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Laparoscopic incisional hernia repair: are transfascial sutures necessary? A review of the literature

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Abstract

Background

Laparoscopic repair of incisional and ventral hernias is rapidly becoming more commonplace in the armamentarium of general surgeons. Its utility and low recurrence rates make it a very attractive option. As with all newer procedures, controversies exist with this approach. One significant aspect is the method of fixation for the biomaterial. Most authors add the use of transfascial sutures. Others, in the minority, do not.

Methods

A literature search using Medline and PubMed was used to evaluate the best practice for fixation in laparoscopic incisional and ventral hernia repair.

Results

This review of the current literature (including comparative series) seems to show that the recurrence rate is approximately 4% with the use of sutures and 1.8% without their use. However, these data do not show that there is tremendous variation in the method and manner of placing transfascial sutures or that long-term follow-up evaluation is inadequate in most series. No firm conclusions can be drawn about whether it is detrimental to omit the use of transfascial sutures.

Conclusions

On the basis of this review, a larger overlap of the prosthesis (5 vs 3 cm) is necessary if sutures are not used. If sutures are used, they should be placed no more than 5 cm apart. Prospective randomized trials with and without of transfascial sutures using a consistent biomaterial are necessary to settle this issue.

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Authors and Affiliations

  1. Minimally Invasive Surgery Institute, 7777 Hennessy Boulevard, Suite 612, Baton Rouge, LA, 70808, USA

    K. A. LeBlanc

  2. Clinical Associate Professor, Louisiana State University School of Medicine, New Orleans, LA, USA

    K. A. LeBlanc

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  1. K. A. LeBlanc
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Correspondence to K. A. LeBlanc.

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LeBlanc, K.A. Laparoscopic incisional hernia repair: are transfascial sutures necessary? A review of the literature. Surg Endosc 21, 508–513 (2007). https://doi.org/10.1007/s00464-006-9032-8

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  • DOI: https://doi.org/10.1007/s00464-006-9032-8

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