Laparoscopic treatment of incisional hernia. State of the art in 2012

Abstract

Laparoscopic repair of ventral incisional hernia is technically feasible and reliable for large hernia defects, even in obese patients. This approach should be reserved for patients with no history of previous hernia repair in order to avoid the risk of intestinal injury. It appears to allow for a shortened duration of hospitalization.

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

“…All these patients were treated by laparoscopic repair, but no specific data have been reported [11,103]. In other studies with a lower level of evidence, all the reported recurrences were approached by laparoscopy [18,44,51,107,133].…”

“…Several randomized controlled studies and meta-analysis of controlled trials published in the last decade have demonstrated that laparoscopic repair should be considered a safe technique, and there is a sufficient follow-up to state that most of the barrier mesh prostheses determine a very low risk when placed intraperitoneally [11,36,61,103].…”

“…In non-responders, a laparoscopic lysis of the adhesions to the prosthesis and the tacks or removal of the fixation devices located in the areas of the referred pain could provide the solution of the problem [181]. A critical issue is the mixture of primary ventral, incisional, and spigelian hernia, as well as primary and recurrent incisional hernia in the different studies [11,103]. Their outcomes should be individually studied.…”

“…When hernia recurrence is suspected by clinical assessment, imaging evaluation is recommended [103].…”

“…A metaanalysis suggests that the risk of recurrence be the same as for open abdominal hernia repair [11,103]. When a recurrence is suspected but not clinically evident, an ultrasonography or computed tomography (CT scan) or both are indicated [43,133].…”