 2011;15:233–7.CrossRefGoogle Scholar
  15. 15.
    Berger D, Bientzle M, Muller A. Postoperative complications after laparoscopic incisional hernia repair. Incidence and treatment. Surg Endosc. 2002;16:1720–3.CrossRefGoogle Scholar
  16. 16.
    Kingsnorth AN, Shahid MK, Valliattu AJ, Hadden RA, Porter CS. Open onlay mesh repair for major abdominal wall hernias with selective use of components separation and fibrin sealant. World J Surg. 2008;32:26–30.CrossRefGoogle Scholar
  17. 17.
    Klima DA, Augenstein VA, Heniford BT. Medical talc and seroma formation following ventral hernia repair: invited comment to: medical talc increases the incidence of seroma formation following onlay repair of major abdominal wall hernias. Parameswaran R, Hornby ST, Kingsnorth AN. DOI:  https://doi.org/10.1007/s10029-013-1097-4. Hernia 2013;17:457–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Klima DA, Brintzenhoff RA, Tsirline VB, et al. Application of subcutaneous talc in hernia repair and wide subcutaneous dissection dramatically reduces seroma formation and postoperative wound complications. Am Surg. 2011;77:888–94.PubMedGoogle Scholar
  19. 19.
    Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M, Chowbey PK. Laparoscopic ventral/incisional hernia repair: a single centre experience of 1,242 patients over a period of 13 years. Hernia. 2011;15:131–9.CrossRefGoogle Scholar
  20. 20.
    LeBlanc KA, Elieson MJ, Corder JM. Enterotomy and mortality rates of laparoscopic incisional and ventral hernia repair: a review of the literature. JSLS. 2007;11:408–14.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Itani KM, Hur K, Kim LT, et al. Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg. 2010;145:322–8. discussion 8.CrossRefGoogle Scholar
  22. 22.
    Carbonell AM, Kercher KW, Sing RF, Heniford BT. Susceptibility of prosthetic biomaterials to infection. Surg Endosc. 2005;19:1670.CrossRefGoogle Scholar
  23. 23.
    Losanoff JE, Millis JM. Susceptibility of prosthetic biomaterials to infection. Surg Endosc. 2006;20:174–5.CrossRefGoogle Scholar
  24. 24.
    Schug-Pass C, Tamme C, Sommerer F, Tannapfel A, Lippert H, Kockerling F. A lightweight, partially absorbable mesh (Ultrapro) for endoscopic hernia repair: experimental biocompatibility results obtained with a porcine model. Surg Endosc. 2008;22:1100–6.CrossRefGoogle Scholar
  25. 25.
    Gray SH, Vick CC, Graham LA, Finan KR, Neumayer LA, Hawn MT. Risk of complications from enterotomy or unplanned bowel resection during elective hernia repair. Arch Surg. 2008;143:582–6.CrossRefGoogle Scholar
  26. 26.
    Kingsnorth AN, Sivarajasingham N, Wong S, Butler M. Open mesh repair of incisional hernias with significant loss of domain. Ann R Coll Surg Engl. 2004;86:363–6.CrossRefGoogle Scholar
  27. 27.
    Bailey J, Shapiro MJ. Abdominal compartment syndrome. Crit Care. 2000;4:23–9.CrossRefGoogle Scholar
  28. 28.
    Pain IAftSo. Classification of chronic pain. Description of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press; 1999.Google Scholar
  29. 29.
    McLanahan D, King LT, Weems C, Novotney M, Gibson K. Retrorectus prosthetic mesh repair of midline abdominal hernia. Am J Surg. 1997;173:445–9.CrossRefGoogle Scholar
  30. 30.
    Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240:578–83. discussion 83–5.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Carbajo MA, Martp del Olmo JC, Blanco JI, et al. Laparoscopic approach to incisional hernia. Surg Endosc. 2003;17:118–22.CrossRefGoogle Scholar
  32. 32.
    Welty G, Klinge U, Klosterhalfen B, Kasperk R, Schumpelick V. Functional impairment and complaints following incisional hernia repair with different polypropylene meshes. Hernia. 2001;5:142–7.CrossRefGoogle Scholar
  33. 33.
    Eriksen JR, Poornoroozy P, Jorgensen LN, Jacobsen B, Friis-Andersen HU, Rosenberg J. Pain, quality of life and recovery after laparoscopic ventral hernia repair. Hernia. 2009;13:13–21.CrossRefGoogle Scholar
  34. 34.
    Carbonell AM, Harold KL, Mahmutovic AJ, et al. Local injection for the treatment of suture site pain after laparoscopic ventral hernia repair. Am Surg. 2003;69:688–91. discussion 91–2.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Wassenaar E, Schoenmaeckers E, Raymakers J, van der Palen J, Rakic S. Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair: a randomized trial of three fixation techniques. Surg Endosc. 2010;24:1296–302.CrossRefGoogle Scholar
  36. 36.
    Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D. Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc. 2011;25:749–55.CrossRefGoogle Scholar
  37. 37.
    Snyder CW, Graham LA, Vick CC, Gray SH, Finan KR, Hawn MT. Patient satisfaction, chronic pain, and quality of life after elective incisional hernia repair: effects of recurrence and repair technique. Hernia. 2011;15:123–9.CrossRefGoogle Scholar
  38. 38.
    LeBlanc KA, Whitaker JM. Management of chronic postoperative pain following incisional hernia repair with Composix mesh: a report of two cases. Hernia. 2002;6:194–7.CrossRefGoogle Scholar
  39. 39.
    Nguyen SQ, Divino CM, Buch KE, et al. Postoperative pain after laparoscopic ventral hernia repair: a prospective comparison of sutures versus tacks. JSLS. 2008;12:113–6.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Hope WW, Lincourt AE, Newcomb WL, Schmelzer TM, Kercher KW, Heniford BT. Comparing quality-of-life outcomes in symptomatic patients undergoing laparoscopic or open ventral hernia repair. J Laparoendosc Adv Surg Tech A. 2008;18:567–71.CrossRefGoogle Scholar
  41. 41.
    Heniford BT, Walters AL, Lincourt AE, Novitsky YW, Hope WW, Kercher KW. Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg. 2008;206:638–44.CrossRefGoogle Scholar
  42. 42.
    Arroyo A, Garcia P, Perez F, Andreu J, Candela F, Calpena R. Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg. 2001;88:1321–3.CrossRefGoogle Scholar
  43. 43.
    Luijendijk RW, Lemmen MH, Hop WC, Wereldsma JC. Incisional hernia recurrence following “vest-over-pants” or vertical Mayo repair of primary hernias of the midline. World J Surg. 1997;21:62–5. discussion 6.CrossRefGoogle Scholar
  44. 44.
    Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S. Recurrences after laparoscopic repair of ventral and incisional hernia: lessons learned from 505 repairs. Surg Endosc. 2009;23:825–32.CrossRefGoogle Scholar
  45. 45.
    Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg. 1989;13:545–54.CrossRefGoogle Scholar
  46. 46.
    den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev. 2008;3:CD006438.Google Scholar
  47. 47.
    Froylich D, Segal M, Weinstein A, Hatib K, Shiloni E, Hazzan D. Laparoscopic versus open ventral hernia repair in obese patients: a long-term follow-up. Surg Endosc. 2016;30:670–5.CrossRefGoogle Scholar
  48. 48.
    Carlson MA, Frantzides CT, Shostrom VK, Laguna LE. Minimally invasive ventral herniorrhaphy: an analysis of 6,266 published cases. Hernia. 2008;12:9–22.CrossRefGoogle Scholar
  49. 49.
    Koehler RH, Voeller G. Recurrences in laparoscopic incisional hernia repairs: a personal series and review of the literature. JSLS. 1999;3:293–304.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Perrone JM, Soper NJ, Eagon JC, et al. Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery. 2005;138:708–15. discussion 15–6.CrossRefGoogle Scholar
  51. 51.
    Parker HH, Nottingham JM, Bynoe RP, Yost MJ. Laparoscopic repair of large incisional hernias. Am Surg. 2002;68:530–3. discussion 3–4.PubMedGoogle Scholar
  52. 52.
    Bencini L, Sanchez LJ, Bernini M, et al. Predictors of recurrence after laparoscopic ventral hernia repair. Surg Laparosc Endosc Percutan Tech. 2009;19:128–32.CrossRefGoogle Scholar
  53. 53.
    Asencio F, Aguilo J, Peiro S, et al. Open randomized clinical trial of laparoscopic versus open incisional hernia repair. Surg Endosc. 2009;23:1441–8.CrossRefGoogle Scholar
  54. 54.
    Bageacu S, Blanc P, Breton C, et al. Laparoscopic repair of incisional hernia: a retrospective study of 159 patients. Surg Endosc. 2002;16:345–8.CrossRefGoogle Scholar
  55. 55.
    van’t Riet M, de Vos van Steenwijk PJ, Kleinrensink GJ, Steyerberg EW, Bonjer HJ. Tensile strength of mesh fixation methods in laparoscopic incisional hernia repair. Surg Endosc. 2002;16:1713–6.CrossRefGoogle Scholar
  56. 56.
    Raftopoulos I, Vanuno D, Khorsand J, Ninos J, Kouraklis G, Lasky P. Outcome of laparoscopic ventral hernia repair in correlation with obesity, type of hernia, and hernia size. J Laparoendosc Adv Surg Tech A. 2002;12:425–9.CrossRefGoogle Scholar
  57. 57.
    Birgisson G, Park AE, Mastrangelo MJ Jr, Witzke DB, Chu UB. Obesity and laparoscopic repair of ventral hernias. Surg Endosc. 2001;15:1419–22.CrossRefGoogle Scholar
  58. 58.
    Langbach O, Holmedal SH, Grandal OJ, Rokke O. Adhesions to mesh after ventral hernia mesh repair are detected by mri but are not a cause of long term chronic abdominal pain. Gastroenterol Res Pract. 2016;2016:2631598.CrossRefGoogle Scholar
  59. 59.
    DeGuzman LJ, Nyhus LM, Yared G, Schlesinger PK. Colocutaneous fistula formation following polypropylene mesh placement for repair of a ventral hernia: diagnosis by colonoscopy. Endoscopy. 1995;27:459–61.CrossRefGoogle Scholar
  60. 60.
    Seelig MH, Kasperk R, Tietze L, Schumpelick V. Enterocutaneous fistula after Marlex net implantation. A rare complication after incisional hernia repair. Chirurg. 1995;66:739–41.PubMedGoogle Scholar
  61. 61.
    LeBlanc KA. Incisional hernia repair: laparoscopic techniques. World J Surg. 2005;29:1073–9.CrossRefGoogle Scholar
  62. 62.
    Blatnik JA, Harth KC, Aeder MI, Rosen MJ. Thirty-day readmission after ventral hernia repair: predictable or preventable? Surg Endosc. 2011;25:1446–51.CrossRefGoogle Scholar
  63. 63.
    Sorensen LT, Karlsmark T, Gottrup F. Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg. 2003;238:1–5.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Egea DA, Martinez JA, Cuenca GM, et al. Mortality following laparoscopic ventral hernia repair: lessons from 90 consecutive cases and bibliographical analysis. Hernia. 2004;8:208–12.CrossRefGoogle Scholar
  65. 65.
    Jindal V, Khan RN, Panwar R, Bansal VK, Misra MC. Nationwide study of early outcomes after incisional hernia repair (Br J Surg 2009; 96: 1452–1457). Br J Surg. 2010;97:617–8. author reply 8.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.North Devon District HospitalBarnstapleUK

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