Outcomes of laparoscopic incisional hernia repair: A prospective evaluation

Abstract

Objective: Although laparoscopic incisional hernioplasty has been gaining in popularity, the best approach for the repair of incisional hernia remains controversial. The present study was undertaken to evaluate the medium-term outcomes of laparoscopic incisional hernioplasties utilizing onlay GORE-TEX DualMesh (GORE-TEX DualMesh Biomaterial; W.L. Gore and Associates, Flagstaff, Arizona, TX, USA). Methodology: Between June 2000 and July 2004, 42 patients underwent laparoscopic incisional hernioplasties at our institution. Perioperative data and postoperative outcomes were collected prospectively and analyzed. Results: Laparoscopic incisional hernioplasty was successfully performed on 39 (93%) patients. Conversion to open repair was required in three patients. The overall mean operative time was 108 min. Sixteen patients (37%) were found to have more than one hernial defect after reduction of the hernial contents. Postoperative morbidity included seroma (n = 8), urinary retention (n = 3), ileus (n = 1), pneumonia (n = 1), fever (n = 1), wound infection (n = 1), and prolonged suture site pain (n = 1) in 13 patients. All these morbidities resolved spontaneously without intervention. Two-thirds of the patients were discharged within 2 days after surgery. With a median follow up of 2 years, two clinical recurrences (4.8%) were detected. Conclusion: Laparoscopic approach was a safe and efficacious technique for the repair of incisional hernia. Medium-term outcomes were promising with low postoperative morbidity and recurrence rates. This technique allows clear identification of multiple hernial defects and confers the advantages of minimal access surgery.