Laparoscopic Repair of Ventral Hernia

  • Gerald M. Larson


The general indication for a laparoscopic repair of a ventral hernia is the presence of a hernia with a fascial defect 3 cm or greater in patients who would otherwise meet the criteria for a traditional open surgical repair. Small hernia defects less than 3 cm in diameter are readily repaired by standard techniques, and the laparoscopic approach usually offers no advantage to the patient. Abdominal wall hernias in the midline or in the upper and lower quadrants are equally accessible by the laparoscopic approach. Special conditions include:
  1. a.

    The incarcerated hernia can be repaired laparoscopically if one can obtain a good laparoscopic view of the hernia and its contents, dissect the adhesions, and reduce the hernia.

  2. b.

    In the multiply operated abdomen, the extent and density of adbesions are the main determinants of length and difficulty of laparoscopic ventral hernia repair. Adhesion formation is unpredictable; therefore, multiple previous operations do not preclude the laparoscopic approach provided that an entry point for the first trocar can be obtained and a pneumoperitoneum safely established.

  3. c.

    Swiss-cheese hernias (multiple small defects) are actually a good indication for the laparoscopic approach because the number of fascial defects and extent of hernia formation are often greater than expected. The laparoscopic approach allows a clear delineation of all defects, so that the mesh prosthesis is tailored accordingly.



Abdominal Wall Hernia Repair Laparoscopic Approach Ventral Hernia Laparoscopic Repair 
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Copyright information

© Society of American Gastrointestinal Endoscopic Surgeons 1999

Authors and Affiliations

  • Gerald M. Larson

There are no affiliations available

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