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Laparoscopic repair of incisional hernia: Outcomes of 100 consecutive cases comprising 25 wall defects larger than 15 cm

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An Erratum to this article was published on 06 March 2008

Abstract

Background

Minimal access surgery for incisional hernia repair is still debated, especially for large and giant wall defects. This study was undertaken to analyze the results of the use of the laparoscopic technique in incisional hernias smaller and larger than 15 cm of diameter.

Method

From 2002 to 2007 a total of 100 patients with incisional hernia were operated on by laparoscopy and were included in this study. As much as 38 patients were obese, with a body mass index (BMI) > 30 kg/m2. The mean follow-up span was 24 months (range = 2–58). The fascial defect was recurrent in 19 patients, in 13 after previous repair with mesh and in 6 after repair without mesh. The wall defect was larger than 15 cm in 25 patients and in 6 of them it was 20 cm or larger as measured from within the peritoneal cavity.

Results

The mean operating time was 152 ± 25 min (range = 45–275), and for defects larger than 15 cm it was 205 ± 101 min (range = 85–540). Two patients with massive adhesions needed conversion to open surgery, one after an intraoperative injury of an intestinal loop. Postoperative complications occurred in 23 patients; local complications were 10. Pulmonary embolism caused death in one obese patient. Morbidity and hospital stay were similar in obese and nonobese patients and the differences were not statistically relevant (p > 0.05). The outcomes in patients with wall defects larger than 15 cm showed no significant difference with outcomes of the remaining patients with smaller defects (p > 0.05). Recurrence occurred in three cases, and in one case local infection led to removal of the mesh.

Conclusions

Minimal access procedures can provide good results in the repair of incisional hernia, even when the diameter is larger than 15 cm. Obesity is not a contraindication to laparoscopic repair. Further studies are expected to confirm these promising results.

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References

  1. Amid PK, Shulman AG, Lichtenstein IL (1995) A simple stapling technique for prosthetic repair of massive incisional hernias. Am Surg 60:934–937

    Google Scholar 

  2. Gersin KS (2004) Laparoscopic incisional hernia repair. Op Tech Gen Surg 6:189–199

    Article  Google Scholar 

  3. 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

    Article  PubMed  CAS  Google Scholar 

  4. Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias. Ann Surg 238:391–400

    PubMed  Google Scholar 

  5. Mudge M, Hughes LE (1985) Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg 72:70–71

    Article  PubMed  CAS  Google Scholar 

  6. Navarra G, Musolino C, De Marco ML, Bartolotta M, Barbera A, Centorrino T (2007) Retromuscular sutured incisional hernia repair: a randomized controlled trial to compare open and laparoscopic approach. Surg Laparosc Endosc Percutan Tech 17:86–90

    Article  PubMed  Google Scholar 

  7. Rudmik LR, Schieman C, Dixon E, Debru E (2006) Laparoscopic incisional hernia repair: a review of the literature. Hernia 10:110–119

    Article  PubMed  CAS  Google Scholar 

  8. Chevrel JP, Rath AM (2000) Classification of incisional hernias of the abdominal wall. Hernia 4:7–11

    Article  Google Scholar 

  9. Korenkov M, Paul A, Sauerland S, Neugebauer E, Arndt M, Chevrel JP, Corcione F, Fingerhut A, Flament JB, Kux M, Matzinger A, Myrvold HE, Rath AM, Simmermacher RKJ (2001) Classification and surgical treatment of incisional hernia. Results of an experts’ meeting. Langebeck’s Arch Surg 386:65–73

    Article  CAS  Google Scholar 

  10. Arnaud JP, Tuech JJ, Pessaux P, Hadchity Y (1999) Surgical treatment of postoperative incisional hernia by intraperitoneal insertion of dacron mesh and an aponeurotic graft. Arch Surg 134:1260–1262

    Article  PubMed  CAS  Google Scholar 

  11. Hamy A, Pessaux P, Mucci-Hennekinne S, Radriamananjo S, Regent N, Arnaud JP (2003) Surgical treatment of large incisional hernias by an intraperitoneal dacron mesh and an aponeurotic graft. J Am Coll Surg 196:531–534

    Article  PubMed  Google Scholar 

  12. Lucas CE, Ledgerwood AM, Bender J (1998) Autologous closure of giant abdominal wall defects. Am Surg 64:607–610

    PubMed  CAS  Google Scholar 

  13. Vargo D (2004) Component separation in the management of the difficult abdominal wall. Am J Surg 188:633–637

    Article  PubMed  Google Scholar 

  14. Carbajo MA, del Olmo JCM, Blanco JI, de la Cuesta C, Toledano M, Martin F, Vaquero C, Inglada L (1999) Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13:250–252

    Article  PubMed  CAS  Google Scholar 

  15. Aldridge AJ,Simson JNL (2001) Erosion and perforation of colon by synthetic mesh in a recurrent paracolostomy hernia. Hernia 5:110–112

    Article  PubMed  CAS  Google Scholar 

  16. Perrone JM, Soper NJ, Eagon JC, Klingesmith ME, Aft RL, Frisella MM, Brunt LM (2005) Perioperative outcome and complications of laparoscopic ventral hernia repair. Surgery 138:708–715

    Article  PubMed  Google Scholar 

  17. Riaz AA, Ismail M, Barsam A, Bunce CJ (2004) Mesh erosion into the bladder: A late complication of incisional hernia repair. A case report and a review of the literature. Hernia 8:158–159

    Article  PubMed  CAS  Google Scholar 

  18. Topart P, Ferrand L, Vandenbroucke F, Lozac’h P (2005) Laparoscopic ventral hernia repair with the Goretex Dualmesh: long-term results and review of the literaure. Hernia 9:348–352

    Article  PubMed  Google Scholar 

  19. Bernard C, Polliand C, Mutelica L, Champault G (2007) Repair of giant incisional abdominal wall hernias using open intraperitoneal mesh. Hernia 2007 11:315-320

    Article  CAS  Google Scholar 

  20. Novitsky YW, Cobb WS, Kercher KW, Matthews BD, Sing RF, Heniford BT (2006) Laparoscopic ventral hernia repair in obese patients. A new standard of care. Arch Surg 141:57–61

    Article  PubMed  Google Scholar 

  21. Petersen S, Henke G, Freitag M, Faulhaber A, Ludwig K (2001) Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome. Eur J Surg 157:453–457

    Article  Google Scholar 

  22. Sanchez LJ, Bencini L, Moretti R (2004) Recurrences after laparoscopic ventral hernia repair: results and critical review. Hernia 8:138–143

    Article  PubMed  CAS  Google Scholar 

  23. Tonante A, Lo Schiavo MG, Bonanno L, D’Alia C, Taranto F, Gagliano E, Sturniolo G (2004) Le complicanze della chirurgia protesica “open” dei grandi laparoceli. Chir Ital 5:629–637

    Google Scholar 

  24. Olmi S, Scaini A, Cesana GC, Erba L, Croce E (2007) Laparoscopic versus open incisional hernia repair. An open randomized controlled study. Surg Endosc 21:555-559

    Article  PubMed  CAS  Google Scholar 

  25. Samir J (2005) Laparoscopic incisional hernia repair in obese patients. JSLS 9:47–50

    Google Scholar 

  26. Berger D, Bientzle M, Muller A (2002) Postoperative complications after laparoscopic incisional hernia. Incidence and treatment. Surg Endosc 16:1720–1723

    Article  PubMed  CAS  Google Scholar 

  27. Carbajo MA, Martin del Olmo JC, Blanco JI, Toledano M, de la Cuesta C, Ferreras C, Vaquero C (2003) Laparoscopic approach to incisional hernia. Surg Endosc 17:118–122

    Article  PubMed  CAS  Google Scholar 

  28. Salameh JR, Sweeney JF, Graviss EA, Essien FA, Williams MD, Awad S, Itani KM, Fisher WE (2002) Laparoscopic ventral hernia repair during the learning curve. Hernia 6:182–187

    Article  PubMed  CAS  Google Scholar 

  29. Cassar K, Munro A (2002) Surgical treatment of incisional hernia. Br J Surg 89:534–545

    Article  PubMed  CAS  Google Scholar 

  30. Holzman MD, Purut CM, Reintgen K, Eubanks S, Pappas TN (1997) Laparoscopic ventral and incisional hernioplasty. Surg Endosc 11:32–35

    Article  PubMed  CAS  Google Scholar 

  31. Tsimoyiannis EC, Siakas P, Glantzounis G, Koulas S, Mavridou P, Gossios K (2001) Seroma in laparoscopic ventral hernioplasty. Surg Laparosc Endosc Percutan Tech 11(5):317–321

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Surgery and Videolaparoscopy Department, Niguarda Hospital, Milan, Piazza Ospedale Maggiore 3, 20162, Milano, Italy

    Giovanni Carlo Ferrari, Angelo Miranda, Stefano Di Lernia, Fabio Sansonna, Carmelo Magistro, Dario Maggioni, Ildo Scandroglio, Andrea Costanzi, Maurizio Franzetti & Raffaele Pugliese

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  1. Giovanni Carlo Ferrari
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  2. Angelo Miranda
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  3. Stefano Di Lernia
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  5. Carmelo Magistro
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Correspondence to Fabio Sansonna.

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Ferrari, G.C., Miranda, A., Lernia, S.D. et al. Laparoscopic repair of incisional hernia: Outcomes of 100 consecutive cases comprising 25 wall defects larger than 15 cm. Surg Endosc 22, 1173–1179 (2008). https://doi.org/10.1007/s00464-007-9707-9

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  • DOI: https://doi.org/10.1007/s00464-007-9707-9

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