Abstract
Background
Laparoscopic incisional hernia repair has become widely accepted in the management of incisional hernias. There has been recent interest in combining fascial closure along with mesh placement to improve outcomes. We report our experience with this technique.
Methods
Cases were evaluated retrospectively from 2012 to 2015. There were no exclusions. Cases were included which involved laparoscopic ventral hernia repair with fascial closure and mesh placement. Fascial closure was performed using non-absorbable sutures passed with a suture passage device percutaneously. A 5-cm overlap was performed using intra-peritoneal mesh. Fixation was performed using absorbable tacks in a double crown technique.
Results
One hundred and twelve cases were included. The mean age was 57 years old (range 33–81 years). Fifty-nine were females and 53 were males. The median post-operative stay for the non-fascial closure group was 0 days (range 0–12 days). The median post-operative stay for the fascial closure group was 0 days (range 0–12 days). All cases were followed up clinically at 6 weeks. In the non-fascial closure group, five patients developed a seroma (12 %). One patient developed a wound infection (3 %). Six patients presented with a recurrence over the study period (15 %). In the fascial closure group, four patients had a seroma, which was managed conservatively (5 %). One patient developed a wound infection (1 %). Five patients developed a recurrence over the study period (7 %).
Conclusion
We have shown comparable rates for seroma and recurrence to other series. Laparoscopic incisional hernia repair with defect closure is feasible and reduces seroma rate and recurrence.
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References
Nguyen DH, Nguyen MT, Askenasy EP, Kao LS, Liang MK (2014) Primary fascial closure with laparoscopic ventral hernia repair: systematic review. World J Surg 38(12):3097–3104
Franklin ME, Gonzalez JJ, Glass JL (2004) Laparoscopic ventral and incisional hernia repair: 11-year experience. Hernia 8:23–27
Clapp ML, Hicks SC, Awad SS, Liang MK (2013) Trans-cutaneous Closure of Central Defects (TCCD) in laparoscopic ventral hernia repairs (LVHR). World J Surg 37(1):42–51
Tse GH, Stutchfield BM, Duckworth AD (2010) Pseudo-recurrence following laparoscopic ventral and incisional hernia repair. Hernia 14:222–229
Rea R, Falco P, Izzo D, Leongito M, Amato B (2012) Laparoscopic ventral hernia repair with primary transparietal closure of the hernial defect. BMC Surg 12(Suppl 1):S33
Banerjee A, Beck C, Narula VK (2012) Laparoscopic ventral hernia repair: does primary repair in addition to placement of mesh decrease recurrence? Surg Endosc 26:1264–1268
Orenstein SB, Dumeer JL, Monteagudo J, Poi MJ, Novitsky YW (2012) Outcomes of laparoscopic ventral hernia repair with routine defect closure using “shoelacing” technique. Surg Endosc 25:1452–1457
Zeichen MS, Lujan HJ, Mata WN (2013) Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh. Hernia 17:589–596
Wennergren JE, Plymale M, Davenport D, Levy S, Hazey J, Perry KA, Stigall K, Roth JS (2015) Quality-of-life scores in laparoscopic preperitoneal inguinal hernia repair. Surg Endosc. doi:10.1007/s00464-015-4631-x
Coskun K (2015) Evaluation of quality of life after incisional hernia repair using condition-specific scales and risk factors. Ann Surg. doi:10.1097/SLA.0000000000001554
Ross SW, Wormer BA, Kim M, Oommen B, Bradley JF, Lincourt AE, Augenstein VA, Heniford BT (2015) Defining surgical outcomes and quality of life in massive ventral hernia repair: an international multicenter prospective study. Am J Surg 210(5):801–813
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Mr. Duncan Light and Mr. Sadiq Bawa have no financial disclosures to declare.
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Light, D., Bawa, S. Trans-fascial closure in laparoscopic ventral hernia repair. Surg Endosc 30, 5228–5231 (2016). https://doi.org/10.1007/s00464-016-4868-z
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DOI: https://doi.org/10.1007/s00464-016-4868-z