Postoperative complications after laparoscopic incisional hernia repair. Incidence and treatment

Abstract

Background: The popularity of laparoscopic repair of incisional hernias is increasing due to the apparent advantages of laparoscopy.

Patients and methods: A group of 150 consecutive patients with incisional hernias were treated by laparoscopic IPOM technique with a Goretex Dualmesh between September 1999 and September 2001 and subsequently followed up. Some minor and major complications could clearly identify advantages as well as drawbacks of the technique.

Results: No primary mesh infection were observed but 4 recurrences, 3 of them due to technical mistakes, and 1 case with ileus due to a volvolus at day 4 p.o. were recorded. Further major complications included 2 early and 2 later stage trocar hernias, which needed surgical correction. Two patients developed secondary bowel perforation after thermal injury and after primary enterotomy which was closed by laparotomy.

Conclusions: All complications, except one recurrence due to failure of the material, were surgical mistakes and cannot be attributed to the laparoscopic procedure. Consequently, after taking into account the surgical mistakes and possible technical errors, the low recurrence rate justifies further application of laparoscopic ventral hernia repair.