Laparoscopic vs Open Ventral Hernia Repair in the Era of Obesity

Lee, Justin; Mabardy, Allan; Kermani, Reza; López, Marvin J.; Pecquex, Nicole; McCluney, Anthony

doi:10.1001/jamasurg.2013.1395

Cited by 37 publications

(17 citation statements)

References 10 publications

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“…A retrospective cohort (11) with 47.661 patients were selected from the Nationwide Inpatient Sample database showed that laparoscopy was associated with a fewer overall complication rate and lower mean total hospital charges.…”

Section: Discussionmentioning

confidence: 99%

LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

Castro

Rabelato

Monteiro

et al. 2014

Arq. Gastroenterol.

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-Objective -To compare the laparotomy and laparoscopy techniques for correction of ventral hernia when related to perioperative complications, length of hospitalization, surgical time, and recurrence of hernia. Methods -This was a systematic review of randomized controlled trials, which included studies retrieved from four databases (MEDLINE, Embase, Cochrane and LILACS), using a combination of the terms (Hernia, Ventral) and (Laparoscopy) and (Laparotomy). Results -Six randomized trials were included, totaling 566 patients, 283 in the Laparoscopy group and 283 in the Laparotomy group. Laparoscopy reduced the risk of infection of the surgical wound (NNT = 5) and seroma formation (NNT = 13) and less length hospitalization (P = 0.02) compared to laparotomy in the correction of ventral hernias. Furthermore, laparoscopy increased the incidence of enterotomy (NNH = 25) and post operative pain (NNH = 8) and longer surgical time (P = 0.0009) when compared with laparotomy. There was no difference related to abscess (P = 0.79), hematoma (P = 0.43) and recurrency of ventral hernias (P = 0.25). Conclusion -In the correction of ventral hernias, the use of laparoscopic technique is effective to reduce infections of the surgical wound and seroma formation, as well as, decrease the length hospitalization. HEADINGS -Ventral hernia. Laparoscopy. Laparotomy. Review.

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Section: Discussionmentioning

confidence: 99%

LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

Castro

Rabelato

Monteiro

et al. 2014

Arq. Gastroenterol.

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“…The external defect measurement on insufflated abdomen is usually performed even it overestimates the defect size [5]. It is very important to choose a mesh size which overlaps with a minimum 5 cm in all directions the parietal defect(s), to avoid postoperative mesh shrinkage and recurrence [1][2][3][4][5][6][7][8][9].…”

Section: Parietal Defect(s) Assessmentmentioning

confidence: 99%

“…Laparoscopic Ventral Hernia Repair (LVHR) is associated with decreased hospital stay, low rate of postoperative infection and low rate of recurrence compared with open repair techniques [1,2]. To achieve these better outcomes several key points were described: adequate patients' selection, choice of the peritoneal cavity entry and capnopneumo-peritoneum creation, trocars placement, adhesiolysis, abdominal wall exploration with careful inspection of parietal defect(s) (site(s), dimensions), mesh insertion, deployment and fixation [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Ventral Hernia Repair by Laparoscopic Approach, how to do it

2014

J de Chirurgie

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“…Uncontrolled coagulopathy is a contraindication for laparoscopic hernia surgery, and because the procedure is usually performed under general anesthesia, inability to tolerate general anesthesia is also a contraindication. Old age itself is not a contraindication for this procedure [ 10 ], and obese patients are good candidates for laparoscopic ventral hernia repair, too [ 11 ].…”

Section: Indications and Contraindications (Table 301 )mentioning

confidence: 99%

“…Other ports used for adhesiolysis and mesh fi xation should be 5-mm at most. Use of a bladeless optical trocar as the fi rst trocar is encouraged if the patient is obese [ 11 ]. Of course, the trocar site should be away from the previous surgical incision under which substantial adhesion is anticipated.…”

Section: Tips and Tricksmentioning

confidence: 99%

Incisional and Ventral Hernia Repair

Wada

Furukawa

Kitagawa

2014

Reduced Port Laparoscopic Surgery

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Ventral hernia is a common type of abdominal hernia. There are three types of ventral hernia: incisional hernia, spigelian hernia, and epigastric hernia. Traditionally, hernia repairs have been performed as open procedures. In the last decade, laparoscopic hernia repair has become popular. Laparoscopic surgery allows for a smaller incision, which results in less post-operative pain and less risk of incisional hernia. Decreases in the size and number of trocars should be considered if outcomes similar to those of traditional laparoscopic technique can be obtained. The indication for laparoscopic ventral hernia is a hernia with a minimum defect size of 3 cm. In cases of simultaneous contamination, the use of mesh is basically contraindicated. An inability to tolerate general anesthesia and uncontrolled coagulopathy are also contraindications. A small incision of 2-3 cm is made on the hernia bulge along the previous surgical scar. A silicone wound protector is used, and a silicone cap for use of several trocars is set. At least two trocars of 5-mm are needed to introduce the laparoscope and a tacker for mesh fi xation. After complete detachment of all adhesions below the surgical scar, all incisional hernias must be evaluated, including small fascial defects. The mesh should be larger than the hernia defect with a margin of at least 3 cm in all directions. The silicone cap is opened, and the mesh is easily introduced through the wound protector and spread fl at with the knitted side up. Lifting stitches are caught by a suture passer and fi xed to the abdominal wall. With the use of fi xation tacks, the edge of the mesh is circumferentially fi xed to the abdominal wall.

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Laparoscopic vs Open Ventral Hernia Repair in the Era of Obesity

Abstract: In the era of laparoscopy, the overall use of laparoscopic VHR in obese patients has increased significantly and appears to be safe, with a shorter stay and a lower cost of care.

Cited by 37 publications

References 10 publications

LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

Ventral Hernia Repair by Laparoscopic Approach, how to do it

Incisional and Ventral Hernia Repair

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