Emergent laparoscopic repair of incarcerated incisional and ventral hernia

Abstract Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.

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Laparoscopic repair of umbilical and paraumbilical hernias: a prospective and interventional study in government hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20194066 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3283

Author(s):

Kiren B. Patel ◽

Mithun V. Barot

Keyword(s):

Surgical Site Infection ◽

Hospital Stay ◽

Wound Infection ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Umbilical Hernia ◽

Operative Time ◽

Postoperative Hospital Stay ◽

Site Infection ◽

Drain Removal

Background: Umbilical and ventral hernia occurs as a result of weakness in musculofascial layer of anterior abdominal wall. The most important causes are congenital, acquired, incisional and traumatic. UH and VH can be repair by open surgical procedure. A successful series of laparoscopic repair of umbilical hernia and VH was done by Le blanc in 1993. The cost can be optimised by selection of mesh and optimal uses of transabdominal suture and various fixation devices. This original article reveals methods, techniques, indication, contraindication, post-op pain, operative time, surgical site infection recurrence and outcome of laparoscopic umbilical hernia and paraumbilical hernia repair.Methods: A total of 21 patients of ventral hernia (umbilical, paraumbilical and incisional), who underwent laparoscopic hernia repair from October 2014 to October 2016, were selected have taken part in study with valid consent, in B.J. Medical College Ahmedabad Gujarat. All patient study regarding operative time, postoperative pain, postoperative hospital stay, surgical site infection like wound infection, seroma, hernia defect size, mean drain removal and recurrence.Results: Out of 21 patients male are 33% and female are 67%. Mean age of patients is 45 yrs with range being 18-65 yrs. 28%, 33.33%, and 38.1% of patient had umbilical, paraumbilical and incisional hernia respectively. Mean size defect was 7.8 cm2. Mean operative time in this study is 98.6 minute. Mean drain removal is 2.80 day. Mean postoperative hospital stay was 3.3 days. 4.7% had wound infection, 9.5% had seroma formation. There is 0% recurrence in present study.Conclusions: The laparoscopic approach appears to be safe, effective and acceptable. It is also effective in those who are obese, with co morbidities (complex) and who have recurrence from prior open repair and having ascites.

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Laparoscopic Repair of Ventral Hernia

Laparoscopic Hernia Repair ◽

10.5005/jp/books/11876_9 ◽

2013 ◽

pp. 190-190

Author(s):

RK Mishra ◽

Adel Al-Galladi

Keyword(s):

Ventral Hernia ◽

Laparoscopic Repair

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Laparoscopic repair of paraumbilical ventral hernia with increasing size in an obese patient

Surgical Endoscopy ◽

10.1007/bf00188487 ◽

1996 ◽

Vol 10 (9) ◽

pp. 933-935 ◽

Cited By ~ 6

Author(s):

M. Hashizume ◽

S. Migo ◽

Y. Tsugawa ◽

K. Tanoue ◽

M. Ohta ◽

...

Keyword(s):

Obese Patient ◽

Ventral Hernia ◽

Laparoscopic Repair

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Preoperative chemical component relaxation using Botulinum toxin A: enabling laparoscopic repair of complex ventral hernia

Surgical Endoscopy ◽

10.1007/s00464-016-5030-7 ◽

2016 ◽

Vol 31 (2) ◽

pp. 761-768 ◽

Cited By ~ 23

Author(s):

Kristen E. Elstner ◽

John W. Read ◽

Omar Rodriguez-Acevedo ◽

Peter H. Cosman ◽

Anthony N. Dardano ◽

...

Keyword(s):

Botulinum Toxin ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Botulinum Toxin A ◽

Chemical Component ◽

Toxin A ◽

Complex Ventral Hernia

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Laparoscopic hernioplasty of large ventral hernia with transfascial sutures: short term utility and outcome

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15314 ◽

2016 ◽

Vol 18 (3) ◽

pp. 52

Author(s):

A Kumar ◽

CS Agrawal ◽

S Sah ◽

RK Gupta

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Ventral Hernia Repair ◽

Open Repair ◽

Mesh Fixation ◽

Laparoscopic Approach ◽

Laparoscopic Ventral Hernia Repair ◽

University Hospital ◽

Large Ventral Hernia

Introduction: The laparoscopic approach to repairing ventral and incisional hernias has gained increasing popularity worldwide. The approximation of the hernia defect during laparoscopic ventral hernia repair, prior to mesh fixation, provides a more physiologic and anatomic repair. Defect closure also provides more defect overlap with mesh placement and, possibly decreases recurrence rates. We reviewed the experience of laparoscopic repair of large ventral hernia (diameter ≥5cm) at a university hospital in the Nepal with particular reference to patients with massive defects (diameter ≥15cm) and transfascial closure.Methods: A total of 32 patients underwent laparoscopic ventral (incisional or umbilical/paraumbilical) hernia repair between July 2014 and September 2015.Results: The prevalence of conversion to open surgery was 3.1%. The prevalence of postoperative complications was 15.6%. Median postoperative follow-up was 8.2 months. A total of 9.4% cases suffered late complications and 3.1% developed recurrence. Twelve patients underwent repair of defects ≥10cm in diameter with no recurrence. Three patients underwent repair of ‘massive’ incisional hernia (diameter ≥15cm) with a prevalence of recurrence of 3.1%. Ten patients with a body mass index (BMI) ≥30kg/m2 (range, 32–35kg/m2) underwent laparoscopic repair without any recurrence.Conclusions: Laparoscopic ventral hernia repair with transfascial suturing can be carried out safely with a low prevalence of recurrence. It may have advantages in obese patients in whom open repair would represent a significant undertaking. Laparoscopic ventral hernia repair may be used in cases of large and massive hernias, in which the risk of recurrence increases but is comparable with open repair and associated with low morbidity.

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