Current opinions about laparoscopic incisional hernia repair: a survey of practicing surgeons

Alder, Adam C.; Alder, Stephen C.; Livingston, Edward H.; Bellows, Charles F.

doi:10.1016/j.amjsurg.2007.08.002

Cited by 30 publications

(7 citation statements)

References 31 publications

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“…[18][19][20][21][22] The survey was approved by the OTA Research Committee and posted on the official survey page of the OTA Web site from November 2012 to January 2013. This online survey software has been used successfully in multiple specialties to assess trends among their respective cohorts.…”

Section: Methodsmentioning

confidence: 99%

Preoperative Decision Making in the Treatment of High-Angle “Vertical” Femoral Neck Fractures in Young Adult Patients

Luttrell

Beltran

Collinge

2014

Journal of Orthopaedic Trauma

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Section: Methodsmentioning

confidence: 99%

Preoperative Decision Making in the Treatment of High-Angle “Vertical” Femoral Neck Fractures in Young Adult Patients

Luttrell

Beltran

Collinge

2014

Journal of Orthopaedic Trauma

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“…Out of that group, 81 per cent stated that they would not start performing laparoscopic hernia repair for reasons including lack of improved results, risk of enterotomy, operative time, cost, and experience. 14 As a result of this disparity, in defining the optimal surgical approach, we evaluated our patient population at the University of Virginia and compared outcomes from both laparoscopic and open ventral hernia repairs over a 2-year time period. As a secondary goal we also looked at preoperative patient characteristics and comorbidities between the two groups.…”

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confidence: 99%

A Comparative Analysis between Laparoscopic and Open Ventral Hernia Repair at a Tertiary Care Center

Davies

Turza

Sawyer

et al. 2012

The American Surgeon

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Laparoscopic ventral hernia repair reportedly yields lower postoperative complications than open repair. We hypothesized that patients undergoing laparoscopic repair would have lower postoperative infectious outcomes. Also, certain preoperative patient characteristics and preoperative hernia characteristics are hypothesized to increase complication risk in both groups. All ventral hernia repairs performed at University of Virginia from January 2004 to January 2006 were reviewed. Primary outcomes included wound healing complications and hernia recurrence. Categorical data were analyzed with χ2 and Fisher's exact tests. Continuous variables were evaluated with independent t tests and Mann-Whitney U tests. Multivariable logistic regression was performed. A total of 268 repairs (110 open, 158 laparoscopic) were evaluated. Patient and hernia characteristics were similar between groups, though the percents of wound contamination (5.4% vs 0.6%; P = 0.02) and simultaneous surgery (7.2% vs 0%; P = 0.001) were greater in the open procedures. Univariate analysis also revealed that open cases had a greater incidence of postoperative superficial surgical site infection (SSI) (30.0% vs 10.7%; P < 0.0001). Multivariable analysis revealed that both diabetes and open repair were associated with an increased risk of superficial SSI ( P = 0.019; odds ratio = 3.512; 95% confidence interval = 1.229–10.037 and P = 0.001; odds ratio = 4.6; 95% confidence interval = 1.9–11.2, respectively). Laparoscopic ventral hernia repair yielded lower rates of postoperative superficial SSI than open surgery. Other pre-operative patient characteristics and preoperative hernia characteristics, with the exception of diabetes, were not found to be associated with an increased risk of postoperative complications.

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“…Laparoscopic repair of ventral/incisional hernias is currently accepted when the defect size is at least of 3 cm, because smaller defects can be safely treated with suture repair under local anesthesia [34,35]. Small midline hernias are best treated by laparoscopy.…”

Section: Strong Recommendation (Panel Consensus 100 %)mentioning

confidence: 99%

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

et al. 2015

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The availability of recent level 1 evidence (a meta-analysis of 10 RCTs) allowed to recommend that not only laparoscopic repair is an acceptable alternative to the open repair, but also it is advantageous in terms of shorter hospital stay and wound infection rate. This conclusion appears to be extremely relevant in a clinical setting. Indications about specific conditions could also be issued: laparoscopy is recommended for the treatment of recurrent ventral hernias and obese patients, while it is a potential option for compensated cirrhotic and childbearing-age female patients. Many relevant and controversial topics were thoroughly examined by this consensus conference for the first time. Among them are the issue of safety of the intraperitoneal mesh placement, traditionally considered a major drawback of the laparoscopic technique, the role for the biologic meshes, and various aspects of the laparoscopic approach for particular locations of the defect such as the abdominal border or parastomal hernias.

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Current opinions about laparoscopic incisional hernia repair: a survey of practicing surgeons

Abstract: Background-Incisional hernias are common. The optimal repair is one of the most analyzed and debated topics. There is no consensus as to the appropriate surgical technique.

Cited by 30 publications

References 31 publications

Preoperative Decision Making in the Treatment of High-Angle “Vertical” Femoral Neck Fractures in Young Adult Patients

Preoperative Decision Making in the Treatment of High-Angle “Vertical” Femoral Neck Fractures in Young Adult Patients

A Comparative Analysis between Laparoscopic and Open Ventral Hernia Repair at a Tertiary Care Center

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

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