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Laparoscopic transperitoneal sublay mesh repair: a new technique for the cure of ventral and incisional hernias

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Abstract

Background

Incisional hernia is a frequent complication after abdominal surgery. Today open sublay mesh repair and the laparoscopic intraperitoneal onlay mesh repair are the most widely used techniques for its cure. We developed a laparoscopic transperitoneal sublay mesh repair for the treatment of small- and medium-size ventral and incisional hernias. Outcomes of the new technique and the Rives–Stoppa repair were compared.

Methods

This prospective cohort study with a control group involved 93 patients. Between 2008 and 2010, 43 patients underwent the laparoscopic transperitoneal sublay mesh repair. During the same period of time, a control group of 50 patients underwent an open sublay repair after Rives and Stoppa. In 2011, all patients were invited for follow-up. This included pain assessments and physical examinations with use of ultrasound.

Results

The two groups were comparable in terms of patient characteristics and hernia data. The operating time was slightly longer for the laparoscopic technique. The hospital stay was shorter in the laparoscopy group. There was less chronic pain in the laparoscopy group, but this difference was not statistically significant. There was no significant difference in postoperative complications, use of analgetics, foreign body sensation, and paresthesia between the two groups. We found one long-term hematoma in the laparoscopy group and one seroma in the open group. In this series, there were no recurrences and no wound infections.

Conclusions

Our initial results indicate that the new laparoscopic transperitoneal sublay mesh repair is a safe and effective method for the treatment of small- and medium-size ventral and incisional hernias.

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Acknowledgments

The authors thank Dr. Dan N. Tran for his suggestions on preparing the manuscript.

Disclosures

Drs. Eike Sebastian Debus, Michael Schroeder, Wolfgang Matthias Johann Reinpold, and Alexander Daniel Schroeder have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Alexander Daniel Schroeder

  2. Department of Vascular Medicine, University Heart Center Hamburg-Eppendorf, Hamburg, Germany

    Eike Sebastian Debus

  3. Department of Surgery, Wilhelmsburg Gross-Sand Hospital, Gross-Sand 3, 21107, Hamburg, Germany

    Michael Schroeder & Wolfgang Matthias Johann Reinpold

Authors
  1. Alexander Daniel Schroeder
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  2. Eike Sebastian Debus
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  3. Michael Schroeder
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  4. Wolfgang Matthias Johann Reinpold
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Corresponding author

Correspondence to Wolfgang Matthias Johann Reinpold.

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Schroeder, A.D., Debus, E.S., Schroeder, M. et al. Laparoscopic transperitoneal sublay mesh repair: a new technique for the cure of ventral and incisional hernias. Surg Endosc 27, 648–654 (2013). https://doi.org/10.1007/s00464-012-2508-9

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  • DOI: https://doi.org/10.1007/s00464-012-2508-9

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