Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis

Sajid, M. S.; Bokhari, Syed Akhtar Hussain; Mallick, Ali Sameer; Cheek, Elizabeth; Baig, Mirza

doi:10.1016/j.amjsurg.2007.12.051

Cited by 223 publications

(114 citation statements)

References 33 publications

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“…La mediana del diámetro mayor de los defectos reparados fue 6 cm (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). 67,7% de los defectos reparados correspondieron a hernias incisionales, un 26% (n = 33) de los casos eran recidivas de reparaciones anteriores, esteroidales y paracetamol por horario.…”

Section: Resultsunclassified

“…Actualmente es una técnica validada para el manejo de hernias de la pared abdominal, con ventajas en cuanto a recidiva, complicaciones, dolor postoperatorio y estadía hospitalaria 3 .…”

Section: Discussionunclassified

“…Estos últimos constituyen una complicación frecuente posterior a una laparotomía con una incidencia reportada de hasta un 30% 1 . Pese a los adelantos en la técnica quirúrgica y los materiales protésicos utilizados, la recidiva de la reparación abierta continúa siendo elevada (30-60%) 2 , con una morbilidad de hasta un 25% asociada principalmente a la formación de seroma e infección de sitio operatorio 3 . La introducción de la cirugía mínimamente invasiva, abrió la posibilidad de la reparación laparoscópica de las hernias ventrales.…”

Section: Introductionunclassified

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Hernioplastía Ventral Laparoscópica

et al. 2014

Rev Chil Cir

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Laparoscopic repair of ventral herniasBackground: Ventral hernias are defects of the anterior abdominal wall, the laparoscopic repair has shown some advantages compared to open repair. Aim: To evaluate perioperative outcomes of the laparoscopic ventral hernia repair and to describe risk factors associated to recurrence. Methods: Non-concurrent prospective cohort study, clinical data of all patients who underwent laparoscopic ventral hernia repair between June 2006 and May 2013 were reviewed. Univariate analyses were performed using chi-square for categorical variables and U Mann-Whitney test for continuous variables. Multivariate analysis was performed using a logistic regression model. Results: 127 patients underwent laparoscopic ventral hernia, 52% female, age of 58.1 ± 1.2 years old. Mean Body Mass Index (BMI) was 31 ± 0.5 kg/m 2 and 67.7% were incisional hernias. Median operative time was 80 minutes (ranging from 30-350) and the median defect size was 6 cm (ranging from 2-20). Conversion to open surgery was necessary in 4 cases (3.9%). Median of hospital stay was 2 days (ranging from 1-15). Recurrence rate was 14.2% and the median to recurrence was 9 months. Recurrence rate was associated positively to defect size > 10 cm (p = 0.002), previous recurrence (p = 0.029) and operative time > 90 minutes (p = 0.017) in the univariate analyses. However, it was only associated to the first two in the multivariate analysis (OR 3.906; respectively). Conclusions: Laparoscopic repair of ventral hernia is a safe procedure with acceptable perioperative complication rates. Defect size and previous recurrence are associated to a higher recurrence rate.

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Section: Resultsunclassified

“…Actualmente es una técnica validada para el manejo de hernias de la pared abdominal, con ventajas en cuanto a recidiva, complicaciones, dolor postoperatorio y estadía hospitalaria 3 .…”

Section: Discussionunclassified

Section: Introductionunclassified

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Hernioplastía Ventral Laparoscópica

et al. 2014

Rev Chil Cir

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“…SPA may results in less parietal scarring in these patients prone to incisional hernia at trocar port site. Laparoscopic repair of ventral hernia has become popular, being associated with decreased postoperative pain and shorter recovery compared with open approach, while allowing complete revision of the abdominal wall [1][2][3][4]15]. However, the rate of incisional hernia at trocar port site after laparoscopic hernia repair is non negligible according to the literature (1-22%) [1,5].…”

Section: Discussionmentioning

confidence: 99%

“…Keywords Single-port access (SPA) Á Laparoendoscopic single-site surgery (LESS) Á Single incision Á Laparoscopy Á Ventral hernia Á Incisional hernia Laparoscopic ventral hernia repair has been shown to be safe, efficient, and associated with shorter recovery compared with open approach [1][2][3][4]. However, the risk of incisional hernia at port access after these surgeries remains a concern, and seems non negligible according to the literature (1-22%) [1,5].…”

Section: Introductionmentioning

confidence: 99%

Single-port access prosthetic repair for primary and incisional ventral hernia: toward less parietal trauma

2010

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Background Although still under development, single-port access (SPA) approach may be of interest in patients prone to port-side incisional hernia, ensuring absence of increased fascial incision. This forms the basis for evaluating SPA for prosthetic ventral hernia repair. We report a new SPA technique of ventral hernia repair using working-channel endoscope, standard laparoscopic instruments, and 10-mm port. Methods Prospective experience with SPA prosthetic repair of primary and incisional ventral hernia in 52 patients for 55 ventral hernias is presented. Median (range) patient age was 46 years (26-85 years), and BMI was 28 kg/m 2 (20-38 kg/m 2 ). Mean fascial defect was 16.2 cm 2 for primary hernia (n = 23) and 48.3 cm 2 for incisional hernia (n = 32). Intraperitoneal composite mesh repair was achieved through single 10-mm flank port using working-channel endoscope. Meshes were fixed using absorbable tackers and transfascial stitches. Results SPA repair of primary and incisional ventral hernia was completed in all cases without conversion to standard laparoscopy. Median (range) operative time was 54 min (39-95 min). Mesh size ranged from 118 to 500 cm 2 . No intra-or postoperative complications were recorded, except two seromas. Median (range) hospital stay was 1 day (1-5 days). One patient presented prolonged postoperative pain on mesh fixation that resolved after 3 months. No recurrence or port-site incisional hernias have been recorded at median (range) follow-up of 16 months (3-28 months). Conclusions SPA prosthetic repair of primary and incisional ventral hernia is easily feasible according to natural exposition by pneumoperitoneum and gravity. In the present series, SPA ventral hernia repair appears to be safe for experienced SPA surgeons. It may decrease parietal trauma and scarring in patients prone to incisional hernia. SPA repair may be associated with a decrease in rate of port-site incisional hernia compared with multiport laparoscopy, but this has to be verified by randomized trial with standard laparoscopic approach on long-term follow-up.

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