Abstract
Purpose
Laparoscopic mesh repair is an established alternative to the open repair of herniae of the antero-lateral abdominal wall. However, a definition in the literature of “recurrence” is lacking. This study reviews the phenomenon of pseudo-recurrence in patients who describe recurrent symptoms despite an apparently successful laparoscopic ventral or incisional hernia repair (LVIHR).
Methods
Cases of LVIHR from 1st January 2004 to 31st December 2007 were identified from the Lothian Surgical Audit database. Patients were contacted by telephone after a minimum of 11 months following operation. Pseudo-recurrences were identified by history and clinical examination, together with radiological investigation if the diagnosis remained in doubt.
Results
One hundred and forty-three repairs were performed in the study period. One hundred and twenty-one patients were contacted (63 incisional and 58 other ventral herniae). Twenty possible recurrences were reported (16.5%). Four were true recurrences and two more were new incisional herniae. There were 14 pseudo-recurrences, arising after 12 incisional and two other ventral hernia repairs. These were due to mesh bulge (10), seroma (3) and retained hernia contents (1).
Conclusion
True recurrences after LVIHR do occur but should be preventable with good surgical technique. Pseudo-recurrences are more common and may mimic true recurrence. We recommend computed tomography (CT) to clarify the diagnosis and determine the indication for revisional surgery.
Similar content being viewed by others
References
Pham CT, Perera CL, Watkin DS, Maddern GJ (2009) Laparoscopic ventral hernia repair: a systematic review. Surg Endosc 23:4–15
Bageacu S, Blanc P, Breton C, Gonzales M, Porcheron J, Chabert M, Balique JG (2002) Laparoscopic repair of incisional hernia: a retrospective study of 159 patients. Surg Endosc 16:345–348
Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 204:578–585
LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41
Tsimoyiannis EC, Tassis A, Glantzounis G, Jabarin M, Siakas P, Tzourou H (1998) Laparoscopic intraperitoneal onlay mesh repair of incisional hernia. Surg Laparosc Endosc 8:360–362
Rosenberg J, Burcharth J (2008) Feasibility and outcome after laparoscopic ventral hernia repair using Proceed mesh. Hernia 12:453–456
Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S (2009) Recurrences after laparoscopic repair of ventral and incisional hernia: lessons learned from 505 repairs. Surg Endosc 23:825–832
Cobb WS, Kercher KW, Matthews BD, Burns JM, Tinkham NH, Sing RF, Heniford BT (2006) Laparoscopic ventral hernia repair: a single center experience. Hernia 10:236–242
Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238:391–399
Schug-Pass C, Sommerer F, Tannapfel A, Lippert H, Köckerling F (2009) The use of composite meshes in laparoscopic repair of abdominal wall hernias: are there differences in biocompatibility?: experimental results obtained in a laparoscopic porcine model. Surg Endosc 23:487–495
Novitsky YW, Harrell AG, Cristiano JA, Paton BL, Norton HJ, Peindl RD, Kercher KW, Heniford BT (2007) Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term intra-abdominal implantation in a rabbit. J Surg Res 140:6–11
Klinge U, Klosterhalfen B, Birkenhauer V, Junge K, Conze J, Schumpelick V (2002) Impact of polymer pore size on the interface scar formation in a rat model. J Surg Res 103:208–214
Bringman S, Conze J, Cuccurullo D, Deprest J, Junge K, Klosterhalfen B, Parra-Davila E, Ramshaw B, Schumpelick V (2010) Hernia repair: the search for ideal meshes. Hernia 14:81–87
LeBlanc KA, Booth WV, Whitaker JM, Bellanger DE (2000) Laparoscopic incisional and ventral herniorrhaphy in 100 patients. Am J Surg 180:193–197
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Oral presentation to the 4th Joint Meeting of the American Hernia Society (AHS) and the European Hernia Society(EHS), Berlin, Germany, 2009. Abstract published in Hernia 2009;13(Suppl 1):S45.
Rights and permissions
About this article
Cite this article
Tse, G.H., Stutchfield, B.M., Duckworth, A.D. et al. Pseudo-recurrence following laparoscopic ventral and incisional hernia repair. Hernia 14, 583–587 (2010). https://doi.org/10.1007/s10029-010-0709-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-010-0709-5