Recurrence and Pseudorecurrence after Laparoscopic Ventral Hernia Repair: Predictors and Patient-focused Outcomes

Laparoscopic ventral hernia repair (LVHR) is gaining popularity as an option to repair abdominal wall hernias. Bulging after repair remains common after this technique. This study evaluates the incidence and factors associated with bulging after LVHR. Between 2000 and 2010, 201 patients underwent LVHR at two affiliated institutions. Patients who developed recurrence or pseudorecurrence (seroma or eventration) were analyzed with univariate and multivariate analyses to identify predictors of these complications. Of the 201 patients who underwent LVHR, 40 (19.9%) patients developed a seroma, 63 (31.3%) patients had radiographically proven eventration, and 25 (12.4%) patients had a hernia recurrence. On multivariate analysis, seromas were associated with number of prior ventral hernia repairs, surgical site infections, and prostate disease. Mesh eventration was associated with hernia size and surgical technique. Tissue eventration was associated with primary hernias and surgical technique. Hernia recurrence was associated with incisional hernias and mesh type used. Recurrence and pseudorecurrence are important complications after LVHR. Large hernia size, infections, and surgical technique are important clinical factors that affect outcomes after LVHR.

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Outcome of Laparoscopic Ventral Hernia Repair in Correlation with Obesity, Type of Hernia, and Hernia Size

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/109264202762252695 ◽

2002 ◽

Vol 12 (6) ◽

pp. 425-429 ◽

Cited By ~ 38

Author(s):

Ioannis Raftopoulos ◽

Daniel Vanuno ◽

Jubin Khorsand ◽

Joseph Ninos ◽

G. Kouraklis ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Hernia Size

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Effects of Malignancy on Hernia Recurrence and Perioperative Outcomes of Laparoscopic Ventral Hernia Repair

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2016.08.196 ◽

2016 ◽

Vol 223 (4) ◽

pp. e75

Author(s):

Raul J. Rosenthal ◽

Sherif Y. Shalaby ◽

David Gutierrez Blanco ◽

Emanuele Lo Menzo ◽

Samuel Szomstein

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Hernia Recurrence ◽

Laparoscopic Ventral Hernia Repair ◽

Perioperative Outcomes

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Delineation of factors associated with prolonged length of stay after laparoscopic ventral hernia repair leads to a clinical pathway and improves quality of care

Surgical Endoscopy ◽

10.1007/s00464-015-4391-7 ◽

2015 ◽

Vol 30 (4) ◽

pp. 1614-1618 ◽

Cited By ~ 7

Author(s):

Jennifer Leonard ◽

Tina J. Hieken ◽

Malek Hussein ◽

W. Scott Harmsen ◽

Mark Sawyer ◽

...

Keyword(s):

Quality Of Care ◽

Length Of Stay ◽

Hernia Repair ◽

Ventral Hernia ◽

Clinical Pathway ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Prolonged Length ◽

Factors Associated

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Long-Term Outcomes with Transfascial Sutures versus Tacks in Laparoscopic Ventral Hernia Repair: A Review

The American Surgeon ◽

10.1177/000313481107700423 ◽

2011 ◽

Vol 77 (4) ◽

pp. 458-465 ◽

Cited By ~ 22

Author(s):

Jason B. Brill ◽

Patricia L. Turner

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Mesh Fixation ◽

Hernia Recurrence ◽

Laparoscopic Ventral Hernia Repair ◽

Pain Patient ◽

Significant Difference

Although most surgeons report using both transfascial sutures and laparoscopically placed tacks to secure prostheses in laparoscopic ventral hernia repair, a significant minority have reported large series in which sutures were omitted. A systematic review of the available literature was conducted for large case series and controlled trials documenting long-term follow-up. Forty-three articles were identified, including 6015 patients whose prostheses were secured with transfascial sutures (with or without tacks), and 2450 patients receiving tacks or staples alone. The mean follow-up time reported was 30.1 months. No significant difference was found in rates of hernia recurrence, mesh removal, prolonged postoperative pain, patient body mass index, or hernia defect size between the two groups. The suture group did experience a significantly higher rate of surgical site infection. Although suture tensile strength is greater than that of tacks, and despite numerous anecdotal reports of hernia recurrence secondary to suture failure or omission, the existing literature does not show superiority of one mesh fixation technique over the other for recurrence, whereas infection rates increase when transfascial suture is used.

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Robotic versus Laparoscopic Ventral Hernia Repair: A Multicenter, Blinded Randomized Controlled Trial

SSRN Electronic Journal ◽

10.2139/ssrn.3453330 ◽

2019 ◽

Author(s):

Oscar Olavarria ◽

Karla Bernardi ◽

Shinil K. Shah ◽

Todd D. Wilson ◽

Shuyan Wei ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Controlled Trial ◽

Laparoscopic Ventral Hernia Repair ◽

Randomized Controlled

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Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Hernia ◽

10.1007/s10029-021-02486-6 ◽

2021 ◽

Author(s):

P. J. O’Dwyer ◽

C. Chew ◽

H. Qandeel

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Ct Scans ◽

Unique Problem ◽

Polyester Mesh

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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