Laparoscopic management of incisional hernias ≥15 cm in diameter

PREBIOUS trial: A multicenter randomized controlled trial of PREventive midline laparotomy closure with a BIOabsorbable mesh for the prevention of incisional hernia: Rationale and design

“…Incisional hernias after laparotomy are mostly related to failure of the fascia to heal and involve technical and biological factors [35]. There is abundant evidence of treatment modalities and outcome of incisional hernia repair once a hernia has been developed [36][37][38][39][40] but data regarding protection against incisional hernia by the prophylactic prosthetic reinforcement of midline abdominal incisions is scarce and particularly focused on high-risk patients and permanent synthetic materials placed similarly as an incisional hernia is repaired (onlay, sublay, etc.) [20][21][22].…”

Proper mesh overlap is a key determinant in hernia recurrence following laparoscopic ventral and incisional hernia repair

“…However, in laparoscopic surgery, accurate measurement of defect size is critical for estimating the size of the mesh to be used [14][15][16]. Additionally, appropriate mesh size and sufficient overlap is critical for lowering the rate of recurrence when a laparoscopic procedure is used to repair large hernia defects [17,18].…”

Sutureless Laparoscopic Ventral Hernia Repair in Obese Patients

“…2 The classic technique of LVHR comprises placement of TFS to facilitate the mesh placement and lessen the risk of hernia recurrence. 2 A study by Ferrari et al 3 demonstrated that obesity is not a contraindication to laparoscopic repair. The occurrence of a ventral hernia can be attributed to technical and patient-related factors, such as obesity, older age, male sex, malnutrition, ascites, pregnancy, and wound infections.…”

“…In our practice, we consider TFS a standard component of laparoscopic ventral herniorrhaphy (LVHR), because these sutures augment the durability of the repair; however, studies have shown that TFS also contributes to postoperative pain 2 and, resultantly, prolonged hospital stay. Although studies have shown that obesity is not a contraindication to LVHR, 3 the role of TFS in this particular population is not well studied. We sought to examine LVHR without TFS in obese patients with small abdominal wall hernias.…”