A decade of experience with laparoscopic ventral hernia repairs

Lund, Sarah; Farley, David R.

doi:10.1016/j.amjsurg.2018.10.008

Cited by 8 publications

(12 citation statements)

References 12 publications

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“…In particular, bulging was diagnosed in 58 of 1,029 patients (5.6%) and hernia recurred in 40 of 1,029 patients (3.9%). Literature data reports heterogeneous recurrence rates, ranging from 23% by Lund et al 25 and 5% or less in other studies. 2,30,31 Logistic regression analyses enabled us to identify clear independent surgical risk factors for hernia recurrence as a mesh overlap smaller than 4 cm, the use of absorbable fixation devices and M1 (subxiphoidal) type.…”

Section: Discussionmentioning

confidence: 87%

“…Clinical experience and literature data suggest that the correct fixation of the mesh is a vital aspect of the surgical procedure, affecting both postoperative pain and early and late recurrence rates. 15,25 Despite this, literature data are conflicting about recurrence rates following the use of absorbable or nonabsorbable staples, 11,14,16,26,27 whereas some studies suggest that the use of fibrin glue enables a vast reduction in postoperative pain with very low recurrence rates. 28 In our series, different staples were used, depending on the surgeon's choice, and this enabled us to compare the results for different device categories.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Abdominal Wall Hernia Repair

Olmi

Uccelli

Cesana³

et al. 2020

JSLS

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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 Ͻ .001); a mesh overlap equal or greater than 5 cm appeared to be a significant protective factor for bulging (P Ͻ .001), whereas the use of resorbable fixing devices was a significant risk factor for hernia recurrence (odds ratio, 111.53, P Ͻ .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.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Abdominal Wall Hernia Repair

Olmi

Uccelli

Cesana³

et al. 2020

JSLS

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“…19 We also recorded a bulging and recurrence rate of < 5%. Literature reports heterogeneous recurrence rates, ranging from 23% (Lund et al 21 ) and 5% or less in other studies. 2,26,27 Logistic regression analyses enabled us to identify as independent risk factors for recurrence: overlap smaller than 4 cm, use of absorbable fixation devices, bulging, and mesh infection; while patient-related risk factors were advanced age and L3 lateral iliac hernia type.…”

Section: Discussionmentioning

confidence: 94%

“…The correct fixation is crucial, influencing both postoperative pain and both short and long-term hernia recurrence. 11,21 Previous studies present conflicting data about recurrence related to the use of absorbable or nonabsorbable staples, 7,10,12,22,23 with some authors suggesting that the use of fibrin glue significantly reduces postoperative pain with very low recurrence rates. 24 In our experience, different tacks were employed, depending on the surgeon's choice, which enabled us to compare results for different device categories.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Treatment of Incisional and Ventral Hernia

Olmi¹,

Millo²,

Piccoli³

et al. 2021

JSLS

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Background and Objectives: Although several large studies regarding patients undergoing minimally invasive repair of incisional hernia are currently available, the results are not particularly reliable as they are based on heterogeneous groups, different surgical techniques, different mesh types, or with a too short follow period.Methods: We conducted a retrospective observational trial, collecting data from patients who underwent laparoscopic repair of a primary abdominal wall or an incisional hernia using the laparoscopic Intraperitoneal Onlay Mesh technique and a single mesh type, i.e., a composite polyester mesh with a hydrophilic film (Parietex Composite TM mesh -Medtronic, Minneapolis, MN -USA). All patients signed an informed consent.Results: One thousand seven hundred seventy-seven patients were enrolled. The median surgery time was 50 minutes and the median length of hospital stay was 2 days. Intraoperative complications occurred in 12 patients (0.7%), while early postoperative surgical complications occurred in 115 (6.5%); during follow-up, bulging mesh was diagnosed in 4.5% of cases and hernia recurred in 4.3% of patients. An overlap equal or greater than 4 cm resulted as a significant protective factor, while the use of absorbable fixing devices was a risk factor for recurrence (odds ration: 9.06, p < 0.001, 95% confidence interval: 4.19 -19.57).Conclusions: Minimally invasive treatment of primary and postincisional abdominal wall hernias is a safe, effective, and reproducible procedure. An overlap equal or greater than 4 cm, the use of nonabsorbable fixing devices and a postoperative care and follow-up regime are crucial in order to obtain good results and low recurrence rates.

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“…An Ultrasound assisted diagnosis demonstrated seroma in 100% of cases. Lund et al reported postoperative seroma occurred in 22% of cases after laparoscopic ventral hernia repair [14]. Additionally, it has been shown that degree of lymphatic interruption, such as axillary or inguinal lymph node dissection, increases rate of seroma formation [15].…”

Section: Introductionmentioning

confidence: 99%

Preventing Postoperative Seroma formation in Abdominal wall Hernia by Intraoperative Hypertonic Saline Irrigation, early Report

Dudai¹

2019

OAJS

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Seroma formation is a frequent post-operative complication of many operations, mainly abdominal wall Hernias and reconstructive surgeries, where extensive dissection take place. It increases overall morbidity and can be challenging to manage. Drains, aspirations and sclerotherapy are established for treating postoperative seromas and increase the risk for infections. No study has yet to describe the use of intraoperative hypertonic saline irrigation as a preventive measure for seroma formation. The purpose of this report is to describe a novel intraoperative method of hypertonic saline irrigation to abdominal wall subcutaneous surgical cavity, which prevent seroma formation and enables a shorter drainage usage due to early drain removal. Thus, reducing infections and overall morbidity, shortening hospitalization period and decreasing the annoying inconveniency of repeated aspirations and drains insertion with significant cost saving.Our experience is preventing abdominal wall seromas formation in seven patients undergone the Extended Endoscopic Hernia & Linea Alba Reconstruction Glue surgery for Ventral Hernias and Rectus Muscles Separation. A wide endoscopic dissection of the anterior Rectus fascia is followed by mesh placing over the repaired Rectus muscles which is fused to the muscles with Fibrin Glue. A developed novel preventive method includes Intraoperative Irrigation of the cavity through two 7mm Jackson-Pratt closed system drains with 20 cc of NaCl 10%, left in place for 10 minutes. We have excellent early results of seroma prevention, reduced secretions and drain removal within 20 hours. This method can be applied in other potential seroma formation surgeries. Further follow up will be needed.

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A decade of experience with laparoscopic ventral hernia repairs

Cited by 8 publications

References 12 publications

Laparoscopic Abdominal Wall Hernia Repair

Laparoscopic Abdominal Wall Hernia Repair

Laparoscopic Treatment of Incisional and Ventral Hernia

Preventing Postoperative Seroma formation in Abdominal wall Hernia by Intraoperative Hypertonic Saline Irrigation, early Report

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