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Observational Study
. 2020 Jan-Mar;24(1):e2020.00007.
doi: 10.4293/JSLS.2020.00007.

Laparoscopic Abdominal Wall Hernia Repair

Stefano Olmi  1 , Matteo Uccelli  1 , Giovanni Carlo Cesana  1 , Alberto Oldani  1 , Riccardo Giorgi  2 , Stefano Maria De Carli  1 , Francesca Ciccarese  1 , Roberta Villa  1
Affiliations
Observational Study

Laparoscopic Abdominal Wall Hernia Repair

Stefano Olmi et al. JSLS. 2020 Jan-Mar.

Abstract

Background and objectives: The aim of this retrospective monocentric study was to evaluate results and recurrence rate with long-term follow-up after laparoscopic incisional/ventral hernia repair.

Methods: This was a retrospective, single-center, observational trial, collecting data from patients who underwent laparoscopic incisional/ventral abdominal hernia repair using the open intraperitoneal onlay mesh technique and a single mesh type. All patients signed an informed consent form before surgery.

Results: A total of 1,029 patients were included. The median surgery time was 40 min (range 30-55) and the median length of hospital stay was 2 d (range 2-3). Intraoperative complications occurred in two of 1,029 patients (0.19%), whereas early postoperative surgical complications (within 30 d) occurred in 50 patients (4.86%). Postoperative complications according to Clavien-Dindo classification were as follows: I, 3.30% (34 of 1,029); II, 0.97% (10 of 1,029); IIIB, 0.58% (six of 1,029); IV, 0.00% (none of 1,029); and V, 0.00% (none of 1,029). During follow-up, bulging mesh was diagnosed in 58 of 1,029 patients (5.6%), and hernia recurred in 40 of 1,029 patients (3.9%). A mesh overlap equal to or greater than 4 cm appeared to be a significant protective factor for hernia recurrence (P < .001); a mesh overlap equal or greater than 5 cm appeared to be a significant protective factor for bulging (P < .001), whereas the use of resorbable fixing devices was a significant risk factor for hernia recurrence (odds ratio, 111.53, P < .001, 95% confidence interval, 21.53-577.67).

Conclusion: This study demonstrates that laparoscopic repair of ventral/incisional abdominal wall hernias is a safe, effective, and reproducible procedure. Identified risk factors for recurrence are an overlap of less than 4 cm and the use of resorbable fixation means.

Keywords: incisional hernia; intraperitoneal onlay mesh; laparoscopic repair; ventral hernia.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflict of interest.

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